Associations of suicide-related media reporting characteristics with help-seeking and suicide in Oregon and Washington.

OBJECTIVE: Specific content characteristics of suicide media reporting might differentially impact suicides in the population, but studies have not considered the overarching theme of the respective media stories and other relevant outcomes besides suicide, such as help-seeking behaviours. METHODS: We obtained 5652 media reports related to suicide from 6 print, 44 broadcast and 251 online sources in Oregon and Washington states, published between April 2019 and March 2020. We conducted a content analysis of stories regarding their overarching focus and specific content characteristics based on media recommendations for suicide reporting. We applied logistic regression analyses to assess how focus and content characteristics were associated with subsequent calls to the US National Suicide Prevention Lifeline (Lifeline) and suicides in these two states in the week after publication compared to a control time period. RESULTS: Compared to a focus on suicide death, a focus on suicidal ideation, suicide prevention, healing stories, community suicide crises/suicide clusters and homicide suicide was associated with more calls. As compared to a focus on suicide death, stories on suicide prevention and stories on community suicide crises/suicide clusters were also associated with no increase in suicides. Regarding specific content characteristics, there were associations that were largely consistent with previous work in the area, for example, an association of celebrity suicide reporting with increases in suicide. CONCLUSION: The overall focus of a media story may influence help-seeking and suicides, and several story characteristics appear to be related to both outcomes. More research is needed to investigate possible causal effects and pathways.

Association of 7 million+ tweets featuring suicide-related content with daily calls to the Suicide Prevention Lifeline and with suicides, United States, 2016-2018.

OBJECTIVE: The aim of this study was to assess associations of various content areas of Twitter posts with help-seeking from the US National Suicide Prevention Lifeline (Lifeline) and with suicides. METHODS: We retrieved 7,150,610 suicide-related tweets geolocated to the United States and posted between 1 January 2016 and 31 December 2018. Using a specially devised machine-learning approach, we categorized posts into content about prevention, suicide awareness, personal suicidal ideation without coping, personal coping and recovery, suicide cases and other. We then applied seasonal autoregressive integrated moving average analyses to assess associations of tweet categories with daily calls to the US National Suicide Prevention Lifeline (Lifeline) and suicides on the same day. We hypothesized that coping-related and prevention-related tweets are associated with greater help-seeking and potentially fewer suicides. RESULTS: The percentage of posts per category was 15.4% (standard deviation: 7.6%) for awareness, 13.8% (standard deviation: 9.4%) for prevention, 12.3% (standard deviation: 9.1%) for suicide cases, 2.4% (standard deviation: 2.1%) for suicidal ideation without coping and 0.8% (standard deviation: 1.7%) for coping posts. Tweets about prevention were positively associated with Lifeline calls (B = 1.94, SE = 0.73, p = 0.008) and negatively associated with suicides (B = -0.11, standard error = 0.05, p = 0.038). Total number of tweets were negatively associated with calls (B = -0.01, standard error = 0.0003, p = 0.007) and positively associated with suicide, (B = 6.4 × 10-5, standard error = 2.6 × 10-5, p = 0.015). CONCLUSION: This is the first large-scale study to suggest that daily volume of specific suicide-prevention-related social media content on Twitter corresponds to higher daily levels of help-seeking behaviour and lower daily number of suicide deaths. PREREGISTRATION: As Predicted, #66922, 26 May 2021.

¡Yo no Estoy Loca! A Behavioral Health Telenovela Style Entertainment Education Video: Increasing Mental Health Literacy Among Latinas.

Lack of knowledge and negative attitudes towards mental health is linked to low utilization of services among Latinxs. Entertainment-education videos have been effective at increasing literacy and reducing stigma across different health domains but Latinxs have not been a focus of research. We developed an E-E video aimed at reducing stigma and increasing mental health literacy. Focus groups (N = 28) and expert consultants (N = 2) were used to aid in the development of the video. After the video was developed, we conducted a randomized control trial (RCT) in which Latina participants (N = 111) were assigned to view the video or receive an informational brochure. Results indicated that participants in the video intervention condition experienced statistically significant increases in mental health literacy as compared to the participants in the flyer condition and that both the video and the flyer contributed to shifts in stigma.

A Theory-based Educational Pamphlet With Low-residue Diet Improves Colonoscopy Attendance and Bowel Preparation Quality.

