Modeling the Distinct Pathways of Influence of Coping Strategies on Youth Suicidal Ideation: A National Longitudinal Study

National surveys indicate high rates of suicidal ideation in youth, especially among females. Coping skill training programs hold promise as a potential intervention that can help young people better manage stress and not consider suicide as a solution to life??s problems. To assess the promise of this strategy, the present research examined which coping strategies (if any) predicted reduction in youth suicidal ideation over a 1-year follow-up, and explored the potential pathways through which their influence was channeled. Two waves of panel data from a nationally representative sample of youth, assessed 1?year apart (N?=?710; Mean age?=?18?years) were analyzed separately by gender using multiple group path analytic procedures. Four coping strategies, namely problem solving, emotional regulation, support seeking and acceptance were found to predict reduction in suicidal ideation among both males and females. However, the influence of these strategies (at baseline) was channeled through distinct pathways. The effect of emotional regulation (and acceptance) was channeled through its use at follow-up and was mediated by reductions in perceived stress and depressive symptoms, leading to reduction in suicidal ideation. The influence of support seeking was also channeled through its more recent use at follow-up, but directly predicted reduction in suicidal ideation, with no effect on perceived stress or depressive symptoms. The effect of problem solving on suicidal ideation was mediated by reduction in depressive symptoms, but was not channeled through its use at follow-up, suggesting a longer time course for the protective influence of this strategy. Finally, acceptance had a direct risk-enhancing effect on suicidal ideation. Coping strategies commonly used by youth can be effective in reducing suicidal ideation and therefore universal training in the effective use of these strategies should be considered. An understanding of the distinct pathways through which their effect on suicidal ideation is transmitted can better inform the design of youth suicide prevention interventions.     

Transitions in Suicide Risk in a Nationally Representative Sample of Adolescents

PurposeSuicide is the third leading cause of death among older adolescents, and represents a significant public health problem. Preventing suicidal behavior depends on an understanding of the developmental transitions in suicide risk and whether the likelihood of a suicide attempt can be predicted prospectively.MethodsData from the National Longitudinal Study of Adolescent Health were used for the study. The sample is nationally representative, and includes 10,424 youth assessed over three time points spanning 7 years. MPLUS was used to analyze the data.ResultsLatent class analysis showed that youth could be classified into three latent classes representing degree of suicide risk. Indicators of risk included depressive symptoms, hopelessness, suicidal ideation, having a family history of suicidal behavior, and having a friend history of suicidal behavior. Latent transition analyses showed that youth in the low-risk group remained at low risk both 1 and 7 years later. Although some youth who were classified as high-risk transitioned to a lower risk group 7 years later, a significant proportion remained at high risk. Analyses also revealed that the probability of making a suicide attempt was higher for youth in the high-risk latent class 1 and 7 years earlier.ConclusionsFindings indicate that suicide prevention efforts should be targeted primarily at youth at high risk for suicide; most youth classified as “low risk” remained at low risk as they transitioned to young adulthood.     

A cross-sectional study of prevalence and correlates of self-harm and suicidal ideation in older adults with dual sensory loss

BackgroundLoss of vision and hearing (dual sensory loss: DSL) presents risk factors for self-harm and/or suicidal ideation, although this has rarely been examined for older adults.ObjectivesThis study estimated the prevalence of thoughts about self-harm and suicide ideation in a national sample of adults with DSL in Denmark.MethodsAll 513 people aged 50 years or older who were registered with the national provider of service for people with DSL in Denmark were eligible to participate. Surveys were returned by 290 participants. Participants were mostly female (70%) and aged 50–100 years (M = 81). Surveys contained questions related to thoughts of self-harm and suicide as well as physical, mental, and social wellbeing.ResultsIn total, 17% of participants reported thoughts of self-harm and/or suicide in the past two weeks. Not participating in social activities, poorer self-rated health, and presence of more depressive symptoms were associated with self-harm and suicidal ideation. Factors that were associated with self-harm and suicidal ideation were lower levels of emotional support, non-participation in social activities, and symptoms of depression.ConclusionsThese finding highlight the importance of ongoing mental health screening and support for older adults with DSL, especially in ensuring accessible mental health services.     

