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The British Journal of Clinical... Nov 2022We examined associations between the severity of symptoms of prolonged grief disorder (PGD) and depression and recent suicidal ideation among bereaved family members.
OBJECTIVES
We examined associations between the severity of symptoms of prolonged grief disorder (PGD) and depression and recent suicidal ideation among bereaved family members.
METHODS
Individuals who survived the death of a family member 1-8 year earlier (N = 225) were surveyed using self-report measures in the cross-sectional study. Regression analyses were conducted to test the multivariable effects of PGD and depression symptom severity-including their interactive effect-on recent suicidal ideation among the full sample and subsample of suicidal ideators (n = 38).
RESULTS
The severity of PGD symptoms was positively associated with frequency of recent suicidal ideation in the full sample and subsample of suicidal ideators. Depressive symptoms were positively related to suicidal ideation in the full sample; however, they were significant only in the presence of PGD symptoms in the subsample of suicidal ideators.
CONCLUSIONS
Severity of PGD and depression symptoms are positively associated with suicidal ideation among bereaved individuals, highlighting the need to attend to both PGD and depressive symptoms in understanding risk for suicidal ideation among bereaved individuals.
Topics: Bereavement; Cross-Sectional Studies; Depression; Grief; Humans; Prolonged Grief Disorder; Suicidal Ideation
PubMed: 35869636
DOI: 10.1111/bjc.12381 -
Nature Human Behaviour May 2023
Topics: Humans; Suicidal Ideation; Suicide; Risk Factors
PubMed: 37024723
DOI: 10.1038/s41562-023-01560-6 -
Journal of Medical Internet Research Jun 2023Suicide is a global public health problem. Digital interventions are considered a low-threshold treatment option for people with suicidal ideation or behaviors.... (Meta-Analysis)
Meta-Analysis Review
The Effects of Internet-Based Cognitive Behavioral Therapy for Suicidal Ideation or Behaviors on Depression, Anxiety, and Hopelessness in Individuals With Suicidal Ideation: Systematic Review and Meta-Analysis of Individual Participant Data.
BACKGROUND
Suicide is a global public health problem. Digital interventions are considered a low-threshold treatment option for people with suicidal ideation or behaviors. Internet-based cognitive behavioral therapy (iCBT) targeting suicidal ideation has demonstrated effectiveness in reducing suicidal ideation. However, suicidal ideation often is related to additional mental health problems, which should be addressed for optimal care. Yet, the effects of iCBT on related symptoms, such as depression, anxiety, and hopelessness, remain unclear.
OBJECTIVE
We aimed to analyze whether digital interventions targeting suicidal ideation had an effect on related mental health symptoms (depression, anxiety, and hopelessness).
METHODS
We systematically searched CENTRAL, PsycInfo, Embase, and PubMed for randomized controlled trials that investigated guided or unguided iCBT for suicidal ideation or behaviors. Participants reporting baseline suicidal ideation were eligible. Individual participant data (IPD) were collected from eligible trials. We conducted a 1-stage IPD meta-analysis on the effects on depression, anxiety, and hopelessness-analyzed as 2 indices: symptom severity and treatment response.
RESULTS
We included IPD from 8 out of 9 eligible trials comprising 1980 participants with suicidal ideation. iCBT was associated with significant reductions in depression severity (b=-0.17; 95% CI -0.25 to -0.09; P<.001) and higher treatment response (ie, 50% reduction of depressive symptoms; b=0.36; 95% CI 0.12-0.60; P=.008) after treatment. We did not find significant effects on anxiety and hopelessness.
CONCLUSIONS
iCBT for people with suicidal ideation revealed significant effects on depression outcomes but only minor or no effects on anxiety and hopelessness. Therefore, individuals with comorbid symptoms of anxiety or hopelessness may require additional treatment components to optimize care. Studies that monitor symptoms with higher temporal resolution and consider a broader spectrum of factors influencing suicidal ideation are needed to understand the complex interaction of suicidality and related mental health symptoms.
