scholarly journals A-18 Executive Dysfunction is Associated with Suicidal Ideation in Iraq/Afghanistan-era Combat-exposed Veterans

2019 ◽  
Vol 34 (6) ◽  
pp. 877-877
Author(s):  
L Crocker ◽  
A Keller ◽  
S Jurick ◽  
V Merritt ◽  
S Hoffman ◽  
...  

Abstract Objective Suicidal ideation (SI) is highly prevalent in Veterans and reducing Veteran suicide is a national priority. The present study examined factors associated with SI in combat-exposed Veterans in order to inform suicide prevention efforts. Method Combat-exposed Iraq/Afghanistan-era Veterans (N = 77) completed questionnaires detailing demographic characteristics and combat-related experiences, as well as structured interviews assessing history of mild traumatic brain injury (mTBI), current posttraumatic stress disorder (PTSD), and suicidality in the past month. Veterans also underwent a comprehensive neuropsychological assessment. Analyses examined differences between endorsers versus non-endorsers of current SI, as well as predictors of SI, with a focus on cognitive variables. Results There were no SI group differences in demographic variables, levels of combat exposure, or rates of PTSD, or mTBI history. However, independent samples t-tests indicated that those who endorsed SI demonstrated worse executive functioning relative to those who denied SI (t(75) = 2.74, p = .008), whereas no group differences were observed on measures of attention/processing speed or memory. A logistic regression analysis predicting SI indicated that executive functioning remained a significant predictor of SI (B = .94, OR = 2.55, p = .047) even when adjusting for age, years of education, level of combat exposure, history of mTBI, and PTSD diagnosis. Conclusions Executive dysfunction may make it difficult for Veterans to inhibit maladaptive negative thoughts (particularly suicidal thoughts), regulate emotions, and problem solve in stressful situations, thus contributing to suicidality. Interventions addressing executive dysfunction in combat-exposed Veterans with SI may be a promising adjunct to current suicide prevention efforts.

Crisis ◽  
2015 ◽  
Vol 36 (4) ◽  
pp. 267-273 ◽  
Author(s):  
Hajime Sueki ◽  
Jiro Ito

Abstract. Background: Nurturing gatekeepers is an effective suicide prevention strategy. Internet-based methods to screen those at high risk of suicide have been developed in recent years but have not been used for online gatekeeping. Aims: A preliminary study was conducted to examine the feasibility and effects of online gatekeeping. Method: Advertisements to promote e-mail psychological consultation service use among Internet users were placed on web pages identified by searches using suicide-related keywords. We replied to all emails received between July and December 2013 and analyzed their contents. Results: A total of 139 consultation service users were analyzed. The mean age was 23.8 years (SD = 9.7), and female users accounted for 80% of the sample. Suicidal ideation was present in 74.1%, and 12.2% had a history of suicide attempts. After consultation, positive changes in mood were observed in 10.8%, 16.5% showed intentions to seek help from new supporters, and 10.1% of all 139 users actually took help-seeking actions. Conclusion: Online gatekeeping to prevent suicide by placing advertisements on web search pages to promote consultation service use among Internet users with suicidal ideation may be feasible.


2020 ◽  
Vol 26 (1) ◽  
pp. 41-60
Author(s):  
Sheraz Ali ◽  
Johar Ali

This study focuses on suicidal ideation in victims of sexual abuse. Drawing upon semi-structured interviews of thirty victims of sexual abuse in Khyber Pukhtunkhwah, Pakistan, this paper discusses the theme, i.e. domestic violence, including indiscriminate sexual abuse and the abhorring crime of incest, which remains hidden due to aggressively upheld patriarchal norms of women exploitation. The interviews conducted at six different locations, present women's narratives of their untold plight for the first time. The findings of this research show that among the respondents, only those women had strong suicidal ideations who were the victims of incest. Irritation, aggression and self-deprecating behaviour were strong symptoms of their suicidal temptations. Pain, physical and emotional, caused by overwhelming stress in the form of familial and social hatred, social disconnectedness, burdensomeness and the previous history of violence were the main factors that highly escalated their risk factor in committing suicide


BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e029108 ◽  
Author(s):  
Karen Lascelles ◽  
Lisa Marzano ◽  
Fiona Brand ◽  
Hayley Trueman ◽  
Rupert McShane ◽  
...  

