Preadolescent Suicidal Behavior: The Role of Cognitive Functioning

The recent suicidal behavior of fifty-three hospitalized preadolescents was assessed in interviews with children and their parents. Children described by their parents as more suicidal scored higher on measures of verbal intelligence and language production than their less suicidal counterparts, with unique variance predicted only by language production ability. The results suggest that parents of preadolescents with better language production skills may be more aware of their youngsters' suicidal thoughts than parents of children with poorer language production ability.     

The Role of Endogenous Opioids in the Pathophysiology of Self-Injurious and Suicidal Behavior

Multiple lines of evidence suggest that endogenous opioids are involved in the pathogenesis of non-suicidal self-injury (NSSI). Evidence for such a role is based on the partial success of opioid antagonist treatment to ameliorate NSSI, reports of altered pain sensitivity during episodes of NSSI, and findings of altered endogenous opioid levels in individuals with NSSI. While suicidal behavior (SB) and NSSI are distinct behaviors, NSSI is a significant risk factor for suicide attempts and suicide. The high co-occurrence of SB and NSSI suggests that they may share a common biology. Available data indicate that endogenous opioids may be involved in the pathophysiology of SB. Future studies of the role of opioids in the biological mechanisms of NSSI and SB are merited and may lead to the development of new treatment modalities.     

Immigration and Suicide: The Role of Marital Status,Duration of Residence,and Social Integration

The purpose of the study was to assess the impact of immigration on suicide. An unmatched case-control design was employed. Data on cases were obtained on suicides in Riverside County, California, 1998 to 2001. Information on controls was obtained from the 2000 Census. Immigration increased suicide risk. Immigrant divorced persons were over 2 times more likely to commit suicide than natives. Single immigrants were nearly 2.6 times more likely to kill themselves than the native born. Shorter duration of residence was associated with higher suicide risk. Integration of immigrants in receiving societies is important for decreasing suicide. Policies aimed at reducing suicide should target more recent immigrants.     

The Role of Parental Bonding and Early Maladaptive Schemas in the Risk of Suicidal Behavior Repetition

The current study examined the role of perceived parental bonding and early maladaptive schemas in suicidal behavior. Participants completed measures of perceived parental bonding; schemas; risk of repeating suicidal behavior; anxiety; and depression following their presentation at Accident and Emergency with suicidal behavior. A suicidal behavior group (n = 60) differed from a comparison clinical (n = 46) and non-clinical (n = 48) group on measures of early maladaptive schemas, anxiety, and depression. No significant difference was noted between the suicidal behavior group and the comparison clinical group on a measure of parental bonding. Within the suicidal behavior group, significant associations were indicated between perceived parental bonding and risk of repetition of suicidal behavior; and early maladaptive schemas and risk of repetition of suicidal behavior. Early maladaptive schemas were found to mediate the relationship between perceived parental bonding and risk of repetition of suicidal behavior, with schemas of Social Alienation and Defectiveness/Shame offering mediator roles. The findings of the current study emphasize the complexities of suicidal behavior and factors that are associated with suicidal behavior. Although causality cannot be assumed, the findings highlight the importance and inter-relationships of not only perceived early experiences, but of underlying schemas in relation to suicidal behavior.     

Suicidal Behavior in Juvenile Delinquents: The Role of ADHD and Other Comorbid Psychiatric Disorders

This study evaluated the role of psychiatric morbidity in relation to a history of suicidal behavior, with a particular focus on attention-deficit/hyperactivity disorder (ADHD). Suicidality and psychiatric diagnoses were assessed in 370 incarcerated male juvenile delinquents from Northern Russia using the semi-structured K-SADS-PL psychiatric interview. A lifetime history of suicidal ideation only (24.7?%) and suicidal ideation with suicide attempts (15.7?%) was common. Binary logistic regression analysis was used to assess the role of ADHD and other psychiatric disorders in suicidal ideation and suicide attempts. A history of suicidal ideation and of suicide attempts were associated with higher rates of psychiatric morbidity and with the number of comorbid psychiatric disorders. An ADHD diagnosis was associated with an increased risk for both suicidal ideation and for suicide attempts. The comorbidity of ADHD with drug dependence further increased the risk for suicidal ideation, while ADHD and alcohol dependence comorbidity increased the risk for suicide attempts. Our findings highlight the importance of adequately detecting and treating psychiatric disorders in vulnerable youths, especially when they are comorbid with ADHD.     

