Beyond words: Semantic satiation and the mental accessibility of the concept of suicide.

Disrupting the accessibility of the mental representation of suicide may be a possible pathway to a strategy for suicide prevention. Our study aims to theoretically evaluate this perspective by examining the impact of temporarily disrupting the concept of suicide on perceptions of suicide. Using a within-subject design, we tested the effects of semantic satiation targeting the word "suicide" on the perceptual judgment of suicide-relevant pictures in 104 young adults. On each trial, participants repeated aloud one of the three words (i.e., "accident," "murder," or "suicide") either three times (priming) or 30 times (satiation) and indicated whether a subsequent picture matched with the word. Results indicated that satiation of the word "suicide" slowed the accurate categorization of pictures related to all three words, and satiation of "murder" and "accident" delayed participants' judgment of suicide-relevant pictures. Our findings support that semantic satiation can render the suicide concept temporarily less accessible, thereby providing preliminary support for the strategy of concept disruption in suicide prevention.

Is physical pain causally related to suicidal behavior: An experimental test.

Existing evidence suggests a link between physical pain and suicide, but the nature of this relationship remains unknown. To address this critical gap in knowledge, the present study leveraged a validated virtual reality (VR) suicide paradigm to experimentally examine the causal effects of physical pain on subsequent virtual suicidal behaviors. Based on previous findings, we hypothesized that physical pain would causally drive virtual suicidal behavior only if suicide was conceptualized as having desirable anticipated consequences (e.g., a means of escaping from current pain; an opportunity to avoid future pain). We tested this by randomizing 326 participants across four different conditions: a physical pain condition, an anticipated escape condition, an anticipated avoidance condition, and a control condition. As predicted, physical pain alone did not result in statistically significant increases in VR suicide rates; however, the anticipation that virtual suicidal behavior would result in the avoidance of future physical pain had a large causal effect on VR suicide rates (B = 1.61, p < .001, IRR = 5.01). We failed to find evidence that anticipating that VR suicide would provide an escape from currently experienced physical pain increases the likelihood of VR suicide. Our findings add to a growing body of evidence suggesting that the anticipated consequences of suicide (e.g., avoidance of future physical pain) may serve as primary causes of suicidal behavior.

Efficacy of psychotropic medications on suicide and self-injury: a meta-analysis of randomized controlled trials.

Using psychotropic medications to treat and prevent self-injurious thoughts and behaviors (SITBs) has become increasingly popular, but conclusive evidence supporting the efficacy this approach remains elusive. To empirically examine whether psychotropic medications are efficacious treatments for SITBs, the present meta-analysis comprehensively summarizes all published randomized controlled trials (RCTs) that have reported the causal effects of psychotropic medications on suicide and self-injury. A total of 251 papers from 718 unique RCTs were included. A frequentist pairwise approach was adopted for meta-analyses. Potential effect modifiers were examined via met regressions and potential biases were evaluated through sensitivity analyses. On average, medications yielded an 8% reduction in SITB frequency and a reduction of 0.2 standard deviations in symptoms and severity. Findings were largely consistent across potential effect modifiers, and significant evidence of publication bias was not detected. Only one medication class (i.e., antipsychotics) and two specific medications (i.e., citalopram, ketamine) produced larger-than-average treatment effects. Psychostimulants and typical antipsychotics may produce iatrogenic effects. Less than 4% of included studies required individuals to exhibit SITBs, and nearly half of analyzed effects were drawn from studies that excluded individuals on the basis of SITB risk. Taken together, findings suggest that psychotropic medications produce small treatment effects on SITBs; however, these findings should be considered in light of the methodological constraints of the existing literature, including the lack of studies intentionally including individuals with SITBs. It is critical for future RCTs to prioritize including individuals with existing SITBs to further clarify treatment effects in self-injurious and suicidal populations. Additional research is needed to better understand the treatment mechanisms of psychotropic medications and identify the causal processes underlying SITBs.

Efficacy of interventions for suicide and self-injury in children and adolescents: a meta-analysis.

