Thoughts of Death and Suicidal Ideation in Nonpsychiatric Human Immunodeficiency Virus Seropositive Individuals

The present study examines the prevalence of death thoughts and suicidality in HIV infection. Subjects (n = 246) were examined for psychiatric morbidity and suicidality. Compared to high risk HIV seronegatives, HIV seropositives (HIV +) had significantly increased frequency and severity of both suicidal ideation and death thoughts. Two-thirds of seropositives had suicidal ideation at some point; half of the seropositives reported suicide plans and one quarter suicide attempts; and third of seropositives reported current suicidal ideation. Suicidal ideation did not increase with advancing disease. The high prevalence of suicidal ideation suggests inclusion of its assessment in HIV treatment regardless of stage.     

Poisoning and suicide by cyanide jewelry cleaner in the US Hmong community: A case series

Abstract

Over 200?000 persons of Hmong ethnicity live in the United States. The majority of this Southeast Asian ethnic group live in California, Minnesota and Wisconsin. Tradition plays a strong role in the Hmong population, and difficulty in assimilation into “Western ways” has been reported to result in depression and suicide attempts. Some products sold at Southeast Asian ethnic markets are well-known within the Hmong community to be lethal but are essentially unknown to the outside community. We describe eight cases in which cyanide-containing products were ingested by Hmong patients. Seven cases were suicide attempts involving the ingestion of a locally-purchased substance intended for cleaning metal, coins, or jewelry. One case involved the fatal ingestion of a cyanide-containing “herbal” cure. In the majority of the cases, cyanide was not initially suspected, and treatment was delayed due to lack of information regarding the product ingested. In the two patients who survived, the cyanide antidote kit (sodium nitrite, amyl nitrite, and sodium thiosulfate) was administered early. Clinicians should be aware that unusual and potentially lethal products are easily available at ethnic markets. Cyanide toxicity should be suspected, and empiric antidote therapy initiated early, in patients of Hmong or Southeast Asian descent who present with sudden and unexplained cardiovascular collapse and metabolic acidosis, especially in the setting of a suspected suicidal ingestion.     

Poisoning and suicide by cyanide jewelry cleaner in the US Hmong community: a case series

Over 200?000 persons of Hmong ethnicity live in the United States. The majority of this Southeast Asian ethnic group live in California, Minnesota and Wisconsin. Tradition plays a strong role in the Hmong population, and difficulty in assimilation into "Western ways" has been reported to result in depression and suicide attempts. Some products sold at Southeast Asian ethnic markets are well-known within the Hmong community to be lethal but are essentially unknown to the outside community. We describe eight cases in which cyanide-containing products were ingested by Hmong patients. Seven cases were suicide attempts involving the ingestion of a locally-purchased substance intended for cleaning metal, coins, or jewelry. One case involved the fatal ingestion of a cyanide-containing "herbal" cure. In the majority of the cases, cyanide was not initially suspected, and treatment was delayed due to lack of information regarding the product ingested. In the two patients who survived, the cyanide antidote kit (sodium nitrite, amyl nitrite, and sodium thiosulfate) was administered early. Clinicians should be aware that unusual and potentially lethal products are easily available at ethnic markets. Cyanide toxicity should be suspected, and empiric antidote therapy initiated early, in patients of Hmong or Southeast Asian descent who present with sudden and unexplained cardiovascular collapse and metabolic acidosis, especially in the setting of a suspected suicidal ingestion.     

Thwarted Belongingness Mediates the Relationship Between Fear of Negative Evaluation and Suicidal Ideation

Fear of negative evaluation has been documented as a mechanism that explains variations in feelings of belongingness. According to the interpersonal theory of suicide (Joiner 2005), feelings of thwarted belongingness, that one does not belong, can significantly increase desire and risk for suicide. We proposed that differences in thwarted belongingness may explain variations in suicidal ideation and behavior as a function of levels of fear of negative evaluation. This hypothesis was tested by examining self-reported fears of negative evaluation, thwarted belongingness, and suicidal ideation in 107 young adults, many who were explicitly targeted for recruitment due to a history of suicidal ideation and behavior [13.1 % had thoughts about suicide without a previous attempt; 15.9 % reported at least one previous attempt (max = 5 attempts)]. Mediation analyses were conducted with suicidal ideation entered as the outcome variable. Results indicated that greater fears of negative evaluation were significantly and positively associated with levels of suicidal ideation. Differences in thwarted belongingness fully accounted for the relationship between fears of negative evaluation and suicidal ideation. We conclude with clinical implications and future directions.     