Prospective Associations between Delinquency and Suicidal Behaviors in a Nationally Representative Sample

PurposeWe examined the prospective associations between delinquency and suicidal behaviors among adolescents using a nationally representative sample.MethodsThe National Longitudinal Study of Adolescent Health was used to assess the prospective associations between delinquency at ages 12–17 years and suicidal behaviors (ideation, attempts, treatment for attempts) 1 and 7 years later.ResultsControlling for demographic variables, delinquency was prospectively associated with an increased risk for all three suicidal behaviors 1 year later, and to ideations and attempts 7 years later. After controlling for other risk factors (i.e., depression, self-esteem, problem drinking, impulsivity, religiosity), delinquency was still significantly related to an increased likelihood for suicidal ideation 1 and 7 years later, and to suicide attempts 1 year later. Further, delinquency was significantly related to suicidal ideation for girls more than for boys.ConclusionsThese findings suggest that delinquent youth, particularly delinquent girls, should be targeted in interventions to reduce suicidal behaviors.     

Suicidal ideation and self-harm behavior in a community sample of preadolescent youth: a case-control study

ObjectiveResearch has focused on understanding risk factors associated with suicidal ideation and self-harm behaviors in older youth, but less is known regarding these behaviors in preadolescents. We examined characteristics associated with suicidal ideation and self-harm behavior in youth aged 10–13 years.Design/MethodsA community sample of 387 youth was enrolled in a prospective study assessing precursors of risk behaviors. Twenty-three subjects endorsing items regarding suicidal ideation or self-harm behaviors (Achenbach's Youth Self-Report) (endorsers) were matched with 23 non-endorsers. Groups were compared on problem behaviors, impulsivity, neurocognitive function, risk behaviors, and other variables.ResultsEndorsers had higher levels of impulsivity, were more likely in borderline/clinical range on 5 of 8 Youth Self-Report Syndrome scales, and reported more risk taking. Endorsers and non-endorsers were similar in neurocognitive function. More non-endorsers were on stimulants, but groups were similar in parental monitoring and parental report of behavioral/emotional issues, socioeconomic status, and marital status.ConclusionIn this study, preadolescent endorsers report significantly more problem behaviors than non-endorsers. However, parental monitoring and parent report of problems were similar between groups. Given these findings, we suggest that at-risk youth may be underrecognized at young ages.     

Analysis of risk factors affecting suicidal ideation in South Korea by life cycle stage

ObjectivesThis study analyzed risk factors for suicidal ideation in South Koreans from a life cycle perspective.Methods A secondary analysis was conducted of data collected in 2015 as part of the 6th Korea National Health and Nutrition Examination Survey (KNHANES). The participants comprised 5,935 individuals aged 12 years or older. The statistical analysis reflected the complex sampling design of the KNHANES, and the Rao-Scott chi-square test and multiple logistic regression analysis were performed.Results The prevalence of suicidal ideation was 5.7% in adolescents, 3.7% in young adults, 5.4% in middle-aged adults, and 7.0% in older adults. Depression and stress were risk factors in every stage of the life cycle. In those aged 12 to 19 years, activity restrictions were significantly associated with suicidal ideation. Education and subjective health status were risk factors in adults aged 20 to 39 years, and education, activity restrictions, and quality of life were the major risk factors in those aged 40 to 64 years. For adults 65 years of age or older, the risk of suicidal ideation was higher among those with inappropriate sleep time.Conclusion The risk factors for suicidal ideation were found to be different across stages of the life cycle. This suggests a need for individualized suicide prevention plans and specific government policies that reflect the characteristics of each life cycle stage.     

Perceived stress,coping, and adjustment in adolescents

PurposeTo investigate age and gender effects on perceived interpersonal stress, coping with interpersonal stressors, and psychological adjustment among early and middle adolescents. Furthermore, the associations of perceived stress and coping with adjustment were examined.MethodsThe sample included 286 Austrian adolescents aged 10 to 14 years who attended the fifth to seventh grade. Self-report data on perceived stress, coping, as well as emotional and behavioral problems, were assessed.ResultsFifth graders scored lower on maladaptive coping strategies and externalizing problems and reported more adaptive coping strategies than sixth and seventh graders. Compared with boys, girls evaluated a higher amount of perceived interpersonal stress and used more social support. Additionally, girls scored higher on maladaptive coping strategies and emotional distress and scored lower on distraction than boys. Problem-focused and emotion-focused coping were negatively related to emotional and behavioral problems, whereas perceived stress and maladaptive coping was positively associated with adjustment problems. These relations were stronger in female than in male adolescents.ConclusionsEvaluating multidimensional coping patterns is supported. Particularly, implementation of primary preventive programs during late childhood is suggested.     