Despite increased numbers of children and adolescents seeking and receiving mental health treatment, rates of self-injurious thoughts and behaviors (SITBs) in youth are rising. In the hopes of aiding ongoing efforts to alleviate the burden of SITBs in this vulnerable population, the present study summarizes current knowledge on the efficacy of SITB interventions in children and adolescents. We conducted a meta-analysis of randomized controlled trials (RCTs) assessing treatment effects on SITBs in child and adolescent populations. A total of 112 articles comprising 558 effect sizes were included in analyses. Nearly all interventions produced nonsignificant reductions in SITBs. For binary SITB outcomes, a nonsignificant treatment effect was detected, with an RR of 1.06 (95% CIs [0.99, 1.14]). For continuous SITB outcomes, analyses also yielded a nonsignificant treatment effect (g = - 0.04 [- 0.12, 0.05]). These patterns were largely consistent across SITB outcomes, regardless of intervention type, treatment components, sample and study characteristics, and publication year. Our findings highlight opportunities for improving SITB intervention development and implementation in child and adolescent populations. The most efficacious interventions are likely to directly target the causes of SITBs; therefore, future research is needed to identify the causal processes underlying the onset and maintenance of SITBs in youth.

Does Body Mass Index Confer Risk for Future Suicidal Thoughts and Behaviors? A Meta-analysis of Longitudinal Studies.

PURPOSE OF REVIEW: Body mass index (BMI) outside of the "normal" range is commonly cited as a predictor of adverse health outcomes and has been identified as a potential risk factor for suicidal thoughts and behaviors (STBs). This meta-analysis provides a descriptive and quantitative summary of the literature evaluating the longitudinal relationship between BMI/weight status and STBs. RECENT FINDINGS: The longitudinal literature examining the relationship between BMI/weight status and STBs is small and methodologically constrained. Within the existing literature, BMI and weight status are generally weak or nonsignificant risk factors for STBs. It is possible that body weight has a complex relationship with physical and mental health, including STBs, which may not be possible to accurately capture with a singular metric such as BMI. BMI and weight status do not appear to robustly predict STBs, at least within the methodological constraints of the existing literature.

Raising doubt about the anticipated consequences of suicidal behavior: Evidence for a new approach from laboratory and real-world experiments.

OBJECTIVE: Converging evidence from basic science and experimental suicide research suggest that the anticipated consequences of suicide may have direct causal effects on suicidal behavior and accordingly represent a promising intervention target. Raising doubt about individuals' desirable anticipated consequences of suicide may be one means of disrupting this target. We tested this possibility across two complementary experimental studies. METHOD: Study 1 tested the effects of raising doubt about desirable anticipated consequences on virtual reality (VR) suicide in the lab, randomizing 413 participants across four conditions. In Study 2, 226 suicidal adults were randomized to an anticipated consequence manipulation or control condition then re-assessed at 2- and 8-weeks post-baseline. RESULTS: In Study 1, anticipating that engaging in VR suicide would guarantee a desirable outcome significantly increased the VR suicide rate; conversely, raising doubt about the desirable anticipated consequences significantly reduced the VR suicide rate. In Study 2, raising doubt about the anticipated consequences of attempting suicide by firearm significantly reduced the perceived lethality of firearms as well as self-predicted likelihood of future suicide attempts, with effects sustained at 2-week follow-up. CONCLUSIONS: Findings suggest that raising doubt about desirable anticipated consequences of suicide merits further research as one potential approach to inhibit suicidal behavior.

Does fearlessness about death mediate the association between NSSI and suicide attempts? A longitudinal study of over 1,000 high-risk individuals.

