Psychosocial and financial well-being mediated the effects of COVID-19 distress on suicidality: a serial mediation model among Hong Kong young adults.

PURPOSE: The COVID-19 pandemic has brought significant distress on not only the physical health but also mental health of individuals. The present study investigated the direct and indirect effects from COVID-19 distress to suicidality via psychosocial and financial well-being among young people. METHODS: This cross-sectional survey recruited 1472 Hong Kong young people via random sampling in 2021. The respondents completed a phone survey on COVID-19 distress, the four-item Patient Health Questionnaire and items on social well-being, financial well-being, and suicidality. Structural equation modeling (SEM) was conducted to examine the direct and indirect effects of COVID-19 distress on suicidality via psychosocial and financial well-being. RESULTS: The direct effect of COVID-19 distress on suicidality was not significant (ß = 0.022, 95% CI - 0.097-0.156). The total indirect effect from COVID-19 distress to suicidality was significant and positive (αßγ = 0.150, 95% CI = 0.085-0.245) and accounted for 87% of the total effect (B = 0.172, 95% CI = 0.043-0.341). There were significant specific indirect effects via social well-being and psychological distress, and financial well-being and psychological distress. CONCLUSION: The present findings support different pathways from COVID-19 distress to suicidality via functioning in different domains among young people in Hong Kong. Measures are needed to ameliorate the impact on their social and financial well-being to reduce their psychological distress and suicidality.

Risk Assessment Suicidality Scale (RASS)-Based On-Line Calculator Targeting Early Prevention of Suicides in General Population: from COMET-G Study Results Towards Integration of the Screening Tool into Routine Clinical Practice.

BACKGROUND: Suicide is a major global health concern, particularly among young people. This study evaluates an online suicide risk calculator based on the Risk Assessment of Suicidality Scale (RASS), which is designed to enhance accessibility and early detection of suicide risk. METHODS: The study involved 444 participants who completed the RASS via an online calculator. Results were compared with data from the COMET-G study's Russian sample (n=7572). Descriptive statistics, correlation analysis, and two-way ANOVA were used to analyze the data. RESULTS: The mean age of participants was 22.71 years (SD=7.94). The mean total RASS standardized score was 837.7 (SD=297.8). There was a significant negative correlation between age and RASS scores (r=-0.463, p<0.0001). The online calculator sample showed significantly higher RASS scores compared to the COMET-G sample, with 71% of online users scoring above the 90th percentile of the COMET-G sample. CONCLUSION: Our study demonstrated the advantage of the on-line suicidality risk calculator based on the RASS scale as a sensitive tool in detecting suicidal behaviours and measuring the severity of suicidality risks, offering a capability for broad reach and immediate assessment during clinical conversation between doctor and patient. Moreover, the RASS on-line psychometric instrument, when being freely distributed among the general population over internet sources, enabled to attract vulnerable groups of respondents with significantly higher suicidality risks. Future research should focus on integrating such tools into comprehensive suicide prevention programs and developing appropriate follow-up monitoring strategies for high risk-cases.

A Study of the Characteristics of Suicide Notes in China.

Background: Suicide notes in China are rarely studied and seldom available. Aims: This study examines the characteristics of suicide note leavers and analyzes the contents of their suicide notes for the period of 2004-2016 in Pudong, Shanghai, which has more than 5.5 million inhabitants. Method: The characteristics of the note leavers (n = 458) and those who left no notes (n = 1949) were compared. Four major groupings of the suicide note content were identified, namely, addressees, mandates/requests, expressions, and difficulties. Results: Only 19.0% of the deceased left suicide notes and they were characterized by having no diagnosed psychiatric illnesses, being in debt, having a high education level, having made no previous suicide attempts, and having used suicide methods that required preparation. Wanting to hide their suicide information was not uncommon for these individuals (9.7%). Adolescents were likely to mention a negative interpersonal relationship with someone (27.4%). Illnesses/pain was frequently mentioned by adults (33.4%) and older people (61.5%). Limitations: Many features of suicide notes, e.g., interpersonal features of suicides, were not examined. Conclusion: Education level might be a key factor influencing the likelihood of leaving suicide notes. Most people who left suicide notes showed a negative attitude toward suicidal behavior. The myth of an afterlife should also be addressed.

Neurocognitive vulnerability to youth suicidal behavior.

Neurocognitive deficits have been associated with suicidal behavior in adults with major depressive disorder (MDD), but it is unclear if similar impairments are linked to youth suicidal behavior. This study compared neurocognitive functioning in suicidal and non-suicidal youth with a lifetime history of MDD and explored whether neurocognitive functioning predicted future suicide attempts. Neurocognition was examined using the Cambridge Neuropsychological Test Automated Battery (CANTAB) and Iowa Gambling Task (IGT) in 309 youths ages 12-15 (117 suicide attempters; 132 suicidal ideators; 60 never-suicidal). Prospective analyses included 284 youths (41 youth with a future attempt; 243 without a future attempt). Multivariate analysis of variance (MANOVA) yielded a significant group-by-sex interaction effect [Wilks' Λ = 0.901, F (16, 560) = 1.87, p = .021] for the primary neurocognitive outcomes, guiding the decision to stratify the sample by sex. Female suicide attempters and ideators were slower to respond correctly to both positive and negative emotion words than never-suicidal controls on tests of affective bias. Male suicide attempters and ideators made significantly more total and between errors than never-suicidal subjects. Exploratory analyses found that total commission errors on the Affective Go/No-Go (AGN) test significantly predicted future suicide attempts in females, and that higher strategy scores on Spatial Working Memory (SWM) tests predicted future male attempts. Study findings identified sex-specific neurocognitive deficits that differentiate suicidal and non-suicidal youth with histories of MDD. Extended longitudinal studies are needed to elucidate the temporal association between neurocognitive impairments and suicidal behavior and frame targets for early preventive interventions.

Characteristics and Precipitating Circumstances of Suicide Among Incarcerated Youth.

OBJECTIVE: Studies show incarcerated youth are at increased risk for suicidal behavior, yet little is known about factors associated with suicide for this population. Using a nationally representative sample, this study examined characteristics and precipitating circumstances of suicide in incarcerated youth decedents compared with youth suicide decedents in the general population. METHOD: Data were analyzed for suicide decedents 10- to 24-years-old (N = 10,126) in the United States from 2003 through 2012 from the National Violent Death Reporting System. Logistic regression compared precipitating circumstances of suicide for incarcerated youth decedents and those not in custody. Details on suicide deaths in detained youth were captured from coroner/medical examiner and law enforcement reports associated with each incident. RESULTS: Most youth suicide decedents were older, white, and male regardless of incarceration status. Incarcerated youth suicide decedents were more likely to die by hanging, strangulation, or suffocation and less likely to disclose suicide intent, leave a suicide note, or exhibit depressive symptoms compared with those not in custody. Additional risk factors for suicide were not significantly different between youth decedents in custody and those not in custody, suggesting that unique aspects of the incarceration environment could be associated with an increased risk of suicide. CONCLUSION: Study findings highlight the need for early suicide risk detection and developmentally relevant interventions tailored for youth in correctional settings. Future efforts should include evaluation studies to support suicide prevention programs designed for incarcerated youth and research that examines distinctive factors associated with suicidal behavior in youth in custody.