Low Mood and Risk of Dementia: The Role of Marital Status and Living Situation

ObjectiveThis study aims to explore whether low mood is related to an increased dementia risk in two cohorts of older adults of different generations, and whether marital status and living situation modify this association.MethodsParticipants (≥70 years), free from dementia and living at home, were identified from two population-based studies: the Kungsholmen Project (KP; n = 1,197) and the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K; n = 1,402). Low mood was obtained by self-report (KP and SNAC-K) at baseline in 1987–89 (KP) and 2001–04 (SNAC-K). Incident dementia cases were ascertained over 9 years, using the same diagnostic procedures and comparable criteria for the two cohorts (DSM-III-R in KP and DSM-IV-TR in SNAC-K). Hazard ratios (HR) were derived from Cox proportional hazards models.ResultsThose having low mood at baseline were at higher risk of dementia in both cohorts combined (HR: 1.2, 95% confidence interval (CI): 1.0–1.4) than those without low mood. However, an increased risk was detected only in those who did not have a partner (HR: 1.5, 95% CI: 1.2–1.9), or lived alone (HR: 1.5, 95% CI: 1.2–1.9), but not among those who had a partner or lived with someone (HR: 0.8, 95% CI: 0.5–1.2).ConclusionMarital status and living situation have the potential to buffer the detrimental effects of low mood on dementia onset. Thus, specific attention from health care should target individuals having low mood and who do not have a partner or live alone.     

Non-Suicidal Self-Injury and Suicidal Behavior in a Diverse Sample: The Moderating Role of Social Problem-Solving Ability

Non-suicidal self-injury and suicidal behavior are prevalent in young adults, and often constitute a continuum of self-destructiveness. Not all those who self-injure, however, engage in suicidal behaviors with intent to die, perhaps due to protective intrapersonal characteristics. We examined the role of one such potential buffer, social problem-solving ability, as a moderator of the association between non-suicidal self-injury and suicidal thoughts and attempts, hypothesizing that individuals with greater social problem-solving ability would report fewer suicidal behaviors in relation to self-harm. An ethnically diverse sample was recruited from a large, Northeastern urban university, and completed self-report questionnaires assessing non-suicidal self-injury, suicidal behaviors, and social problem-solving ability. Multivariate hierarchical regression analyses were conducted. For the entire sample, individuals with higher social problem-solving abilities reported fewer suicidal behaviors associated with non-suicidal self-injury. In ethnically stratified analyses, social problem-solving significantly moderated the relationship between self-injury and suicidal behaviors for Whites and Hispanics only. Promotion of problem-solving skills may weaken the linkage between self-injury and potential for future suicidal behaviors for some individuals; however, culture-specific differences in this effect may exist.     

Pain and Suicidal Behavior in Primary Care Patients: Mediating Role of Interpersonal Needs

Individuals experiencing chronic pain are at greater risk for suicidal behavior. The mechanism of action for this association is unexplored, but may involve the influence of pain on interpersonal functioning. We examined the mediating role of unsatisfied interpersonal needs on the relation between pain severity and interference, and suicidal behavior. Low income, uninsured participants completed self-report measures of pain severity and interference, thwarted interpersonal needs and suicidal behavior. Our hypotheses were partially supported; in simple mediation models, an indirect only effect existed for both thwarted belongingness and perceived burdensomeness in the relation between pain severity and pain interference and suicidal behavior. These effects did not persist in multiple mediation analyses. Our findings suggest that, for patients experiencing pain, assessment and improvement of the quantity and quality of interpersonal relationships may reduce risk for suicide ideation and attempts.     

