Psychology › Clinical Psychology

Suicide and Self-Harm Studies

Works Count: 77479

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This cluster of papers focuses on the epidemiology, risk factors, and prevention strategies related to suicidal behavior, particularly among adolescents and young adults. It covers topics such as the interpersonal theory of suicide, psychological autopsy studies, non-suicidal self-injury, and the assessment of suicidal behavior. The research also delves into the global patterns of mortality, neurobiology, and the impact of various interventions in mitigating suicide risk.

Keywords

Suicide; Suicidal Behavior; Prevention Strategies; Risk Factors; Adolescents; Psychological Autopsy; Self-harm; Interpersonal Theory; Non-suicidal Self-injury; Epidemiology

Suicide and suicidal behaviour

2015-09-16

Gustavo Turecki , David A. Brent

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The Three-Step Theory (3ST): A New Theory of Suicide Rooted in the “Ideation-to-Action” Framework

2015-06-01

E. David Klonsky , Alexis M. May

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Hopelessness and eventual suicide: a 10-year prospective study of patients hospitalized with suicidal ideation

1985-05-01

Aaron T. Beck , Robert A. Steer , Mária Kovács +1 more

The authors intensively studied 207 patients hospitalized because of suicidal ideation, but not for recent suicide attempts, at the time of admission. During a follow-up period of 5-10 years, 14 … The authors intensively studied 207 patients hospitalized because of suicidal ideation, but not for recent suicide attempts, at the time of admission. During a follow-up period of 5-10 years, 14 patients committed suicide. Of all the data collected at the time of hospitalization, only the Hopelessness Scale and the pessimism item of the Beck Depression Inventory predicted the eventual suicides. A score of 10 or more on the Hopelessness Scale correctly identified 91% of the eventual suicides. Taken in conjunction with previous studies showing the relationship between hopelessness and suicidal intent, these findings indicate the importance of degree of hopelessness as an indicator of long-term suicidal risk in hospitalized depressed patients.

Solving the puzzle of deliberate self-harm: The experiential avoidance model

2005-05-06

Alexander L. Chapman , Kim L. Gratz , Milton Z. Brown

Prevalence, Correlates, and Treatment of Lifetime Suicidal Behavior Among Adolescents

2013-01-09

Matthew K. Nock , Jennifer Green , Irving Hwang +4 more

Although suicide is the third leading cause of death among US adolescents, little is known about the prevalence, correlates, or treatment of its immediate precursors, adolescent suicidal behaviors (ie, suicide … Although suicide is the third leading cause of death among US adolescents, little is known about the prevalence, correlates, or treatment of its immediate precursors, adolescent suicidal behaviors (ie, suicide ideation, plans, and attempts).To estimate the lifetime prevalence of suicidal behaviors among US adolescents and the associations of retrospectively reported, temporally primary DSM-IV disorders with the subsequent onset of suicidal behaviors.Dual-frame national sample of adolescents from the National Comorbidity Survey Replication Adolescent Supplement.Face-to-face household interviews with adolescents and questionnaires for parents.A total of 6483 adolescents 13 to 18 years of age and their parents.Lifetime suicide ideation, plans, and attempts.The estimated lifetime prevalences of suicide ideation, plans, and attempts among the respondents are 12.1%, 4.0%, and 4.1%, respectively. The vast majority of adolescents with these behaviors meet lifetime criteria for at least one DSM-IV mental disorder assessed in the survey. Most temporally primary (based on retrospective age-of-onset reports) fear/anger, distress, disruptive behavior, and substance disorders significantly predict elevated odds of subsequent suicidal behaviors in bivariate models. The most consistently significant associations of these disorders are with suicide ideation, although a number of disorders are also predictors of plans and both planned and unplanned attempts among ideators. Most suicidal adolescents (>80%) receive some form of mental health treatment. In most cases (>55%), treatment starts prior to onset of suicidal behaviors but fails to prevent these behaviors from occurring.Suicidal behaviors are common among US adolescents, with rates that approach those of adults. The vast majority of youth with suicidal behaviors have preexisting mental disorders. The disorders most powerfully predicting ideation, though, are different from those most powerfully predicting conditional transitions from ideation to plans and attempts. These differences suggest that distinct prediction and prevention strategies are needed for ideation, plans among ideators, planned attempts, and unplanned attempts.

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Risk factors for suicide in psychiatric outpatients: A 20-year prospective study.

2000-01-01

Gregory K. Brown , Aaron T. Beck , Robert A. Steer +1 more

To determine the risk factors for suicide, 6,891 psychiatric outpatients were evaluated in a prospective study. Subsequent deaths for the sample were identified through the National Death Index. Forty-nine (1%) … To determine the risk factors for suicide, 6,891 psychiatric outpatients were evaluated in a prospective study. Subsequent deaths for the sample were identified through the National Death Index. Forty-nine (1%) suicides were determined from death certificates obtained from state vital statistics offices. Specific psychological variables that could be modified by clinical intervention were measured using standardized scales. Univariate survival analyses revealed that the severity of depression, hopelessness, and suicide ideation were significant risk factors for eventual suicide. A multivariate survival analysis indicated that several modifiable variables were significant and unique risk factors for suicide, including suicide ideation, major depressive disorder, bipolar disorder, and unemployment status.

Self-Injurious Thoughts and Behaviors Interview: Development, reliability, and validity in an adolescent sample.

2007-01-01

Matthew K. Nock , Elizabeth B. Holmberg , Valerie I. Photos +1 more

The authors developed the Self-Injurious Thoughts and Behaviors Interview (SITBI) and evaluated its psychometric properties. The SITBI is a structured interview that assesses the presence, frequency, and characteristics of a … The authors developed the Self-Injurious Thoughts and Behaviors Interview (SITBI) and evaluated its psychometric properties. The SITBI is a structured interview that assesses the presence, frequency, and characteristics of a wide range of self-injurious thoughts and behaviors, including suicidal ideation, suicide plans, suicide gestures, suicide attempts, and nonsuicidal self-injury (NSSI). This initial study, based on the administration of the SITBI to 94 adolescents and young adults, suggested that the SITBI has strong interrater reliability (average kappa = .99, r = 1.0) and test-retest reliability (average kappa = .70, intraclass correlation coefficient = .44) over a 6-month period. Moreover, concurrent validity was demonstrated via strong correspondence between the SITBI and other measures of suicidal ideation (average kappa = .54), suicide attempt (kappa = .65), and NSSI (average kappa = .87). The authors concluded that the SITBI uniformly and comprehensively assesses a wide range of self-injury-related constructs and provides a new instrument that can be administered with relative ease in both research and clinical settings.

Risk factors for suicide in individuals with depression: A systematic review

2013-02-12

Keith Hawton , Carolina Casañas i Comabella , Camilla Haw +1 more

Thwarted belongingness and perceived burdensomeness: Construct validity and psychometric properties of the Interpersonal Needs Questionnaire.

2011-09-19

Kimberly A. Van Orden , Kelly C. Cukrowicz , Tracy K. Witte +1 more

The present study examined the psychometric properties and construct validity of scores derived from the Interpersonal Needs Questionnaire (INQ) using latent variable modeling with 5 independent samples varying in age … The present study examined the psychometric properties and construct validity of scores derived from the Interpersonal Needs Questionnaire (INQ) using latent variable modeling with 5 independent samples varying in age and level of psychopathology. The INQ was derived from the interpersonal theory of suicide and was developed to measure thwarted belongingness and perceived burdensomeness-both proximal causes of desire for suicide. Results support that thwarted belongingness and perceived burdensomeness are distinct but related constructs and that they can be reliably measured. Further, multiple-group analyses were consistent with invariance for young versus older adults and nonclinical versus clinical populations, thereby supporting the relevance of these constructs to diverse populations. Finally, both constructs demonstrated convergent associations with related interpersonal constructs-including loneliness and social support for belongingness and social worth and death ideation for burdensomeness--as well as prospective associations with suicidal ideation.

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Contact With Mental Health and Primary Care Providers Before Suicide: A Review of the Evidence

2002-06-01

Jason B. Luoma , Catherine Martin , Jane L. Pearson

OBJECTIVE: This study examined rates of contact with primary care and mental health care professionals by individuals before they died by suicide. METHOD: The authors reviewed 40 studies for which … OBJECTIVE: This study examined rates of contact with primary care and mental health care professionals by individuals before they died by suicide. METHOD: The authors reviewed 40 studies for which there was information available on rates of health care contact and examined age and gender differences among the subjects. RESULTS: Contact with primary care providers in the time leading up to suicide is common. While three of four suicide victims had contact with primary care providers within the year of suicide, approximately one-third of the suicide victims had contact with mental health services. About one in five suicide victims had contact with mental health services within a month before their suicide. On average, 45% of suicide victims had contact with primary care providers within 1 month of suicide. Older adults had higher rates of contact with primary care providers within 1 month of suicide than younger adults. CONCLUSIONS: While it is not known to what degree contact with mental health care and primary care providers can prevent suicide, the majority of individuals who die by suicide do make contact with primary care providers, particularly older adults. Given that this pattern is consistent with overall health-service-seeking, alternate approaches to suicide-prevention efforts may be needed for those less likely to be seen in primary care or mental health specialty care, specifically young men.

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Physical Violence in American Families: Risk Factors and Adaptations to Violence in 8,145 Families.

1990-11-01

Ann Goetting , Murray A. Straus , Richard J. Gelles

Prevalence of and Risk Factors for Lifetime Suicide Attempts in the National Comorbidity Survey

1999-07-01

Ronald C. Kessler , Guilherme Borges , Ellen E. Walters

Background: General population survey data are presented on the lifetime prevalence of suicide attempts as well as transition probabilities to onset of ideation, plans among ideators, and attempts among ideators … Background: General population survey data are presented on the lifetime prevalence of suicide attempts as well as transition probabilities to onset of ideation, plans among ideators, and attempts among ideators either with or without a plan.Risk factors for these transitions are also studied.Methods: Data are from part II of the National Comorbidity Survey, a nationally representative survey carried out from 1990 to 1992 in a sample of 5877 respondents aged 15 to 54 years to study prevalences and correlates of DSM-III-R disorders.Transitions are estimated using life-table analysis.Risk factors are examined using survival analysis.Results: Of the respondents, 13.5% reported lifetime ideation, 3.9% a plan, and 4.6% an attempt.Cumulative prob-abilities were 34% for the transition from ideation to a plan, 72% from a plan to an attempt, and 26% from ideation to an unplanned attempt.About 90% of unplanned and 60% of planned first attempts occurred within 1 year of the onset of ideation.All significant risk factors (female, previously married, age less than 25 years, in a recent cohort, poorly educated, and having 1 or more of the DSM-III-R disorders assessed in the survey) were more strongly related to ideation than to progression from ideation to a plan or an attempt.Conclusions: Prevention efforts should focus on planned attempts because of the rapid onset and unpredictability of unplanned attempts.More research is needed on the determinants of unplanned attempts.

A Functional Approach to the Assessment of Self-Mutilative Behavior.

2004-10-01

Matthew K. Nock , Mitchell J. Prinstein

This study applied a functional approach to the assessment of self-mutilative behavior (SMB) among adolescent psychiatric inpatients. On the basis of past conceptualizations of different forms of self-injurious behavior, the … This study applied a functional approach to the assessment of self-mutilative behavior (SMB) among adolescent psychiatric inpatients. On the basis of past conceptualizations of different forms of self-injurious behavior, the authors hypothesized that SMB is performed because of the automatically reinforcing (i.e., reinforced by oneself; e.g., emotion regulation) and/or socially reinforcing (i.e., reinforced by others; e.g., attention, avoidance-escape) properties associated with such behaviors. Data were collected from 108 adolescent psychiatric inpatients referred for self-injurious thoughts or behaviors. Adolescents reported engaging in SMB frequently, using multiple methods, and having an early age of onset. Moreover, the results supported the structural validity and reliability of the hypothesized functional model of SMB. Most adolescents engaged in SMB for automatic reinforcement, although a sizable portion endorsed social reinforcement functions as well. These findings have direct implications for the understanding, assessment, and treatment of SMB.