安徽省医科大学生不同形式社会支持与自杀意念的关联及性别差异分析

  目的  了解不同形式社会支持对安徽省医科大学生自杀意念的影响及性别差异。  方法  采用分层整群抽样方法，以安徽省两所医科院校大一、大二4 799名学生为研究对象，了解一般人口统计学指标、社会支持和自杀意念等信息，建立多因素Logistic回归模型分析不同形式社会支持（类型与来源）对自杀意念的影响，并比较男女差异。  结果  大学生自杀意念的检出率为6.2%，性别间差异无统计学意义（χ2=1.224，P=0.269）。随各种形式社会支持水平的降低，男女大学生自杀意念呈增加趋势。控制相关混杂因素的影响，低水平各种形式的社会支持是总体大学生和女生的自杀意念的独立危险因素（均有P<0.05），低水平社会支持、主观支持和支持利用度会增加男生自杀意念的风险（P值分别为0.049，0.002，0.031）。暴露于低社会支持、低客观支持及低水平的不同来源社会支持，女生自杀意念的风险均高于男生。  结论  社会支持是医科大学生自杀意念的重要影响因素，并表现有性别差异，开展针对性干预有益于医科大学生自杀意念的防控。     

社会支持在超重肥胖青少年心理健康与自杀意念间的中介作用

目的 探讨超重肥胖青少年心理健康、社会支持与自杀意念的关系,为促进超重肥胖青少年心理健康发展,降低自杀意念检出率提供指导。方法 2018年3-5月选取潍坊市4 250名青少年,采用自杀意念自评量表(SIOSS)、心理健康自评量表(K10)、社会支持量表(SSRS)进行调查。结果 青少年超重检出率为9.55%(406/4 250),肥胖检出率为6.94%(295/4 250);农村超重肥胖青少年心理健康得分显著高于城市青少年(P<0.001),城市超重肥胖青少年社会支持得分显著高于农村,超重肥胖青少年自杀意念得分农村显著高于城市(P<0.001);心理健康与自杀意念呈显著正相关(r=0.639,P<0.01),社会支持分别与心理健康、自杀意念呈显著负相关(r=-0.378和-0.449,P<0.01);心理健康与社会支持对超重肥胖青少年自杀意念有显著预测作用(β=0.278和-0.197,P<0.01;R²=0.459),且社会支持在心理健康与自杀意念之间起部分中介作用。结论 通过改善超重肥胖青少年的心理健康状况,提高其社会支持,从而降低超重肥胖青少年的自杀意念。     

Adolescent Alcohol Use,Suicidal Ideation,and Suicide Attempts

PurposeTo examine the association between self-reported alcohol use and suicide attempts among adolescents who did and did not report suicidal ideation during the past year.MethodsScreening data from 31,953 students attending schools in the United States that implemented the Signs of Suicide (SOS) program in 2001–2002 were used in this analysis. Two types of alcohol use were investigated: heavy episodic drinking, and drinking while down. Self-reported suicide attempts were regressed on suicidal ideation and both measures of alcohol use, controlling for participants’ levels of depressive symptoms, and demographic characteristics.ResultsLogistic regression analyses indicated that both drinking while down and heavy episodic drinking were significantly associated with self-reported suicide attempts. Analyses examining the conditional association of alcohol use and suicidal ideation with self-reported suicide attempts revealed that drinking while down was associated with significantly greater risk of suicide attempt among those not reporting suicidal ideation in the past year. Heavy episodic drinking was associated with increased risk of suicide attempt equally among those who did and did not report suicidal ideation.ConclusionsThis study identified the use of alcohol while sad or depressed as a marker for suicidal behavior in adolescents who did not report ideating prior to an attempt, and hence, may not be detected by current strategies for assessing suicide risk. Findings from this study should provide further impetus for alcohol screening among clinicians beyond that motivated by concerns about alcohol and substance use.     

