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1.
Psychol Serv ; 2020 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-32105121

RESUMO

Suicide rates within the U.S. military are elevated. The interpersonal theory of suicide, supported within military samples, suggests that social disconnectedness confers risk for suicide. Autism spectrum disorder (ASD) is characterized by symptoms-difficulties in social communication/interaction (SCI) and restricted and repetitive behaviors (RRBs)-that contribute to social disconnectedness. To our knowledge, no study has examined ASD-related traits and suicide risk among active duty U.S. military service members. Participants included 292 active duty U.S. military service members (M [SD] age = 28.67 [7.40] years, 68.5% male, 78.1% White). The Autism Spectrum Quotient, Repetitive Behaviours Questionnaire-2 for Adults, Self-Injurious Thoughts and Behaviors Interview-Short Form, and Interpersonal Needs Questionnaire assessed for SCI difficulties, RRBs, suicidal symptoms, and interpersonal theory of suicide constructs (i.e., perceived burdensomeness, thwarted belongingness), respectively. Elevated levels of SCI difficulties and RRBs were associated with increased odds of reporting suicidal thoughts and behaviors occurring since joining the military, controlling for the number of years of service and suicidal symptoms occurring prior to joining the military. Perceived burdensomeness and thwarted belongingness statistically accounted for the relationship between ASD-related traits and suicidal ideation occurring since joining the military; a rival mediator, emotion dysregulation, was not a significant mediator. Among active duty U.S. military service members, greater ASD-related traits were associated with an increased likelihood of reporting suicidal thoughts and behaviors occurring since joining the military. Clinical efforts targeting perceived burdensomeness and thwarted belongingness might reduce suicide risk among military service members with elevated ASD-related traits. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

2.
J Consult Clin Psychol ; 88(4): 372-383, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31916797

RESUMO

OBJECTIVE: Firearms are the most common method of suicide in the United States. The provision of firearm-specific lethal means safety interventions is a best practice for the prevention and management of suicide risk. However, few data exist to inform firearm-specific lethal means safety interventions. This study tested four different lethal means safety interventions that varied on two dimensions salient to health behavior change (i.e., fear appeals and emphasis on temporariness). METHOD: Overall, 96 college-enrolled young adults with a history of suicidal ideation and current firearm familiarity (i.e., firearm ownership, access, and/or a desire/intention to obtain a firearm) were randomized to one of four different firearm-specific lethal means safety interventions occurring in the context of the Safety Planning Intervention. Assessments occurred at preintervention, postintervention, and 1-month follow-up. RESULTS: Participants who received the firearm-specific lethal means safety intervention that deemphasized fear and emphasized temporariness reported significantly greater intentions to adhere to clinician recommendations to limit their access to firearms for safety purposes compared to individuals randomized to the other groups (Intervention × Time), F(6, 184) = 2.300, p = .036, corresponding to a medium effect size (ηp² = .070). Across groups, 35.4% of participants reported an increase in engagement in firearm safety thoughts/behaviors from preintervention to 1-month follow-up; there were no significant group differences. All four intervention approaches were rated as similarly highly acceptable. CONCLUSIONS: Findings underscore the potential importance of deemphasizing fear and emphasizing temporariness in firearm-specific lethal means safety interventions. Future studies leveraging these pilot data are needed to replicate and extend findings. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

3.
J Nerv Ment Dis ; 208(3): 208-214, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31904668

RESUMO

Nonalcohol substance use is a robust correlate of suicide risk. However, few data exist regarding the degree to which nonalcohol substance use, as measured by objective indicators (e.g., urinalysis toxicology screen), is related to suicide risk. This study examined the associations of a multimodal assessment of nonalcohol substance use and multiple indicators of suicide risk. Overall, 168 acute care psychiatric inpatients participated and provided data spanning urinalysis toxicology screen and self-report instruments. Substance use per urinalysis toxicology screen and self-report was not related to current suicidal ideation severity. However, substance use per urinalysis toxicology screen was significantly associated with a suicide attempt history and suicidality as a primary reason for admission. Substance use is an important variable to consider in suicide risk conceptualization. Findings underscore the importance of leveraging, when possible, objective indicators of substance use (e.g., urinalysis toxicology screen) in suicide risk formulations.