OBJECTIVE: Nonsuicidal self-injury (NSSI) is often cited as a key risk factor for future suicidal behavior. Capability for suicide has been repeatedly cited as an important mechanism that can account for this association. Despite this, direct tests of this hypothesis have been rare and methodologically constrained. In the present study, we conducted a direct test of this hypothesis while addressing several constraints of prior literature. METHOD: In a large sample of suicidal and self-injuring adults (n = 1,020), we tested whether changes in fearlessness about death (FAD), a core facet of the capability for suicide, accounted for the relationship between NSSI and future suicide attempts at 28-day and 2-year follow-up. FAD was assessed using the gold-standard self-report form (ACSS-FAD), an implicit test of suicide-related affect (affect misattribution paradigm-Suicide), and explicit affective ratings of suicide-relevant images. Mediation with bootstrapping was implemented to test our main hypotheses. RESULTS: As anticipated, lifetime NSSI frequency was significantly associated with suicide attempt frequency at follow-up; however, FAD failed to consistently mediate this association. Results were largely consistent across all three measures of FAD. Post hoc power analyses indicated sufficient power to detect small effects. CONCLUSIONS: Taken together, these results fail to support the hypothesis that capability for suicide explains the link between NSSI and future suicidal behavior. We discuss the implications of our results for research and theory, situating our findings in the context of recent advances in the understanding of suicide risk more broadly. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Do suicidal desire and facets of capability for suicide predict future suicidal behavior? A longitudinal test of the desire-capability hypothesis.

Capability-based models propose that people die by suicide because they want to, and they can. Despite the intuitive appeal of this hypothesis, longitudinal evidence testing its predictive validity has been limited. This study tested the predictive validity of the desire-capability hypothesis. A total of 1,020 self-injuring and/or suicidal adults were recruited worldwide online from suicide, self-injury, and mental health web forums. After baseline assessment, participants completed follow-up assessments at 3, 14, and 28 days after baseline. Participant retention was high (>90%) across all follow-up assessments. Analyses examined the effect of the statistical interaction between suicidal desire and indices of capability for suicide on future nonfatal suicide attempts. Main analyses focused on the fearlessness about death facet of capability for suicide; exploratory analyses examined preparations for suicide. Logistic regression was used to predict suicide attempt status at follow-up; zero-inflated negative binomial models were implemented to predict the frequency of nonfatal suicide attempts at follow-up. Results were consistent across models, finding very little evidence of the desire-capability interaction as a significant predictor of suicide attempt status or frequency at follow-up. We close with a discussion of the limitations of this study as well as the implications of our findings for future suicide science. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Sleep disturbances as risk factors for suicidal thoughts and behaviours: a meta-analysis of longitudinal studies.

In recent years, there has been a growing interest in understanding the relationship between sleep and suicide. Although sleep disturbances are commonly cited as critical risk factors for suicidal thoughts and behaviours, it is unclear to what degree sleep disturbances confer risk for suicide. The aim of this meta-analysis was to clarify the extent to which sleep disturbances serve as risk factors (i.e., longitudinal correlates) for suicidal thoughts and behaviours. Our analyses included 156 total effects drawn from 42 studies published between 1982 and 2019. We used a random effects model to analyse the overall effects of sleep disturbances on suicidal ideation, attempts, and death. We additionally explored potential moderators of these associations. Our results indicated that sleep disturbances are statistically significant, yet weak, risk factors for suicidal thoughts and behaviours. The strongest associations were found for insomnia, which significantly predicted suicide ideation (OR 2.10 [95% CI 1.83-2.41]), and nightmares, which significantly predicted suicide attempt (OR 1.81 [95% CI 1.12-2.92]). Given the low base rate of suicidal behaviours, our findings raise questions about the practicality of relying on sleep disturbances as warning signs for imminent suicide risk. Future research is necessary to uncover the causal mechanisms underlying the relationship between sleep disturbances and suicide.

Emotion regulation accounts for associations between mindfulness and depression across and within diagnostic categories.

BACKGROUND: Previous research shows that mindfulness and emotion regulation (ER) are highly related to each other. Preliminary evidence in small clinical populations show that ER may partially account for the relationship between mindfulness and depressive symptoms. The present study aimed to investigate which diagnostic categories were associated with depressive symptoms after controlling for ER in a heterogeneous sample of treatment-seeking patients. METHODS: A large sample of psychiatric outpatients (N = 911) completed the Structured Clinical Interview for DSM-IV (SCID), Five Facet Mindfulness Questionnaire (FFMQ), Difficulties in Emotion Regulation Scale (DERS), and Clinically Useful Depression Outcome Scale (CUDOS). Partial correlations were conducted to evaluate to what degree the relationship between depression scores and facets of mindfulness were accounted for by ER scores. RESULTS: When controlling for baseline mindfulness, the relationship between emotion dysregulation and depression symptoms remained significant for all data points; however, when controlling for baseline emotion dysregulation, the association between mindfulness and depression was not significant in the majority of cases. Nonjudging was most resistant to this result. CONCLUSIONS: Although mindfulness is negatively associated with depressive symptoms, this association may be better accounted for by emotion dysregulation.