The Relationship between Suicidal Behavior,Ideation, and Binge Drinking among College Students

Suicidal ideation and behavior among college students are serious and prevalent problems that warrant considerable attention. While a variety of situational and personality factors have been linked to suicidal behavior, alcohol use is one of the most commonly cited factors. As alcohol consumption is a frequent activity for many college students, the association between alcohol use and suicidal behavior may have particularly lethal consequences for students. Yet, to date, few studies have examined the relationship between drinking and suicidal ideation and behavior in this population. This study provides empirical support for this relationship. That is, significant relationships were found between past alcohol use and past suicide attempt(s) and between past binge drinking and past suicidal behavior and ideation. The results are discussed in light of their implications for intervention with and assessment of students presenting with suicidal ideation, behavior, and/or binge drinking.     

Minority Sexual Orientation,Gender Identity Status and Suicidal Behavior: Serial Indirect Effects of Hope,Hopelessness and Depressive Symptoms

Death by suicide, and suicidal behaviors, are a significant public mental health problem, and individuals who are lesbian, gay, bisexual, transgendered and questioning (LGBTQ), may be at increased risk. Potential underlying mechanisms of this association are unknown, but may involve the impact of LGBTQ status on future orientation and mood. Our purpose was to determine the influence of sexual identity, sequentially, on cognitive and emotional functioning, and consequent relation to suicidal behavior. In a sample of 349 college students, we used serial mediation models to investigate the relation between self-identification as LGBTQ and suicidal behavior, with hope and hopelessness as first-order mediators and depression as a second order mediator. Supporting hypotheses, we found that LGBTQ status was related to less hope and greater hopelessness and, in serial fashion, to depressive symptoms and consequent suicidal behavior. Our findings may have clinical implications. Resolution of hopelessness and depression, and promotion of hopefulness, perhaps via Motivational Interviewing and Cognitive Behavioral Therapy strategies, such as goal-setting, may reduce suicidal risk in LGBTQ young adults.     

Role of Pain-Based Catastrophizing in Pain,Disability, Distress,and Suicidal Ideation

Background: In chronic pain, patients’ coping affects their adaptation. In two studies, we examined the role of pain catastrophizing, a maladaptive coping strategy, in pain, distress, and disability. In Study 2 we compared catastrophizing to pain acceptance and to other coping strategies. Methods: Study 1. Chronic pain patients (N = 428) were assessed four times as to their pain, disability, catastrophizing, and distress (depression and anxiety). Study 2. Patients (N = 165) were assessed as to coping and pain acceptance, pain, related distress, depression, hope, suicidal ideations, perceived burdensomeness, and thwarted belongingness. Results: Study 1. A Structural Equation Modeling (SEM) analysis revealed that Time 1 Pain-based catastrophizing prospectively predicted pain (β =.36, p < .001). Distress prospectively predicted pain related disability (β = .34, p <.001). Study 2. Pain-based catastrophizing predicted sensory pain (β = .22, p = .018), depression (β = .43, p < .001), and suicidal ideation (O.R. = 1.88), which were also predicted by depression and perceived burdensomeness. Distraction predicted sensory pain (β = .21, p = .017, respectively). Activity engagement predicted low levels of depression (β = -.29, p < .001, respectively), and willingness to accept pain predicted low pain-related distress (β = -.16, p = .05). Conclusions: Pain catastro-phizing and pain acceptance constitute risk and resilience factors. Both should be assessed and targeted in pain management.     

Cognitive,Emotional, Temperament,and Personality Trait Correlates of Suicidal Behavior

Suicide is one of the leading causes of violent death in many countries and its prevention is included in worldwide health objectives. Currently, the DSM-5 considers suicidal behavior as an entity that requires further study. Among the three validators required for considering a psychiatric disorder, there is one based on psychological correlates, biological markers, and patterns of comorbidity. This review includes the most important and recent studies on psychological factors: cognitive, emotional, temperament, and personality correlates (unrelated to diagnostic criteria). We included classic factors related to suicidal behavior such as cognitive, inflexibility, problem-solving, coping, rumination, thought suppression, decision-making, autobiographical memory, working memory, language fluency, burdensomeness, belongingness, fearless, pain insensitivity, impulsiveness, aggressiveness, and hopelessness. The personality correlates reported are mainly based on the personality theories of Cloninger, Costa and McCrae, and Eysenck. Moreover, it explores conceptual links to other new pathways in psychological factors, emptiness, and psychological pain as a possible origin and common end path for a portion of suicidal behaviors.     