4.
Artigo em Inglês | MEDLINE | ID: mdl-31399392

RESUMO

BACKGROUND: Existing research suggests that inhibitory control deficits may differentiate individuals who think about suicide from those who make a suicide attempt. However, no available research, to our knowledge, has examined whether suicidal behaviors are associated with disruptions in the ability to determine when inhibitory control is needed or the ability to engage inhibition of an inappropriate or maladaptive behavior. The current study utilized event-related potentials to investigate specific facets of inhibitory control and their associations with suicide attempt history among a heterogeneous clinical sample who reported current suicidal ideation. METHODS: Ideators with no past suicide attempts (n = 46) and those with a history of suicide attempts (n = 22) completed a complex go/no-go task. Raw waveforms and temporospatial principal components analysis were used to index conflict detection (i.e., ΔN2) and motor inhibition (i.e., ΔP3a). Behavioral performance indices were also examined. RESULTS: Suicide attempters exhibited deficits in detecting the need for inhibitory control, as indexed by a more positive ΔN2 factor, than did ideating nonattempters, even when accounting for psychiatric comorbidity and age. However, these results only emerged in the principal components analysis-derived latent factor. No differences in behavioral performance or ΔP3a amplitude emerged. CONCLUSIONS: A relative inability to detect when to inhibit a maladaptive behavior, but not the ability to engage motor inhibition to stop that behavior, may distinguish suicide ideators who make a suicide attempt from those who do not. However, future research with prospective designs are needed to determine how conflict detection deficits may contribute to the emergence or escalation of a suicidal crisis.

5.
Transcult Psychiatry ; : 1363461519847812, 2019 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-31088223

RESUMO

Firefighters represent a group at elevated suicide risk. Identifying segments of the fire service at increased risk may facilitate the targeted provision of suicide prevention initiatives. Among the general population, American Indian/Alaska Native (AI/AN) individuals report higher rates of suicide attempts. This study sought to examine suicide attempt rates among AI/AN firefighters and to determine if greater exposure to painful and provocative events and/or fearlessness about death explains the relationship between AI/AN identity and suicidal behaviors. A total of 917 US firefighters completed a web-based mental health survey (6.2% AI/AN). Participants completed a modified version of the Self-Injurious Thoughts and Behaviors Interview-Short Form, the Painful and Provocative Events Scale, and the Acquired Capability for Suicide Scale-Fearlessness About Death scale. Bootstrap mediation analyses were conducted, controlling for years of service as a firefighter. Although AI/AN firefighters accounted for only 6.2% of the sample, they accounted for 34.4% of the career suicide attempts. AI/AN firefighters were 16.31 (95% CI = 7.96, 33.42) times more likely to report a career suicide attempt history than non-AI/AN firefighters, adjusting for years of service as a firefighter. Painful and provocative events, but not fearlessness about death, was a statistically significant mediator of the relationship between AI/AN identity and suicide attempts. Firefighters identifying as AI/AN represent a subgroup within the fire service at increased risk for suicide. Findings suggest that greater exposure to painful and provocative events among AI/AN firefighters may explain the elevated suicide risk among this population.

6.
Arch Suicide Res ; : 1-15, 2019 Apr 07.
Artigo em Inglês | MEDLINE | ID: mdl-30955470

RESUMO

Research has linked agitation and low body trust to suicidal thoughts and behaviors. We investigated a pathway with agitation accounting for the relationship between body trust and suicidality. 511 individuals recruited via MTurk (Study 1) and 167 undergraduate students (62.9% with suicide attempt history) (Study 2) completed measures of study variables. For ideation, the proposed pathway was significant across samples, as was a pathway with agitation predicting and body trust mediating. In Study 1, agitation explained the relationship between body trust and attempt history. In Study 2, neither independent variable was related to attempt history. Results suggest body trust is independently associated with suicidal ideation. Results were discrepant regarding suicide attempt history, necessitating future studies.