AGE AND PROBLEM BEHAVIORS AMONG ADOLESCENT MULTI-ETHNIC FEMALES

Depression, alcohol use, and suicidal behaviors are common among adolescents. However, little is known if these problem behaviors differ among ethnically diverse females across the adolescent years. Using the National Longitudinal Study of Adolescent Health database, we conducted regression analyses to compare these problem behaviors in three age cohorts across five ethnic groups of adolescent females. The random sample (N = 3,297, aged 12–19 years) included Latinas, African-, Asian-, Native-, and Euro-American females. There are differences in these problem behaviors between some age cohorts across ethnic groups. Significance and implications of the results to mental health nursing research and practice are described.     

Perfectionism and Loneliness as Predictors of Depressive and Anxious Symptoms in Asian and European Americans: Do Self-Construal Schemas Also Matter?

In the present study, we examined ethnic differences in perfectionism, loneliness, and self-construal schemas, as unique predictors of depressive and anxious symptoms in a sample of 223 Asian Americans and 309 European Americans. Results of comparative analyses indicated greater concern over mistakes, parental expectations, parental criticism, doubts about actions, loneliness, and interdependence in Asian, compared to European Americans. Furthermore, results of conducting hierarchical regression analyses indicated support for a pan-ethnic model involving perfectionism and loneliness as additive predictors of both depressive and anxious symptoms across Asian and European Americans. Interestingly, across both ethnic groups, self-construal was found to augment the prediction model of depressive symptoms, but not of anxious symptoms, beyond what was accounted for by perfectionism and loneliness. Some implications of the present findings are discussed.     

Thoughts of death and suicidal ideation in nonpsychiatric human immunodeficiency virus seropositive individuals

The present study examines the prevalence of death thoughts and suicidality in HIV infection. Subjects (n = 246) were examined for psychiatric morbidity and suicidality. Compared to high risk HIV seronegatives, HIV seropositives (HIV +) had significantly increased frequency and severity of both suicidal ideation and death thoughts. Two-thirds of seropositives had suicidal ideation at some point; half of the seropositives reported suicide plans and one quarter suicide attempts; and third of seropositives reported current suicidal ideation. Suicidal ideation did not increase with advancing disease. The high prevalence of suicidal ideation suggests inclusion of its assessment in HIV treatment regardless of stage.     

Suicidal and Online: How Do Online Behaviors Inform Us of This High-Risk Population?

To assist suicide prevention we need a better understanding of how suicidal individuals act in their environment, and the online world offers an ideal opportunity to examine daily behaviors. This anonymous survey (N = 1,016) provides first-of-its-kind empirical evidence demonstrating suicide-risk people (n = 290) are unique in their online behaviors. Suicidal users reported more time online, greater likelihood of developing online personal relationships, and greater use of online forums. In addition, suicide-risk women reported more time browsing/surfing and social networking. The authors conclude that suicide prevention efforts should respond to suicide-risk users' greater demands for online interpersonal communications.     

Grit and Perseverance in Suicidal Behavior and Non-Suicidal Self-Injury

Data indicate persistence facilitates suicidal behavior. Non-suicidal self-injury (NSSI) is characterized by difficulty persisting while upset. The relationship between NSSI and suicidal behavior thus may hinge upon persistence. Participants were 604 undergraduates (79.5% women; 42.4% African American; 6.1% with 1 + prior suicide attempt). Data were collected online via self-report and analyzed using hierarchical multiple regression. As expected, higher levels of grit and perseverance predicted more frequent suicide attempts. Furthermore, grit and perseverance moderated the relationship between NSSI and suicide attempts, which increased in magnitude as individuals reported greater persistence. Findings depict suicidal behavior as a deliberate pursuit of death.     

