Predicting potential underreporting of firearm ownership in a nationally representative sample.

PURPOSE: This study utilized demographic and intrapersonal variables to identify individuals who may have falsely denied firearm ownership and determined if individuals can be divided into meaningful subgroups. METHODS: Participants were United States residents (N = 3500) recruited from January to June 2020. matched to the 2010 census data for age, race, sex, income, and education level. A Zero-Inflated Negative Binomial (ZINB) regression was utilized to determine potential underreporting of firearm ownership, and a latent class analysis was utilized to determine unique subgroups of those who were identified as underreporting firearm ownership in the ZINB. RESULTS: Participants (N = 1306) were identified as underreporting firearm ownership (excess zeros) based on a model that included demographic and intrapersonal variables. A latent class analysis indicated that among excess zeros, three unique subgroups exist. CONCLUSIONS: Determining who may be underreporting firearm ownership will allow for a more comprehensive understanding of firearm ownership in the US and more targeted safe storage messages that may reach those who own firearms and are at risk for firearm-related injury and death.

Difficulties with emotion regulation within PTSD clusters and moral injury subtypes.

Treatment and research centered on trauma-related mental health issues have largely focused on posttraumatic stress disorder (PTSD); however, moral injury is another important mental health concern requiring attention. There is a paucity of research examining how PTSD and moral injury affect emotion regulation. The current investigation examined how PTSD clusters and moral injury subtypes were uniquely associated with difficulties with emotion regulation. Participants consisted of 253 previously deployed military personnel who were recruited online. To be included in the study, participants had to verify that they had served in the U.S. Military, had been deployed as part of their military service, and endorsed elevated levels of symptoms associated with PTSD and/or moral injury. A hierarchical linear regression was conducted to examine the association between PTSD symptom clusters, moral injury subtypes, and difficulties with emotion regulation. Results indicated that alterations in arousal and reactivity was the only PTSD symptom cluster associated with difficulties with emotion regulation. Self-transgressions was the only facet of moral injury significantly associated with difficulties with emotion regulation. This is the first study to examine the association between emotion dysregulation, PTSD symptom clusters, and moral injury in previously deployed U.S. Military.

The associations between sport- and physical activity-related concussions and suicidality, suicide capability, and hopelessness among high school adolescents.

BACKGROUND: Concussions are associated with a variety of physical, cognitive, and mental health impairments. If sustained during adolescence, a time when the brain is undergoing development, the risk of long-term impairments becomes heightened. This is a notable subject for investigation as many concussions are sustained among adolescents during high school sports and other physical activities. METHODS: We used data from the 2019 United States Youth Risk Behavior Survey to investigate the association between concussions and suicidality (i.e., suicide ideation, planning, and attempts), suicide capability (i.e., physical fighting and weapon carrying), and hopelessness, a risk factor for suicide. We utilized a cross-sectional design and used multivariate regression models and t tests for analysis. RESULTS: Participants were 1754 adolescent students who sustained a concussion during the prior year (54.61% male; M age = 15.94) and 9795 adolescent students who did not sustain a concussion during the prior year (47.27% male; M age = 15.95). Females were less likely (13.23%) than males (17.12%) to report at least one concussion in the past 12 months. Both male and female students who had experienced a concussion were more likely to report physical fighting, weapon carrying, and hopelessness. Male students with a concussion history were also more likely to report suicide attempts than male students without a concussion history. CONCLUSION: Findings indicate that concussions are associated with an increased risk of suicide attempts, suicide capability, and hopelessness among male adolescents and suicide capability and hopelessness among female adolescents. They further suggest a need for additional mental health support and safety policies for student-athletes and other at-risk adolescents.

Demographic differences in the type of firearm and location of bodily injury in firearm suicide decedents.

This study describes the type of firearm used and location of bodily injury among demographic subgroups of suicide decedents. Data on those who died by suicide via firearm from the National Violent Death Reporting System (N = 117,126) between the years 2003-2018 was utilized. A series of five logistic regression analyses examining the age of decedent, type of firearm, location of wound site, loaded vs. unloaded firearms, and locked vs. unlocked storage, using predictors including gender, race, who owns the firearm and age were performed. Findings have important public health implications. Increasing safe storage or removing the specific types of firearms one is likely to use in their death from the home during a time of crisis may decrease risk of suicide.