Binary Donor-Acceptor Adducts of Tetrathiafulvalene Donors with Cyclic Trimetallic Monovalent Coinage Metal Acceptors.

Reactions between the π-acidic cyclic trimetallic coinage metal(I) complexes {[Cu(µ-3,5-(CF3)2pz)]3, {[Ag(µ-3,5-(CF3)2pz)]3, and {[Au(µ-3,5-(CF3)2pz)]3 with TTF, DBTTF and BEDT-TTF give rise to a series of coinage metal(I)-based new binary donor-acceptor adducts {[Cu(µ-3,5-(CF3)2pz)]3DBTTF} (1), {[Ag(µ-3,5-(CF3)2pz)]3DBTTF} (2), {[Au(µ-3,5-(CF3)2pz)]3DBTTF} (3), {[Cu(µ-3,5-(CF3)2pz)]3TTF} (4), {[Ag(µ-3,5-(CF3)2pz)]3TTF} (5), {[Au(µ-3,5-(CF3)2pz)]3TTF} (6), {[Cu(µ-3,5-(CF3)2pz)]3BEDT-TTF} (7), {[Ag(µ-3,5-(CF3)2pz)]3BEDT-TTF} (8), and {[Au(µ-3,5-(CF3)2pz)]3BEDT-TTF} (9), where pz = pyrazolate, TTF = tetrathiafulvalene, DBTTF = dibenzotetrathiafulvalene, and BEDT-TTF = bis(ethylenedithio)tetrathiafulvalene. This series of binary donor-acceptor adducts has been found to exhibit remarkable supramolecular structures in both the solid state and solution, whereby they exhibit supramolecular stacked chains and oligomers, respectively. The supramolecular solid-state and solution binary donor-acceptor adducts also exhibit superior shelf stability under ambient laboratory storage conditions. Structural and other electronic properties of solids and solutions of these adducts have been characterized by single-crystal X-ray diffraction (XRD) structural analysis, 1H and 19F NMR, UV-vis-near-IR spectroscopy, Fourier transform infrared, and computational investigations. The combined results of XRD structural data analysis, spectroscopic measurements, and theoretical studies suggest sustenance of the donor-acceptor stacked structure and electronic communication in both the solid state and solution. These properties are discussed in terms of potential applications for this new class of supramolecular binary donor-acceptor adducts in molecular electronic devices, including solar cells, magnetic switching devices, and field-effect transistors.

Mechanistic Investigations of Photoinduced Oxygenation of Ru(II) Bis-bipyridyl Flavonolate Complexes.

We previously reported that a Ru-bound flavonolate model of flavonol dioxygenases, [RuII(bpy)2(3-hydroxyfla)][PF6], photochemically reacts with dioxygen in two different manners. Broad-band excitation generates mixtures of products characteristic of 1,3-addition of dioxygen across the central pyrone ring, as is observed in enzymatic reactions. However, low temperature excitation at wavelengths longer than 400 nm generates a unique Ru-bound 2-benzoatophenylglyoxylate product resulting from a 1,2-dioxetane intermediate. Herein, we investigate this reactivity in a series of Ru(II)bis-bipyridyl flavonolate complexes [RuII(bpy)2(3-hydroxyflaR)][PF6] (bpy = 2,2'-bipyridine; fla = flavonolate; R = p-OMe (1), p-Me (2), p-H (3), p-Cl (4)), and [RuII(bpy)2(5-hydroxyfla)][PF6] (5). The complexes' structures, photophysical and electrochemical properties, and photochemical reactivity with oxygen were investigated in detail. Two different reaction product mixtures, from 1,2- and 1,3-additions of dioxygen, are observed by illumination into distinct excitation/emission manifolds. By analogy to previous reports of excited state intramolecular proton transfer, the two manifolds are attributed to tautomeric diradicals that predict the observed reactivity patterns.