Well-Being and Suicidal Ideation of Secondary School Students From Military Families

BackgroundThe mental health of children is a primary public health concern; adolescents of military personnel may be at increased risk of experiencing poorer well-being overall and depressive symptoms specifically. These adolescents experience individual and intrafamilial stressors of parental deployment and reintegration, which are directly and indirectly associated with internalizing behaviors.PurposeThe present study sought to better understand the influence of parental military connectedness and parental deployment on adolescent mental health.MethodsData from the 2011 California Healthy Kids Survey examined feeling sad or hopeless, suicidal ideation, well-being, and depressive symptoms by military connectedness in a subsample (n = 14,299) of seventh-, ninth-, and 11th-grade California adolescents. Cross-classification tables and multiple logistic regression analyses were used.ResultsMore than 13% of the sample had a parent or sibling in the military. Those with military connections were more likely to report depressive symptoms and suicidal ideation. Controlling for grade, gender, and race/ethnicity, reporting any familial deployment compared with no deployments was associated with increasing odds of experiencing sadness or hopelessness, depressive symptoms, and suicidal ideation.ConclusionsFindings emphasize the increased risk of mental health issues among youth with parents (and siblings) in the military. Although deployment-related mental health stressors are less likely during peace, during times of war there is a need for increased screening in primary care and school settings. Systematic referral systems and collaboration with community-based mental health centers will bolster screening and services.     

Emotional Suppression Mediates the Relation Between Adverse Life Events and Adolescent Suicide: Implications for Prevention

Suicidal ideation substantially increases the odds of future suicide attempts, and suicide is the second leading cause of death among adolescents. A history of adverse life events has been linked with future suicidal ideation and attempts, although studies examining potential mediating variables have been scarce. One probable mediating mechanism is how the individual copes with adverse life events. For example, certain coping strategies appear to be more problematic than others in increasing future psychopathology, and emotional suppression in particular has been associated with poor mental health outcomes in adults and children. However, no studies to date have examined the potential mediating role of emotional suppression in the relation between adverse life events and suicidal thoughts/behavior in adolescence. The goal of the current study was to examine emotional suppression as a mediator in the relation between childhood adversity and future suicidal thoughts/behaviors in youth. A total of 625 participants, aged 14–19 years, seeking ER services were administered measures assessing adverse life events, coping strategies, suicidal ideation in the last 2 weeks, and suicide attempts in the last month. The results suggest that emotional suppression mediates the relation between adversity and both (1) suicidal thoughts and (2) suicide attempts above and beyond demographic variables and depressive symptoms. This study has important implications for interventions aimed at preventing suicidal thoughts and behavior in adolescents with histories of adversity.     

Living in the shadow of terrorism: psychological distress and alcohol use among religious and non-religious adolescents in Jerusalem

This study examines the effects of prolonged exposure to terrorism in 600 religious and non-religious Jewish adolescents living in Jerusalem, particularly post-traumatic stress (PTS) symptoms, depressive symptoms, alcohol use, coping strategies and social support. The youth in Jerusalem reported high exposure to terrorist acts. This exposure was associated with high PTS, depressive symptoms and alcohol use. Despite an apparently greater exposure to terrorism, religious adolescents reported lower levels of PTS and alcohol consumption, but similar levels of depressive symptoms to non-religious adolescents. Problem-solving coping predicted higher depressive symptoms for religious adolescents exposed to terrorism but not for similarly exposed non-religious adolescents. In contrast, emotion-focused coping predicted more alcohol consumption among highly exposed non-religious adolescents, while emotion-focused coping predicted more alcohol consumption among religious adolescents with low exposure. The overall findings suggest that religiosity may buffer the negative consequences of exposure in other ways than through coping or support.     