The Suicidal Behaviors Questionnaire-Revised (SBQ-R):Validation with Clinical and Nonclinical Samples

2001-12-01

Augustine Osman , Courtney L. Bagge , Peter M. Gutierrez +3 more

Past suicidal behaviors including ideation and attempts have been identified as significant risk factors for subsequent suicidal behavior. However, inadequate attention has been given to the development or validation of … Past suicidal behaviors including ideation and attempts have been identified as significant risk factors for subsequent suicidal behavior. However, inadequate attention has been given to the development or validation of measures of past suicidal behavior. The present study examined the reliability and validity of a brief self-report measure of past suicidal behavior, the Suicidal Behaviors Questionnaire-Revised (SBQ-R). Participants included psychiatric inpatient adolescents, high school students, psychiatric inpatient adults, and undergraduates. Logistic regression analyses provided empirical support for the usefulness of the SBQ-R as a risk measure of suicide to differentiate between suicide-risk and nonsuicidal study participants. Receiver operating characteristic (ROC) analyses indicated that the most useful cutoff scores on the SBQ-R were 7 for nonsuicidal samples, and 8 for clinical samples. Both the single SBQ-R Item 1 and SBQ-R total scores are recommended for use in clinical and nonclinical settings.

Prevalence of Nonsuicidal Self‐Injury in Nonclinical Samples: Systematic Review, Meta‐Analysis and Meta‐Regression

2014-01-15

Sarah Swannell , Graham Martin , Andrew Page +2 more

Published prevalence estimates of nonsuicidal self‐injury (NSSI) among nonclinical samples are highly heterogeneous, raising concerns about their reliability and hindering attempts to explore the alleged increase in NSSI over time. … Published prevalence estimates of nonsuicidal self‐injury (NSSI) among nonclinical samples are highly heterogeneous, raising concerns about their reliability and hindering attempts to explore the alleged increase in NSSI over time. Accordingly, the objectives of this study were to investigate the influence of methodological factors on heterogeneity in NSSI prevalence estimates, explore changes over time, and estimate overall international NSSI prevalence. Results showed that methodological factors contributed over half (51.6%) of the heterogeneity in prevalence estimates, and, after adjusting for these factors, NSSI prevalence did not increase over time. Overall, pooled NSSI prevalence was 17.2% among adolescents, 13.4% among young adults, and 5.5% among adults. Clearly, development of standardized methodology in NSSI research is crucial if accurate estimates are desired.

Psychiatric Diagnosis in Child and Adolescent Suicide

1996-04-01

David Shaffer

<h3>Background:</h3> The age, sex, and ethnic distribution of adolescents who commit suicide is significantly different from that of the general population. The present study was designed to examine psychiatric risk … <h3>Background:</h3> The age, sex, and ethnic distribution of adolescents who commit suicide is significantly different from that of the general population. The present study was designed to examine psychiatric risk factors and the relationship between them and demographic variables. <h3>Methods:</h3> A case-control, psychologic autopsy study of 120 of 170 consecutive subjects (age, <20 years) who committed suicide and 147 community age-, sex-, and ethnic-matched control subjects who had lived in the Greater New York (NY) area. <h3>Results:</h3> By using parent informants only, 59% of subjects who committed suicide and 23% of control subjects who met<i>DSM-III</i>criteria for a psychiatric diagnosis, 49% and 26%, respectively, had had symptoms for more than 3 years, and 46% and 29%, respectively, had had previous contact with a mental health professional. Best-estimate rates, based on multiple informants for these parameters, for suicides only, were 91%, 52%, and 46%, respectively. Previous attempts and mood disorder were major risk factors for both sexes; substance and/or alcohol abuse was a risk factor for males only. Mood disorder was more common in females, substance and/or alcohol abuse occurred exclusively in males (62% of 18-to 19-year-old suicides). The prevalence of a psychiatric diagnosis and, in particular, substance and/or alcohol abuse increased with age. <h3>Conclusion:</h3> A limited range of diagnoses—most commonly a mood disorder alone or in combination with conduct disorder and/or substance abuse—characterizes most suicides among teenagers.

Suicide as an outcome for mental disorders

1997-03-01

E Clare Harris , B. M. Barraclough

Background Mental disorders have a strong association with suicide. This meta-analysis, or statistical overview, of the literature gives an estimate of the suicide risk of the common mental disorders. Method … Background Mental disorders have a strong association with suicide. This meta-analysis, or statistical overview, of the literature gives an estimate of the suicide risk of the common mental disorders. Method We searched the medical literature to find reports on the mortality of mental disorders. English language reports were located on MEDLINE (1966–1993) with the search terms mental disorders', ‘brain injury’, ‘eating disorders’, ‘epilepsy’, ‘suicide attempt’, ‘psychosurgery’, with ‘mortality’ and ‘follow-up studies’, and from the reference lists of these reports. We abstracted 249 reports with two years or more follow-up and less than 10% loss of subjects, and compared observed numbers of suicides with those expected. A standardised mortality ratio (SMR) was calculated for each disorder. Results Of 44 disorders considered, 36 have a significantly raised SMR for suicide, five have a raised SMR which fails to reach significance, one SMR is not raised and for two entries the SMR could not be calculated. Conclusions If these results can be generalised then virtually all mental disorders have an increased risk of suicide excepting mental retardation and dementia. The suicide risk is highest for functional and lowest for organic disorders with substance misuse disorders lying between. However, within these broad groupings the suicide risk varies widely.

Handbook of social psychology

1990-01-01

Robert Dantzer

Assessment of suicidal intention: The Scale for Suicide Ideation.

1979-01-01

Aaron T. Beck , Mária Kovács , Arlene Weissman

This article describes the rationale, development, and validation of the Scale for Suicide Ideation (SSI), a 19-item clinical research instrument designed to quantify and assess suicidal intention. The scale was … This article describes the rationale, development, and validation of the Scale for Suicide Ideation (SSI), a 19-item clinical research instrument designed to quantify and assess suicidal intention. The scale was found to have high internal consistency and moderately high correlations with clinical ratings of suicidal risk and self-administered measures of self-harm. Furthermore, it was sensitive to changes in levels of depression and hopelessness over time. Its construct validity was supported by two studies by different investigators testing the relationship between hopelessness, depression, and suicidal ideation and by a study demonstrating a significant relationship between high level of suicidal ideation and dichotomous attitudes about life and related concepts on a semantic differential test. Factor analysis yielded three meaningful factors: active suicidal desire, specific plans for suicide, and passive suicidal desire.

Suicide, Suicide Attempts, and Suicidal Ideation

2016-01-16

E. David Klonsky , Alexis M. May , Boaz Y. Saffer

Suicidal behavior is a leading cause of death and disability worldwide. Fortunately, recent developments in suicide theory and research promise to meaningfully advance knowledge and prevention. One key development is … Suicidal behavior is a leading cause of death and disability worldwide. Fortunately, recent developments in suicide theory and research promise to meaningfully advance knowledge and prevention. One key development is the ideation-to-action framework, which stipulates that (a) the development of suicidal ideation and (b) the progression from ideation to suicide attempts are distinct phenomena with distinct explanations and predictors. A second key development is a growing body of research distinguishing factors that predict ideation from those that predict suicide attempts. For example, it is becoming clear that depression, hopelessness, most mental disorders, and even impulsivity predict ideation, but these factors struggle to distinguish those who have attempted suicide from those who have only considered suicide. Means restriction is also emerging as a highly effective way to block progression from ideation to attempt. A third key development is the proliferation of theories of suicide that are positioned within the ideation-to-action framework. These include the interpersonal theory, the integrated motivational-volitional model, and the three-step theory. These perspectives can and should inform the next generation of suicide research and prevention.

Suicide and Suicidal Behavior

2008-05-14

Matthew K. Nock , Guilherme Borges , E. J. Bromet +3 more

Suicidal behavior is a leading cause of injury and death worldwide. Information about the epidemiology of such behavior is important for policy-making and prevention. The authors reviewed government data on … Suicidal behavior is a leading cause of injury and death worldwide. Information about the epidemiology of such behavior is important for policy-making and prevention. The authors reviewed government data on suicide and suicidal behavior and conducted a systematic review of studies on the epidemiology of suicide published from 1997 to 2007. The authors' aims were to examine the prevalence of, trends in, and risk and protective factors for suicidal behavior in the United States and cross-nationally. The data revealed significant cross-national variability in the prevalence of suicidal behavior but consistency in age of onset, transition probabilities, and key risk factors. Suicide is more prevalent among men, whereas nonfatal suicidal behaviors are more prevalent among women and persons who are young, are unmarried, or have a psychiatric disorder. Despite an increase in the treatment of suicidal persons over the past decade, incidence rates of suicidal behavior have remained largely unchanged. Most epidemiologic research on suicidal behavior has focused on patterns and correlates of prevalence. The next generation of studies must examine synergistic effects among modifiable risk and protective factors. New studies must incorporate recent advances in survey methods and clinical assessment. Results should be used in ongoing efforts to decrease the significant loss of life caused by suicidal behavior.

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Cross-national prevalence and risk factors for suicidal ideation, plans and attempts

2008-02-01

Matthew K. Nock , Guilherme Borges , Evelyn J. Bromet +7 more

Background Suicide is a leading cause of death worldwide; however, the prevalence and risk factors for the immediate precursors to suicide – suicidal ideation, plans and attempts – are not … Background Suicide is a leading cause of death worldwide; however, the prevalence and risk factors for the immediate precursors to suicide – suicidal ideation, plans and attempts – are not well-known, especially in low- and middle-income countries. Aims To report on the prevalence and risk factors for suicidal behaviours across 17 countries. Method A total of 84 850 adults were interviewed regarding suicidal behaviours and socio-demographic and psychiatric risk factors. Results The cross-national lifetime prevalence of suicidal ideation, plans, and attempts is 9.2% (s.e.=0.1), 3.1% (s.e.=0.1), and 2.7% (s.e.=0.1). Across all countries, 60% of transitions from ideation to plan and attempt occur within the first year after ideation onset. Consistent cross-national risk factors included being female, younger, less educated, unmarried and having a mental disorder. Interestingly, the strongest diagnostic risk factors were mood disorders in high-income countries but impulse control disorders in low- and middle-income countries. Conclusion There is cross-national variability in the prevalence of suicidal behaviours, but strong consistency in the characteristics and risk factors for these behaviours. These findings have significant implications for the prediction and prevention of suicidal behaviours.

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Youth Suicide Risk and Preventive Interventions: A Review of the Past 10 Years

2003-04-01

Madelyn S. Gould , Ted Greenberg , Drew M. Velting +1 more

Risks of all-cause and suicide mortality in mental disorders: a meta-review

2014-06-01

Edward Chesney , Guy M. Goodwin , Seena Fazel

A meta-review, or review of systematic reviews, was conducted to explore the risks of all-cause and suicide mortality in major mental disorders. A systematic search generated 407 relevant reviews, of … A meta-review, or review of systematic reviews, was conducted to explore the risks of all-cause and suicide mortality in major mental disorders. A systematic search generated 407 relevant reviews, of which 20 reported mortality risks in 20 different mental disorders and included over 1.7 million patients and over a quarter of a million deaths. All disorders had an increased risk of all-cause mortality compared with the general population, and many had mortality risks larger than or comparable to heavy smoking. Those with the highest all-cause mortality ratios were substance use disorders and anorexia nervosa. These higher mortality risks translate into substantial (10-20 years) reductions in life expectancy. Borderline personality disorder, anorexia nervosa, depression and bipolar disorder had the highest suicide risks. Notable gaps were identified in the review literature, and the quality of the included reviews was typically low. The excess risks of mortality and suicide in all mental disorders justify a higher priority for the research, prevention, and treatment of the determinants of premature death in psychiatric patients.