A preliminary assessment of the link between anxiety sensitivity cognitive concerns and suicidal thoughts through dissociative symptoms.

Anxiety sensitivity (AS) and AS subfactors (physical, cognitive, and social) have been found to have robust associations with suicide risk. While the direct association between AS subfactors and suicide risk have been explored, little is known about how specific mechanisms, such as dissociation, might explain this relationship. This study aimed to run three analyses to examine the direct and indirect effects of suicidal thoughts and AS via dissociative symptoms. We predicted that dissociation would be a pathway through which AS physical concerns (ASPC) and AS cognitive concerns (ASCC) predicts suicidal ideation. Participants included 84 undergraduate students from a Southeastern University who were elevated on ASCC. Participants completed measures examining dissociative experiences, anxiety sensitivity, and current suicidal ideation. Results revealed that dissociation had a significant indirect effect with ASPC but not ASCC. The current preliminary study showed that ASCC had direct associations with suicide risk; however, those with lower levels of ASPC and dissociation may also be more likely to develop suicide risk. Future research should explore the possibility that the dissociation/ASPC and ASCC pathways are separate, but related, paths to suicidality.

Lethal Means Counseling, Distribution of Cable Locks, and Safe Firearm Storage Practices Among the Mississippi National Guard: A Factorial Randomized Controlled Trial, 2018-2020.

Objectives. To examine whether lethal means counseling and provision of cable locks prompt safe firearm storage relative to control among firearm-owning members of the Mississippi National Guard.Methods. This randomized controlled trial utilized a 2 × 2 factorial design (lethal means counseling vs control, provision of cable locks vs no cable locks). Follow-up assessments took place at 3 and 6 months after baseline. Data were collected (n = 232; 87.5% male; mean age = 35.01 years; 77.2% White) from February 2018 through July 2020.Results. Relative to control, lethal means counseling and provision of cable locks resulted in greater adoption of several safe storage methods over time. Lethal means counseling outperformed control (3 months: 55.0% vs 39.0%; odds ratio [OR] = 1.91). Cable locks outperformed control at 3 and 6 months on number of storage methods (1.41 vs 1.11; d = 0.29 and 1.34 vs 1.16; d = 0.15, respectively) and locking devices (59.8% vs 29.9%; OR = 3.49 and 58.4% vs 35.8%; OR = 2.52, respectively)Conclusions. Lethal means counseling and cable locks can result in sustained changes in firearm storage.Public Health Implications. The military may benefit from lethal means counseling, perhaps administering at point of entry.Trial Registration. Clinical Trials.gov identifier: NCT03375099.

Expanding Fear of Loss of Vigilance: Intolerance of Uncertainty, Responsibility for Harm, and Fear of Sleep for Predicting Nocturnal Panic.

OBJECTIVE/BACKGROUND: Nocturnal panic involves experiencing panic attacks out of a sleeping state without obvious causes. Roughly half of patients with panic disorder will experience nocturnal panic in addition to panic attacks while awake, or daytime panic. Like daytime panic, nocturnal panic also occurs in other disorders such as PTSD. The Fear of Loss of Vigilance theory is currently the only model available to explain nocturnal panic. It suggests nocturnal panickers fear states in which they cannot easily react to or protect themselves from danger. The current study sought to expand upon the existing theory by including constructs from the broader anxiety literature. Nocturnal panickers were expected to report higher scores on these measures when compared to daytime panickers and non-panickers. PARTICIPANTS: A sample of 166 participants were screened for panic history. METHODS: Participants completed self-report measures regarding panic attacks, fear of sleep, intolerance of uncertainty, responsibility for harm, and fear of loss of vigilance. RESULTS: Measures of fear of sleep and responsibility for harm successfully differentiated nocturnal from daytime panickers, whereas measures of intolerance of uncertainty and fear of loss of vigilance did not. CONCLUSIONS: These results provide partial support for the Fear of Loss of Vigilance theory. Modifications to the theory to incorporate additional constructs are suggested.

