Do bipolar disorder symptom profiles matter for suicide risk? A latent class approach to investigating differences in suicidal desire and acquired capability.

INTRODUCTION: Depressive and mixed symptoms in bipolar disorder (BD) have been linked to higher suicide risk. Based on Klonsky and May's three-step theory and Joiner's Interpersonal Psychological Theory of Suicide, we hypothesized that patients diagnosed with BD who reported severe levels of depressive symptoms and mixed depressive and manic symptoms would also report higher levels of suicidal desire and acquired capability of suicide, as well as suicidal thoughts and behaviors. METHODS: The sample included 177 outpatients diagnosed with BD. Latent class analysis was conducted to replicate the identified groups of a previously conducted study using a smaller but overlapping dataset. Between-class and pairwise analyses with measures of suicidal desire and acquired capability were conducted. RESULTS: As expected, the classes characterized by severe depressive symptoms and mixed symptoms reported higher levels of suicidal desire. However, the results regarding acquired capability were less consistent. CONCLUSION: Given the overall elevated suicide risk of BD and the consistent relationship between depressive symptoms and other strong correlates of suicide, clinicians who work with patients diagnosed with BD should closely monitor changes in their depressive symptoms.

Intimate Partner Violence, Legal Systems and Barriers for African American Women.

Although many African American IPV survivors need services, they often do not access care. Hopelessness may partially explain low rates in help-seeking for this population and serve as a significant barrier to care for African American IPV survivors particularly those who have had prior legal system involvement. In a sample of 185 African American women, we first examined whether hopelessness mediated the relation between IPV and barriers to services. If such a mediation effect was found, we then would explore whether legal system involvement moderated the mediated effect of hopelessness on the relation between IPV and barriers to services. As anticipated, hopelessness partially served to explain (i.e., mediated) the relation between IPV and barriers to services. Further, this mediated effect was moderated by legal system involvement such that when legal system involvement was included as a moderator, hopelessness mediated the association between IPV and barriers to services only for those survivors who had been involved with the legal system. These results underscore the critical role of hopelessness as a barrier to accessing services for African American IPV survivors, especially those with prior involvement with the legal system. Recommendations are offered that underscore the importance of interventions that empower African American women who have survived violence instead of penalizing them.

Does Self-Silencing Behavior Mediate the Relation Between Rejection Sensitivity and Sexual Violence Victimization?

Previous research reveals that rejection sensitivity is associated with both sexual violence victimization and self-silencing behavior, yet the association among these variables has not been examined. As the foundation for this study, we propose a theoretical model that integrates these constructs. Using mediational analyses with bootstrapping, the results from a sample of 241 heterosexual college women revealed that consistent with the proposed model, self-silencing mediated the link between rejection sensitivity and reports of unwanted sexual contact and rape. The implications of the findings for the prevention of victimization/revictimization and interventions with victimized women are discussed.

Childhood maltreatment, impulsive aggression, and suicidality among patients diagnosed with bipolar disorder.

OBJECTIVE: Bipolar disorder is associated with a history of childhood maltreatment, impulsive aggression, and lethal suicide attempts. Often, aggression and violence prevent the diagnosed individual from receiving timely access to mental health care, leading to adverse outcomes such as repeated psychiatric hospitalization or even incarceration. METHOD: In this study, we recruited a sample of 150 low-income patients with bipolar disorder from an outpatient behavioral health clinic affiliated with an urban public hospital in Southeastern United States. We explored whether different types of childhood maltreatment (physical, sexual, emotional) are associated with impulsive aggression among individuals with bipolar disorder. Additionally, we examined whether impulsive aggression is related to suicidality. Finally, we sought to test the potential mediated effect of impulsive aggression on the relationship between childhood maltreatment and suicidality. RESULTS: Findings suggest that all direct associations were significant and that impulsive aggression was a significant mediator in the relationship between childhood emotional and sexual abuse. However, when childhood physical abuse was included as an independent variable in the model, impulsive aggression did not mediate the association, even though impulsive aggression was related to suicidality. CONCLUSION: Results from this study suggest that impulsive aggression exerts a wide-ranging impact on suicidality in the context of childhood trauma in those with bipolar disorder. In the future, targeted interventions to address the underlying etiologies of aggression may translate into an improved quality of life, decreased rates of suicidality, and positive clinical outcomes among individuals with bipolar disorder. (PsycInfo Database Record (c) 2022 APA, all rights reserved).