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Suicide Risk in Relation to Socioeconomic, Demographic, Psychiatric, and Familial Factors: A National Register–Based Study of All Suicides in Denmark, 1981–1997

2003-03-31

Ping Qin , Esben Agerbo , Preben Bo Mortensen

OBJECTIVE: Suicide risk was addressed in relation to the joint effect of factors regarding family structure, socioeconomics, demographics, mental illness, and family history of suicide and mental illness, as well … OBJECTIVE: Suicide risk was addressed in relation to the joint effect of factors regarding family structure, socioeconomics, demographics, mental illness, and family history of suicide and mental illness, as well as gender differences in risk factors. METHOD: Data were drawn from four national Danish longitudinal registers. Subjects were all 21,169 persons who committed suicide in 1981–1997 and 423,128 live comparison subjects matched for age, gender, and calendar time of suicide by using a nested case-control design. The effect of risk factors was estimated through conditional logistic regression. The interaction of gender with the risk factors was examined by using the log likelihood ratio test. The population attributable risk was calculated. RESULTS: Of the risk factors examined in the study, a history of hospitalization for psychiatric disorder was associated with the highest odds ratio and the highest attributable risk for suicide. Cohabiting or single marital status, unemployment, low income, retirement, disability, sickness-related absence from work, and a family history of suicide and/or psychiatric disorders were also significant risk factors for suicide. Moreover, these factors had different effects in male and female subjects. A psychiatric disorder was more likely to increase suicide risk in female than in male subjects. Being single was associated with higher suicide risk in male subjects, and having a young child with lower suicide risk in female subjects. Unemployment and low income had stronger effects on suicide in male subjects. Living in an urban area was associated with higher suicide risk in female subjects and a lower risk in male subjects. A family history of suicide raised suicide risk slightly more in female than in male subjects. CONCLUSIONS: Suicide risk is strongly associated with mental illness, unemployment, low income, marital status, and family history of suicide. The effect of most risk factors differs significantly by gender.

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The functions of deliberate self-injury: A review of the evidence

2006-10-03

E. David Klonsky

Adolescent suicide and suicidal behavior

2006-02-22

Jeffrey A. Bridge , Tina R. Goldstein , David A. Brent

This review examines the descriptive epidemiology, and risk and protective factors for youth suicide and suicidal behavior. A model of youth suicidal behavior is articulated, whereby suicidal behavior ensues as … This review examines the descriptive epidemiology, and risk and protective factors for youth suicide and suicidal behavior. A model of youth suicidal behavior is articulated, whereby suicidal behavior ensues as a result of an interaction of socio‐cultural, developmental, psychiatric, psychological, and family‐environmental factors. On the basis of this review, clinical and public health approaches to the reduction in youth suicide and recommendations for further research will be discussed.

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Psychological autopsy studies of suicide: a systematic review

2003-04-01

Jonathan Cavanagh , Alan Carson , Michael Sharpe +1 more

The psychological autopsy method offers the most direct technique currently available for examining the relationship between particular antecedents and suicide. This systematic review aimed to examine the results of studies … The psychological autopsy method offers the most direct technique currently available for examining the relationship between particular antecedents and suicide. This systematic review aimed to examine the results of studies of suicide that used a psychological autopsy method.A computer aided search of MEDLINE, BIDS ISI and PSYCHLIT, supplemented by reports known to the reviewers and reports identified from the reference lists of other retrieved reports. Two investigators systematically and independently examined all reports. Median proportions were determined and population attributable fractions were calculated, where possible, in cases of suicide and controls.One hundred and fifty-four reports were identified, of which 76 met the criteria for inclusion; 54 were case series and 22 were case-control studies. The median proportion of cases with mental disorder was 91% (95 % CI 81-98%) in the case series. In the case-control studies the figure was 90% (88-95%) in the cases and 27% (14-48%) in the controls. Co-morbid mental disorder and substance abuse also preceded suicide in more cases (38%, 19-57%) than controls (6%, 0-13%). The population attributable fraction for mental disorder ranged from 47-74% in the seven studies in which it could be calculated. The effects of particular disorders and sociological variables have been insufficiently studied to draw clear conclusions.The results indicated that mental disorder was the most strongly associated variable of those that have been studied. Further studies should focus on specific disorders and psychosocial factors. Suicide prevention strategies may be most effective if focused on the treatment of mental disorders.

Self-harm and suicide in adolescents

2012-06-01

Keith Hawton , Kate Saunders , Rory C. O’Connor

Suicide Prevention Strategies

2005-10-26

J. John Mann , Alan Apter , José Manoel Bertolote +7 more

In 2002, an estimated 877,000 lives were lost worldwide through suicide. Some developed nations have implemented national suicide prevention plans. Although these plans generally propose multiple interventions, their effectiveness is … In 2002, an estimated 877,000 lives were lost worldwide through suicide. Some developed nations have implemented national suicide prevention plans. Although these plans generally propose multiple interventions, their effectiveness is rarely evaluated.To examine evidence for the effectiveness of specific suicide-preventive interventions and to make recommendations for future prevention programs and research.Relevant publications were identified via electronic searches of MEDLINE, the Cochrane Library, and PsychINFO databases using multiple search terms related to suicide prevention. Studies, published between 1966 and June 2005, included those that evaluated preventative interventions in major domains; education and awareness for the general public and for professionals; screening tools for at-risk individuals; treatment of psychiatric disorders; restricting access to lethal means; and responsible media reporting of suicide.Data were extracted on primary outcomes of interest: suicidal behavior (completion, attempt, ideation), intermediary or secondary outcomes (treatment seeking, identification of at-risk individuals, antidepressant prescription/use rates, referrals), or both. Experts from 15 countries reviewed all studies. Included articles were those that reported on completed and attempted suicide and suicidal ideation; or, where applicable, intermediate outcomes, including help-seeking behavior, identification of at-risk individuals, entry into treatment, and antidepressant prescription rates. We included 3 major types of studies for which the research question was clearly defined: systematic reviews and meta-analyses (n = 10); quantitative studies, either randomized controlled trials (n = 18) or cohort studies (n = 24); and ecological, or population- based studies (n = 41). Heterogeneity of study populations and methodology did not permit formal meta-analysis; thus, a narrative synthesis is presented.Education of physicians and restricting access to lethal means were found to prevent suicide. Other methods including public education, screening programs, and media education need more testing.Physician education in depression recognition and treatment and restricting access to lethal methods reduce suicide rates. Other interventions need more evidence of efficacy. Ascertaining which components of suicide prevention programs are effective in reducing rates of suicide and suicide attempt is essential in order to optimize use of limited resources.

The interpersonal theory of suicide.

2010-01-01

Kimberly A. Van Orden , Tracy K. Witte , Kelly C. Cukrowicz +3 more

Suicidal behavior is a major problem worldwide and, at the same time, has received relatively little empirical attention. This relative lack of empirical attention may be due in part to … Suicidal behavior is a major problem worldwide and, at the same time, has received relatively little empirical attention. This relative lack of empirical attention may be due in part to a relative absence of theory development regarding suicidal behavior. The current article presents the interpersonal theory of suicidal behavior. We propose that the most dangerous form of suicidal desire is caused by the simultaneous presence of two interpersonal constructs-thwarted belongingness and perceived burdensomeness (and hopelessness about these states)-and further that the capability to engage in suicidal behavior is separate from the desire to engage in suicidal behavior. According to the theory, the capability for suicidal behavior emerges, via habituation and opponent processes, in response to repeated exposure to physically painful and/or fear-inducing experiences. In the current article, the theory's hypotheses are more precisely delineated than in previous presentations (Joiner, 2005), with the aim of inviting scientific inquiry and potential falsification of the theory's hypotheses.

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Cognitive-Behavioral Treatment of Chronically Parasuicidal Borderline Patients

1991-12-01

Marsha M. Linehan , Hubert E. Armstrong , Alejandra Suárez +2 more

• A randomized clinical trial was conducted to evaluate the effectiveness of a cognitive-behavioral therapy, ie, dialectical behavior therapy, for the treatment of chronically parasuicidal women who met criteria for … • A randomized clinical trial was conducted to evaluate the effectiveness of a cognitive-behavioral therapy, ie, dialectical behavior therapy, for the treatment of chronically parasuicidal women who met criteria for borderline personality disorder. The treatment lasted 1 year, with assessment every 4 months. The control condition was "treatment as usual" in the community. At most assessment points and during the entire year, the subjects who received dialectical behavior therapy had fewer incidences of parasuicide and less medically severe parasuicides, were more likely to stay in individual therapy, and had fewer inpatient psychiatric days. There were no between-group differences on measures of depression, hopelessness, suicide ideation, or reasons for living although scores on all four measures decreased throughout the year.

A Hundred Cases of Suicide: Clinical Aspects

1974-10-01

B. M. Barraclough , Jane Bunch , Barry Nelson +1 more

Historically, doctors have not always acknowledged that they have an obligation to prevent suicide, partly because they shared the prevalent idea that most suicides were caused by moral crises, no … Historically, doctors have not always acknowledged that they have an obligation to prevent suicide, partly because they shared the prevalent idea that most suicides were caused by moral crises, no concern of theirs—and indeed suicide was a criminal matter until quite recently; but more, perhaps, because a fatalism has characterized their attitudes to its prevention, even where the suicide was clearly suffering from mental illness. Yet two recent American studies have shown more than 90 per cent of suicides to be mentally ill before their death (17, 8); this finding and the familiar clinical observation that suicidal thoughts disappear when the illness is successfully treated provide a strong case for a medical policy of prevention.

The Columbia–Suicide Severity Rating Scale: Initial Validity and Internal Consistency Findings From Three Multisite Studies With Adolescents and Adults

2011-12-01

Kelly Posner , Gregory K. Brown , Bárbara Stanley +7 more

The Columbia–Suicide Severity Rating Scale was initially designed to assess suicidal ideation and behavior in clinical trials. Psychometric analysis of data on adolescents indicated that a lifetime history of worst-point … The Columbia–Suicide Severity Rating Scale was initially designed to assess suicidal ideation and behavior in clinical trials. Psychometric analysis of data on adolescents indicated that a lifetime history of worst-point suicidal ideation including either suicidal intent or intent with a plan predicts a future risk of an actual attempt that is four times as great as the risk associated with a history of current suicidal ideation—including a desire to be dead—or increased general ratings of depression.