Topics: Humans; Depression; Suicidal Ideation; Anxiety; Cognitive Behavioral Therapy; Internet
PubMed: 37358893
DOI: 10.2196/46771 -
BMC Psychiatry May 2022Suicidal ideation in cancer patients is a critical challenge. At present, few studies focus on factors associated with suicidal ideation, and predictive models are still...
BACKGROUND
Suicidal ideation in cancer patients is a critical challenge. At present, few studies focus on factors associated with suicidal ideation, and predictive models are still lacking. This study aimed at investigating the risk factors for suicidal ideation among cancer patients, and developed a predictive nomogram to screen high risk cancer patients for early prevention and intervention.
METHODS
A questionnaire survey was conducted among cancer patients between May 2021 and January 2022. The factors associated with suicidal ideation were used to construct a multivariate logistic regression model, which was visualized as a predictive nomogram to evaluate the risk of suicidal ideation. Areas under the curve, calibration plot, decision curve analysis, and internal and external validation were used to validate the discrimination, calibration and clinical usefulness of the model.
RESULTS
A total of 820 patients with cancer were recruited for this study and 213 (25.98%) developed suicidal ideation. Levels of demoralization, depression and cancer staging, marital status, residence, medical financial burden, and living condition were influence factors for suicidal ideation. Comparing nomogram with Self-rating Idea of Suicide Scale (SIOSS), the nomogram had a satisfactory discrimination ability with an AUC of 0.859 (95% CI: 0.827-0.890) and 0.818 (95% CI: 0.764-0.873) in the training and validation sets, respectively. The calibration plot and decision curve analysis revealed that this nomogram was in good fitness and could be beneficial in clinical applications.
CONCLUSIONS
Suicidal ideation is common in cancer patients. Levels of demoralization, depression and cancer staging were independent predictors of suicidal ideation. The nomogram is an effective and simple tool for predictive suicidal ideation in cancer patients.
Topics: Factor Analysis, Statistical; Humans; Neoplasms; Nomograms; Risk Factors; Suicidal Ideation
PubMed: 35610595
DOI: 10.1186/s12888-022-03987-z -
Psychophysiology Dec 2021Suicidal thoughts and behaviors (STBs) are thought to result from, at least in part, abnormalities in various neural systems. Event-related potentials (ERPs) are a... (Meta-Analysis)
Meta-Analysis
Suicidal thoughts and behaviors (STBs) are thought to result from, at least in part, abnormalities in various neural systems. Event-related potentials (ERPs) are a useful method for studying neural activity and can be leveraged to study neural deficits related to STBs; however, it is unknown how effective ERPs are at differentiating various STB groups. The present meta-analysis examined how well ERPs can differentiate (a) those with and without suicidal ideation, (b) those with and without suicide attempts, (c) those with different levels of suicide risk, and (d) differences between those with suicide attempts versus those with suicidal ideation only. This meta-analysis included 208 effect sizes from 2,517 participants from 27 studies. We used a random-effects meta-analysis using a restricted maximum likelihood estimator with robust variance estimation. We meta-analyzed ERP-STB combinations that had at least three effect sizes across two or more studies. A qualitative review found that for each ERP and STB combination, the literature is highly mixed. Our meta-analyses largely did not find significant relationships between STBs and ERPs. We also found that the literature is likely severely underpowered, with most studies only being sufficiently powered to detect unrealistically large effect sizes. Our results provided little-to-no support for a reliable relationship between the ERPs assessed and STBs. However, the current literature is severely underpowered, and there are many methodological weaknesses that must be resolved before making this determination. We recommend large-scale collaboration and improvements in measurement practices to combat the issues in this literature.
