Social connections and suicidal thoughts and behavior.

Disrupted social connectedness is associated with suicidal thoughts and behaviors among individuals with substance use disorders (SUDs). The current study sought to further characterize this relationship by examining several indices of social connectedness—(a) living alone, (b) perceived social support, (c) interpersonal conflict, and (d) belongingness. Participants (n = 814) were recruited from 4 residential substance-use treatment programs and completed self-report measures of social connectedness as well as whether they had ever thought about or attempted suicide. Multivariate results indicated that interpersonal conflict and belongingness were significant predictors of a history of suicidal ideation, and that belongingness, perceived social support, and living alone were significant predictors of suicide attempt. These results indicate the most consistent support for the relationship between suicidality and thwarted belongingness, and also support the clinical utility of assessing whether individuals live alone. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Social support and suicidal ideation in French-Canadians.

70 French-Canadian men and 80 French-Canadian women completed French versions of measures including the Life Experiences Survey, Rosenberg Self Esteem Scale, Eysenck Personality Inventory, and the Minnesota Multiphasic Personality Inventory (MMPI) Depression scale as well as scales assessing social support and suicidal ideation. Results of a backstep multiple regression analysis identified level of self-esteem, life stress, and relative religiousness as significant predictors of suicidal ideation. The contribution of social support was only significant at the 10% level. The pattern of variables associated with suicidal ideation resembled that of a neurotic lifestyle. Results suggest that interventions limited to social support may not be adequate to reduce suicidal ideation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Main predictions of the interpersonal–psychological theory of suicidal behavior: Empirical tests in two samples of young adults.

The interpersonal–psychological theory of suicidal behavior (T. E. Joiner, 2005) makes 2 overarching predictions: (a) that perceptions of burdening others and of social alienation combine to instill the desire for death and (b) that individuals will not act on the desire for death unless they have developed the capability to do so. This capability develops through exposure and thus habituation to painful and/or fearsome experiences and is posited by the theory to be necessary for overcoming powerful self-preservation pressures. Two studies tested these predictions. In Study 1, the interaction of (low) family social support (cf. social alienation or low belonging) and feeling that one does not matter (cf. perceived burdensomeness) predicted current suicidal ideation, beyond depression indices. In Study 2, the 3-way interaction among a measure of low belonging, a measure of perceived burdensomeness, and lifetime number of suicide attempts (viewed as a strong predictor of the level of acquired capability for suicide) predicted current suicide attempt (vs. ideation) among a clinical sample of suicidal young adults, again beyond depression indices and other key covariates. Implications for the understanding, treatment, and prevention of suicidal behavior are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impact of social support, social cognitive variables, and perceived threat on depression among adults with diabetes.

Tested a model of social support and cognitive appraisal of self-efficacy, outcome expectancies, and illness threat on depression. Study participants were community-dwelling adults with diabetes who completed a mailed questionnaire (N?=?362). Results of structural equation modeling indicated that 52% of the variance in depression was explained by the model—largely by the direct effects of physical functioning, the perceived availability of social support, and the perceived threat of diabetes as well as the indirect paths from perceived support to perceived threat and from physical functioning to perceived support and perceived threat of diabetes. Diabetes-specific social support, self-efficacy, and outcome expectancies were not significant predictors of depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A longitudinal investigation of depression, hopelessness, social support, and major and minor life events and their relation to suicidal ideation in adolescents

The longitudinal relationship of psychological and social-environmental factors with adolescent suicidal ideation over a 1-year-period was examined in a sample of 374 high school students. Students were assessed twice over a 1-year period with measures of depression, hopelessness, major negative life events, daily hassles, social support, and suicidal ideation. At the initial assessment, daily hassles and negative life events for males and social support and depression for females were significant factors related to suicidal ideation levels 1 year later. Changes in depression and hopelessness were significantly related to changes in suicidal ideation over the 1 year interval for males and females. Differences found between males and females in the relationship of psychological and social-environmental variables with suicidal ideation supports the need to examine gender specific relationships when conducting research on suicidal behavior in adolescents.     

The prediction of suicidal intent in depressed patients

The aim of the present study was to examine the relationships between suicidal ideation or suicidal attempts and severity of depression, presence of personality disorders, and sociodemographic factors in a population of depressed in-patients. A total of 338 adult depressed psychiatric in-patients were examined and classified according to DSM-III criteria as having major depression with or without melancholic or psychotic features, adjustment disorder with depressed mood or dysthymic disorder. Scores on the Hamilton Depression Rating Scale (HDRS), Beck Depression Inventory (BDI) and Zung Self-Rating Depression and Anxiety Scales (SDS and SAS) were measured. We found that suicidal ideation was significantly related to severity of depression (according to the HDRS and all self-rating scales), a lower global assessment of functioning the year before hospitalization, and previous psychiatric hospitalizations. The items with the strongest predictive value for suicidal ideation were hopelessness, depressed mood, feelings of guilt, loss of interest and low self-esteem. These symptoms predicted 43% of the variance in suicidal ideation. None of the above predictors of suicidal ideation was related to suicidal attempts. Depressed patients with a personality disorder attempted significantly more suicidal attempts and showed more suicidal ideation than depressed patients without personality disorder. No significant correlations were found between suicidal ideation or suicide attempts and gender, marital status, employment status or psychosocial stressors during the previous 6 months.     