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Childhood Abuse, Household Dysfunction, and the Risk of Attempted Suicide Throughout the Life Span

2001-12-26

Shanta R. Dube , Robert F. Anda , Vincent J. Felitti +3 more

ContextSuicide is a leading cause of death in the United States, but identifying persons at risk is difficult. Thus, the US surgeon general has made suicide prevention a national priority. … ContextSuicide is a leading cause of death in the United States, but identifying persons at risk is difficult. Thus, the US surgeon general has made suicide prevention a national priority. An expanding body of research suggests that childhood trauma and adverse experiences can lead to a variety of negative health outcomes, including attempted suicide among adolescents and adults.ObjectiveTo examine the relationship between the risk of suicide attempts and adverse childhood experiences and the number of such experiences (adverse childhood experiences [ACE] score).Design, Setting, and ParticipantsA retrospective cohort study of 17 337 adult health maintenance organization members (54% female; mean [SD] age, 57 [15.3] years) who attended a primary care clinic in San Diego, Calif, within a 3-year period (1995-1997) and completed a survey about childhood abuse and household dysfunction, suicide attempts (including age at first attempt), and multiple other health-related issues.Main Outcome MeasureSelf-reported suicide attempts, compared by number of adverse childhood experiences, including emotional, physical, and sexual abuse; household substance abuse, mental illness, and incarceration; and parental domestic violence, separation, or divorce.ResultsThe lifetime prevalence of having at least 1 suicide attempt was 3.8%. Adverse childhood experiences in any category increased the risk of attempted suicide 2- to 5-fold. The ACE score had a strong, graded relationship to attempted suicide during childhood/adolescence and adulthood (P<.001). Compared with persons with no such experiences (prevalence of attempted suicide, 1.1%), the adjusted odds ratio of ever attempting suicide among persons with 7 or more experiences (35.2%) was 31.1 (95% confidence interval, 20.6-47.1). Adjustment for illicit drug use, depressed affect, and self-reported alcoholism reduced the strength of the relationship between the ACE score and suicide attempts, suggesting partial mediation of the adverse childhood experience–suicide attempt relationship by these factors. The population-attributable risk fractions for 1 or more experiences were 67%, 64%, and 80% for lifetime, adult, and childhood/adolescent suicide attempts, respectively.ConclusionsA powerful graded relationship exists between adverse childhood experiences and risk of attempted suicide throughout the life span. Alcoholism, depressed affect, and illicit drug use, which are strongly associated with such experiences, appear to partially mediate this relationship. Because estimates of the attributable risk fraction caused by these experiences were large, prevention of these experiences and the treatment of persons affected by them may lead to progress in suicide prevention.

Toward a Clinical Model of Suicidal Behavior in Psychiatric Patients

1999-02-01

J. John Mann , Christine Waternaux , Gretchen L. Haas +1 more

Risk factors for suicide attempts have rarely been studied comprehensively in more than one psychiatric disorder, preventing estimation of the relative importance and the generalizability of different putative risk factors … Risk factors for suicide attempts have rarely been studied comprehensively in more than one psychiatric disorder, preventing estimation of the relative importance and the generalizability of different putative risk factors across psychiatric diagnoses. The authors conducted a study of suicide attempts in patients with mood disorders, psychoses, and other diagnoses. Their goal was to determine the generalizability and relative importance of risk factors for suicidal acts across diagnostic boundaries and to develop a hypothetical, explanatory, and predictive model of suicidal behavior that can subsequently be tested in a prospective study.Following admission to a university psychiatric hospital, 347 consecutive patients who were 14-72 years old (51% were male and 68% were Caucasian) were recruited for study. Structured clinical interviews generated axis I and axis II diagnoses. Lifetime suicidal acts, traits of aggression and impulsivity, objective and subjective severity of acute psychopathology, developmental and family history, and past substance abuse or alcoholism were assessed.Objective severity of current depression or psychosis did not distinguish the 184 patients who had attempted suicide from those who had never attempted suicide. However, higher scores on subjective depression, higher scores on suicidal ideation, and fewer reasons for living were reported by suicide attempters. Rates of lifetime aggression and impulsivity were also greater in attempters. Comorbid borderline personality disorder, smoking, past substance use disorder or alcoholism, family history of suicidal acts, head injury, and childhood abuse history were more frequent in suicide attempters.The authors propose a stress-diathesis model in which the risk for suicidal acts is determined not merely by a psychiatric illness (the stressor) but also by a diathesis. This diathesis may be reflected in tendencies to experience more suicidal ideation and to be more impulsive and, therefore, more likely to act on suicidal feelings. Prospective studies are proposed to test this model.

Non-suicidal self-injury among adolescents: Diagnostic correlates and relation to suicide attempts

2006-08-03

Matthew K. Nock , T JOINERJR , Kathy Gordon +2 more

Clozapine Treatment for Suicidality in Schizophrenia<subtitle>International Suicide Prevention Trial (InterSePT)</subtitle>

2003-01-01

Herbert Y. Meltzer , Larry Alphs , Alan I. Green +7 more

<h3>Background</h3> Approximately 50% of patients with schizophrenia or schizoaffective disorder attempt suicide, and approximately 10% die of suicide. Study results suggest that clozapine therapy significantly reduces suicidal behavior in these … <h3>Background</h3> Approximately 50% of patients with schizophrenia or schizoaffective disorder attempt suicide, and approximately 10% die of suicide. Study results suggest that clozapine therapy significantly reduces suicidal behavior in these patients. <h3>Methods</h3> A multicenter, randomized, international, 2-year study comparing the risk for suicidal behavior in patients treated with clozapine vs olanzapine was conducted in 980 patients with schizophrenia or schizoaffective disorder, 26.8% of whom were refractory to previous treatment, who were considered at high risk for suicide because of previous suicide attempts or current suicidal ideation. To equalize clinical contact across treatments, all patients were seen weekly for 6 months and then biweekly for 18 months. Subsequent to randomization, unmasked clinicians at each site could make any interventions necessary to prevent the occurrence of suicide attempts. Suicidal behavior was assessed at each visit. Primary end points included suicide attempts (including those that led to death), hospitalizations to prevent suicide, and a rating of "much worsening of suicidality" from baseline. Masked raters, including an independent suicide monitoring board, determined when end point criteria were achieved. <h3>Results</h3> Suicidal behavior was significantly less in patients treated with clozapine vs olanzapine (hazard ratio, 0.76; 95% confidence interval, 0.58-0.97;<b>P</b>= .03). Fewer clozapine-treated patients attempted suicide (34 vs 55;<b>P</b>= .03), required hospitalizations (82 vs 107;<b>P</b>=.05) or rescue interventions (118 vs 155;<b>P</b>= .01) to prevent suicide, or required concomitant treatment with antidepressants (221 vs 258;<b>P</b>= .01) or anxiolytics or soporifics (301 vs 331;<b>P</b>=.03). Overall, few of these high-risk patients died of suicide during the study (5 clozapine vs 3 olanzapine-treated patients;<b>P</b>= .73). <h3>Conclusions</h3> Clozapine therapy demonstrated superiority to olanzapine therapy in preventing suicide attempts in patients with schizophrenia and schizoaffective disorder at high risk for suicide. Use of clozapine in this population should lead to a significant reduction in suicidal behavior.

Fatal and non-fatal repetition of self-harm

2002-08-30

David Owens , Judith Horrocks , Allan House

Non-fatal self-harm frequently leads to non-fatal repetition and sometimes to suicide. We need to quantify these two outcomes of self-harm to help us to develop and test effective interventions.To estimate … Non-fatal self-harm frequently leads to non-fatal repetition and sometimes to suicide. We need to quantify these two outcomes of self-harm to help us to develop and test effective interventions.To estimate rates of fatal and non-fatal repetition of self-harm.A systematic review of published follow-up data, from observational and experimental studies. Four electronic databases were searched and 90 studies met the inclusion criteria.Eighty per cent of studies found were undertaken in Europe, over one-third in the UK. Median proportions for repetition 1 year later were: 16% non-fatal and 2% fatal; after more than 9 years, around 7% of patients had died by suicide. The UK studies found particularly low rates of subsequent suicide.After 1 year, non-fatal repetition rates are around 15%. The strong connection between self-harm and later suicide lies somewhere between 0.5% and 2% after 1 year and above 5% after 9 years. Suicide risk among self-harm patients is hundreds of times higher than in the general population.

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Relationship between hopelessness and ultimate suicide: a replication with psychiatric outpatients

1990-02-01

A T Beck , Gary Brown , Robert J. Berchick +2 more

A prospective study of 1,958 outpatients found that hopelessness, as measured by the Beck Hopelessness Scale, was significantly related to eventual suicide. A scale cutoff score of 9 or above … A prospective study of 1,958 outpatients found that hopelessness, as measured by the Beck Hopelessness Scale, was significantly related to eventual suicide. A scale cutoff score of 9 or above identified 16 (94.2%) of the 17 patients who eventually committed suicide, thus replicating a previous study with hospitalized patients. The high-risk group identified by this cutoff score was 11 times more likely to commit suicide than the rest of the outpatients. The Beck Hopelessness Scale thus may be used as a sensitive indicator of suicide potential.

Suicide: A Study in Sociology.

1951-08-01

Harry Alpert , Émile Durkheim , John A. Spaulding +4 more

Suicide prevention strategies revisited: 10-year systematic review

2016-06-11

Gil Zalsman , Keith Hawton , Danuta Wasserman +7 more

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Risk factors for suicidal thoughts and behaviors: A meta-analysis of 50 years of research.

2016-11-14

Joseph C. Franklin , Jessica D. Ribeiro , Kathryn R. Fox +7 more

Suicidal thoughts and behaviors (STBs) are major public health problems that have not declined appreciably in several decades. One of the first steps to improving the prevention and treatment of … Suicidal thoughts and behaviors (STBs) are major public health problems that have not declined appreciably in several decades. One of the first steps to improving the prevention and treatment of STBs is to establish risk factors (i.e., longitudinal predictors). To provide a summary of current knowledge about risk factors, we conducted a meta-analysis of studies that have attempted to longitudinally predict a specific STB-related outcome. This included 365 studies (3,428 total risk factor effect sizes) from the past 50 years. The present random-effects meta-analysis produced several unexpected findings: across odds ratio, hazard ratio, and diagnostic accuracy analyses, prediction was only slightly better than chance for all outcomes; no broad category or subcategory accurately predicted far above chance levels; predictive ability has not improved across 50 years of research; studies rarely examined the combined effect of multiple risk factors; risk factors have been homogenous over time, with 5 broad categories accounting for nearly 80% of all risk factor tests; and the average study was nearly 10 years long, but longer studies did not produce better prediction. The homogeneity of existing research means that the present meta-analysis could only speak to STB risk factor associations within very narrow methodological limits-limits that have not allowed for tests that approximate most STB theories. The present meta-analysis accordingly highlights several fundamental changes needed in future studies. In particular, these findings suggest the need for a shift in focus from risk factors to machine learning-based risk algorithms. (PsycINFO Database Record

Epidemiology of Suicide and the Psychiatric Perspective

2018-07-06

Silke Bachmann

Suicide is a worldwide phenomenon. This review is based on a literature search of the World Health Organization (WHO) databases and PubMed. According to the WHO, in 2015, about 800,000 … Suicide is a worldwide phenomenon. This review is based on a literature search of the World Health Organization (WHO) databases and PubMed. According to the WHO, in 2015, about 800,000 suicides were documented worldwide, and globally 78% of all completed suicides occur in low- and middle-income countries. Overall, suicides account for 1.4% of premature deaths worldwide. Differences arise between regions and countries with respect to the age, gender, and socioeconomic status of the individual and the respective country, method of suicide, and access to health care. During the second and third decades of life, suicide is the second leading cause of death. Completed suicides are three times more common in males than females; for suicide attempts, an inverse ratio can be found. Suicide attempts are up to 30 times more common compared to suicides; they are however important predictors of repeated attempts as well as completed suicides. Overall, suicide rates vary among the sexes and across lifetimes, whereas methods differ according to countries. The most commonly used methods are hanging, self-poisoning with pesticides, and use of firearms. The majority of suicides worldwide are related to psychiatric diseases. Among those, depression, substance use, and psychosis constitute the most relevant risk factors, but also anxiety, personality-, eating- and trauma-related disorders as well as organic mental disorders significantly add to unnatural causes of death compared to the general population. Overall, the matter at hand is relatively complex and a significant amount of underreporting is likely to be present. Nevertheless, suicides can, at least partially, be prevented by restricting access to means of suicide, by training primary care physicians and health workers to identify people at risk as well as to assess and manage respective crises, provide adequate follow-up care and address the way this is reported by the media. Suicidality represents a major societal and health care problem; it thus should be given a high priority in many realms.