Understanding hazardous drinking and suicidal ideation and suicide risk among college students: anxiety sensitivity as an explanatory factor.

Suicide is a leading cause of death among college students. Although previous work indicates that the (hazardous) use of alcohol contributes to suicidal ideation/risk, little work has examined potential underlying explanatory factors. One example is anxiety sensitivity (AS). The current study evaluated whether AS explains associations between hazardous drinking and suicidal ideation and risk among college students. Data from racially/ethnically diverse students (N = 1,206; 76.7% non-White; Mage = 22.13) were analyzed. Hazardous drinking was a significant predictor of suicidal ideation (p < 0.001) and risk (p < 0.001). There were significant indirect associations of hazardous drinking via AS with both ideation (b = 0.07, 95% CI [0.05, 0.10]) and risk (b = 0.04, 95% CI [0.03, 0.06]); AS explained a significant portion of variance in both associations (42.6-51.4%). AS cognitive concerns (but not physical or social concerns) contributed significantly to the explanatory pathways. Students who engaged in hazardous drinking were also greater than twice as likely to screen positive for suicide risk (p < 0.001). The findings suggest that AS, particularly cognitive concerns, partially accounts for the associations between hazardous drinking and suicidal ideation/risk. Hazardous drinking may exacerbate AS which, in turn, may influence suicidal ideation and risk; however, results need to be replicated with longitudinal data.

Evaluating the Positive Drinking Consequences Questionnaire: Support for a Four-Factor Structure and Measurement Invariance.

The 14-item Positive Drinking Consequences Questionnaire (PDCQ) was developed to assess experienced positive drinking consequences. The present study sought to advance the psychometric evaluation of the PDCQ via exploratory and confirmatory factor analyses, measurement invariance, criterion-related validity, and internal consistency. Participants were 1,088 traditional-age college students (81% female) who reported drinking in the past month. Exploratory factor analysis supported a four-factor model (i.e. Sociability, Tension Reduction, Liquid Courage, and Sexual Enhancement), and the confirmatory factor analysis indicated the four factors loaded on a higher-order factor ("PDCQ"). Invariance testing supported invariance for the PDCQ across gender. The PDCQ was positively associated with alcohol use and alcohol-related negative consequences, and negatively associated with protective behavioral strategies. Finally, the four factors of the PDCQ were discriminant from positive expectancies. Collectively, positive drinking consequences appear to be more nuanced than originally conceptualized. Evaluation of specific types of positive drinking consequences may assist in more precise prevention and intervention efforts in the future.

Treatment Seeking among College Students with Comorbid Hazardous Drinking and Elevated Mood/Anxiety Symptoms.

BACKGROUND: Hazardous drinking is prevalent among college students and often comorbid with mood and/or anxiety disorders; however, these disorders frequently go untreated. Prior studies have found that individuals with comorbid hazardous drinking are more likely to seek treatment than those with an hazardous drinking alone. OBJECTIVES: The current study tested possible psychological and structural explanations to understand these treatment seeking behaviors. METHODS: A sample of 222 students identified as hazardous drinkers (AUDIT ≥ 8) participated from September 2010 to April 2011. Behavioral measures designed to mimic actual treatment seeking and self-report measures were used to assess treatment seeking behaviors, and the influence of psychopathology and individual predictors on treatment interest. RESULTS: Students were more interested in treatment for emotional problems than for alcohol problems. Further, treatment seeking interest was significantly higher among individuals with comorbid hazardous drinking. When provided a telephone offer for a free on-campus clinic appointment, no students were interested in receiving treatment for alcohol use problems, but some were interested in an appointment for emotional problems (n = 13). Of those students expressing interest on the phone, seven attended the clinic appointment. Logistic regression analyses revealed that students with anxiety, anxiety sensitivity, and depression were more likely to attend the clinic appointment. Conclusions/Importance: In sum, targeting mood and anxiety disorders may be a viable way to increase treatment seeking rates in hazardous drinking college students.