GOALS/BACKGROUND: Patients who "no-show" for colonoscopy or present with poor bowel preparation waste endoscopic resources and do not receive adequate examinations for colorectal cancer (CRC) screening. Using the Health Belief Model, we modified an existing patient education pamphlet and evaluated its effect on nonattendance rates and bowel preparation quality. STUDY: We implemented a color patient education pamphlet to target individual perceptions about CRC and changed bowel preparation instructions to include a low-residue diet instead of the previous clear liquid diet. We compared the nonattendance rate over a 2-month period before and after the introduction of the pamphlet, allowing for a washout period during which pamphlet use was inconsistent. We compared the Boston Bowel Preparation Scale (BBPS) in 100 consecutive patients who underwent colonoscopy during each of the 2 periods. RESULTS: Baseline characteristics between the 2 groups were similar, although patients who received the pamphlet were younger (P=0.03). The nonattendance rate was significantly lower in patients who received the pamphlet (13% vs. 21%, P=0.01). The percentage of patients with adequate bowel preparation increased from 82% to 86% after introduction of the pamphlet, although this was not statistically significant (P=0.44). The proportion of patients with a BBPS score of 9 was significantly higher in the pamphlet group (41% vs. 27%, P=0.03). There was no difference in adenoma and sessile serrated adenoma detection rates before and after pamphlet implementation. CONCLUSIONS: After implementing a theory-based patient education intervention with a low-residue diet, our absolute rate for colonoscopy nonattendance decreased by 8% and the proportion of patients with a BBPS score of 9 increased by 14%. The Health Belief Model appears to be a useful construct for CRC screening interventions.

The Behavioral Model of Health: Education, Behavioral Health Factors, and Stigma as Predictors of Help-Seeking Attitudes.

Per the behavioral model of health, help-seeking attitudes (and even behavioral health service use) are a function of predisposing and enabling individual characteristics (e.g. demographic characteristics, health beliefs), as well as contextual characteristics (resources, social structures such as education etc.). While researchers have examined how demographic (gender and ethnicity) and socioeconomic (education and income) characteristics, psychological factors, and internal barriers relate to help-seeking attitudes, the majority of these works have investigated how different variables independently act on help-seeking attitudes in lieu of more comprehensively investigating how they operate in tandem. The purpose of the current study was to examine how demographic (gender and ethnicity) and socioeconomic (education and income) characteristics, behavioral health factors, and internal barriers relate to help-seeking attitudes in a diverse sample of primary care patients. We also sought to examine differences in demographic and socioeconomic characteristics in mental health literacy, stigma, and help-seeking attitudes. Participants were 286 primary care patients. Results from this study indicate that a combination of socioeconomic characteristics (i.e. education), behavioral health factors (level of distress and history of behavioral health service utilization), and internal barriers (personal stigma) predicted help-seeking attitudes among primary care patients. There was an inverse relationship between education and personal stigma and help-seeking attitudes such that higher levels of education and higher levels of personal stigma were associated with more negative help-seeking attitudes.

"Breaking the Silence" Suicide Prevention Media Campaign in Oregon, April 7-14, 2019.

Background: Between April 7 and 14, 2019, the "Breaking the Silence" media engagement campaign was launched in Oregon. Aims: We aimed to assess the consistency of media content related to the campaign with media guidelines and the quantitative footprint on Twitter (now X) over time. Method: Media items related to the campaign were analyzed regarding focus and consistency with media guidelines for suicide reporting and compared with other suicide-related reports published in the same time frame, as well as with reporting in Washington, the control region. Tweets related to the campaign were retrieved to assess the social media footprint. Results: There were n = 104 media items in the campaign month, mainly in the campaign week. Items typically used a narrative featuring suicide advocacy or policy/prevention programs. As compared to other items with a similar focus, they scored better on several protective characteristics listed in media recommendations. Stories of coping with adversity, however, were scarce. The social media footprint on Twitter was small. Limitations: Inability to make causal claims about campaign impact. Conclusion: Media items from the Breaking the Silence campaign appeared mainly consistent with media guidelines, but some aspects, such as stories of recovery, were under-represented.

Primary non-gestational mediastinal choriocarcinoma metastatic to the brainstem.

Choriocarcinoma is a highly malignant tumour emerging from the syncytiotrophoblast divided into gestational and non-gestational presentations. Primary choriocarcinoma of the mediastinum is rare. Metastases to the brain often occur; however, brainstem involvement has not been reported for non-gestational choriocarcinoma. We described a middle-aged man who developed a complete left oculomotor nerve paralysis secondary to a brainstem tumour at the midbrain. The workup for the primary source of the brainstem tumour included a chest CT scan, which revealed a mediastinal mass. A mediastinal mass needle biopsy confirmed the diagnosis of primary mediastinal choriocarcinoma. Despite aggressive chemotherapy, the patient died 6 months after the initial presentation from neurological complications and multiorgan failure.

¡No me duele cuando me deprimo!: An Examination of Ethnic Differences in Depression Symptoms Among Latinx and Non-Latinx Primary Care Patients.

The research on ethnic differences in prevalence rates of depression is mixed. Additionally, culture has been hypothesized to impact symptom manifestation. The purpose of this study was to examine prevalence rates of depression among Spanish-speaking Latinx and non-Latinx White (NLW) primary care patients and explore ethnic differences in how depression symptoms manifest. Participants were 240 primary care patients who completed a demographic questionnaire and the Beck Depression-Inventory-2 (BDI-II). Latinx primary care patients had lower prevalence rates of depressive symptoms and less severe depressive symptoms than NLW primary care patients. Holding total BDI-II score constant, Latinxs also endorse pessimism, past failures, feelings of being punished, agitation, and problems with sleeping less than their NLW counterparts. This study adds support to research that indicates that Latinxs have lower rates of depression than NLWs and suggests that Latinxs are not more likely to endorse somatic complaints.

