Identifying Suicide Typologies Among Trauma-Exposed Veterans

Crisis ◽  
2020 ◽  
Vol 41 (4) ◽  
pp. 288-295 ◽  
Author(s):  
Nadia Bounoua ◽  
Jasmeet P. Hayes ◽  
Naomi Sadeh

Abstract. Background: Suicide among veterans has increased in recent years, making the identification of those at greatest risk for self-injurious behavior a high research priority. Aims: We investigated whether affective impulsivity and risky behaviors distinguished typologies of self-injurious thoughts and behaviors in a sample of trauma-exposed veterans. Method: A total of 95 trauma-exposed veterans (ages 21–55; 87% men) completed self-report measures of self-injurious thoughts and behaviors, impulsivity, and clinical symptoms. Results: A latent profile analysis produced three classes that differed in suicidal ideation, suicide attempts and nonsuicidal self-injury (NSSI): A low class that reported little to no self-injurious thoughts or behaviors; a self-injurious thoughts (ST) class that endorsed high levels of ideation but no self-harm behaviors; and a self-injurious thoughts and behaviors (STaB) class that reported ideation, suicide attempts and NSSI. Membership in the STaB class was associated with greater affective impulsivity, disinhibition, and distress/arousal than the other two classes. Limitations: Limitations include an overrepresentation of males in our sample, the cross-sectional nature of the data, and reliance on self-report measures. Conclusion: Findings point to affective impulsivity and risky behaviors as important characteristics of veterans who engage in self-injurious behaviors.

2012 ◽  
Vol 43 (2) ◽  
pp. 179-187
Author(s):  
Randy A. Sansone ◽  
Joy Chang ◽  
Bryan Jewell

Background: While a number of previous studies have examined limited forms of self-harm behavior, such as suicidal ideation/attempts/completions, or one specific behavior such as cutting or burning oneself (most frequently in psychiatric populations), few studies have examined the lifetime prevalence of multiple self-harm behaviors in a single non-psychiatric population and no study has done so among obstetrics/gynecology outpatients. Method: Using a cross-sectional consecutive sample of 370 women presenting to an obstetrics/gynecology outpatient clinic and a self-report survey methodology, we examined the lifetime prevalence of 22 self-harm behaviors. Results: In this sample, the most frequently self-reported self-harm behaviors were: engaged in emotionally abusive relationships (24.7%), abused alcohol (22.0%), been promiscuous (21.0%), attempted suicide (18.3%), and tortured self with self-defeating thoughts (16.7%). Four of these preceding behaviors were also the most commonly reported 5 of 22 behaviors in 3 previous studies of self-harm behavior in different clinical populations. Conclusions: It appears that the most frequently reported lifetime self-harm behaviors are relatively common across various non-psychiatric clinical populations of adults, albeit in different proportions, with some exceptions (i.e., suicide attempts in the present sample).


Crisis ◽  
2011 ◽  
Vol 32 (5) ◽  
pp. 272-279 ◽  
Author(s):  
Allison S. Christian ◽  
Kristen M. McCabe

Background: Deliberate self-harm (DSH) occurs with high frequency among clinical and nonclinical youth populations. Although depression has been consistently linked with the behavior, not all depressed individuals engage in DSH. Aims: The current study examined maladaptive coping strategies (i.e., self-blame, distancing, and self-isolation) as mediators between depression and DSH among undergraduate students. Methods: 202 students from undergraduate psychology courses at a private university in Southern California (77.7% women) completed anonymous self-report measures. Results: A hierarchical regression model found no differences in DSH history across demographic variables. Among coping variables, self-isolation alone was significantly related to DSH. A full meditational model was supported: Depressive symptoms were significantly related to DSH, but adding self-isolation to the model rendered the relationship nonsignificant. Limitations: The cross-sectional study design prevents determination of whether a casual relation exists between self-isolation and DSH, and obscures the direction of that relationship. Conclusions: Results suggest targeting self-isolation as a means of DSH prevention and intervention among nonclinical, youth populations.


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.


BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e041609
Author(s):  
Emmanuel Nii-Boye Quarshie ◽  
Farag Shuweihdi ◽  
Mitch Waterman ◽  
Allan House

ObjectivesTo identify the prevalence, methods, associations and reported reasons for self-harm among in-school and street-connected adolescents in Ghana.DesignA cross-sectional survey. We applied multi-level regression models and model-based cluster analysis to the data.SettingThree contexts in the Greater Accra region were used: second cycle schools, facilities of charity organisations and street census enumeration areas (sleeping places of street-connected adolescents, street corners, quiet spots of restaurants, markets, train and bus stations, and lorry and car parks).ParticipantsA regionally representative sample of 2107 (1723 in-school and 384 street-connected) adolescents aged 13–21 years.Outcome measuresParticipants responded to a structured self-report anonymous questionnaire describing their experience of self-harm and eliciting demographic information and social and personal adversities.ResultsThe lifetime prevalence of self-harm was 20.2% (95% CI 19.0% to 22.0%), 12-month prevalence was 16.6% (95% CI 15.0% to 18.0%) and 1-month prevalence was 3.1% (95% CI 2.0% to 4.0%). Self-injury alone accounted for 54.5% episodes and self-poisoning alone for 16.2% episodes, with more than one method used in 26% of episodes. Self-cutting (38.7%) was the most common form of self-injury, whereas alcohol (39.2%) and medications (27.7%) were the most commonly reported means of self-poisoning. The factors associated with self-harm were interpersonal: conflict with parents (adjusted OR (aOR)=1.87, 95% CI 1.24 to 2.81), physical abuse victimisation (aOR=1.69, 95% CI 1.16 to 2.47), difficulty in making and keeping friends (aOR=1.24, 95% CI 0.85 to 1.80), sexual abuse victimisation (aOR=1.21, 95% CI 0.78 to 1.87) and conflict between parents (aOR=1.07, 95% CI 0.73 to 1.56).ConclusionsSelf-harm is a significant public health problem among in-school and street-connected adolescents in the Greater Accra region of Ghana. Its origins are very largely in social and familial adversity, and therefore prevention and treatment measures need to be focused in these areas.


2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Mathew Gullotta ◽  
David Greenberg ◽  
Olayan Albalawi ◽  
Armita Adily ◽  
Azar Karminia ◽  
...  

Abstract Objective Prisoners complete suicide and self-harm more frequently than members of the community. Sex offenders have been found to be at greater risk of engaging in these behaviours. This study examines the characteristics, prevalence, and predictors of self-harm and suicide attempts among: sex offenders that only victimise children (ChildSOs); adults (AdultSOs); or both (age-crossover polymorphous; PolySOs). Methods Data from three waves (1996, 2001, 2009) of the New South Wales (NSW) Inmate Health Survey was linked to the State’s re-offending database to identify men with histories of sexual offending. The health surveys captured self-report data on self-harm and suicidality. Results Non-sexual violent offenders (15%) and AdultSOs (14%) had the highest rate of self-harm, significantly more than ChildSOs (11%), non-sexual non-violent offenders (10%), and PolySOs (0%). Several factors significantly predicted self-harm at the bivariate level for both ChildSOs and AdultSOs, with unique predictors for each group. At the multivariate level, manic-depression trended towards significance for ChildSOs and any mental health condition remained a significant predictor for AdultSOs who self-harmed relative to AdultSOs who had not (aOR = 11.989, 95%CI [1.14, 126.66]). Approximately 23% of AdultSOs, 22% of PolySOs, and 19% of ChildSOs reported a suicide attempt throughout their lifetime, whereas only 15% of non-sexual non-violent offenders reported an attempt. At the bivariate level, few factors were significant for ChildSOs while several factors were significant for AdultSOs. At the multivariate level, a diagnosis of depression and treatment with psychiatric medication trended towards being significant predictors of suicide attempts for ChildSOs. In contrast, treatment with psychiatric medication (aOR = 25.732, 95%CI [1.91, 347.19])] remained a significant predictor for AdultSOs who attempted suicide relative to AdultSOs who had not, as well as historical psychiatric hospitalisation (aOR = 6.818, 95%CI [1.04, 44.82]) and self-harm (aOR = 5.825, 95%CI [1.31, 25.99]). Conclusion Sex offenders are at significantly higher risk of attempting and completing suicide relative to non-sexual non-violent offenders and warrant special attention. The prevalence rates and predictors of self-harm and suicidality suggest differences between sex offender subgroups may exist. These hold implications for the criminal justice and public health systems for addressing needs and identifying those most at risk of self-harm and suicide.