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Age, period, and cohort trends in mood disorder indicators and suicide-related outcomes in a nationally representative dataset, 2005–2017.

2019-03-14

Jean M. Twenge , Alysha Cooper , Thomas E. Joiner +2 more

Drawing from the National Survey on Drug Use and Health (NSDUH; N = 611,880), a nationally representative survey of U.S. adolescents and adults, we assess age, period, and cohort trends … Drawing from the National Survey on Drug Use and Health (NSDUH; N = 611,880), a nationally representative survey of U.S. adolescents and adults, we assess age, period, and cohort trends in mood disorders and suicide-related outcomes since the mid-2000s. Rates of major depressive episode in the last year increased 52% 2005-2017 (from 8.7% to 13.2%) among adolescents aged 12 to 17 and 63% 2009-2017 (from 8.1% to 13.2%) among young adults 18-25. Serious psychological distress in the last month and suicide-related outcomes (suicidal ideation, plans, attempts, and deaths by suicide) in the last year also increased among young adults 18-25 from 2008-2017 (with a 71% increase in serious psychological distress), with less consistent and weaker increases among adults ages 26 and over. Hierarchical linear modeling analyses separating the effects of age, period, and birth cohort suggest the trends among adults are primarily due to cohort, with a steady rise in mood disorder and suicide-related outcomes between cohorts born from the early 1980s (Millennials) to the late 1990s (iGen). Cultural trends contributing to an increase in mood disorders and suicidal thoughts and behaviors since the mid-2000s, including the rise of electronic communication and digital media and declines in sleep duration, may have had a larger impact on younger people, creating a cohort effect. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Suicide

2009-04-01

Keith Hawton , Kees van Heeringen

Assessment of suicidal intention: The Scale for Suicide Ideation.

1979-01-01

Aaron T. Beck , Mária Kovács , Arlene Weissman

The American Journal of Sociology

1939-07-01

C. B. F.

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Self-Injury

2010-03-01

Matthew K. Nock

People have engaged in self-injury—defined as direct and deliberate bodily harm in the absence of suicidal intent—for thousands of years; however, systematic research on this behavior has been lacking. Recent … People have engaged in self-injury—defined as direct and deliberate bodily harm in the absence of suicidal intent—for thousands of years; however, systematic research on this behavior has been lacking. Recent theoretical and empirical work on self-injury has significantly advanced the understanding of this perplexing behavior. Self-injury is most prevalent among adolescents and young adults, typically involves cutting or carving the skin, and has a consistent presentation cross-nationally. Behavioral, physiological, and self-report data suggest that the behavior serves both an intrapersonal function (i.e., decreases aversive affective/cognitive states or increases desired states) and an interpersonal function (i.e., increases social support or removes undesired social demands). There currently are no evidence-based psychological or pharmacological treatments for self-injury. This review presents an integrated theoretical model of the development and maintenance of self-injury that synthesizes prior empirical findings and proposes several testable hypotheses for future research.

Exploring The Link Between Demographic Factors and Non-Suicidal Self-Injury (NSSI) Among Indonesian Adolescents : An Educational Psychology Perspective

2025-06-25

Inge Uli Wiswanti , Donny Hendrawan | Jurnal Kependidikan Jurnal Hasil Penelitian dan Kajian Kepustakaan di Bidang Pendidikan Pengajaran dan Pembelajaran

This study aims to explore the relationship between demographic factors and self-injury behavior (Non-Suicidal Self-Injury/ NSSI) in Indonesian adolescents from an educational psychology perspective. Using a cross-sectional study method with … This study aims to explore the relationship between demographic factors and self-injury behavior (Non-Suicidal Self-Injury/ NSSI) in Indonesian adolescents from an educational psychology perspective. Using a cross-sectional study method with a quantitative approach, this study involved 213 adolescents aged 12-18 years (Mage = 14.95; SD = 1.52). Participants were recruited via a purposive sampling method. The Deliberate Self-Harm Inventory (DSHI) was employed to assess self-injurious behaviors. Inferential analysis utilized the Chi-square test to examine associations between categorical demographic variables, while one-way ANOVA was conducted to identify significant differences in mean NSSI scores across independent groups. The result showed that the proportion of participants who reported doing NSSI did not differ by socioeconomic status and education level. However, a significant association was found between NSSI and gender. Furthermore, it was also found a significant difference in the degree of NSSI between male and female adolescents. Females were more potential than males to do NSSI. These findings emphasize the imperative for educational psychology policies to incorporate routine screenings, targeted intervention or educational programs to alleviate NSSI among female adolescents. It should also implement professional training and culturally sensitive mental health services to create stigma-free environments that promote early intervention and resilience-building.

Correction: Understanding adolescent self-harm attempts in Ghana: a qualitative analysis of family and social risk factors

2025-06-25

Wisdom Kudzo Axame , Lebene Kpodo , James Kofi Bilabam +3 more | BMC Psychiatry

Review: Suicide and its relationship to aggression and impulsivity

2025-06-25

Yoojin Lee , Jessica R. Gilbert , Laura R. Waldman +2 more | Cognitive Affective & Behavioral Neuroscience

University Students’ Awareness and Willingness to Intervene: Bystander Response to Peer Suicidal Risk in Kyrgyzstan

2025-06-24

Leila Salimova , Meerim K. Nurbaeva , Noah Agbo | Research Square (Research Square)

<title>Abstract</title> While suicide is widely recognized as a serious concern, there is limited research on how university students perceive and respond to suicide risk among their peers. Our research aims … <title>Abstract</title> While suicide is widely recognized as a serious concern, there is limited research on how university students perceive and respond to suicide risk among their peers. Our research aims to explore Kyrgyzstani university students' awareness and personal connections to suicide risk among peers, as well as their likelihood to intervene. We conducted a cross-sectional survey among 239 university students in Kyrgyzstan, employing an instrument based on the Bystander Intervention (BSI) Model. Responses were analyzed using descriptive statistics, visualizations, and thematic grouping of open-ended questions to identify trends and insights. Students show a strong awareness of the severity in Kyrgyzstan. While students view suicidal ideation as an emergency, they struggle to identify manipulative behaviors and specific signs. Students are generally willing to intervene but lack the knowledge and confidence for concrete actions. This study highlighted the critical role of personal experience, awareness, and skill development in shaping students' readiness to support peers at suicidal risk, emphasizing the need for targeted educational interventions to equip bystanders with effective knowledge and resources for proactive suicide prevention.

N2 and P3 responses in adolescents with non-suicidal self-injury and their association with clinical outcomes: a cohort follow-up study based on the affective stroop paradigm

2025-06-24

Fei Yin , Feng Si , Wenlong Jiang +4 more | Frontiers in Psychiatry

Background Non-suicidal self-injury (NSSI), a prevalent psychiatric behavioral problem in adolescents, manifests diverse outcomes including cessation of remission, aggravation, and even progression to suicidal behaviors. It is crucial to track … Background Non-suicidal self-injury (NSSI), a prevalent psychiatric behavioral problem in adolescents, manifests diverse outcomes including cessation of remission, aggravation, and even progression to suicidal behaviors. It is crucial to track its progression and identify predictors of clinical outcomes in NSSI. The aim of this study was to determine whether the N2 and P3 responses in adolescents with NSSI were defective in the presence of the affective Stroop paradigm and associated with their clinical outcomes. Methods Participants were selected from an ongoing longitudinal study designed to predict clinical outcomes of NSSI in adolescents. Twenty-six in the remission group (RG), twenty-nine in the aggravation group (AG), and twenty-seven in the healthy group (HG) completed the affective Stroop task with EEG. Accuracy and reaction times (RTs) served as behavioral indexes, while N2 and P3 amplitude served as electrophysiological indexes; they were analyzed across groups. We used the EEGNet model to predict the NSSI clinical outcomes with EEG component. Result No significant main effects of group or affective stimuli or an effect of their interaction were observed on accuracy ( p &gt; 0.05). For RTs, there was a significant main effect of group, with slower RTs observed in the AG compared to the HG ( p &lt; 0.05). For N2 and P3 amplitude, there were significant main effect of group and affective stimuli and an effect of their interaction. Under neutral stimuli, the N2 amplitude in the AG was significantly larger than that in the RG ( p &lt; 0.05) and the HG ( p &lt; 0.01), while the P3 amplitude in AG was significantly smaller than that in the HG ( p &lt; 0.05), but there was no significant difference between RG and AG( p &gt; 0.05). The EEGnet model demonstrated that N2 amplitudes elicited by neutral stimuli achieved the highest classification accuracy (92.31%) for predicting clinical outcomes of NSSI. Conclusion The findings indicate that NSSI is linked to cognitive processing deficits, including impaired control and resource allocation to stimuli. Additionally, N2 amplitudes were shown to reliably predict clinical outcomes in NSSI.

Exploring multiple levels of suffering and suicide prevention in an era of emerging national legislations

2025-06-24

Mark J. Goldblatt , Dolores Angela Castelli Dransart , Sylvie Lapierre +2 more | Frontiers in Public Health

Access to assisted dying (variously called assisted suicide, euthanasia, and medical aid/assistance in dying) is increasingly available in many countries around the world. Individual suffering in the present and fears … Access to assisted dying (variously called assisted suicide, euthanasia, and medical aid/assistance in dying) is increasingly available in many countries around the world. Individual suffering in the present and fears for the future, feature prominently in the request for assisted dying, which then affects many people beyond the identified individual, including family and loved ones, the clinical team associated with the dying process and societies. We consider expanding waves of distress, beginning with the subjective intrapsychic suffering of the individual requesting assistance in dying, the interpersonal effect on survivors, and the complex responses in those facing requests for assisted death. The autonomous rights of the individual to the alleviation of suffering are balanced by efforts toward suicide prevention, which are impacted when there are limited options to alleviate the psychosocial and existential suffering of those who express the wish to die.

Identifying high-risk elderly for suicide using machine learning

2025-06-24

Hwanoong Lee , Kwanhyong Lee | Empirical Economics

Re-evaluating national suicide prevention month: strategic timing and enhanced impact

2025-06-24

Jeanne M. Ward , Alina Yang , Yipu Shi +2 more | Critical Public Health

Risk and protective factors for suicide-related outcomes among serving military personnel: a systematic review of cohort studies

2025-06-24

Luke T. Bayliss , Jacinta Hawgood , Zoë Jenkins +4 more | BMJ Military Health

Introduction Understanding risk and protective factors for suicide-related outcomes (suicidal ideation, attempts, and deaths) among military personnel is key to the development and design of suicide prevention initiatives. Current literature … Introduction Understanding risk and protective factors for suicide-related outcomes (suicidal ideation, attempts, and deaths) among military personnel is key to the development and design of suicide prevention initiatives. Current literature has predominantly focused on ex-serving or a combination of ex-personnel and serving-personnel. Therefore, factors that may be pertinent for serving personnel are less understood. This review aims to identify risk and protective factors for suicide-related outcomes comprising serving military personnel. Methods The review adhered to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and was registered on PROSPERO. A systematic literature search of academic databases on military personnel and suicide from 2004 was conducted. Two independent reviewers conducted study selection. Inclusion criteria included serving personnel, cohort study design, and suicide-related outcomes. Exclusion criteria were National Guard or reservists, and studies not in English. Data on study and participant characteristics, military-specific variables, and suicide-related outcomes were extracted. All studies were critically appraised. Results A total of 53 studies were included. Most studies were published in the past 10 years, comprised army personnel from the USA, and focused on suicide attempts. Overarching risk factor categories included adverse military experiences, deployment, repeated help seeking and support, junior rank, occupation and time in service and vulnerability factors within the military context. Since many of these risk factors are inherent to military service, they may potentially be considered non-modifiable. Despite a limited number of studies on protective factors, several studies found that unit cohesion reduced the likelihood of suicidal ideation and suicide attempts. Conclusions Suicide prevention strategies within the military may be enhanced by targeting risk factors that are potentially modifiable. Less modifiable risk factors could potentially be targeted through improved personnel management practices, particularly in preparation for and after deployment among first-year personnel. Longitudinal research programmes that identify and examine risk and protective factors for serving military personnel are needed. PROSPERO registration number CRD42024558183.