étude des composantes dépressives chez des adolescents à tendances suicidaires.

Studied symptoms of depression in adolescents with suicidal tendencies. Ss were 2,850 secondary school students (aged 12–18 yrs). Ss completed a questionnaire assessing sociodemographic variables, symptoms of depression, and suicidality. Results from the following subsamples were compared: (1) 105 Ss with suicidal ideation; (2) 206 Ss with suicidal ideation who had contemplated specific means of suicide; (3) 94 Ss who had attempted suicide; (4) 62 Ss with depression but without suicidal ideation; and (5) 336 age-, gender-, and grade-matched comparison Ss without suicidal ideation. The Dysphoria Scale by L. S. Radloff (1977) was used. (English abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The pharmacokinetics and physiological effects of buprenorphine infusion in premature neonates

Whereas some people appear to cope after learning that they have human immunodeficiency virus (HIV) infection, others experience depression and suicidal ideation. In this study, 142 persons with HIV infection were administered the Center for Epidemiological Studies Depression Scale (CES-D). High levels of depression were predicted by lower perceived social support, attributions that health was influenced more by chance, high-risk sexual behavior practices, and greater number of HIV illness symptoms and greater duration of time knowing of one's own positive serostatus. Ongoing high-risk sexual behavior practices were predicted by higher levels of recreational drug use and of depression. These findings highlight the need for improved mental health services for persons with HIV conditions.     

Depression, PTSD, and suicidal ideation among active duty veterans in an integrated primary care clinic.

Active duty veterans increasingly access primary care for needed mental health services, but the relationship among depression, PTSD, and suicidal ideation in this subpopulation remains unclear. The relationship is explored in 120 active duty members treated in a military integrated primary care behavioral health service. Logistic regression analyses resulted in a significant relationship between PTSD and suicidal ideation, but this relationship was fully explained by depression symptoms. The interaction between depression and PTSD symptoms was likewise unrelated to suicidal ideation, and it did not improve overall model fit, suggesting that depression independently explained increased risk for suicidal ideation in the current sample. The authors discuss the differences between suicidal ideation and suicidal behaviors, and how depression and PTSD symptoms might differentially relate to each. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Factors associated with severity of depression and high-risk sexual behavior among persons diagnosed with human immunodeficiency virus (HIV) infection.

Whereas some people appear to cope after learning that they have HIV infection, others experience depression and suicidal ideation. In this study, 142 persons with HIV infection were administered the Center for Epidemiological Studies Depression Scale. High levels of depression were predicted by lower perceived social support, attributions that health was influenced more by chance, high-risk sexual behavior practices, and greater number of HIV illness symptoms and greater duration of time knowing of one's own positive serostatus. Ongoing high-risk sexual behavior practices were predicted by higher levels of recreational drug use and of depression. These findings highlight the need for improved mental health services for persons with HIV conditions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differentiating suicidal motivations and manifestations in a nonclinical population.

Investigated the relationships among three indices of suicidal behaviour (ideation, attempts, reported likelihood to commit) and four predictors (depression, hopelessness, motivations based on internal perturbations, extrapunitive/manipulative motivations). 262 nonclinical participants (aged 17–70 yrs) completed measures including the Beck Depression Inventory and the Reasons for Attempting Suicide Questionnaire. Three key findings emerged. First, not all indices of suicidal behaviour were equivalent. Second, hopelessness and motivations based on internal perturbations were consistently the significant, nonredundant predictors of the various suicide indices. Third, two underlying dimensions explained the relationships among variables: negative cognitions and action orientation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Behavioral correlates of depression: Antecedents or consequences?