The Association between Unstable Employment and Suicidal Behavior in Young-Adult Precarious Workers

ObjectivePrecarious workers have increased over the past two decades in South Korea. Employment instability, especially among young adults, is considered a serious social problem. The unstable employment status of precarious workers has negative impacts on their mental health, such as suicidal behavior. This study aims to identify the effect of the unstable employment conditions on the suicidal behavior of precarious workers. MethodsAn online survey was conducted with a panel sample of South Korean adults (n=797) who were precarious workers aged between 25–34 years. We applied Model 6 of SPSS PROCESS MACRO 3.5 to examine the multiple mediation effects of depression and anger in the relationship between employment instability and suicide. ResultsUnstable employment had no direct effect on suicidal behavior. The path of unstable employment to suicidal behavior via depression and anger had a significant indirect effect. However, employment and anger were negatively related. The indirect effect of depression and anger on the relation between unstable employment and suicidal behavior was statistically significant. ConclusionThis study suggests an association between unstable employment and suicidal behavior, mediated by depression and anger. Specifically, a high level of unstable employment status increased depression. In contrast, a low level of unstable employment status increased anger, which ultimately led to an increase in suicidal behavior. These contrasting findings are likely to reflect the heterogeneity of precarious workers. Further longitudinal studies are necessary to identify the causality between precarious employment and suicidal behavior over time.     

Marital Therapy and the Resolution of Gender Role Conflict

Marital therapy offers many opportunities to conduct gender-sensitive treatment around problems affected by rigid gender socialization. This paper uses a case example to illustrate the concepts of gender role rigidity, gender role confusion, and gender appreciation, and concludes with four principles for gender-sensitive marital therapy.     

The Role of Perceived and Objective Social Connectedness on Risk for Suicidal Thoughts and Behavior in Late-Life and Their Moderating Effect on Cognitive Deficits

ObjectiveImpaired cognition increases suicide risk while social connectedness protects against suicide risk in late life. We examined the independent and interactive effects of social connectedness and cognition on suicide risk in late life.MethodsParticipants included 570 individuals aged 50+ from a late-life suicide study. The Interpersonal Support Evaluation List and Social Network Index were used to assess perceived and objective social connectedness, respectively, while the Mattis Dementia Rating Scale and Executive Interview were used to assess cognition.ResultsSuicide attempters and ideators reported lower perceived social connectedness and exhibited worse executive function than non-suicidal depressed and healthy comparison participants, while only attempters had worse objective social connectedness relative to the other groups. Executive dysfunction was linked to low objective social connectedness in attempters but higher objective social connectedness in healthy comparisons.ConclusionInterventions targeting suicide risk may consider bolstering social connectedness, particularly in those with low cognitive health.     

The Role of Masculinity and Depressive Symptoms in Predicting Suicidal Ideation in Homeless Men

Men’s suicide rates may be influenced by difficulties recognizing externalizing depressive symptoms in men that adhere to hegemonic masculine gender role norms. The purpose of this study was to investigate the ability of externalizing depressive symptoms, internalizing depressive symptoms, and hegemonic masculinity in predicting the existence and severity of suicidal ideation. Homeless men (n?=?94) completed questionnaires at a resource center in the Rocky Mountain Western United States. Internalizing symptoms predicted the existence of suicidal ideation, and both externalizing and internalizing symptoms predicted increased severity of suicidal ideation. The masculine norms violence and playboy were correlated with men’s suicidal ideation. An externalizing-internalizing model of predicting suicide in men and men’s adherence to certain masculine gender role norms may be valuable to further efforts in suicide assessment and prevention.