2020 ◽  
Author(s):  
Michelle Guerrero ◽  
Joel Barnes ◽  
Mark Tremblay ◽  
Laura Pulkki-Råback

Abstract Objective: The purpose of the current study was to use latent profile analysis to identify family typologies characterized by parental acceptance, parental monitoring, and family conflict, and to examine whether such typologies were associated with the number of movement behavior recommendations (i.e., physical activity, screen time, and sleep) met by children. Methods: Data for this cross-sectional observational study were part of the baseline data from the Adolescent Brain Cognitive Development (ABCD) study. Data were collected from September 1, 2016 to September 15, 2018, across 21 study sites in the United States. Participants included 11,875 children aged 9 and 10 years. Results: Results from latent profile analysis showed that children were meaningfully classified into one of five family typologies, ranging from ideal (high acceptance, high monitoring, and low conflict) to poor (medium acceptance, low monitoring, and high conflict) functioning. Children from good (OR= 0.54; 95% CI, 0.39-0.76), average (OR=0.28; 95% CI, 0.20, 0.40), fair (OR=0.24; 95% CI, 0.16, 0.36), and poor (OR=0.19; 95% CI, 0.12-0.29) functioning families were less likely to meet all three movement behavior recommendations compared to children from ideal functioning families. The odds of meeting all recommendations progressively decreased as family functioning worsened. Similar findings and pattern of results were found for meeting ≥2 recommendations and ≥1 recommendation. Conclusions: These findings highlight the importance of the family environment for promoting healthy movement behaviors among children.


Author(s):  
Vilmantė Pakalniškienė ◽  
Roma Jusienė ◽  
Sandra B. Sebre ◽  
Jennifer Chun-Li Wu ◽  
Ilona Laurinaitytė

This study explored the profiles of elementary-school-aged children’s Internet use in relation to their emotional and behavioral problems. Participating in this cross-sectional study were 877 child–parent dyads from Latvia, Lithuania, and Taiwan. Children (8–10 years old) provided information on three variables: the amount of time they spent online, frequency of online activities, and knowledge of how to do things online. Latent profile analysis including these three variables provided a four-class solution for child Internet use. A comparison between Latvia, Lithuania, and Taiwan on the percentage of the sample distribution in each class showed that there was no difference between sites for the high class (high ratings on all three variables). The largest differences were for the low and average classes (low and average ratings on all three variables, namely, time online, frequency, and knowledge): the Lithuanian and Taiwanese samples were similar in that a higher percentage of each sample was in the low class, whereas the Latvian sample had children equally distributed between the low class and the average class. Analysis of the data from the entire sample for differences in parent-reported child behavioral difficulties suggested that children in the high class had an elevated level of behavioral problems and compulsive Internet use.


2019 ◽  
Vol 24 (7) ◽  
pp. 672-685
Author(s):  
Greta Ontrup ◽  
Justine Patrzek

Purpose Research on workaholism distinguishes between enthusiastic and non-enthusiastic workaholics, a typology used in many studies. Yet, the methodical foundation on which the derivation of the types is based lacks robust statistical evidence. The purpose of this paper is twofold: first, to replicate the often-cited typology of enthusiastic and non-enthusiastic workaholics (and non-workaholic subtypes), based on model-based clustering as a robust statistical technique; and second, to validate the class solution based on affective, cognitive and behavioral measures. Design/methodology/approach The study followed a cross-sectional design, targeting a sample of people from various fields of industries. An online questionnaire was distributed; workaholism was assessed with McMillan et al.’s (2002) Work-BAT-R scales. A total of 537 respondents’ data were analyzed. Findings Latent profile analysis extracted four classes, namely, enthusiastic and non-enthusiastic workaholics and relaxed and uninvolved non-workaholics. As expected, workers characterized by high enjoyment (enthusiasts and relaxed) showed higher job satisfaction and occupational self-efficacy than workers with low enjoyment (non-enthusiasts and uninvolved). Relaxed workers reported higher life satisfaction than all other classes. Originality/value The robust methodology applied establishes a good starting point for future studies investigating workers subtypes: the replication suggests that the workaholic subtypes might be core profiles that occur in different populations with regularity. As a next step, the replication of the typology based on alternative operationalizations of workaholism is proposed for future studies.