Topics: Evoked Potentials; Humans; Suicidal Ideation; Suicide, Attempted
PubMed: 34494671
DOI: 10.1111/psyp.13939 -
Annals of Clinical Psychiatry :... Nov 2023Suicide is a leading cause of death in adolescents. Problematic internet use (PIU) has been associated with suicidal behavior in this age group. To assess this... (Review)
Review
BACKGROUND
Suicide is a leading cause of death in adolescents. Problematic internet use (PIU) has been associated with suicidal behavior in this age group. To assess this association, we reviewed population-based studies that examined the relationship between PIU and suicidal behavior.
METHODS
We searched PubMed, PsycINFO, and Web of Science for studies published in English from 1995 through 2021. Only studies with the stated aim to examine the relationship between PIU and suicidal behavior in participants age 13 through 18 were included. Also, each study had to include a measure of internet overuse with resultant impairment/distress. To minimize selection bias, studies with convenience samples were excluded.
RESULTS
Seven cross-sectional studies with at least 9,500 participants each met the inclusion/exclusion criteria. Five assessed both suicidal ideation and suicide attempts and 2 examined suicidal ideation only. All studies found a statistically significant association between suicidal behavior and PIU. Effect sizes were mostly in the minimal to small range.
CONCLUSIONS
All 7 studies supported a positive relationship between PIU and suicidal ideation and suicide attempts, which could be clinically important. Longitudinal studies with improved methodology are needed to identify risk factors and determine whether PIU is causally related to suicidality.
Topics: Humans; Adolescent; Suicidal Ideation; Internet Use; Cross-Sectional Studies; Suicide, Attempted; Internet
PubMed: 37850997
DOI: 10.12788/acp.0119 -
Journal of Affective Disorders Dec 2020Depression and other psychopathology are often assessed retrospectively. Few studies have evaluated the validity of these reports by comparing prospectively-assessed...
BACKGROUND
Depression and other psychopathology are often assessed retrospectively. Few studies have evaluated the validity of these reports by comparing prospectively-assessed symptoms to retrospective reports during the same time period.
METHODS
This study utilized a subset of participants (n = 68) from the Oregon Adolescent Depression Project who completed at least one mailer assessment of depressive symptoms during a retrospectively-reported depressive episode. Participants completed up to seven mailer assessments of depression and suicidal ideation and diagnostic assessments that included retrospectively-reported depressive episodes that coincided with the mailer assessments.
RESULTS
Multilevel linear models examined differences in depressive symptoms and suicidal ideation during and between retrospectively-reported depressive episodes. Results showed that individuals reported significantly higher levels of depression and suicidal ideation for retrospectively-reported depressive episodes compared to when they were not in depressive episodes. In addition, the average level of depressive symptoms endorsed during retrospectively-reported depressive episodes reached established clinical cut-offs.
LIMITATIONS
Although we were able to determine whether symptoms during retrospectively-reported depressive episodes approached clinical cut-offs, we were unable to examine whether symptoms met criteria for depressive episodes. Additionally, we could not examine whether episode severity related to recall ability, and other forms of psychopathology were not assessed.
CONCLUSION
These findings provide critical evidence for the validity of retrospectively-reported depressive episodes. Future research should examine whether these findings generalize across varying recall periods and retrospective assessments for other psychopathology.
Topics: Adolescent; Depression; Humans; Retrospective Studies; Suicidal Ideation
PubMed: 33065833
DOI: 10.1016/j.jad.2020.08.067 -
Psychosocial Intervention Aug 2023In recent years, suicide rates among bullying victims have raised much concern among educators and health professionals. Suicide is the fourth leading cause of...