Profiling Attitudes Toward Individuals Who Self-Harm Among Mental Health Workers in Sweden: A Cross-Sectional Study

2025-06-24

Reid Lantto , Tomas Jungert , Sara Probert-Lindström +2 more | Issues in Mental Health Nursing

Mental health workers' attitudes toward individuals who self-harm impact accessibility and quality of care. Previous studies have established the role of training on professionals' attitudes, with mixed findings for gender … Mental health workers' attitudes toward individuals who self-harm impact accessibility and quality of care. Previous studies have established the role of training on professionals' attitudes, with mixed findings for gender and work experience. While self-report attitudinal scales are frequently used, latent response trends across such scales are seldom considered. The present study examines mental health workers' responses across the Self-Harm Antipathy Scale - Swedish Revised (SHAS-SR) and explores the predictive roles of various intrapersonal and contextual factors. On a sample of 596 mental health workers in Sweden, we employed standard multiple regression to predict outcomes on the SHAS-SR. We performed latent profile analysis on SHAS-SR subscales to identify distinct attitude profiles and their predictors. We identified four distinct attitude profiles: Sympathetic, Reluctant, Judging, and Antipathic. Area of work and gender predicted both wholescale scores and certain profile memberships. Working in emergency settings was associated with more negative attitudes and nearly nine times higher odds of an Antipathic rather than Sympathetic scoring pattern, compared to non-emergency workers. Interventions to improve attitudes toward individuals who self-harm ought to be prioritized in emergency settings. The SHAS-SR scale might be used to identify target groups for health equity efforts in mental healthcare.

What is self-harm in dance? A conceptualisation of UK dance teachers’ perceptions of self-harm

2025-06-24

Maria Kolitsida , Anna Lavis , Erin Sanchez +1 more | International Journal of Sport and Exercise Psychology

Adverse childhood experiences and adolescent non-suicidal self-injury: The role of social support in a national survey on sexual orientation and gender expression

2025-06-24

Yannan Guo , Shuyi Peng , Qianyu Liu +4 more | Child Abuse & Neglect

Suicide in subjects under the age of 30: a retrospective analysis

2025-06-24

Alberto Blandino , Luca Pietro Ernesto Sbrissa , Emma Flutti +4 more | International Journal of Legal Medicine

Inclusion Overcomes Intimidation: Toward Identity Safety

2025-06-24

Douglas L. Robertson | Behavior and Social Issues

Religious Reactions to Suicide Cases in Nigeria: A Netnographic Study

2025-06-24

Collins Ikeokwu Nwafor | African Journal of Social Sciences and Humanities Research

Death by suicide elicits reactions depending on one’s perception of the phenomenon or affiliation with the victim. In Nigeria, various motifs characterise the responses to the news of suicide deaths. … Death by suicide elicits reactions depending on one’s perception of the phenomenon or affiliation with the victim. In Nigeria, various motifs characterise the responses to the news of suicide deaths. Some of these reactions are based on religious sentiments and cultural taboos ascribed to such death. There is, however, a dearth of studies that examine the reactions or comments over the news on death by suicide, for most available research only focuses on the impact of this reportage. This study investigated the religious sentiments in the reactions to deaths by suicide as reported on digital media. A netnographic method was used, where 13 social media platforms and online newspaper sites were consulted to collate reports of death by suicide. The comments (164) to these reports were thematically categorised to determine their religious/theological outlook. These reactions were classified under the following themes: prayer to God, the role of God in tragedy, judgment and sin, and worldly and supernatural forces. These help to see that there are Nigerians who still hold and mediate their thoughts within a theological, religious, and/or spiritual lens in the face of a growing number of suicides among young people and adults.

Social Support and Suicide Ideation in Clinical and Community Adolescents

2025-06-24

Taylor Kalgren , Amy M. Brausch | Journal of Clinical Psychology

In the United States, over 3 million adolescents report suicide ideation, and ~800,000 attempt suicide each year (CDC 2021). Social support has repeatedly been identified as a protective factor for … In the United States, over 3 million adolescents report suicide ideation, and ~800,000 attempt suicide each year (CDC 2021). Social support has repeatedly been identified as a protective factor for suicide ideation in adolescent community samples. However, findings are mixed for adolescents in clinical samples. The current study examined associations between social support and suicide ideation in clinical and community adolescents with the intent to gain a comprehensive understanding of the potential buffering effects of social support. Sample 1 included 456 students from public middle and high schools, and Sample 2 included 100 adolescents from a children's crisis stabilization unit. A total of 47 (11%) participants in Sample 1 and 76 (78%) participants in Sample 2 reported lifetime suicide ideation. Both peer and parent support were significantly associated with lower lifetime suicide ideation severity in the community sample. However, no significant associations were found in the clinical sample. Our findings highlight the importance of social support as a buffer for suicide ideation in adolescents in community settings. Results highlighted the need for additional interventions for adolescents in clinical settings.

School Connectedness and Suicidal Ideation Among Black Youth: A Latent Class Analysis

2025-06-24

Danielle R. Harrell , Sonyia Richardson , Arielle H. Sheftall | School Mental Health

Suicidal behaviours among 13 to 15 year olds in four South East Asian countries – Trends and contributing factors

2025-06-24

Thach Tran , Hau Nguyen , Jane Fisher | Cambridge Prisms Global Mental Health

Pattern of emergency department presentations for deliberate self-harm at a tertiary care hospital in Pakistan: A cross-sectional study

2025-06-24

Nazish Imran , Qasim Qadeer , Suhail Niaz Khan Niazi +5 more | Australasian Psychiatry

Objective Deliberate self-harm (DSH) is a complex event with multitude of contributing factors. The emergency department has an essential role as first point of contact with patients who present with … Objective Deliberate self-harm (DSH) is a complex event with multitude of contributing factors. The emergency department has an essential role as first point of contact with patients who present with DSH. We aimed to determine the pattern of DSH presenting in emergency department of a tertiary care hospital in Pakistan. Method Following ethical approval, data including demographics, methods, reasons, and intent were collected for 6 months (January–June 2022) and analyzed using SPSS-26. Results 485 cases (53.2% males) with mean age of 29 years (SD ± 13.16), were included. More than half (55.4%) were married with urban predominance (81.9%). One-fourth of patients were housewives. The most frequent DSH method was ingestion of a poisonous substance (95.1%), followed by firearms (1.2%). Among ingested substances, intake of wheat pills (23.1%), corrosives/acid (11.5%), and bleach (10.3%) was frequent. Immediate triggers for DSH included family conflicts (16.3%), intent to put pressure on family (17.7%), financial reasons (11.3%), and to get out of a situation (7.2%). Twenty-two percent (106) people had an intent to die. There were almost three presentations of DSH per day. Conclusion Ingestion of poisonous substances, due to easy availability, highlights ongoing gaps that the policymakers can address to reduce the burden of DSH in Pakistan.

An update meta-analysis on the relationship between psychotic experiences and self-injurious thoughts and behaviors in children and adolescents

2025-06-24

Di Wang , Chenglei Wang , Ting Li +3 more | European Child & Adolescent Psychiatry

Nonsuicidal self-injury (NSSI) functions moderate the relationship between NSSI-specific cognitions and NSSI maintenance

2025-06-23

Yuya Iijima , Taisuke Katsuragawa , Hironori Shimada | Cogent Psychology

Technology, isolation, and drug use: a social network analysis of suicide risk

2025-06-23

Brenda García-Jarquín , Mario Aguilar-Fernández , Marco Antonio Sánchez-Medina +2 more | Frontiers in Education

The purpose of this study is to identify the most influential variables in suicide among students, based on studies conducted from 2019 to 2024. Given the increase in suicide rates … The purpose of this study is to identify the most influential variables in suicide among students, based on studies conducted from 2019 to 2024. Given the increase in suicide rates within this demographic group, 26 variables were identified, analyzed, and modeled in a social network. Indices of density, centrality, and closeness were used to assess the influence of each variable within the network. The results showed that the use of technologies, isolation, depression, and repeated exposure to traumatic experiences increase suicidal ideation and, therefore, the risk of suicide. These findings emphasize the need to develop multifaceted prevention programs tailored to student populations for more effective outcomes.

Refining measurement of suicide ideation to improve testability of suicide theories.

2025-06-23

Kirsten Christensen , Sarah E. Victor | Journal of Psychopathology and Clinical Science

Modern ideation-to-action suicide theories distinguish risk factors for suicide ideation (SI) from factors that move a person from SI to suicidal behavior. Effectively testing these theories requires valid measures of … Modern ideation-to-action suicide theories distinguish risk factors for suicide ideation (SI) from factors that move a person from SI to suicidal behavior. Effectively testing these theories requires valid measures of SI, which must be distinct from those measuring suicidal behavior itself or non-SI risk factors for suicidal behavior. Unfortunately, most SI measures fall short of these expectations. Prominent tools characterized as measures of SI often assess a wide range of experiences relevant to suicidal thoughts and behaviors, aggregated into a total score. These composite measures introduce noise into suicide-focused research, which hampers efforts to understand and predict suicidal thoughts and behaviors as distinct phenomena. Assessing non-SI risk factors for suicidal behavior within measures that purport to capture SI may yield improved prediction of suicidal behavior, but at the expense of construct validity and the necessary specificity to test modern suicide theories. Our recommendations focus on development, testing, and use of independent measures of SI, suicidal behaviors, and other risk factors for these experiences. We encourage researchers to be explicit regarding constructs captured in measurement of SI and related phenomena to ensure that suicide science is robust, replicable, and informative to both the testing of suicide theories and the implementation of suicide prevention efforts in clinical practice. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Family Socioeconomic Status and Adolescent Suicide: A Comparative Study of Immigrant and Non-Immigrant Adolescents in Sweden

2025-06-23

Shervin Assari , Mehdi Osooli , Henrik Ohlsson +2 more | Research Square (Research Square)

<title>Abstract</title> <bold>Objectives:</bold> While adolescents from high socioeconomic status (SES) backgrounds are generally protected against suicide, recent studies from the United States suggest that these effects may be weaker for marginalized … <title>Abstract</title> <bold>Objectives:</bold> While adolescents from high socioeconomic status (SES) backgrounds are generally protected against suicide, recent studies from the United States suggest that these effects may be weaker for marginalized populations, including immigrants—a pattern known as Marginalization-related Diminished Returns (MDRs). However, knowledge on the diminished returns of SES indicators on adolescent suicide among immigrants in European settings remains scarce. <bold>Aims:</bold> This longitudinal study examined the association between an SES summary score, along with four specific family SES indicators, and adolescent suicide (attempts or completions). It also compared these associations between immigrant and non-immigrant adolescents. <bold>Methods:</bold> Utilizing a retrospective cohort design, we analyzed data from nationwide registers in Sweden from January 2001 to December 2020, including immigrant and non-immigrant adolescents aged 12-18 years. Independent variables included an SES summary score (based on principal component analysis), parental education, parental employment, family income, and parental presence. The outcome was adolescent suicide, based on the Swedish national patient and mortality registers. Sex and study year served as confounders, and immigration status as a moderator. Cox regression models were employed for statistical analysis. <bold>Results:</bold> Higher SES summary scores, as well as individual SES indicators such as higher parental education, parental employment, higher income, and the presence of two parents in the family, were associated with a reduced risk of adolescent suicide. However, 12 statistically significant interactions indicated differential protective effects of these SES indicators. Nine of these interactions suggested weaker protective effects of SES indicators like parental education, parental employment, household income, and two parents in the family for immigrant adolescents compared to non-immigrant adolescents while three interactions suggested stronger effects of the SES indicators for immigrant adolescents. <bold>Conclusions:</bold>There is a need to investigate the societal and structural causes behind the differential protective effects of family SES against adolescent suicide in immigrant and non-immigrant families in Sweden. These results have implications for the prevention of adolescent suicide in intersectional groups based on SES and immigration. Clinical trial number: not applicable.

