Attachment Organization in Suicide Prevention Research

Crisis ◽  
2014 ◽  
Vol 35 (1) ◽  
pp. 60-66 ◽  
Author(s):  
Amanda Venta ◽  
Carla Sharp

Background: Identifying risk factors for suicide-related thoughts and behaviors (SRTB) is essential among adolescents in whom SRTB remain a leading cause of death. Although many risk factors have already been identified, influential theories now suggest that the domain of interpersonal relationships may play a critical role in the emergence of SRTB. Because attachment has long been seen as the foundation of interpersonal functioning, we suggest that attachment insecurity warrants attention as a risk factor for SRTB. Aims: This study sought to explore relations between attachment organization and suicidal ideation, suicide attempts, and self-harm in an inpatient adolescent sample, controlling for demographic and psychopathological covariates. Method: We recruited 194 adolescents from an inpatient unit and assigned them to one of four attachment groups (secure, preoccupied, dismissing, or disorganized attachment). Interview and self-report measures were used to create four variables reflecting the presence or absence of suicidal ideation in the last year, single lifetime suicide attempt, multiple lifetime suicide attempts, and lifetime self-harm. Results: Chi-square and regression analyses did not reveal significant relations between attachment organization and SRTB, although findings did confirm previously established relations between psychopathology and SRTB, such that internalizing disorder was associated with increased self-harm, suicide ideation, and suicide attempt and externalizing disorder was associated with increased self-harm. Conclusion: The severity of this sample and methodological differences from previous studies may explain the nonsignificant findings. Nonsignificant findings may indicate that the relation between attachment organization and SRTB is moderated by other factors that should be explored in future research.

Crisis ◽  
2011 ◽  
Vol 32 (5) ◽  
pp. 283-287 ◽  
Author(s):  
L. F. Chan ◽  
T. Maniam ◽  
A. S. Shamsul

Background: Depressed inpatients constitute a high-risk population for suicide attempts. Aims: To describe the interactions of clinical and psychosocial risk factors influencing suicide attempts among a Malaysian sample of depressed inpatients. Methods: Seventy-five subjects were diagnosed with a depressive disorder according to the Structured Clinical Interview for DSM-IV Axis I Disorders-Clinical Version (SCID-CV). Data on suicide attempts, suicidal ideation (Scale for Suicidal Ideation, SSI), depression severity (Beck’s Depression Inventory, BDI), recent life-event changes (Social Readjustment Rating Scale, SRRS), sociodemographic and other relevant clinical factors were collected. Results: A third of the subjects presented after a current suicide attempt. Significant factors for a current suicide attempt were race, religion, recent life-event changes, suicidal ideation, and alcohol use disorder. Independent predictive risk factors for a current suicide attempt were Chinese race, recent marital separation, major mortgage or loans, and being newly diagnosed with depression. Any recent change in personal habits was shown to be a protective factor against current suicide attempt. Age and gender were nonsignificant factors. Conclusions: The findings are generally consistent with existing studies and highlight the role of psychosocial risk factors.


2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Silje Støle Brokke ◽  
Thomas Bjerregaard Bertelsen ◽  
Nils Inge Landrø ◽  
Vegard Øksendal Haaland

Abstract Background Suicide attempt is the most predictive risk factor of suicide. Trauma – especially sexual abuse – is a risk factor for suicide attempt and suicide. A common reaction to sexual abuse is dissociation. Higher levels of dissociation are linked to self-harm, suicide ideation, and suicide attempt, but the role of dissociation in suicidal behavior is unclear. Methods In this naturalistic study, ninety-seven acute psychiatric patients with suicidal ideation, of whom 32 had experienced sexual abuse, were included. Suicidal behaviour was assessed with The Columbia suicide history form (CSHF). The Brief trauma questionnaire (BTQ) was used to identify sexual abuse. Dissociative symptoms were assessed with Dissociative experiences scale (DES). Results Patients who had experienced sexual abuse reported higher levels of dissociation and were younger at onset of suicidal thoughts, more likely to self-harm, and more likely to have attempted suicide; and they had made more suicide attempts. Mediation analysis found dissociative experiences to significantly mediate a substantive proportion of the relationship between sexual abuse and number of suicide attempts (indirect effects = 0.17, 95% CI = 0.05, 0.28, proportion mediated = 68%). Dissociative experiences significantly mediated the role of sexual abuse as a predictor of being in the patient group with more than four suicide attempts (indirect effects = 0.11, 95% CI = 0.02, 0.19, proportion mediated = 34%). Conclusion The results illustrate the importance of assessment and treatment of sexual abuse and trauma-related symptoms such as dissociation in suicide prevention. Dissociation can be a contributing factor to why some people act on their suicidal thoughts.