Conformity motives for alcohol use are associated with risky sexual behavior among alcohol-dependent patients in residential substance abuse treatment.

Alcohol misuse is associated with a variety of negative outcomes, including risky sexual behavior (RSB). In an attempt to better identify the subset of individuals at greatest risk for these negative outcomes, a growing body of research has begun to examine the role of alcohol use motives in risk for alcohol use-related negative outcomes. Although the majority of research in this area has focused on coping motives, conformity motives may be particularly relevant to outcomes such as RSB. Specifically, conformity motives may operate as a proxy risk factor for RSB, reflecting the tendency to engage in interpersonally-oriented risk behaviors in order to avoid rejection, interpersonal conflict, or social ostracism. Therefore, the current study examined the relation between conformity motives for alcohol use and RSB in a sample of 94 patients in a residential substance abuse treatment center. Results indicated that conformity motives were associated with RSB above and beyond other motives for alcohol use, as well as relevant covariates. Findings support the notion that conformity motives may operate as a proxy risk factor that could assist in identifying individuals at elevated risk for engaging in RSB.

Panic symptoms and elevated suicidal ideation and behaviors among trauma exposed individuals: Moderating effects of post-traumatic stress disorder.

Panic attacks (PAs) are highly prevalent among trauma exposed individuals and have been associated with a number of adverse outcomes. Despite high suicide rates among trauma exposed individuals, research to date has not examined the potential relation between panic symptoms and suicidal ideation and behaviors among this high risk population. The current study tested the association of panic with suicidal ideation and behaviors among a large sample of trauma exposed smokers. Community participants (N=421) who reported a lifetime history of trauma exposure were assessed concurrently for current panic, suicidal ideation and behaviors, and psychiatric diagnoses. Those who met criteria for a current panic disorder diagnosis were removed from analyses to allow for the assessment of non-PD related panic in line with the recent addition of the PA specifier applicable to all DSM-5 disorders. Findings indicated that panic symptoms were significantly associated with suicidal ideation and behaviors beyond the effects of depression and number of trauma types experienced. Further, post-traumatic stress disorder (PTSD) diagnostic status significantly moderated this relationship, indicating that the relationship between panic and suicidal ideation and behaviors is potentiated among individuals with a current PTSD diagnosis. This investigation suggests that panic symptoms may be a valuable clinical target for the assessment and treatment of suicidal ideation and behaviors among trauma exposed individuals.

The depression distress amplification model in adolescents: A longitudinal examination of anxiety sensitivity cognitive concerns, depression and suicidal ideation.

Adolescents with comorbid anxiety and depression are at significantly increased risk of suicide. The recently proposed depression distress amplification model appears to have promise for explaining the relations between anxiety, depression, and suicidality, but it has not been tested in adolescents. Participants were 524 adolescents followed over two years. Baseline data for the current report were collected by trained interviewers while the adolescents were in eighth grade. Data were obtained in the same manner when the adolescents were in tenth grade. Baseline anxiety sensitivity cognitive concerns significantly predicted suicidal ideation two years later, above and beyond baseline suicidal ideation and depression. Further, consistent with the depression distress amplification model, anxiety sensitivity cognitive concerns interacted with depressive symptoms to predict suicidal ideation. This report extends the empirical and theoretical support for a relationship between anxiety sensitivity cognitive concerns and suicidality.

Prospective evaluation of the effect of an anxiety sensitivity intervention on suicidality among smokers.

Recent empirical work has revealed a significant relationship between anxiety sensitivity (AS), particularly the AS cognitive concerns subfactor, and suicidality among cigarette smokers. The current study prospectively tested whether an intervention targeting AS (i.e. an AS-augmented smoking cessation program) would predict lower suicidality in a population known to be at increased risk for death by suicide (i.e. cigarette smokers). Participants (N = 169) were randomly assigned to a standard cognitive behavioral smoking intervention or a cognitive behavioral smoking intervention with an AS reduction component. Findings indicate that the participants who received the AS-augmented intervention had lower suicidality compared to those in the standard intervention, even accounting for baseline suicidality, substance use disorder diagnosis, current depression, current anxiety, and current smoking status. As the first examination of the effect of an AS reduction program on suicidality, this study provides initial support for the hypothesis that reducing AS may lead to lower suicidality. Future work should include testing an AS intervention in a sample with elevated suicidality, as well as specifically targeting AS cognitive concerns, which has a stronger and more consistent relationship with suicidality than global AS.

