Flipping up the board: Losing my mother to suicide.

Personal account of losing a parent due to a firearm and a completed suicide attempt related to mental health crisis.

The Perceived Experience of Children Bereaved by Parental Suicide.

Children whose parent died by suicide are a vulnerable and underserved population. This phenomenon will be described, as well as implications for practice and research. "Double Whammy," a conceptualization of the overall experience of this marginalized group, emerged through two in-depth interviews from a phenomenological qualitative study with professionals who facilitate support groups for children bereaved by parental suicide. It was corroborated with current literature and practice experiences of the authors and their colleagues. Stigma was the largest contributor to the "Double Whammy," and the following themes emerged as well: feeling isolated, feeling abandoned, and feeling responsible. The self-volition of suicide challenges how bereaved children make meaning and internalize feelings about the deceased parent, one's self, and others. Developmentally appropriate education about suicide grief, depression, and normalizing the grief process is pivotal in helping children to effectively cope and manage their feelings.

Effectiveness and Acceptability of Interventions Offered for Those Bereaved by Parental Loss to Suicide in Childhood: A Mixed Methods Systematic Review.

OBJECTIVES: Identify interventions offered for children bereaved by parental suicide, investigate reported effectiveness and explore the acceptability of identified interventions. METHOD: Six electronic databases were systematically searched for primary studies investigating intervention effectiveness and acceptability, (August 2011 to June 2023). Eligibility required inclusion of participants bereaved by parental suicide during childhood among sample populations. Methodological quality was evaluated applying JBI critical appraisal tools. Narrative synthesis was conducted using parallel-results convergent design. RESULTS: Of the 22 eligible reports, 19 articles reported on 12 manual-based supports provided during childhood; three papers described users' experiences of various specified intervention types offered following childhood loss. Twenty-one studies reported on interventions offered for heterogeneous participant groups that included children bereaved by parental suicide. Time from loss to intervention generally included both recent (1 < 30mths) and more distant loss, with just one intervention described as solely for recently bereaved children. Eight interventions (n = 12 studies) demonstrated significant positive effects (p < 0.05), for maladaptive grief, mental health, quality of life. Only one study investigated suicide-related outcomes. Qualitative findings (n = 8 studies) facilitated development of four acceptability themes: Perceived utility, Relationships, Components and Delivery. CONCLUSIONS: Heterogeneity in causes of loss/trauma and relationships with the deceased limit specific conclusions regarding effectiveness/acceptability of reviewed interventions for children bereaved by parental suicide. Few sub-group analyses of effects were reported, and qualitative evidence specifically from children bereaved by parental suicide was limited. Further research is recommended regarding mixed-user interventions, specifically for children bereaved by parental suicide.

Significant effects: improved grief responses, mental health, quality of lifeAcceptability themes: Perceived utility, Relationships, Components, DeliveryFindings derive from research involving heterogenous user groups.

Parental suicide attempt and subsequent risk of pre-enlistment suicide attempt among male and female new soldiers in the U.S. Army.

OBJECTIVE: Suicide and suicide attempts among U.S. Army soldiers are a significant concern for public health. This study examined the association of parental suicide attempt prior to age 13 of the soldier with subsequent risk of pre-enlistment suicide attempt. METHOD: We conducted secondary analyses of survey data from new soldiers who participated in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) (N = 38,396). A series of logistic regression analyses were conducted. RESULTS: Of all new soldiers, 1.4% reported that they attempted suicide between age 13 and entering the Army, and 2.3% reported a parental suicide attempt prior to age 13. Parental suicide attempt was associated with increased odds of subsequent suicide attempt; however, this association was moderated by gender and was significant only among male soldiers. The association between parental suicide attempt and pre-enlistment suicide attempt among male soldiers was still significant after controlling for socio-demographic characteristics, soldier/parental psychopathology, and childhood adversities. CONCLUSIONS: These results highlight parental suicide attempt as a unique pre-enlistment risk factor for suicide attempt, especially among male new soldiers. Further studies are needed to separate the genetic and environmental contributions to intra-familial risk for suicidal behavior.

Age at Exposure to Parental Suicide and the Subsequent Risk of Suicide in Young People.

BACKGROUND: We investigated the age at exposure to parental suicide and the risk of subsequent suicide completion in young people. The impact of parental and offspring sex was also examined. METHOD: Using a cohort study design, we linked Taiwan's Birth Registry (1978-1997) with Taiwan's Death Registry (1985-2009) and identified 40,249 children who had experienced maternal suicide (n = 14,431), paternal suicide (n = 26,887), or the suicide of both parents (n = 281). Each exposed child was matched to 10 children of the same sex and birth year whose parents were still alive. This yielded a total of 398,081 children for our non-exposed cohort. A Cox proportional hazards model was used to compare the suicide risk of the exposed and non-exposed groups. RESULTS: Compared with the non-exposed group, offspring who were exposed to parental suicide were 3.91 times (95% confidence interval [CI] = 3.10-4.92 more likely to die by suicide after adjusting for baseline characteristics. The risk of suicide seemed to be lower in older male offspring (HR = 3.94, 95% CI = 2.57-6.06), but higher in older female offspring (HR = 5.30, 95% CI = 3.05-9.22). Stratified analyses based on parental sex revealed similar patterns as the combined analysis. LIMITATIONS: As only register--based data were used, we were not able to explore the impact of variables not contained in the data set, such as the role of mental illness. CONCLUSION: Our findings suggest a prominent elevation in the risk of suicide among offspring who lost their parents to suicide. The risk elevation differed according to the sex of the afflicted offspring as well as to their age at exposure.

Childhood exposure to a parental suicide attempt and risk for substance use disorders.

Childhood exposure to parental suicidal behavior has been linked to a variety of adverse behavioral and health outcomes. However, relatively little is known about the degree to which such exposure may place individuals at risk for a substance use disorder (SUD). Employing data from the National Epidemiologic Survey on Alcohol and Related Conditions, we compared the prevalence of SUDs among those who experienced childhood exposure to parental suicide attempts. Childhood exposure to parental suicide attempts was not associated with increased risk for the development of alcohol, cannabis, or cocaine use disorders. However, individuals who were exposed to a parental suicide attempt as children were significantly more likely to have met criteria for stimulant (AOR=1.40, 95% CI=1.18-1.67), sedative (AOR=1.24, 95% CI=1.04-1.47), tranquilizer (AOR=1.78, 95% CI=1.45-2.20), and opioid (AOR=1.41, 95% CI=1.19-1.67) use disorders in their lifetime. No significant gender differences were identified with respect to the magnitude of the relationship between exposure to parental suicide attempts and SUD risk among men and women. Findings suggest that, controlling for an array of sociodemographic, parental, mental health, and childhood adversity confounds, childhood exposure to parental suicide attempts is a vulnerability factor for low prevalence illicit drugs (i.e. stimulants, sedatives, tranquilizers, opioids), but not for more commonly used substances.