2021 ◽  
Vol 4 (6) ◽  
pp. 29-42
Author(s):  
Johnson F.A. ◽  
Ogunsanmi L. ◽  
Ayokanmi I.

Background: Today, the most prevalent and the leading cause of death among young people is suicide. Worldwide, suicide accounts for an estimated 6% of all deaths among young people. The study examined the various risk factors for suicidal ideation and self-harm amongst Babcock University undergraduates. Method: Descriptive survey research design was utilized with a multistage sampling technique to select 398 undergraduates. The instrument for data collection was a semi-structured questionnaire that sought information on the environmental, social, and intrapersonal factors influencing suicide ideation and self-harm. Results were presented via means and percentages for descriptive statistics; correlation and regression were used to determine the associations between suicidal ideation and the risk factors. Ethical clearance was sought from Babcock University Health Research Ethics Committee. Results: The distribution of participants showed that 46.0% (183) were males while 54.0% (215) were females. Environmental factors influencing suicidal ideation were computed and measured on a 21-point rating scale with a mean ± SD of 13.38±3.458. The respondents' mean ± SD for the social factors measured on a 27-point rating scale was 17.15±5.772. Correlation analysis showed that suicide ideation had a statistically significant relationship with gender (p<0.01), parents' spousal relationship (p<0.01), environmental (p<0.01), social (p<0.01), and intrapersonal factors (p<0.01). Self-harm had a significant relationship with parents' relationship (p<0.01), environmental (p<0.01), social (p<0.01) and intrapersonal factors (p<0.01). However, the practice of self-harm was not different across the two genders (p = 0.170). Conclusion: Suicidal behaviors have been seen to be a serious public health concern. The prevention and intervention programs of suicide and self-harm should consider the particular characteristics of adolescent suicide and self-harm. This should include social transmission and recognition of mental health disorders.


2019 ◽  
Vol 49 (16) ◽  
pp. 2789-2800 ◽  
Author(s):  
Christopher R. Hagan ◽  
Megan L. Rogers ◽  
Amy M. Brausch ◽  
Jennifer J. Muehlenkamp ◽  
Thomas E. Joiner

AbstractBackgroundInteroceptive deficits (ID) have been associated with non-suicidal self-injury (NSSI) and suicidal behavior in multiple studies. Many of these studies are limited in scope, and have not fully examined possible mechanisms explaining how ID affect suicidal behavior.MethodsThis study assesses how self-reported ID relate to suicide ideation and attempts in six distinct and geographically diverse samples of adults (n = 2706) and one sample of adolescents (n = 436). Participants responded to a variety of self-report questionnaires and interviews.ResultsContrary to our hypothesis, self-reported ID were only associated with suicidal ideation in two samples, one of which was the adolescent sample. Largely consistent with our predictions, self-reported ID exhibited an indirect effect on suicide attempts through versatility of NSSI in four of the five adult samples tested. Finally, the indirect effects of self-reported ID on suicide attempts through NSSI versatility did not act indirectly through behaviorally assessed pain tolerance.ConclusionsWe found that, in adults, self-reported ID are not associated with suicidal ideation, but are connected with a history of suicide attempts, through an indirect effect via NSSI. Our findings also indicate that the mechanism of action leading from self-reported ID to suicidal behavior may differ between adolescents and adults, and relate to suicidal behavior independent of pain tolerance. Clinical implications and future directions are discussed.


Crisis ◽  
2019 ◽  
Vol 40 (5) ◽  
pp. 333-339 ◽  
Author(s):  
Joanna Herres ◽  
Annie Shearer ◽  
Tamar Kodish ◽  
Barunie Kim ◽  
Shirley B. Wang ◽  
...  