Feasibility and importance of universal suicide screening in a pediatric emergency department

2025-06-23

Steven C. Rogers , Shane J. Sacco , Kathryn A. Volz +4 more | PLoS ONE

Suicide is a leading cause of death in the United States. In 2018, the Joint Commission recommended screening patients for suicide risk in healthcare settings. Universal screening may increase the … Suicide is a leading cause of death in the United States. In 2018, the Joint Commission recommended screening patients for suicide risk in healthcare settings. Universal screening may increase the safety of at-risk youth, but is challenging for many pediatric emergency departments. We examined the feasibility and outcomes associated with universal suicide risk screening using a combination of two screening tools in a pediatric emergency department. This retrospective cohort study examined 10-18 year old patients presenting to a large, urban pediatric emergency department between September 2019 and August 2021. Key variables included patient demographic information, suicide risk screening results, and subsequent suicide attempts. There were 30,328 encounters in the pediatric emergency department over this two-year period. Screening was completed 84.8% of the time. Of the 17,332 unique patients screened, 83.9% were at minimal suicide risk, 7.0% low risk, 2.1% moderate risk, and 7.0% high risk. In the 6 months following screening, low-risk patients returning to the emergency department were 7.1 times likely to have a suicide attempt than minimal-risk patients, moderate-risk patients were 9.8 times likely, and high-risk patients were 15.5 times likely. Universal screening in a pediatric emergency department is feasible and informative. The combined screening tool protocol appeared to enhance efficiency while maintaining clinical accuracy. Universal screening identified a substantial proportion of pediatric emergency department patients at risk of subsequent suicide attempts, with the likelihood of a subsequent attempt strongly linked to increasing risk levels identified by screening.

The tripartite meaning model and suicidal desire: differential associations of purpose, mattering, and coherence in undergraduate and community samples

2025-06-23

David Manuel , Mikayla C. Pachkowski , E. David Klonsky | Current Psychology

FREE Live Webinar Psychotherapy Series: CAMS Approach to Suicidal Risk ‐ David A. Jobes, PhD, ABPP (Aug 13, 2025)

2025-06-22

| American Journal on Addictions

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SOS for School Staff Suicide Prevention Program: Perspectives of School Staff

2025-06-22

Rebecca G. Mirick | Evidence-Based Practice in Child and Adolescent Mental Health

An exploratory investigation of psychologist approaches to and experience with client suicidality

2025-06-22

Peck Jin Gan , Nadine Pelling , Kurt Lushington | Australian Psychologist

Locating Meaning: Health Professionals’ Views on the Psychological and Clinical Significance of Self-Injury Sites

2025-06-21

Kathryn Jane Gardner , Rachel E. Smith , Gillian Rayner +6 more | International Journal of Environmental Research and Public Health

Background: This study explored how health professionals construct clinical and psychological meaning based on the location of self-injury on the body, particularly in relation to concealed or visible injuries and … Background: This study explored how health professionals construct clinical and psychological meaning based on the location of self-injury on the body, particularly in relation to concealed or visible injuries and how they might inform attributions about risk, self-injury functions, and distress. Methods: This study used qualitative thematic analysis of semi-structured interviews with 19 health professionals with experience working with self-injury, exploring perceptions and attributions about self-injury in different body locations. Results: Seven themes emerged. In some cases, staff’s attributions aligned with the findings from studies of those who self-injure, such as injuries to areas such as the neck are higher risk. Location was one factor among others, such as injury severity, that staff considered when assessing the risk of infection or suicide. Staff often viewed visible injuries as less risky and attributed them to interpersonal communicative functions, and concealed injuries to intrapersonal factors, though not all staff shared these perspectives. Some staff considered other potential drivers of injury location, including past experiences such as trauma, demographic factors, mental health diagnoses, and exposure to social influences. Some staff described the practical determinants of injury location, such as ease of access, and considered the impact of self-injury location on themselves and their colleagues. Conclusions: Injury location can influence staff perceptions of risk, self-injury functions and distress, underscoring the need for individualized assessment and formulation of each self-injury episode to ensure appropriate risk management. Staff training should be adapted to address injury location to improve understanding, raise awareness of related attributions, and enhance the development of clinical skills. Organizations should support staff in their role due to the potential emotional impact of working with individuals who self-injure and are at risk of suicide. Future research should investigate whether location-based attributions are associated with unintended clinical consequences, such as inaccuracies in risk assessment and formulation.

Adolescent weight status, perceived closeness to others, and past year suicide consideration and attempts

2025-06-21

Megan A. Milligan , Katherine M. Kidwell | Clinical Child Psychology and Psychiatry

Purpose The present research leveraged a nationally representative dataset to examine between-group differences in adolescent suicide consideration and attempts by weight status and perceived closeness to others. Findings Adolescents with … Purpose The present research leveraged a nationally representative dataset to examine between-group differences in adolescent suicide consideration and attempts by weight status and perceived closeness to others. Findings Adolescents with overweight and obesity were more likely to report past year suicide consideration (1.54x and 1.43x as likely) and attempts (1.74x and 1.59x as likely) compared to adolescents with healthy weight. A significantly smaller proportion of adolescents with obesity endorsed closeness to others at school compared to adolescents with healthy weight. Adolescents who felt close to others were less likely to report either suicidal ideation or attempts, regardless of weight status. Compared to the healthy weight group, significantly higher proportions of adolescents with overweight or obesity endorsed attempting suicide, both among adolescents who felt close to others, X 2 (2) = 14.76, p = .001, n = 4773, and those who did not, X 2 (2) = 18.58, p < .001, n = 2859. Conclusions Adolescents with overweight and obesity were more likely to consider and attempt suicide relative to those with healthy weight, regardless of perceived closeness to others. Perceived closeness was associated with lower likelihood of suicide consideration and attempts among all weight groups. Further investigation may clarify the prospective utility of social closeness for adolescent suicide risk reduction, especially among those with overweight/obesity.

IRIDOLOGICAL MARKERS IN THE DIAGNOSIS OF SUICIDAL RISK: A PROMISING METHOD FOR FORENSIC MEDICAL EXAMINATION

2025-06-21

Iskandarov A.I. , Yadgarova Sh.Sh. , Nasriddinov S.Z. | European Journal of Technical and Natural Sciences

The association between nonsuicidal and suicidal self-injurious behaviors: A systematic review and expanded theoretical model

2025-06-20

Brooke A. Ammerman , Taylor A. Burke , Caitlin M. O’Loughlin +1 more

Nonsuicidal self-injury (NSSI) is one of the strongest predictors of suicidal behavior. Despite this, the field still has a limited understanding of the mechanisms by which this relationship is conferred. … Nonsuicidal self-injury (NSSI) is one of the strongest predictors of suicidal behavior. Despite this, the field still has a limited understanding of the mechanisms by which this relationship is conferred. As there has been a proliferation of research in this area over the past decade, an updated systematic review of the empirical research examining potential factors driving the relationship between NSSI and suicide-related outcomes is needed to move the field forward. We identified only 18 studies examining moderators or mediators of the relationship. Research to date does little to improve our understanding of the robust, prospective relationship between NSSI and suicide outcomes, highlighting a foundational gap in both the empirical and theoretical literature. Thus, we propose the Nonsuicidal to Suicidal Self-Injury Pathway Model, an expanded theoretical model of this relationship drawing on extant theory and empirical research, as well as discuss future directions for work in this area.

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Mental health and substance use clinical risk factors associated with emergency department and emergency medical services involvement among decedents of suicide by poisoning

2025-06-20

J. Priyanka Vakkalanka , Victor A. Soupene , Azeemuddin Ahmed +1 more | Injury Prevention

Objective To examine mental health and substance use dependence (MH/SUD) clinical risk factors for emergency medical services (EMS) or emergency department (ED) involvement among decedents of suicides by poisoning. Methods … Objective To examine mental health and substance use dependence (MH/SUD) clinical risk factors for emergency medical services (EMS) or emergency department (ED) involvement among decedents of suicides by poisoning. Methods We used a multiyear cross-sectional study design (2013–2021) to identify single suicides by poisoning within the National Violent Death Reporting System. MH/SUD risk factors assessed included the history of attempting suicide, history of MH/SUD conditions and treatment and current MH/SUD condition recognition and treatment. We tested each MH/SUD risk factor for associations with EMS or ED involvement as outcomes using logistic regression, and whether urban/rural residency modified these relationships. Findings Of the 31 237 suicide decedents identified, 86.5% of decedents had EMS involvement and 22% had ED involvement. MH/SUD clinical risk factors associated with EMS involvement included current MH problem (aOR 1.15; 95% CI 1.07 to 1.30) and some evidence of increased history of attempted suicide (aOR 1.10; 95% CI 0.99 to 1.21) and current SUD problem (aOR 1.10; 95 CI 0.99 to 1.23). MH/SUD clinical risk factors associated with ED involvement included history of both attempting suicide (aOR 1.20; 95% CI 1.11 to 1.30) and MH/SUD treatment (aOR 0.80; 95% CI 0.74 to 0.86). Rural areas had lower EMS involvement (aOR 0.73; 95% CI 0.66 to 0.80) but higher ED involvement (aOR 1.09; 95% CI 1.01 to 1.18); however, there was no evidence of effect modification by rurality. Conclusions Individuals with MH/SUD risk factors, especially prior suicide attempts, are more likely to require first responder involvement. Additionally, rural areas show some unique patterns in EMS and ED involvement that should be considered in public health and emergency medical planning.

Demographic Characteristics Influencing Knowledge Regarding Resources Available for Prevention of Suicide among College of Medical Science Students at the University of Guyana

2025-06-20

Obena Vanlewin , Andrew Hutson , Charlan Abrams +2 more | Asian Journal of Medicine and Health

Background: Suicide remains a pressing global public health issue, particularly as the second leading cause of death among 15–29-year-olds. Family structure and geographical location are hypothesized to impact awareness, knowledge, … Background: Suicide remains a pressing global public health issue, particularly as the second leading cause of death among 15–29-year-olds. Family structure and geographical location are hypothesized to impact awareness, knowledge, and access to suicide prevention resources, influencing overall mental health literacy. Subjects: This study involved 243 students from the College of Medical Science at the University of Guyana. The sample was predominantly female (83.5%), with a mix of undergraduate (81.5%) and postgraduate students. Methods: An analytical cross-sectional survey using a modified suicide knowledge and skills questionnaire was employed to examine the relationships between residence type (rural, suburban, urban), parental marital status (married/living together vs. other), and knowledge of suicide resources, as assessed by a 5-point Likert Scale. Data was analyzed using chi-square tests and Fisher's Exact Test, with post-hoc power analysis. Results: A statistically significant association was found between parental marital status and knowledge of resources (p = .005). Participants with parents not married or living together showed a trend toward greater knowledge of resources. There was a marginally significant association between residence type and knowledge of resources (p = .055). Conclusion: These findings underscore the intricate factors influencing mental health literacy in the Caribbean, specifically in Guyana. Interventions aimed at suicide prevention should be culturally tailored to address the unique needs of students from diverse family and residential backgrounds and should address the potential influence of cultural stigma. Further research is needed to explore the reasons behind the unexpected relationship between parental marital status and resource knowledge.