We compared J. C. Coyne's (see record 1976-22455-001) interpersonal model of depression to P. M. Lewinsohn's (1974) social skill model of depression in a large sample of nonreferred college students. Ss completed questionnaires on social skill, social support, depression, hopelessness, social anxiety, and social desirability. Linear structural equation modeling results partially supported Coyne's theory that depression inhibits social skill and social skill deficits negatively affect social support. Lewinsohn's theory that social skill deficits promote depression was not supported. Contrary to both Coyne and Lewinsohn, no evidence of a direct relation between social support and depression was found. Results suggested that social skill deficits are a consequence, not a cause, of depression. Implications for counseling process and interpersonal models of individual pathology are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Suicidal thinking among adolescents with a history of attempted suicide

OBJECTIVE: To examine the risk of suicidal plans and ideation, depression, and other factors (low self-esteem, loneliness, fatalism, pessimism) among adolescents with a lifetime history of attempted suicide. METHOD: A self-administered questionnaire was used in a school-based survey of five middle schools (grades 6 through 8) enrolling 6,400 students. Usable questionnaires were obtained from 5,423 (85.3%). Data were obtained on a wide range of constructs including recent and lifetime suicide attempts, recent and lifetime suicide plans, recent ideation, symptoms of DSM-IV major depression, self-esteem, pessimism, loneliness, and fatalism. RESULTS: Data on crude prevalence showed thoughts about death, wishing to be dead, thoughts of suicide, and suicide plans were all significantly higher among youths with a history of attempts. Suicidal thinking was related to being more lonely, more fatalistic, and more pessimistic, and to less self-esteem, in addition to depression and a history of attempts. Multivariate analyses revealed the strongest factors associated with current suicidal thinking were history of attempts (odds ratio [OR] = 3.50), depression (OR = 5.34), and recent life stress (OR = 2.64). Compared with youths with none of the factors examined, those with six or more were at extreme risk (OR = 67.87). CONCLUSIONS: The strong association between history of suicide attempts, current ideation, and depression indicates that past suicide attempts occur in the context of other signs of psychosocial dysfunction. Given the paucity of epidemiological data on the natural history of suicidal behaviors among youths, more epidemiological studies of the antecedents and consequences of the range of suicidal behaviors among children and adolescents are needed. Given the high risk of subsequent suicidal behaviors by youths who have attempted but not completed suicide, this constitutes a high-risk population on which future research should focus.     

Risk for suicidal ideation in the U.S. Air Force: An ecological perspective.

Objective: Suicidal members of the U.S. military often fail to disclose their suicidal urges and behaviors. Military suicide prevention efforts may therefore be enhanced if they also target less stigmatized psychosocial factors that may decrease risk of suicidality. In keeping with Bronfenbrenner's (1977, 1994) model, this study simultaneously examined 4 ecological levels (i.e., individual, family, workplace, and community) of factors variously associated with increased or decreased risk for suicidal ideation. Method: Active-duty U.S. Air Force members (N = 52,780; 79.3% male; 79.2% non-Hispanic White; mean age = 31.78 years, SD = 7.38) completed the 2006 Community Assessment survey (a biennial, anonymous survey conducted at 82 U.S. Air Force bases worldwide), including the Centers for Disease Control and Prevention's (2008) 5-item measure of past-year suicidality along with scales assessing an array of potential predictors. Results: The 1-year rate of suicidal ideation, defined as (a) more than rarely thinking about suicide or (b) ever seriously considering suicide, was approximately 4%. In multivariate models, for men and women, individual- (depressive symptoms and alcohol problems), family- (relationship satisfaction and intimate partner victimization), workplace- (hours worked), and community-level (social support) variables were retained in the final model. However, some sex differences in retained predictors were noted (e.g., men: dissatisfaction with the U.S. Air Force way of life; women: workplace relationship satisfaction and financial stressors). Conclusions: Addressing depressive symptoms and alcohol use, facilitating healthy relationship functioning, and increasing job satisfaction and social support may aid military suicide prevention efforts. These findings illustrate the importance of attending to multiple levels of potential influence when designing integrated suicide prevention and intervention programs. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Stress, maternal distress, and children's adjustment following immigration: The buffering role of social support.

This study examined, in the context of a stress-buffering model, the relationship of certain family level variables to children's adjustment after immigration. Immigrant Chinese mothers from Hong Kong completed questionnaires regarding postmigration stress, personal distress, perceived social support, and their child's adjustment. Another adult also provided child behavior ratings. Analyses revealed that, for boys, family stress and maternal distress were significant predictors of child problems and that maternal support buffered the association between family stress and child problems. Contrary to expectation, the relationship between maternal distress and boys' problems was stronger at higher levels of maternal support. For families of girls, although there were significant relationships between the predictors and child behavior, no stress buffering was evident. Cultural explanations are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An integrated model of self-harm: Identifying predictors of intent.

The present study was conducted to investigate a Theory of Planned Behaviour (TPB) model, which integrated social–cognitive and symptom variables as predictors of self-harm intent. Participants were 62 young adults with a history of self-harm who completed a series of online questionnaires to investigate the role of depressive symptoms and TPB components as predictors of self-harm intent. Social–cognitive variables predicted unique variance in self-harm intent after controlling for depressive symptoms. Specifically, more favourable attitudes toward self-harm and a lack of perceived behaviour control at the time of self-harm were unique predictors of intent. In the context of more frequent self-harm, attitudes remained a significant and unique predictor of self-harm intent. Favourable attitudes toward self-harm and a lack of perceived control at the time it occurred partially mediate the relation between depressive symptoms and self-harm intent. Findings provide preliminary support for a self-harm model comprising symptom and social–cognitive variables. Results offer new avenues for future research, highlight conceptual issues, and suggest several clinical implications. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hopelessness as a measure of suicidal intent in the depressed elderly.