ObjectiveIt is recognised that ketamine treatment can reduce suicidal ideation (SI) in people with depression, at least in the short term. However, information is lacking on patients’ perspectives on such effects. Studying these can contribute to greater understanding of the mechanisms underlying impact of ketamine treatment on SI. The aim of this study was to investigate patients’ reports of the impact of treatment on their SI, the duration of effects and possible mechanisms.Design and settingThis qualitative study consisted of semi-structured interviews with patients who had received ketamine treatment for depression. Interview data were analysed thematically.ParticipantsFourteen patients (8 females, 6 males, aged 24–64 years) who had received treatment with ketamine for treatment-resistant depression, and had SI at the initiation of treatment. Two participants also had a diagnosis of bipolar type 1 and two of emotionally unstable personality disorder. Eight had a history of self-harm.ResultsSI reduced following ketamine treatment in 12 out of 14 participants for periods of a few hours following a single treatment to up to three years with ongoing treatment. Reduction of SI was variable in terms of extent and duration, and re-emergence of suicidal thoughts often occurred when treatment ceased. Participants’ accounts indicated that reduced SI was associated with improved mood and reduced anxiety, as were clarity of thought, focus and concentration, and ability to function. Participants reported experiencing some or all of these effects in various orders of occurrence.ConclusionGenerally, ketamine treatment was experienced as effective in reducing SI, although duration of effects varied considerably. Patients’ perspectives indicated similarities in the mechanisms of reduction in SI, but some differences in their manifestation, particularly in relation to chronology. Experiences of this cohort suggest that reduced anxiety and improvement in ability to think and function were important mechanisms alongside, or in some cases independently of, improvement in mood. Further studies of patients’ experiences are required to gain enhanced understanding of the variability of effects of ketamine on SI and functionality.


2020 ◽  
Vol 29 (3) ◽  
pp. 1389-1403
Author(s):  
Jessica Brown ◽  
Kelly Knollman-Porter

Purpose Although guidelines have changed regarding federally mandated concussion practices since their inception, little is known regarding the implementation of such guidelines and the resultant continuum of care for youth athletes participating in recreational or organized sports who incur concussions. Furthermore, data regarding the role of speech-language pathologists in the historic postconcussion care are lacking. Therefore, the purpose of this retrospective study was to investigate the experiences of young adults with history of sports-related concussion as it related to injury reporting and received follow-up care. Method Participants included 13 young adults with history of at least one sports-related concussion across their life span. We implemented a mixed-methods design to collect both quantitative and qualitative information through structured interviews. Participants reported experiencing 42 concussions across the life span—26 subsequent to sports injuries. Results Twenty-three concussions were reported to a parent or medical professional, 14 resulted in a formal diagnosis, and participants received initial medical care for only 10 of the incidents and treatment or services on only two occasions. Participants reported concussions to an athletic trainer least frequently and to parents most frequently. Participants commented that previous experience with concussion reduced the need for seeking treatment or that they were unaware treatments or supports existed postconcussion. Only one concussion incident resulted in the care from a speech-language pathologist. Conclusion The results of the study reported herein shed light on the fidelity of sports-related concussion care management across time. Subsequently, we suggest guidelines related to continuum of care from injury to individualized therapy.


Crisis ◽  
2018 ◽  
Vol 39 (1) ◽  
pp. 65-69 ◽  
Author(s):  
Nina Hallensleben ◽  
Lena Spangenberg ◽  
Thomas Forkmann ◽  
Dajana Rath ◽  
Ulrich Hegerl ◽  
...  

Abstract. Background: Although the fluctuating nature of suicidal ideation (SI) has been described previously, longitudinal studies investigating the dynamics of SI are scarce. Aim: To demonstrate the fluctuation of SI across 6 days and up to 60 measurement points using smartphone-based ecological momentary assessments (EMA). Method: Twenty inpatients with unipolar depression and current and/or lifetime suicidal ideation rated their momentary SI 10 times per day over a 6-day period. Mean squared successive difference (MSSD) was calculated as a measure of variability. Correlations of MSSD with severity of depression, number of previous depressive episodes, and history of suicidal behavior were examined. Results: Individual trajectories of SI are shown to illustrate fluctuation. MSSD values ranged from 0.2 to 21.7. No significant correlations of MSSD with several clinical parameters were found, but there are hints of associations between fluctuation of SI and severity of depression and suicidality. Limitations: Main limitation of this study is the small sample size leading to low power and probably missing potential effects. Further research with larger samples is necessary to shed light on the dynamics of SI. Conclusion: The results illustrate the dynamic nature and the diversity of trajectories of SI across 6 days in psychiatric inpatients with unipolar depression. Prediction of the fluctuation of SI might be of high clinical relevance. Further research using EMA and sophisticated analyses with larger samples is necessary to shed light on the dynamics of SI.


Crisis ◽  
2020 ◽  
pp. 1-6
Author(s):  
Mohammed Madadin ◽  
Ritesh G. Menezes ◽  
Maha A. Alassaf ◽  
Abdulaziz M. Almulhim ◽  
Mahdi S. Abumadini ◽  
...  