Harming In Order To Help: An Empirical Characterization of Prosocial Aggression

2025-06-20

Samuel J. West , Gregory John Depow , Drew M. Parton +1 more

People sometimes inflict harm with the intent to help the very target of their aggression. Across six studies (N=1,527), we examined the nature of such prosocial aggression. Many participants believed … People sometimes inflict harm with the intent to help the very target of their aggression. Across six studies (N=1,527), we examined the nature of such prosocial aggression. Many participants believed that altruistically-motivated aggression exists and exhibited a self-serving bias in which most believed their aggression was more altruistic than others’ — beliefs that were linked to greater antisocial and prosocial traits. Translating these beliefs to behavior, participants were often prosocially-aggressive when given the chance — inflicting more harm when their aggression could also help (versus only hurt) the target. Such prosocial aggression also exhibited features of both aggression (i.e., it was positively correlated with dispositional aggressiveness) and altruism (i.e., it was preferentially doled out to people who had been previously kind to participants and even when it was personally costly to do so). We also independently varied the amount of harm and help that prosocial aggression provided, revealing that participants sought to maximize the help and minimize the harm done to people who had been kind to them but not towards those who had provoked them. Our findings argue against models that conceptualize harm- and help-based motives as opponent processes, showing that these motives readily coexist and dynamically interact to shape aggressive behavior — even towards the same target.

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PSYCHOLOGICAL ANALYSIS OF SUICIDE RISK FACTORS AMONG YOUTH

2025-06-20

Məhərrəm Əliyev | Elmi əsərlər.

Youth suicide is a pressing global issue, with rates steadily increasing across various societies. Youth is a critical development period characterized by significant psychological, emotional, and social changes, often making … Youth suicide is a pressing global issue, with rates steadily increasing across various societies. Youth is a critical development period characterized by significant psychological, emotional, and social changes, often making youth particularly vulnerable to suicidal ideation and behavior. This essay delves deeply into the psychological risk factors for youth suicide, integrating theoretical perspectives and empirical studies to provide a comprehensive framework for understanding and addressing this issue.

Depression and non-suicidal self-injury: the mediating roles of childhood trauma and impulsivity

2025-06-20

Wenjing Su , Hao Liu , Xiaoyan Zhou +1 more | Frontiers in Psychiatry

Background This study investigates the factors contributing to non-suicidal self-injury (NSSI) in individuals with depressive disorders, with a focus on how childhood trauma and impulsivity may function as mediating mechanisms. … Background This study investigates the factors contributing to non-suicidal self-injury (NSSI) in individuals with depressive disorders, with a focus on how childhood trauma and impulsivity may function as mediating mechanisms. The findings aim to establish a theoretical framework that enhances clinicians’ ability to assess suicide-related risks in this population more accurately and promptly. Methods This cross-sectional study enrolled patients diagnosed with depression who were hospitalized at Chongqing Mental Health Center between June 2019 and November 2021. All participants completed self- report questionnaires assessing demographic characteristics, NSSI behaviors, depression, anxiety, childhood trauma, impulsivity, family environment, parenting, and experiences in close relationships. Participants were divided into two groups based on NSSI behavior: the NSSI group and the non-NSSI group. Results A total of 265 patients were included, 26.79% of whom were male. The NSSI group consisted of 150 patients (mean age = 17.50 ± 3.88 years), while the non-NSSI group included 115 patients (mean age = 23.06 ± 6.92 years). Binary logistic regression analysis identified several factors significantly associated with NSSI in patients with depression: gender (OR = 2.254, 95% CI: 1.083–4.693, P = 0.03), age (OR = 0.776, 95% CI: 0.708–0.851, P &lt; 0.001), number of hospitalizations (OR = 1.747, 95% CI: 1.128–2.705, P = 0.012), suicide attempts (OR = 14.131, 95% CI: 4.023–49.64, P &lt; 0.001), relationship duration (OR = 1.031, 95% CI: 1.009–1.045, P = 0.005), anxiety (OR = 1.03, 95% CI: 1.006–1.054, P = 0.015), sexual abuse (OR = 1.158, 95% CI: 1.036–1.294, P = 0.01), and negative thoughts (OR = 3.108, 95% CI: 1.101–8.774, P = 0.032). In addition, childhood trauma and impulsivity were found to partially mediate the relationship between depressive symptoms and NSSI, accounting for a total indirect effect of 20.52%. Conclusions This study identifies multiple factors contributing to NSSI among individuals with depression. Notably, childhood trauma and impulsivity partially mediate the relationship between depressive symptoms and NSSI. These findings offer valuable insights for developing targeted prevention and intervention strategies to address NSSI in this population.

Why do suicide rates increase in the spring and decrease in the fall? Insights from an empirical evaluation of Stengel's social hypothesis on suicide

2025-06-20

James Christopher Wiley

<title>Abstract</title> In 1952, the psychiatrist Erwin Stengel hypothesized that suicide becomes rarer in times when the value of life within a society is lower, when death is more common. In … <title>Abstract</title> In 1952, the psychiatrist Erwin Stengel hypothesized that suicide becomes rarer in times when the value of life within a society is lower, when death is more common. In Canada, suicide rates and death rates present with consistent seasonality between years, fluctuating inversely with one another. However, the typical pre-pandemic seasonality seen in death rates was broken during the first year of the COVID-19 pandemic, as a consequence of inordinate deaths occurring at an odd time of year. This offers a unique opportunity to observe whether suicide rates were inversely disrupted. The present study models weekly Canadian suicide rates using death rates, from time series data spanning 2010 to 2019. Results indicate that suicide rates decrease on average by 0.27 standard deviations per 1 standard deviation increase in the death rate. This model is then used to predict 2020 suicide rates, using 2020 death rates. Predictions account for 11.6% of the variation in actual 2020 suicide rates. Furthermore, actual 2020 suicide rates display a negative disruption at the same time as the 2020 death rate positive disruption, and this suicide rate disruption is mimicked by our model predictions. Overall, results are interpreted as being favorable towards Stengel’s theory. As alternative interpretation, we suggest that each non-suicide-related death removes a potential suicide from the population. Overall analysis suggests that elevated death rates during colder seasons are driven by increased communicable disease transmission relative to warmer seasons, resulting in suppressed suicide rates.

Use of childhood adversity and mental health admission patterns to predict suicide in young people

2025-06-20

Anna Tarasenko , Dennis Ougrin | BJPsych Open

Summary Dougall et al found that mental health admissions are a strong predictor of suicide risk in young people. The findings can improve machine learning models for predicting suicide risk. … Summary Dougall et al found that mental health admissions are a strong predictor of suicide risk in young people. The findings can improve machine learning models for predicting suicide risk. Limitations of machine learning models include recent changes in healthcare use patterns during the COVID-19 pandemic and poor long-term predictive value.

The role of parenting styles and depression in predicting suicidal ideation vulnerability among university students

2025-06-20

Mai Hassan , Soma Ali , Amal Sobhy Mahmoud +2 more | BMC Nursing

Abstract Background Parenting practices are relevant in shaping children’s psychological development, and positive parenting tends to be associated with positive outcomes. These practices significantly affect adolescents’ mental health by influencing … Abstract Background Parenting practices are relevant in shaping children’s psychological development, and positive parenting tends to be associated with positive outcomes. These practices significantly affect adolescents’ mental health by influencing depression, suicidal behaviours, and attitudes towards suicide. Aim To examine the predictive role of parenting styles and depression in vulnerability to suicidal ideation among university students. Methods A descriptive correlational study was conducted with 480 university students recruited using stratified multistage cluster sampling from the Faculty of Health Sciences (Medicine and Nursing), Mathematical Sciences (Engineering and Computer Science), and Human Sciences (Arts and Commerce) at Port-Said University. The instruments used for data collection included the Parenting Styles and Dimensions Questionnaire (PSDQ), Beck Depression Inventory, Morey Suicidal Ideation Scale (SUI), and a sociodemographic data sheet. Statistical analysis included Spearman correlation, non-parametric tests, and mediation analysis to explore the direct and indirect relationships. Results Participants’ ratings ranged from moderate levels of depression (13.85 ± 7.68) to suicidal ideation (10.20 ± 5.32). In this regard, participants provided higher ratings for the scores of authoritative parenting reported by both mothers and fathers, with mean scores of 48.61 ± 10.59 and 45.96 ± 10.34, respectively. Suicidal ideation was somewhat negatively related to parenting style ( p < 0.001), and there was a negative relationship between depression and the maternal parenting style ( p < 0.0001). In contrast, depression was positively correlated with suicidal ideation ( p < 0.01). Conclusion The study concluded that Parenting styles significantly influence university students’ mental health. Warmth combined with structure in parenting, which is authoritative parenting, is associated with lower levels of depression and suicidal ideation. These findings suggest that promoting positive parenting practices may foster students’ mental well-being. Clinical trial No clinical trial.

Reducing non-suicidal self-injury in Chinese adolescents through Imagery Communication Psychotherapy

2025-06-19

Renhui Lyu , Shenghong Zhang , Yu Mao +1 more | Journal of Psychologists and Counsellors in Schools

Non-suicidal self-injury (NSSI) among young people remains a challenging public health problem, affecting approximately 20% of middle school students in China. NSSI is strongly correlated with psychological distress and functional … Non-suicidal self-injury (NSSI) among young people remains a challenging public health problem, affecting approximately 20% of middle school students in China. NSSI is strongly correlated with psychological distress and functional impairments and has been shown to significantly increase the risk of subsequent self-harm, suicide attempts and mental health disorders in early adulthood. Difficulties in expressing and regulating emotions are often a key maintaining factor in NSSI. This study investigated the effectiveness of a 10-week group intervention based on Imagery Communication Psychotherapy (ICP) for 16 Chinese middle school adolescents (5 boys and 11 girls, aged = 12–14 years) with NSSI. Structured imagery and related exercises were developed to promote emotion expression and regulation. Results showed that participants reported significant reductions in NSSI, negative affect and overall emotional regulation difficulties. These findings provide preliminary evidence for the efficacy and feasibility of group-based ICP for adolescents with NSSI. Given the unique benefits of ICP for the awareness, expression and transformation of negative emotions, the integration of imagery techniques to improve emotion regulation in the treatment of NSSI is promising. Further research employing randomised controlled trials with larger cohorts is required to establish intervention efficacy and cultural generalisability.

Association Between Suicide-Related Outcomes and Primary Care Outpatient Visits: Impact of Mental Health Screening and Interventions

2025-06-19

Abayomi Adebayo , Chekwube M Obianyo , Kemi Johnson +7 more | Cureus

Long-term Alteration of Heart Rate Variability following Childhood Maltreatment: Results of a General Population Study

2025-06-19

Martin Stürmer , Johanna Klinger-König , Marcus Vollmer +7 more | European Psychiatry