Influences on loneliness,depression, sexual-risk behaviour and suicidal ideation among Thai transgender youth

This study examined the influence of age, education level and number of sex partners on levels of loneliness, depression, suicidal ideation and sexual-risk behaviour in Thai male-to-female transgender youth. A total of 190 participants filled in the study's questionnaire, designed to tap the primary variables of age, level of education, number of sex partners, loneliness, depression, suicidal ideation and sexual-risk behaviour. Results reveal that level of education has a significant influence on depression and loneliness, the number of sex partners has a significant influence on sexual-risk behaviour and suicidal ideation and age has a significant influence on sexual-risk behaviour and suicidal ideation. Participants with higher levels of education reported more loneliness than participants who did not graduate from high school. In addition, participants who did not graduate from high school reported more depression than participants with some university credit. Furthermore, participants aged 15 to 19 years, compared with those of 20 to 25 years, reported higher level of sexual-risk behaviour and higher levels of suicidal ideation.     

Suicide, high-risk behaviors, and coping style in homeless adolescent males' adjustment.

PURPOSE: To evaluate the association among suicide behaviors, high-risk behaviors, coping style, and psychological adjustment (i.e., depressive symptomatology, internalizing and externalizing behavior problems) in homeless and non-homeless adolescent males (aged 16 to 19 years). METHODS: Data were obtained from 100 homeless youth accessing an emergency shelter (Ottawa, ON). The comparison group was comprised of 70 youth accessing local community drop-in centers that lived with their parent(s)/guardian(s) and had never stayed in a shelter. Data were analyzed using Chi-square, Student's t-tests, and regression statistics. RESULTS: Relative to non-homeless youth, homeless youth were more likely to report drug, alcohol, and tobacco use, legal problems, academic difficulties, and mental health problems. Homeless youth presented with a higher prevalence of suicidal ideation, past suicide attempts, depressive symptomatology, and internalizing and externalizing behavior problems. Disengagement coping was a predictor of suicidal ideation, past attempts, depressive symptoms and both internalizing and externalizing behavior problems in homeless youth. CONCLUSIONS: Relative to non-homeless youth, findings indicate that homeless youth reported greater use of a disengaging coping style and are at greater risk for high-risk behaviors, past suicide attempts, and clinically elevated levels of depressive symptoms and behavior problems.     

Adolescents, Celebrity Worship, and Cosmetic Surgery

PurposeTo evaluate the acceptability, feasibility, and effectiveness of a population-based intervention to promote health of youth (age: 16–24 years) in Goa.MethodsTwo pairs of urban and rural communities were selected; one of each was randomly assigned to receive a multi-component intervention and the other wait-listed. The intervention comprised educational institution-based peer education and teacher training (in the urban community), community peer education, and health information materials. Effectiveness was assessed through before–after population surveys at baseline and at 18 months. Outcomes were measured using a structured interview schedule with all eligible youth. Logistic regression compared each pair, adjusted for baseline differences, on prevalence of outcomes in the domains of reproductive and sexual health (RSH), violence, mental health, substance use, and help seeking for health concerns.ResultsIn both intervention communities, prevalence of violence perpetrated and probable depression was significantly lower and knowledge and attitudes about RSH significantly higher (p < .05). The rural sample also reported fewer menstrual complaints and higher levels of help-seeking for RSH complaints by women, and knowledge and attitudes about emotional health and substance use; and, the urban sample reported significantly lower levels of substance use, suicidal behavior, sexual abuse, and RSH complaints. Although information materials were acceptable and feasible in both communities, community peer education was feasible only in the rural community. The institution-based interventions were generally acceptable and feasible.ConclusionsMulticomponent interventions comprising information materials, educational-institution interventions and, in rural contexts, community peer interventions are acceptable and feasible and likely to be effective for youth health promotion.     