Emotion Dysregulation and Vulnerability to Suicidal Ideation and Attempts

This study investigated the predictive utility of a six-dimensional conceptualization of emotion dysregulation for suicidal ideation, as well as its ability to distinguish among individuals with differing histories of suicidality. Young adults (N = 96) with current suicidal ideation but no suicide attempt history (n = 17), a history of a single (n = 20) or multiple attempts (n = 17), or no current ideation/no past attempts (n = 42) completed measures of emotion dysregulation, suicidal ideation, depression, hopelessness, and a diagnostic interview. Multiple suicide attempters differed from participants with no suicidal ideation/no past attempts on two emotion dysregulation dimensions—nonacceptance of emotional responses and perceived limited access to emotion regulation strategies. After adjusting for depression symptoms and the presence of a mood or anxiety diagnosis, limited access to emotion regulation strategies significantly predicted current suicidal ideation, a relation that was found to be statistically mediated by hopelessness.     

Social background, aspects of lifestyle, body image, relations, school situation, and somatic and psychological symptoms in obese and overweight 15-year-old boys in a county in Sweden

OBJECTIVE: To compare lifestyle and health aspects among obese, overweight, and normal-weight 15-year-old boys living in the county of V?stmanland, Sweden. DESIGN: A cross-sectional school-based survey. Setting. All schools in the county of V?stmanland, Sweden. SUBJECTS: A questionnaire was completed anonymously by 989 boys. MAIN OUTCOME MEASURES: The relations between body mass index and social factors, eating habits, physical activity, body image, relations, school situation, use of alcohol, drugs and tobacco, somatic and psychological symptoms in boys. RESULTS: Obese boys had a significant negative outcome in 19 out of 31 items studied compared with normal-weight boys, while the overweight boys had a significant negative outcome in 9 out of 31. The obese boys reported more irregular eating habits than normal-weight boys, were less satisfied with their weight and looks, and had fewer friends. A larger proportion of the obese boys reported that they did not like school, were more absent from school, and had been exposed to more violence. They bullied their schoolmates more often. The obese boys had tried sniffing solvents and used illicit drugs more frequently than their peers. They reported more somatic and psychological symptoms as well as suicidal thoughts and attempts. CONCLUSIONS: Obese 15-year-old boys differed from overweight and normal-weight boys in lifestyle and in the frequency of somatic and psychological symptoms. Early and vigorous intervention is necessary, as they may belong to a risk group that could develop not only medically but also socially negative consequences.     

How Illegal Drug Use,Alcohol Use,Tobacco Use,and Depressive Symptoms Affect Adolescent Suicidal Ideation: A Secondary Analysis of the 2011 Youth Risk Behavior Survey

The purpose of this study was to identify the major risk factors among adolescents who have either contemplated or attempted suicide. Along with successful suicides, suicide attempts and contemplation are coexisting factors that are prominent in the adolescent population and therefore warrant major concern. A secondary data analysis of the Youth Risk Behavior Survey (YRBS) was completed to explore the factors that may influence adolescents’ thoughts or actions about suicidal behavior. The YRBS represents high-school students throughout 50 states. Nine questions from the YRBS were used to elicit information about the relationships among the risk factors: (1) Suicidal thoughts and attempts; (2) illegal drug use; (3) alcohol use; (4) tobacco use; and (5) depressive symptoms. Statistically significant relationships among the risk factors were found for adolescents. Adolescents considered suicide (15.8%); attempted suicide at least once (7.8%); were injured while attempting suicide (n = 2.7%). Our findings support the idea that illegal substance use can lead to suicidal thoughts and actions. Depression had a positive relationship with suicidal ideations, supporting similar studies suggesting that depression leads to suicidal action.     