2020 ◽  
pp. 1-11
Author(s):  
Elizabeth G. Spitzer ◽  
Natasha Benfer ◽  
Kelly L. Zuromski ◽  
Brian P. Marx ◽  
Tracy K. Witte

Abstract Background As self-injurious thoughts and behaviors (SITB) remain a pressing public health concern, research continues to focus on risk factors, such as posttraumatic stress disorder (PTSD). Network analysis provides a novel approach to examining the PTSD-SITB relationship. This study utilized the network approach to elucidate how individual PTSD symptoms may drive and maintain SITB. Methods We estimated cross-sectional networks in two samples of trauma-exposed adults (Sample 1: N = 349 adults; Sample 2: N = 1307 Veterans) to identify PTSD symptoms that may act as bridges to SITB. Additionally, we conducted a cross-lagged panel network in Sample 2 to further clarify the temporal relationship between PTSD symptoms and SITB during a 2-year follow-up. Finally, in both samples, we conducted logistic regressions to examine the utility of PTSD symptoms in prospectively predicting SITB, over a 15-day period (Sample 1) and over a 2-year period (Sample 2), allowing us to examine both short- and long-term prediction. Results Two PTSD symptoms (i.e. negative beliefs and risky behaviors) emerged as highly influential on SITB in both cross-sectional networks. In the cross-lagged panel network, distorted blame emerged as highly influential on SITB over time. Finally, risky behaviors, unwanted memories, and psychological distress served as the strongest predictors of SITB across the two samples. Conclusions Overall, our results suggest that treatments targeting negative beliefs and risky behaviors may prevent SITB in community and Veteran populations, whereas treatments targeting distorted blame and unwanted memories may help reduce SITB for individuals with a history of combat trauma.


2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 7108-7108
Author(s):  
L. Gerber ◽  
S. Mitchell ◽  
L. Li ◽  
G. Diao ◽  
J. Odom ◽  
...  

7108 Background: Chronic graft vs. host disease (cGVHD) is a multi-system disorder and a late complication of cancer therapy experienced by more than 50% of survivors after allogeneic hematopoietic stem cell transplantation. An improved understanding of the underlying biology and its relation to clinical symptoms may guide the development of better treatments for cGVHD. Methods: In a prospective, cross-sectional natural history protocol we examined the associations among organ/system dysfunction, measures of physical performance and health status with clinical measures of inflammation and fat metabolism. Variables included: 1. a composite severity score (CAS) rated by clinician-specialists (skin, eyes, mouth, gastrointestinal/liver, hematological, gynecological, pulmonary function evaluations); 2.functional measures [2 minute walk time (WT), grip strength (GS), SF-36 physical component summary score (PCS), vitality (VT) subscale, maximal activity score (MAS) of the Human Activity Profile]; 3.Laboratory tests (glucose, LDH, hemoglobin, ferritin, platelets, lymphocytes, pre-albumin, cholesterol, lipoproteins (HDL, LDL), triglycerides (TG), beta-2microglobulin (B2), and CRP. Results: 43 pts (mean age 47 yrs) with prior hematologic malignancy participated (mean 3 yrs post transplant). An average of 3.5 organ systems were affected, 77% were on systemic treatment for cGVHD, and 67% had prior acute GVHD. The mean body mass index (BMI) was 25, TG 255, cholesterol 222, LDL 132. They were moderately disabled by self-report (MAS), had slower than normal WT (540 ft/min), lower than normal GS (63 pounds), PCS (36) and VT (46) than a healthy population. Using a backward selection model with a significance of 0.1, low lung diffusing capacity (p<.001) and low PCS (p=0.01) correlated with high CAS. VT correlated negatively with LDH, platelets, B2 and LDL (all p<0.01). Low GS correlated with high LDH and B2 (p=0.01). Conclusions: Reported physical function and vitality in cGVHD patients are associated with abnormal lipid profiles and markers of inflammation. Establishment of such profiles is a critical step in the development of testable and validated outcome measures and for evaluation of new therapies in cGVHD. No significant financial relationships to disclose.


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