Abstract. Background: Adolescent suicidality is a growing public health concern. Although evidence supports a link between anxiety and suicidality, little is known about risk associated with specific anxiety disorders. Aims: This study examined the prevalence of anxiety disorders in a sample of adolescents with depression and suicidal ideation and the associations between specific anxiety disorders and suicide ideation severity and attempt history. Method: The sample consisted of 115 adolescents ( Mage= 14.96 years; 55.8% African American) entering a clinical trial for suicidal ideation and depressive symptoms. Prior to treatment, adolescents completed self-report and interview measures. Results: In all, 48% of the sample met criteria for an anxiety disorder, 22% met criteria for social anxiety disorder (SAD), and 40% met criteria for major depressive disorder (MDD). SAD was uniquely associated with more severe suicidal ideation. Limitations: Findings may not generalize to all suicidal adolescents, and non-measured variables may account for the observed relationships. Conclusion: Future research should examine whether targeting social anxiety would improve treatment response for suicidal adolescents.


2016 ◽  
Vol 33 (S1) ◽  
pp. S71-S71 ◽  
Author(s):  
R. Montoro ◽  
K. Igartua ◽  
B.D. Thombs

IntroductionSexual minority youth are at increased risk for bullying and suicide, but they are heterogeneous in their sexual orientation dimensions (attraction, behavior and identity).ObjectiveTo compare the association of bullying and suicide parameters between (1) heterosexually identified students without same-sex attractions or behaviors (2) heterosexually identified students with same-sex attractions or behaviors and (3) non-heterosexually identified students.MethodsThe Quebec Youth Risk Behavior Survey was a self-report questionnaire given to 1852 students 14–18 years old.ResultsThe heterosexually identified students without same-sex attraction or behavior, and no bullying, was our reference group. When these students had bullying, the likelihood of suicidal ideation was double, but their likelihood of suicide attempts was the same. For non-heterosexually identified students, those with no bullying were twice as likely, and those with bullying were four times as likely to have suicidal ideation. When these students had no bullying, they were not more likely to have suicide attempts, but they were almost three times as likely when they had bullying. Heterosexually identified students with same-sex attraction or behavior were never more likely on any of the suicide measures.ConclusionThis study was the first to show that adolescents with a non-heterosexual identity will have a disproportionately greater likelihood in their suicide parameters when subject to bullying, than heterosexually identified students with or without same-sex attraction or behavior, suggesting that these latter two dimensions were non-contributory to suicide risk. The significance of identity as a predictor of suicidal ideation and behavior will be discussed.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Anna Hansen ◽  
Dessi Slavova ◽  
Gena Cooper ◽  
Jaryd Zummer ◽  
Julia Costich

Abstract Background Non-suicidal self-injury and suicide attempts are increasing problems among American adolescents. This study developed a definition for identifying intentional self-harm (ISH) injuries in emergency department (ED) records coded with International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes. The definition is based on the injury-reporting framework proposed by the Centers for Disease Control and Prevention. The study sought to estimate the definition’s positive predictive value (PPV), and the proportion of ISH injuries with intent to die (i.e., suicide attempt). Methods The study definition, based on first-valid external cause-of-injury ICD-10-CM codes X71-X83, T14.91, T36-T65, or T71, captured 207 discharge records for initial encounters for ISH in one Kentucky ED. Medical records were reviewed to confirm provider-documented diagnosis for ISH, and identify intent to die or suicide ideation. The PPV of the study definition for capturing provider-documented ISH injuries was reported with its 95% confidence interval (95% CI). Results The estimated PPV for the study definition to capture ISH injuries was 88.9%, 95% CI (83.8%, 92.8%). The estimated percentage of ISH with intent to die was 45.9, 95% CI (47.1, 61.0%). The ICD-10-CM code “suicide attempt” (T14.91) captured only 7 cases, but coding guidelines restrict assignment of this code to cases in which the mechanism of the suicide attempt is unknown. Conclusions The proposed case definition supported a robust PPV for ISH injuries. Our findings add to the evidence that the current ICD-10-CM coding system and coding guidelines do not allow identification of ISH with intent to die; modifications are needed to address this issue.