Age and problem behaviors among adolescent multi-ethnic females

Depression, alcohol use, and suicidal behaviors are common among adolescents. However, little is known if these problem behaviors differ among ethnically diverse females across the adolescent years. Using the National Longitudinal Study of Adolescent Health database, we conducted regression analyses to compare these problem behaviors in three age cohorts across five ethnic groups of adolescent females. The random sample (N = 3,297, aged 12-19 years) included Latinas, African-, Asian-, Native-, and Euro-American females. There are differences in these problem behaviors between some age cohorts across ethnic groups. Significance and implications of the results to mental health nursing research and practice are described.     

Ethnic differences in coronary plaque and epicardial fat volume quantified using computed tomography

Epidemiological studies observed a higher prevalence of coronary atherosclerosis in South Asians when compared to Caucasians, but quantitative computed tomography differences in aggregate plaque volume (APV) and epicardial fat volume (EFV) between South Asians, Southeast or East Asians (SEEAs) and Caucasians remain unknown. We aimed to compare APV and EFV quantified on computed-tomographic-coronary-angiography (CTCA) between South Asian, SEEA and Caucasian populations residing in Australia. Age, gender and body-mass-index matched subjects from three ethnic groups who underwent clinically indicated 320-detector CTCA were retrospectively analysed. Percentage APV in the first 5 cm of the left anterior descending artery (LAD) and EFV were quantified using dedicated software (Vital Images, USA). One-hundred-and-fifty subjects (average age?=?57.7 years, 56?% male, n?=?50 in each ethnic group) were analysed. Mean LAD percentage APV was highest in South Asians (44.5?±?8.4?% vs. 37.5?±?6.5?% in SEEAs and 39.5?±?6.4?% in Caucasians, P?=?0.00001). South Asian ethnicity predicted LAD APV above traditional risk factors on multivariate analysis (P?=?0.000002). EFV was significantly higher in both South Asians (103.2?±?41.7 cm³ vs. 85.8?±?39.4 cm³, P?=?0.035) and SEEAs (110.8?±?36.9 cm³ vs. 85.8?±?39.4 cm³, P?=?0.001) when compared with Caucasians. In this cohort LAD percentage APV and EFV, as quantified on CTCA, differs between South Asians, SEEA and Caucasian populations, with higher LAD APV observed in South Asians and lower EFV in Caucasians. Atherosclerotic volume in LAD was best predicted by South Asian ethnicity above traditional risk factors and EFV. Further research is required to establish whether APV and EFV quantification can improve cardiac risk prediction in the South Asian population.     

THE ROLE OF GENDER AND SUICIDE PRECIPITANT IN ATTITUDES TOWARD NONFATAL SUICIDAL BEHAVIOR

This study examined factors affecting young adults' attitudes about nonfatal suicidal behavior. It evaluated how respondent sex, respondent gender identity, the precipitant of the suicidal act (i.e., a relationship loss, an achievement failure, or a physical illness), and gender of the suicidal person influence reactions to a suicidal decision. In this study of nonfatal suicidal behavior, like in studies of suicide, attitudes were least negative when the suicidal act was in response to a physical illness. Men were more likely to agree with and accept the suicidal decision than women. Androgynous persons, on the other hand, tended to view the decision to kill oneself as foolish, independent of precipitant. They also reported less agreement, acceptance, and sympathy for such decision. The implications of these findings for the prevention of suicidal behaviors are considered. Because gender seems to play a role in the acceptability of suicidal behavior, prevention programs ought to explicitly examine gender issues in attitudes toward suicidal behavior.     

Ethnic differences in physical pain sensitivity: Role of acculturation

Although research suggests that Asian Americans are more reactive to physical pain than European Americans, some evidence suggests that the observed differences in ethnicity may actually reflect Asian Americans’ differing levels of acculturation. Two studies were conducted to test this hypothesis. In Study 1, first- and second-generation Asian Americans and European Americans took part in a cold pressor task. Evidence of heightened pain responses was found only among first-generation Asian Americans. Study 2 further controlled for ethnicity and replicated this pattern in finding heightened pain reactions among mainland Chinese students in Hong Kong relative to Hong Kong Chinese students. These findings suggest a role for acculturation in accounting for ethnic differences in physical pain sensitivity.     