AIDS患者感染结果告知、歧视知觉、社会支持与自杀意念的关系

  目的  分析AIDS患者的歧视知觉和自杀意念,以及歧视知觉、自杀意念和HIV感染结果告知及社会支持之间的关系。  方法  采用一般特征调查表、领悟社会支持量表(perceived social support scale, PSSS)、歧视知觉量表(self-stigma scale, SSS)和贝克自杀意念量表中文版(Beck scale for suicide ideation-Chinese version, BSI-CV)对某省会城市1 276名AIDS患者进行匿名调查。  结果  54.2%(692/1 276)的样本报告自己在过去1周或抑郁最严重时有过自杀意念。多因素分析显示,控制其他因素,歧视知觉(OR=0.57, 95% CI: 0.45~0.72, P < 0.001)与社会支持呈负相关,感染结果告知(OR=1.47, 95% CI: 1.12~1.92, P=0.005)与社会支持呈正相关。歧视知觉(OR=5.53, 95% CI: 4.21~7.27, P < 0.001)与自杀意念呈正相关,社会支持(OR=0.58, 95% CI: 0.45~0.76, P < 0.001)与自杀意念呈负相关。感染结果告知在患者的歧视知觉与社会支持间起部分中介作用(中介效应占总效应比例为29.0%);社会支持在患者的歧视知觉与自杀意念间起部分中介作用(中介效应占总效应比例为17.5%)。  结论  AIDS患者当中有自杀意念的比例较高。低歧视知觉、将感染结果告知家人、朋友及固定伴侣的患者领悟到的社会支持更高。高歧视知觉、低社会支持的患者自杀意念较强。感染结果告知在患者的歧视知觉与社会支持间起部分中介作用,而社会支持则在患者的歧视知觉与自杀意念间起部分中介作用。     

Anticipated suicidal ideation among female injecting drug users who are sex workers of negative or unknown HIV status in China

ABSTRACT

In China, female injection drug users who are also sex workers (IDUFSW) have a high prevalence of HIV and low prevalence of HIV testing. They are concerned about HIV infection and may be subjected to the risk of suicidal ideation if they become infected, due to stress and discrimination. During 2005–2006, we recruited 199 IDUFSW who self-reported negative/unknown HIV sero-status in Dazhou, Sichuan, China, to investigate the prevalence of and factors associated with suicidal ideation if they became HIV positive. Among the participants, 40.7% responded affirmatively to the question “Whether you would commit suicide if you were infected with HIV in the future?” In multivariate analyses, hatred toward oneself, perception of dying within 2–3 years, perceived nonavailability of HIV-related treatment, inability to cope with HIV-related trauma, and inclination to leave one’s family if one contracted HIV were significant factors related to anticipated suicidal ideation under the hypothetical situation of HIV infection. The odds ratios (OR) ranged from 2.38 to 10.36 (p < .05). These findings can facilitate the planning of primary suicidal prevention services targeting high-risk, non-HIV-positive IDUFSW. Such programs may enhance psychosocial support, empowerment, cultivation of positive coping strategies, and perceived accessibility to treatment, and be integrated with HIV testing.     

Association between vision impairment and suicidal ideation among older adults: Results from National Survey on Drug Use and Health

BackgroundVision impairment (VI) is a significant risk factor for depression among older adults. The stigma attached to VI, which has multidimensional aspects consisting of ageism and ableism, may constitute a major impediment to accepting one’s VI and engaging in help-seeking behaviors, which could have led to suicide prevention.ObjectiveThis study aims to investigate the relative strength of association for VI on suicidal ideation among a nationally representative sample of older adults.MethodsThe study sample was composed of 10,635 adults aged 65 years and over, drawn from the 2015–2017 National Survey on Drug Use and Health. Respondents were asked if they had serious thoughts about suicide in the past year.ResultsOf the total sample, 6.85% reported VI (n = 729), defined as being blind or having serious difficulty seeing, even when wearing glasses. In comparison to those without VI, older adults with VI were more likely to report impoverished sociodemographic status and poor health conditions. After adjusting for a comprehensive set of covariates, multivariate logistic regression analyses revealed that older adults with VI were more likely to report suicidal ideation, compared to their counterparts without VI (OR = 3.12, 95% CI [1.24, 7.85]. p < 0. 05). Of the covariates, major depressive episodes presented the strongest positive association with suicidal ideation (OR = 14.11, 95% CI [8.93, 22.29], p < 0. 05).DiscussionThis study contributes to the scant body of literature by identifying the relative strength of association between VI and suicide in a nationally representative sample.     

Predictors of rural and urban youth suicidal ideation by gender: a case for targeted approaches to prevention

Depressive symptoms and participation in health-harming behaviours are key risk factors for youth suicidal ideation, while self-esteem and perceived social support are protective factors. The purpose of the present article is to highlight differing patterns of these risk and protective factors for youth suicidal ideation by gender, as well as by rural and urban communities. Through structural equation modelling, the presence of differing patterns of risk and protective factors for youth suicidal ideation potentially supports the case for targeted approaches to prevention based on gender and geographic region.