7.
J Affect Disord ; 243: 432-440, 2019 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-30273881

RESUMO

BACKGROUND: Research suggests that insomnia is associated with elevated perceptions of loneliness and social disconnection; however, few quasi-experimental studies have tested the relationship between these constructs. This study examined whether insomnia symptom severity predicts changes in perceptions of interpersonal connectedness and desire for emotional support following in-laboratory participation in a social exclusion paradigm. METHODS: Young adults (N = 70) completed self-report measures assessing constructs of interest before and after engaging in a social exclusion paradigm (Cyberball). Linear regression analyses were used to evaluate whether baseline insomnia symptom severity predicted perceived burdensomeness, desire for emotional support, and thwarted belongingness after playing Cyberball; analyses controlled for baseline perceived burdensomeness, desire for emotional support, and thwarted belongingness, respectively, as well as baseline social anxiety and depression symptoms. RESULTS: Greater insomnia symptom severity significantly predicted greater feelings of perceived burdensomeness following Cyberball participation, beyond baseline perceived burdensomeness, social anxiety symptoms, and depression symptoms (ß= .24, p = .001). More severe insomnia symptoms also significantly predicted lower desire for emotional support after playing Cyberball, beyond baseline desire for emotional support and social anxiety symptoms (ß= -.14, p = .03) but not beyond baseline depression symptoms (ß= -.16, p = .07). Insomnia symptoms were not significantly associated with thwarted belongingness after Cyberball (ß= -.05-.08, p = .27-.57). LIMITATIONS: Replication in larger samples and using other sleep disturbance indices is needed. CONCLUSIONS: Findings suggest that individuals with more severe insomnia symptoms in the past two weeks experience greater perceptions of being a burden on others and less desire for emotional support in response to social exclusion.


Assuntos
Emoções , Autoimagem , Distúrbios do Início e da Manutenção do Sono/psicologia , Distância Social , Apoio Social , Adolescente , Adulto , Ansiedade/psicologia , Depressão/psicologia , Feminino , Humanos , Relações Interpessoais , Masculino , Pessoa de Meia-Idade , Adulto Jovem
8.
Psychol Serv ; 16(4): 543-555, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29595287

RESUMO

Firefighters experience high rates of posttraumatic stress disorder (PTSD). It is imperative to identify malleable factors that protect against the development of PTSD symptoms among this population. We examined whether perceptions of belongingness broadly (Study 1) and social support from supervisors, coworkers, and family/friends specifically (Study 2) are associated with lower PTSD symptom severity among firefighters. Study 1 included 840 U.S. firefighters (91.1% male); participants completed the Interpersonal Needs Questionnaire and PTSD Checklist-Civilian Version. Study 2 included 200 U.S. women firefighters exposed to a Criterion A traumatic event; participants completed the Generic Job Stress Questionnaire, Life Events Checklist for Diagnostic and Statistical Manual of Mental Disorders-5, and PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-5. Linear regression analyses were conducted, adjusting for the number of years participants served as firefighters. Greater belongingness broadly (Study 1; b = -0.740, p < .001) as well as social support specifically (Study 2) from supervisors (b = -4.615, p < .001), coworkers (b = -4.465, p = .001), and family/friends (b = -3.206, p = .021) were associated with less severe PTSD symptoms. When all sources of social support were entered into a single model, only support from supervisors was significantly associated with lower overall PTSD symptom severity (b = -4.222, p = .004). Belongingness and social support may protect against the development of PTSD among firefighters. Supervisor social support may be particularly salubrious, suggesting that top-down mental wellness promotion within the fire service may be indicated to protect firefighters against PTSD. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

9.
Arch Suicide Res ; : 1-18, 2018 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-30303461

RESUMO

Recent standardized nomenclature has suggested distinctions among aborted, interrupted, and actual suicide attempts. This study examined differences in self-reported symptoms among individuals with a history of aborted, interrupted, and actual suicide attempts. 167 young adults with a history of suicidality completed self-report measures of suicide attempt history and current symptoms, a clinical interview assessing past suicidal behavior, and a pain tolerance task. Only 78.8% of participants who initially reported a suicide attempt history were classified as suicide attempters following the clinical interview. Individuals who reported only aborted attempts during the clinical interview reported less severe clinical symptoms than those reporting a history of at least one actual attempt. Individuals with a history of actual suicide attempts may represent a more clinically severe group than those with a history of aborted attempts only.