Brooding, Reflection, and Anger Rumination Relate to Suicidal Ideation through the Role of Thought Control.

Despite the far-reaching impact of suicide on our communities, suicide prevention has historically focused on distally related risk factors for suicidality, which gives us an incomplete picture of how someone comes to make a suicide attempt. Instead, our focus needs to extend to research that explains the maintenance and progression from an emotional state to a suicidal crisis. One such factor, rumination, may create or worsen suicidal thinking by amplifying the distress associated with negative thoughts. Ruminative thoughts are often described as difficult to control, and people may think about suicide as an escape from these uncontrollable thoughts. The current study examined the relationship between severity of lifetime suicidal thinking and certain forms of rumination (i.e., brooding, reflection, anger rumination, and suicidal rumination) in a sample of 145 undergraduate students with suicidal thoughts. For each form of rumination that was related to suicidal thinking, we then examined whether that relationship was accounted for by perceived uncontrollability of one's own thoughts. We found that all forms of rumination were related to severity of lifetime suicidal thinking, as well as heightened perceived inability to control one's own thoughts. This thought control inability helped account for the relationships between brooding, reflection, and anger rumination with severity of suicidal thinking, but did not play a role in the relationship between suicidal rumination and suicidal ideation severity. Clinicians should be aware of the impact ruminative thoughts may have on suicidal thinking. More research needs to be done to replicate and extend these effects.

Brooding, reflection, anger rumination, and suicidal rumination were examined.All subtypes of rumination were related to suicidal ideation and thought control.All but suicidal rumination were related to ideation through thought control.

Negative mood and optimism bias: An experimental investigation of sadness and belief updating.

BACKGROUND AND OBJECTIVES: Understanding how individuals integrate new information to form beliefs under changing emotional conditions is crucial to describing decision-making processes. Previous research suggests that although most people demonstrate bias toward optimistic appraisals of new information when updating beliefs, individuals with dysphoric psychiatric conditions (e.g., major depression) do not demonstrate this same bias. Despite these findings, limited research has investigated the relationship between affective states and belief updating processes. METHODS: We induced neutral and sad moods in participants and had them complete a belief-updating paradigm by estimating the likelihood of negative future events happening to them, viewing the actual likelihood, and then re-estimating their perceived likelihood. RESULTS: We observed that individuals updated their beliefs more after receiving desirable information relative to undesirable information under neutral conditions. Further, we found that individuals did not demonstrate unrealistic optimism under negative affective conditions. LIMITATIONS: This study incorporated a population of university students under laboratory conditions and would benefit from replication and extension in clinical populations and naturalistic settings. CONCLUSIONS: These findings suggest that momentary fluctuations in mood affect how individuals integrate information to form beliefs.

Considering the Impact of High School Sexual Education on Past Sexual Victimization and Rape Myth Acceptance in a College Sample.

Sexual victimization is a serious public health crisis affecting college students, with high rates reported among both women and men. Sexual consent education is crucial as it defines sexual assault and is linked to reduced risk of victimization. Rape myths and stereotyped beliefs shifting blame to survivors are established risk factors for sexual violence. Comprehensive sexual education can mitigate these attitudes, fostering a supportive environment for survivors. However, most high school students in the United States receive abstinence-based or abstinence-plus education, which uses unstandardized protocols and often lacks information about sexual consent. The following study explores the influence of high school sexual education on past sexual victimization and rape myth acceptance in college students. Six hundred sixty-four undergraduate students participated in an online survey through a university participant pool. Results show that those who received comprehensive sexual education were more likely to understand sexual consent and were less likely to endorse past sexual victimization. In contrast, students without comprehensive sexual education reported lower satisfaction with their sexual education and greater acceptance of rape myths. Despite limitations in the study's sample and reliance on self-reporting, this research highlights the importance of implementing comprehensive sexual education, including consent education, in high schools. Policymakers and educators must recognize the influence of comprehensive sexual education in promoting healthy relationships and combating sexual assault. As a significant public health concern, incorporating standardized sexual consent education into high school curricula can equip students with the knowledge and skills to make informed decisions about their sexual health and relationships. Future research should explore diverse populations and the mediating role of related factors that may further influence these relationships. These efforts will contribute to fostering a safer environment within educational institutions and combating sexual assault.