2017 ◽  
Vol 41 (S1) ◽  
pp. S696-S696
Author(s):  
A. Mirsu-Paun ◽  
J.A. Oliver

IntroductionRomantic relationship quality (RRQ) and break-ups (RRB) among young adults have been associated with the onset of a first major depressive episode or suicide attempts. However, the size of these associations varies across studies and the relative weight of RRB versus RRQ needs to be understood.ObjectivesTo investigate (1) the size of the association between adolescent RRQ/RRB and psychopathology (i.e., depression, suicide ideation, deliberate self-harm, and suicide attempt); and (2) the role of potential moderators (e.g., gender, age, and nationality).MethodsA meta-analysis of 20 manuscripts reporting on 21 studies (n = 19623) was conducted, focusing specifically on adolescents and young adults. Studies focused on physically abusive relationships were excluded.ResultsA model combining relationship quality and break-up yielded a highly significant association between relationship measures and depression/self-harm but the strength of this relationship was modest (r = .229). The strength of the association between depression/self-harm and RRQ (r = .279) was statistically different from RRB (r = .145) (P = .006). Location (US vs. Non-US) had no effect. Age was not significant, B = -0.005, 95% CI [-0.026, 0.016], P = .647. Gender was a weak moderator (B = .160, 95% CI [-0.021, 0.340], P = .083).ConclusionsThe association between psychopathology and RRQ/RRB was statistically significant but relatively small. RRQ was a stronger predictor of depression compared to RRB. This association was slightly stronger for women than for men. Implications for practice and future research will be discussed.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2016 ◽  
Vol 33 (S1) ◽  
pp. S215-S215 ◽  
Author(s):  
M. Pinheiro ◽  
D. Mendes ◽  
T. Mendes ◽  
J. Pais ◽  
T. Cabral ◽  
...  

IntroductionTraumatising experiences have been shown to be important in suicide ideation and attempt. A prolonged and continuous exposure to stressing interpersonal events can have more complex consequences. Therefore, the concept of Complex Post-Traumatic Stress Disorder (C-PTSD) has been emerging.ObjectivesOur goal is to relate the symptoms of C-PTSD with suicide attempt and to evaluate the differences between C-PTSD and PTSD on those patients. Moreover, we compared our findings with a control population without prior suicide attempts.MethodsFifty patients that had been hospitalised in the Psychiatry ward following a suicide attempt were evaluated one week after the event with the ICD-11 Trauma Questionnaire (PTSD and C-PTSD). The same evaluation was performed on a control population without known suicide attempts.ResultsThere is a statistically significant relationship (P < 0.001) between the symptoms of C-PTSD and PTSD and suicide attempt, which effect is higher for C-PTSD. These symptoms are almost absent in the control group.ConclusionC-PTSD seams to be a more relevant risk factor for suicidal attempts. This aspect is important to define preventive and treatment programs and for suicidal attempts follow-up. The importance of traumatic events and of traumatic stress symptoms as moderator factors should be considered in future research.Disclosure of interestThe authors have not supplied their declaration of competing interest.


BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e031541
Author(s):  
A Jess Williams ◽  
Jon Arcelus ◽  
Ellen Townsend ◽  
Maria Michail

IntroductionYoung people who identify as Lesbian, Gay, Bisexual, Transgender, Queer or Questioning (LGBTQ+) are at increased risk for self-harm, suicide ideation and behaviours. However, there has yet to be a comprehensive understanding of what risk factors influence these behaviours within LGBTQ+ young people as a whole. The purpose of this systematic review is to examine risk factors associated with self-harm, suicidal ideation and behaviour in LGBTQ+) young people.Methods and analysisA systematic review will be conducted, conforming to the reporting guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement recommendations. Electronic databases (MEDLINE, Scopus, EMBASE, PsycINFO and Web of Science) will be systematically searched for cross-sectional, prospective, longitudinal, cohort and case–control designs which examine risk factors for self-harm and/or suicidal ideation and behaviour in LGBTQ+ young people (aged 12–25 years). Only studies published in English will be included. No date restrictions will be applied. Study quality assessment will be conducted using the original and modified Newcastle-Ottawa Scales. Meta-analysis or narrative synthesis will be used, dependent on findings.Ethics and disseminationThis is a systematic review of published literature and thereby ethical approval was not sought. The review will be submitted to a peer-reviewed journal, be publicly disseminated at conferences focusing on mental health, self-harm and suicide prevention. The findings will also be shared through public engagement and involvement, particularly those related to young LGBTQ+ individuals.PROSPERO registration numberCRD42019130037.


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