In recent years, suicide rates among bullying victims have raised much concern among educators and health professionals. Suicide is the fourth leading cause of preventable death among adolescents, data that warn about the need to monitor the signs before victims' suicidal behavior to prevent this fatal outcome. In the present study, the role of victims' silence about their victimization situation was analysed, as well as the particular impact of family and school environments. More specifically, we examined the mediating role of the victim's non-disclosure between the parental styles (observing the father's and mother's roles separately) and the school climate, concerning suicidal ideation in victims. The sample consisted of 2,977 adolescents (48.5% boys), aged 11-17 years ( = 14.1, = 1.42), of whom 635 (21.3%) reported having been victims of bullying in the past year. The results showed that parental styles of rejection and indifference were positively related to victims' non-disclosure of bullying and suicidal ideation. Conversely, a positive school climate showed a negative relationship with victims' disclosure of the bullying situation and suicidal ideation. The findings also indicated that non-disclosure mediates the relationship between the mother's parental style and suicidal ideation. These findings expand knowledge about the role of bullying victims' social context and the variable disclosure with regards to suicidal ideation in adolescents victimized by peers at school.
Topics: Male; Humans; Adolescent; Female; Suicidal Ideation; Suicide; Social Environment; Bullying; Schools
PubMed: 37691712
DOI: 10.5093/pi2023a13 -
Journal of Affective Disorders Feb 2023Suicidal behavior is associated with deficits in cognitive control; however, suicidal ideation (SI), a key precursor to suicidal behavior, has been less consistently...
Suicidal behavior is associated with deficits in cognitive control; however, suicidal ideation (SI), a key precursor to suicidal behavior, has been less consistently linked to neuropsychological functioning. Additionally, no study to date has examined attentional control capacities in relation to variability in suicidal ideation, defined as fluctuation in SI intensity and duration across short periods of time. Prior research suggests that suicidal individuals with highly variable SI experience greater stress-responsive increases in SI and cortisol, potentially raising risk for suicidal behavior. Here, we examined attentional control capacities associated with SI variability and severity in ninety-five subjects with major depressive disorder. Variability and severity of SI and depressive affect were quantified using Ecological Momentary Assessment (EMA) over a 7-day period. Participants completed the Continuous Performance Task (CPT) and a computerized Stroop task for assessment of attentional control. EMA SI variability was associated with greater attentional interference on the Stroop task, and this was not accounted for by severity of SI, concurrently assessed depressive affect, or baseline depression. CPT performance was not related to SI variability or intensity. Findings highlight the utility of EMA methods in characterizing patterned experiences of SI and suggest that attentional control deficits may contribute to these characteristic patterns.
Topics: Humans; Attention; Depressive Disorder, Major; Ecological Momentary Assessment; Suicidal Ideation
PubMed: 36549341
DOI: 10.1016/j.jad.2022.12.053 -
Clinical Psychology & Psychotherapy Sep 2019Self-compassion has been implicated in the aetiology and course of mental health with evidence suggesting an association between greater self-compassion and lower...
Self-compassion has been implicated in the aetiology and course of mental health with evidence suggesting an association between greater self-compassion and lower emotional distress. However, our understanding of the nature and extent of the relationship between self-compassion and self-harm (self-injury regardless of suicidal intent) or suicidal ideation remains unclear. This review, therefore, aimed to critically evaluate the extant literature investigating this relationship. To do so, a systematic search, including terms synonymous with self-compassion, was conducted on three main psychological and medical databases (Web of Science, PsycINFO, and Medline). Only studies investigating self-compassion or self-forgiveness and self-harm or suicidal ideation were found to be relevant to the review. Eighteen studies were included in the final narrative synthesis. Heterogeneity of studies was high, and the majority of studies were quantitative and cross-sectional (n = 16) in design. All studies reported significant associations between higher levels of self-forgiveness or self-compassion and lower levels of self-harm or suicidal ideation. Several studies suggested that self-compassion or self-forgiveness may weaken the relationship between negative life events and self-harm. In conclusion, this review highlights the potential importance of self-compassion in the aetiology of suicidal thoughts and self-harm. We discuss the clinical and research implications.
Topics: Empathy; Forgiveness; Humans; Risk Factors; Self-Injurious Behavior; Suicidal Ideation
PubMed: 31046164
DOI: 10.1002/cpp.2372