Primary diffuse large B cell lymphoma of the optic chiasm in an immunocompetent patient.

Primary lymphoma of the visual pathway is rare, especially at the chiasm. Very few cases have been reported. The lesion is frequently confused with an optic-hypothalamic glioma. A 55-year-old man was found disoriented at his home by a friend and evaluated with a brain MRI which demonstrated an expansile mass located at the optic chiasm and hypothalamus level. The principal differential was a high-grade hypothalamic glioma due to the contrast enhancement. A biopsy of the chiasmal lesion was performed. Histological diagnosis of the lesion was compatible with a diffuse large B cell lymphoma. He was started on methotrexate and rituximab; however, his clinical course kept deteriorating, and he died 64 days after his presentation. All prior cases of primary lymphoma of the chiasm are reviewed.

Association of Logic's hip hop song "1-800-273-8255" with Lifeline calls and suicides in the United States: interrupted time series analysis.

OBJECTIVE: To assess changes in daily call volumes to the US National Suicide Prevention Lifeline and in suicides during periods of wide scale public attention to the song "1-800-273-8255" by American hip hop artist Logic. DESIGN: Time series analysis. SETTING: United States, 1 January 2010 to 31 December 2018. PARTICIPANTS: Total US population. Lifeline calls and suicide data were obtained from Lifeline and the Centers for Disease Control and Prevention. MAIN OUTCOME MEASURES: Daily Lifeline calls and suicide data before and after the release of the song. Twitter posts were used to estimate the amount and duration of attention the song received. Seasonal autoregressive integrated moving average time series models were fitted to the pre-release period to estimate Lifeline calls and suicides. Models were fitted to the full time series with dummy variables for periods of strong attention to the song. RESULTS: In the 34 day period after the three events with the strongest public attention (the song's release, the MTV Video Music Awards 2017, and Grammy Awards 2018), Lifeline received an excess of 9915 calls (95% confidence interval 6594 to 13 236), an increase of 6.9% (95% confidence interval 4.6% to 9.2%, P<0.001) over the expected number. A corresponding model for suicides indicated a reduction over the same period of 245 suicides (95% confidence interval 36 to 453) or 5.5% (95% confidence interval 0.8% to 10.1%, P=0.02) below the expected number of suicides. CONCLUSIONS: Logic's song "1-800-273-8255" was associated with a large increase in calls to Lifeline. A reduction in suicides was observed in the periods with the most social media discourse about the song.

Prevalence of Interpersonal Violence Among Latinas: A Systematic Review.

Violence against women continues to be a great concern in today's society. In the United States, women experience high rates of interpersonal violence throughout their lifetime. Among Latinas, interpersonal violence is also highly prevalent however the wide variation of interpersonal prevalence rates among Latinas is problematic. The aims of this systematic review of the literature were to (1) document the prevalence rates of violence among Latinas, (2) determine the types of violence that Latinas are most impacted by, and (3) assess the prevalence rates of interpersonal across Latina subethnicities. The research was based on seven databases including PsycArticles, PsycCRITIQUES, PsycINFO, ScienceDirect, Social Services Abstracts, Social Work Abstracts, and PubMED for articles published from January 2007 up to July 2017. The following key words were used in the search: (Latinas OR Latinos OR Hispanics) AND (victim OR victimization) AND (domestic violence OR intimate partner violence OR Interpersonal Violence). We identified 41 articles in our search that reported rates of interpersonal violence which ranged from 1% to 83% with intimate partner violence and domestic violence being the most prevalent. Interpersonal violence was found to be more prevalent among individuals who identified as Mexican. Based on the findings, it is clear that efforts should be focused on conducting a lager national survey of interpersonal violence among Latinas. It would need to include subethnicity, immigration status, and type of abuse experienced and possibly add socioeconomic factors.

Mental Health Literacy, Stigma, and Behavioral Health Service Use: the Case of Latinx and Non-Latinx Whites.

OBJECTIVES: Two research questions guided this study. What is the difference, if any, between Latinx and non-Latinx Whites (NLWs) in mental health literacy about depression, depression-related stigma, and lifetime history of behavioral health service use? and Does mental health literacy and depression-related stigma mediate the relationship between ethnicity and lifetime history of behavioral health service use? METHOD/DESIGN: Data for this cross-sectional study was collected from a primary care clinic. Participants (N = 271) completed measures on mental health literacy and stigma. RESULTS: Results from a multivariate analysis of covariance revealed that Latinxs had lower levels of mental health literacy, higher levels of stigma, and lower lifetime prevalence rates of behavioral health service use. Results from a path analysis indicated that personal stigma partially mediated the relationship between ethnicity and lifetime history of behavioral health service use. CONCLUSION: Interventions targeting stigma may reduce disparities in behavioral health service utilization.