Abstract. Background: Medical students are at high risk of suicidal ideation. Aim: We aimed to obtain information on suicidal ideation among medical students in Dammam located in the Eastern Province of Saudi Arabia. Method: This cross-sectional study was conducted at the College of Medicine affiliated with Imam Abdulrahman Bin Faisal University in the Eastern Province of Saudi Arabia. Suicidal ideation in the past 12 months was assessed based on responses to four questions in the depression subscale of the General Health Questionnaire 28 (GHQ-28). In addition, data were collected to examine the association of suicidal ideation with various factors. Results: We found that 1 in 3 medical students in the study had suicidal ideation in the past 12 months, while around 40% had lifetime suicidal ideation. Suicidal ideation was associated with feelings of parental neglect, history of physical abuse, and dissatisfaction with academic performance. Limitations: The cross-sectional nature of this study limits its ability to determine causality regarding suicidal ideation. Conclusion: These rates are considerably high when compared with rates from studies in other countries around the world. This study provides a reference in the field of suicidology for this region of Saudi Arabia.


Crisis ◽  
2020 ◽  
pp. 1-8 ◽  
Author(s):  
Stefanie Kirchner ◽  
Benedikt Till ◽  
Martin Plöderl ◽  
Thomas Niederkrotenthaler

Abstract. Background: The It Gets Better project aims to help prevent suicide among lesbian, gay, bisexual, transgender, intersex, and queer (LGBTIQ+) adolescents. It features personal video narratives portraying how life gets better when struggling with adversities. Research on the contents of messages is scarce. Aims: We aimed to explore the content of videos in the Austrian It Gets Better project regarding the representation of various LGBTIQ+ groups and selected content characteristics. Method: A content analysis of all German-language videos was conducted ( N = 192). Messages related to coming out, stressors experienced, suicidal ideation/behavior, and on how things get better were coded. Results: Representation was strong for gay men ( n = 45; 41.7%). Coming out to others was mainly positively framed ( n = 31; 46.3%) and seen as a tool to make things better ( n = 27; 37.5%). Social support ( n = 42; 62.7%) and self-acceptance ( n = 37; 55.2%) were prevalent topics. Common stressors included a conservative setting ( n = 18, 26.9%), and fear of outing ( n = 17; 25.4%). Suicidality ( n = 9; 4.7%) and options to get professional help ( n = 7; 8.2%) were rarely addressed. Limitations: Only aspects explicitly brought up in the videos were codeable. Conclusion: Videos do not fully represent gender identities and sexual orientations. Messaging on suicidality and professional help require strengthening to tailor them better for suicide prevention.


2021 ◽  
pp. 136078042110250
Author(s):  
Julie Schweitzer ◽  
Tamara L Mix

Employing the example of France’s civil nuclear program, we connect political opportunity structures (POSs) to mechanisms of knowledge production, identifying how opposing stakeholders generate knowledge about a controversial technology. A history of nuclear dependence in France creates a context that praises, normalizes, and rationalizes nuclear energy while stigmatizing attempts to question or contest the nuclear industry’s dominant position. Integrating Bond’s knowledge-shaping process with Coy and colleagues’ concept of oppositional knowledge, we consider how the broader social, political, and economic context influences opposing stakeholder assessments of nuclear energy. Employing qualitative semi-structured interviews, we offer unique insight into the French nuclear debate, discussing the role of POS in shaping knowledge production.


2021 ◽  
pp. 154041532110117
Author(s):  
Cheryl A. Smith-Miller ◽  
Diane C. Berry ◽  
Cass T. Miller

Introduction: Evidence suggests that gender may influence many aspects of type 2 diabetes (T2DM) self-management (SM) and we posit that limited English language–proficient Latinx immigrants face additional challenges. Methods: Instruments and semi-structured interviews were used to examine gender differences on health literacy, diabetes knowledge, health-promoting behaviors, diabetes, eating and exercise self-efficacy (SE), and T2DM SM practices among a cohort of limited English language–proficient Latinx immigrants. Statistical and qualitative analysis procedures were performed comparing males and females. Results: Thirty persons participated. Males tended to be older, have higher educational achievement, and more financial security than females. Physiologic measures tended worse among female participants. Health literacy and exercise SE scores were similar, but females scored lower on Eating and Diabetes SE. Forty-seven percent ( n= 9) of the women reported a history of gestational diabetes mellitus and a majority of men ( n = 7) cited difficulty with excessive alcohol. Consumption: Males appeared to receive more SM support compared to females. Females more frequently noted how family obligations and a lack of support impeded their SM. Work environments negatively influenced SM practices. Conclusion: Men and women have unique SM challenges and as such require individualized strategies and support to improve T2DM management.


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