Hanging suicides in northern Finland: A descriptive epidemiological study

The authors examined all hanging-suicides during 1988–2013 (N = 851) in the province of Oulu, northern Finland. Using death-certificate data and ICD-diagnoses from the Finnish Hospital Discharge Register, we focused on gender differences in suicide, mental health, and somatic health. Male victims were more likely to have intoxication or problematic alcohol use; female victims were more likely to have somatic or mental hospitalization. Previous physical or mental hospitalization was related with absence of intoxication at the time of suicide. Suicide prevention should focus on acute alcohol abuse in the presence of acute stressors, suicidal thoughts and mental illness.     

Physical Disability and the Interpersonal Theory of Suicide

Interpersonal Theory of Suicide constructs were examined in individuals with physical disabilities, a population identified as having heightened suicidal ideation. Students (N = 184) answered online-based self-report questionnaires. Students with physical disabilities (n = 49) were expected to endorse higher levels of constructs relative to other students (n = 133). Analyses of covariance indicated that those with disabilities reported higher perceived burdensomeness, but not thwarted belongingness, fearlessness about death, or suicidal ideation. Suicide prevention efforts, particularly in university settings, may benefit from focusing on reducing perceived burdensomeness in this population, as these individuals may be at heightened risk.     

Sexual abuse, alcohol and other drug use, and suicidal behaviors in homeless adolescents.

Previous research has shown that homeless youth have high rates of suicidal ideation, sexual abuse, and abuse of alcohol and other drugs. However, little is known about how these rates differ by gender and ethnicity. Our objective was to describe patterns of sexual abuse, alcohol and other drug use, and indicators of suicidal behaviors in homeless adolescents and to determine gender and ethnic differences in these factors. We used secondary data analysis of data from surveys completed by 96 homeless youth whose average age was 17.9 years. Over 60% of the sample reported a history of sexual abuse; the majority were under the age of 12 years when they first tried alcohol, marijuana, and cocaine; 56.3% had injected drugs, and 46.9% had tried inhalants. During the past 12 months, 35.1% had seriously considered suicide and 12.3% had actually attempted suicide at least once. Significantly more Hispanics than Whites had considered suicide (chi 2 = 4.31, p = .038). A disproportionate number of Hispanics (95% of the sample) reported a history of sexual abuse. Participants with a history of sexual abuse were significantly more likely than those who did not have a history of sexual abuse to have used alcohol and/or marijuana (chi 2 = 9.93, p < .01) and to have considered suicide in the past 12 months (F = 14.93, p < .001). We found that sexual abuse history is greater in this sample than in the general population and is particularly prevalent among Hispanic/Latino subjects. As in other studies, sexual abuse was more common among females than among males. High prevalence of sexual abuse, alcohol and other drug use, and suicidal behaviors in this sample of homeless youth underscores the need to develop and test community-based interventions to improve their health status.     

Suicidal ideation among Viennese high school students

OBJECTIVE: Suicidality spans a spectrum ranging from suicidal thoughts to suicidal acts, and suicidal ideation is more prevalent in youth populations, suggesting important developmental issues. We assessed the prevalence of lifetime suicidal ideation and associated psychosocial factors among Viennese high school students. METHOD: An anonymous self-report survey assessing demographic characteristics and the major psychiatric risk factors of teenage suicide was completed by students at three Viennese high schools (n = 214; mean age 15.4 years). RESULTS: Eighty-one (37.9%) high school students reported having had suicidal thoughts at some point in their lives, girls significantly more often than boys (48.5% vs. 29.1%, P = 0.004). Furthermore, lifetime suicidal ideation in Viennese high school students was associated with living in broken-home families, cigarette smoking, substance problems (alcohol/drugs), self-reported depression, and high school type (the highest prevalence was in grammar school). After adjusting for confounders, we found that female gender, substance problems, school type and cigarette smoking were significantly associated with lifetime suicidal ideation in Viennese high school students. CONCLUSIONS: The psychosocial factors associated with adolescent suicidal ideation require attention in the contexts of suicide prevention and mental health promotion.