Suicidal ideation in the elderly has been related to depression, changes in health, and anticipation of a limited future. The present study examined the Hopelessness Scale (HS) and its relation to these factors in a depressed geriatric population. A total of 120 elderly outpatients, who had applied to receive psychotherapy for depression, completed the HS, Beck Depression Inventory (BDI), health ratings, and the Schedule for Affective Disorder and Schizophrenia (SADS) at intake. The HS was found to be internally consistent, and a principal components analysis revealed three distinct factors that were related to hope, feelings of giving up, and future planning. The HS, BDI, and health ratings were predictive of suicidal ideation as measured by specific items in the SADS. The relation among suicidal ideation hopelessness, depression, and health perceptions for the depressed aged are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Computerized prompts for cancer screening in a community health center

One hundred eleven (58%) of 191 adolescent inpatients previously admitted to the emergency wards at the Child and Adolescent Psychiatric Clinics in the cities of Uppsala and G?teborg participated in a 2-4 year follow-up evaluation. The prevalence, incidence, and stability of depressive symptoms, suicidal ideation, and suicide attempts among the adolescents, and predictors of follow-up functioning were examined. Although a majority of the patients substantially reduced their depressive symptoms over the 2-4 year period, a smaller group (13%), mainly girls (94%), continued reporting high symptom levels at follow-up, and one out of five adolescents had moderate-severe levels of suicidal ideation. The accumulated frequency of suicide attempts among the patients shortly prior to hospitalization and during the follow-up was 59% including two patients who committed suicide. Significant predictors of depressive symptom severity at follow-up were depressive symptom scores and V-diagnoses at inpatient assessment. Previous suicide attempts before hospitalization, high levels of self-reported depressive symptoms and nonintact family status at inpatient assessment predicted suicide attempts during the follow-up period. The high prevalence of attempted and completed suicide in this clinical group underscores the importance of developing effective treatments for suicidal adolescents.     

Help-seeking tendencies in Asian Americans with suicidal ideation and attempts.

Among rising concerns surrounding heightened suicide in certain subgroups of Asian Americans, it is important to understand the help-seeking rates and pathways among Asian Americans experiencing suicidality. This study examined perceived need for care, help-seeking behavior, and chosen sources of care among Asian Americans compared with Latinos in the National Latino and Asian American Study who reported a history of lifetime suicidal ideation, suicide attempts, or mental disorders without history of suicide. Consistent with existing literature in Caucasians, suicide attempts in Asian Americans and Latinos were related to greater help seeking and perceived need beyond that of mental disorders only. However, Asian Americans with suicide attempts still reported lower perceived need and help-seeking behaviors compared with Latinos. In contrast to both the existing literature and Latinos in this study, Asian Americans with suicidal ideation were no more likely to perceive a need for help or seek help than Asian Americans with a mental disorder without history of suicide and were less likely to seek and perceive a need for help than Latinos with suicidal ideation. These findings point to the idea that Asian Americans who have serious suicidal ideation or attempts may underestimate the importance of their condition and do not receive the level of attention and support needed. Findings also show that Asian Americans with suicidal ideation and attempts prefer seeking help from nonprofessional rather than professional sources of help, other than medical professionals. Clinical implications for outreach, assessment, and management of suicide are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Suicide ideation in a college population: A test of a model.

Examined a model of suicide behavior with 65 undergraduate suicide ideators (as measured by a self-report adaptation of the Scale for Suicide Ideators). The model focuses on the relationship between negative life stress, cognitive rigidity and/or poor problem-solving skills, hopelessness, and suicide ideation and attempting. The model proposes that individuals deficient in the capacity for divergent thinking are cognitively unprepared to cope with the high levels of life stress observed in suicide attempters and, as a result, are likely to become hopeless under such circumstances. This hopelessness resulting from the individual's inability to engage in effective problem-solving places the individual at risk for suicidal behavior. Ss were administered a battery of tests that included the Self-Rating Depression Scale, Life Experiences Survey, and Hopelessness Scale. Results indicate that Ss were under higher levels of negative life stress, were more hopeless, and had higher levels of depression than their nonideating peers. Although no relationship was observed between suicide ideation and cognitive rigidity or between suicide intent and cognitive rigidity, poor problem-solvers under high stress were found to be significantly higher on suicide intent than any other group. Results support a stress/problem-solving model of suicidal behavior in which poor problem-solvers under high life stress are considered to be at risk for depression, hopelessness, and suicidal behavior. (19 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)