10.
J Affect Disord ; 238: 281-288, 2018 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-29898427

RESUMO

BACKGROUND: Firefighters are at increased risk for both problematic alcohol use and suicidality. Research has found that problematic alcohol use is related to suicidality among this population; however, limited data exist regarding what might account for this association. The present two-study investigation (1) examined the association between suicidality and problematic alcohol use among two large samples of firefighters and (2) tested whether interpersonal theory of suicide constructs-perceived burdensomeness (PB) and thwarted belongingness (TB)-serve as indirect indicators of this relationship. METHODS: Participants in Study 1 were 944 U.S. firefighters (12.5% female); participants in Study 2 were 241 U.S. women firefighters. Participants completed the Interpersonal Needs Questionnaire, Alcohol Use Disorders Identification Test, and the Depressive Symptom Inventory-Suicidality Subscale (Study 1) or the Self-Injurious Thoughts and Behaviors Interview-Short Form (Study 2). Bias-corrected bootstrap indirect effects path analyses were utilized. RESULTS: In Study 1, more problematic alcohol use was significantly associated with more severe career suicidal ideation via PB but not TB. In Study 2, problematic alcohol use was associated with career suicidal ideation via both PB and TB. PB seems to account for the relationship between problematic alcohol use and career suicidal ideation among male and female firefighters. LIMITATIONS: Limitations include use of a cross-sectional design, use of retrospective measures of suicidal ideation, and our findings derived from subsamples of two existing datasets. CONCLUSIONS: Findings suggest that PB and TB may explain the relationship between problematic alcohol use and suicidal ideation, but that this effect is discrepant based on gender.


Assuntos
Consumo de Bebidas Alcoólicas/psicologia , Bombeiros/psicologia , Doenças Profissionais/psicologia , Ideação Suicida , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Relações Interpessoais , Masculino , Pessoa de Meia-Idade , Percepção , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais , Distância Social , Inquéritos e Questionários , Adulto Jovem
11.
J Affect Disord ; 232: 139-142, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29486340

RESUMO

BACKGROUND: Research suggests that screening for suicidality does not have iatrogenic effects; however, less is known regarding the impact of repeatedly screening for suicidal ideation among individuals with varying levels of exposure to these screenings. This staggered sequential study evaluated whether suicidal ideation severity increases with repeated screening for suicidal ideation and depression symptoms. METHODS: Undergraduates (N = 207) were recruited at one of four time points (baseline [n = 37], 1 month later [n = 61], 4 months later [n = 55], and 12 months later [n = 54]) to complete the self-report Beck Depression Inventory (BDI). Participants completed the BDI at the time point at which they were recruited and all subsequent study time points. Non-parametric tests were employed to compare suicidal ideation severity (BDI Item 9) and depression symptom severity (BDI total score): (1) within each group across time points and (2) within each time point across groups. RESULTS: Suicidal ideation severity did not significantly differ within any group across time points, and for two groups, depression symptom severity decreased over time. For analyses between groups, suicidal ideation and depression symptom scores were, at times, significantly lower during subsequent BDI completion time points. LIMITATIONS: This study utilized a relatively small sample size and participants of low clinical severity. CONCLUSIONS: Findings align with prior research indicating that suicidality screening is not iatrogenic. This study also expanded upon previous studies by leveraging a staggered sequential design to compare suicidal ideation and depression symptom severity among individuals with varying exposure to suicidal ideation screenings.


Assuntos
Transtorno Depressivo/diagnóstico , Ideação Suicida , Suicídio , Adulto , Transtorno Depressivo/psicologia , Feminino , Humanos , Doença Iatrogênica , Masculino , Escalas de Graduação Psiquiátrica , Adulto Jovem
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