Sexual Assault History May Moderate Posttraumatic Cognition and Posttraumatic Stress Among Trauma-Exposed Sexual Minority Women.

Sexual minority women (SMW) are highly vulnerable to trauma exposure and posttraumatic stress disorder (PTSD) symptoms following trauma exposure. Negative posttraumatic cognitions (i.e., negative cognitions about self, world, and self-blame following trauma exposure) are hypothesized to exacerbate and maintain the relationship between trauma exposure and PTSD symptoms. Posttraumatic cognitions are particularly important to examine in relation to PTSD symptoms among trauma-exposed SMW given their elevated risk for trauma exposure and PTSD. It is also important to understand whether the strength of this relationship differs as a function of trauma type to elucidate potentially differential pathways for risk by trauma type in this population. The current study explored whether trauma type (sexual assault vs. nonsexual trauma) moderated the relationship between negative posttraumatic cognitions and PTSD symptom severity among a sample of trauma-exposed SMW. Participants were SMW (n = 516) users of an online survey platform, Prolific. Data were collected via 20-minute online survey. Results indicated that trauma type moderated the relationship between negative posttraumatic cognitions and PTSD symptom severity, such that the relationship was stronger among those who had experienced at least one sexual assault in their lifetime. Results suggest that negative posttraumatic cognitions may be more strongly related to PTSD symptom severity among SMW who have experienced at least one sexual assault. Notably, this difference was in magnitude only, as the posttraumatic cognition-PTSD symptom relationship remained significant among nonsexual trauma survivors. Negative posttraumatic cognitions may be an especially relevant treatment target among SMW survivors of sexual assault.

The Indirect Effects of Proximal Stressors Associated with Posttraumatic Stress Symptoms Severity among Sexually Victimized Sexual Minority Women: A Cross-Sectional Path Analysis.

Sexual minority women (SMW) are at risk for sexual victimization and stressors specifically related to their minority identity (e.g., discrimination). However, SMW experience posttraumatic stress disorder (PTSD) at rates beyond what may be explained by elevated risk for sexual victimization alone. This study aimed to examine the impact of stigma on PTSD symptoms among SMW survivors of sexual victimization. Results indicate that in relation to minority-specific distal stressors (i.e., heterosexist experiences), both minority-specific and general proximal stressors (i.e., internalized heterosexism, negative posttraumatic cognitions) indirectly affected PTSD symptom severity among this cross-sectional sample of sexually victimized SMW.

Determining who military service members deem credible to discuss firearm safety for suicide prevention.

OBJECTIVES: To examine rankings of credible sources for discussing secure storage within a representative sample of firearm-owning service members, and examine how combinations of demographic variables impact the ranking of credible sources. METHODS: The probability-based sample was collected with the help of Ipsos. Participants were US service members who owned a firearm at the time of the survey (n = 719). RESULTS: The total sample ranked service members, Veterans, and members of law enforcement as the most credible sources and faith leaders, casual acquittances, and celebrities as the least credible sources. Black men ranked the NRA as a highly credible source whereas Black females ranked the NRA as one of the least preferred sources. Regardless of political preference, those who lived in non-metropolitan rural environments ranked members of law enforcement as highly credible sources. Those who lived in non-metropolitan rural and urban settings and identified as liberal ranked the National Shooting Sports Foundation as a highly credible source. CONCLUSIONS: Law enforcement officers, military members, and Veterans are ranked as highly credible sources by most subgroups of firearm-owning service members. Leveraging these voices in firearm safety conversations is necessary, may increase adherence to secure storage recommendations, and ultimately reduce suicide.