Psychotic Experiences and Schizotypy in Early Adolescence Predict Subsequent Suicidal Ideation Trajectories and Suicide Attempt Outcomes From Age 18 to 38 Years

Abstract Subclinical risk markers for schizophrenia predict suicidality, but little is known about the nature of the relationship. Suicidal ideation is often considered homogenous, but distinguishing passive from active ideation (ie, thoughts of death vs thoughts of killing oneself) and different temporal patterns may further the understanding of risk factors. We tested whether schizotypy and psychotic experiences (PEs) in early adolescence predict subsequent growth trajectories of suicidal ideation and suicide attempt outcomes. Participants were 1037 members of the population-representative Dunedin Study cohort. PE was measured at 11 years and schizotypy at 13 and 15 years. Outcomes were passive and active suicidal ideation, and suicide attempt, measured at 18, 21, 26, 32, and 38 years. Passive ideation was best represented by 2 trajectories, including persistent and transient ideation classes. Schizotypy predicted membership in the smaller persistent class (odds ratio [OR] = 1.21, P = .041), whereas PE was not associated with class membership. The probability of suicide attempts was 13.8% in the persistent ideation class, compared with 1.8% in the transient class. Active ideation was best represented by a 1-class model, the intercept of which was predicted by schizotypy (OR = 1.23, P = .015). Suicide attempts were predicted by schizotypy (OR = 1.53, P = .040) and PE (OR = 3.42, P = .046), and this was partially mediated by indirect effects via the active ideation trajectory. Findings indicate that adolescent schizotypy and PE are related to subsequent suicidal ideation and attempts. Suicidal ideation is heterogeneous, and schizotypy is specifically related to a persistent passive ideation subgroup.

Download Full-text

Gambling Disorder Symptoms, Suicidal Ideation, and Suicide Attempts

Psychiatry Investigation ◽

10.30773/pi.2020.0035 ◽

2021 ◽

Vol 18 (1) ◽

pp. 88-93

Author(s):

Kounseok Lee ◽

Hyesun Kim ◽

YoungHo Kim

Keyword(s):

Suicidal Ideation ◽

Suicide Attempt ◽

Suicide Risk ◽

Gambling Disorder ◽

Suicide Attempts ◽

Negative Consequences ◽

Financial Problem ◽

Related Risk ◽

Diagnosis Criteria ◽

The Relationship

Objective Gambling disorder (GD) patients have a higher suicide risk compared to the general population. The present study investigates the suicide-related risk factors of GD patients by analyzing GD diagnosis-related symptoms and suicide-related behaviors of subjects.Methods This study investigated which symptoms among GD diagnosis criteria are related to suicide risk in 142 patients diagnosed with GD. To analyze the relationship between GD symptoms and suicidal ideation and suicide attempt, the odds ratio (OR) was determined through multivariate logistic regression.Results The number of symptoms was significantly higher in the subjects who had suicidal ideation group and attempt group. In the cases of past suicide attempts, responses to withdrawal and escape questions were significantly higher; in the cases of ongoing suicidal ideation, responses to negative consequences and bailout questions were significantly higher. When depression was corrected, the ‘bailout’ item was, indicating that ‘bailout’ increased suicidal ideation (OR=4.937, 95% CI=1.009–24.164). In the suicide attempt group, ‘relieve’ item may increase suicide attempt (OR=6.978, 95% CI=1.300–35.562).Conclusion Past suicide attempts in GD patients correlated with withdrawal symptoms, and financial problem correlated with suicidal ideation. This suggests that evaluating suicide risk is important when evaluating GD patients, and evaluation of financial problems is important for GD patients with suicide risks.

Download Full-text

Attachment Organization in Suicide Prevention Research

Crisis ◽

10.1027/0227-5910/a000231 ◽

2014 ◽

Vol 35 (1) ◽

pp. 60-66 ◽

Cited By ~ 10

Author(s):

Amanda Venta ◽

Carla Sharp

Keyword(s):

Risk Factors ◽

Suicidal Ideation ◽

Suicide Attempt ◽

Interpersonal Relationships ◽

Suicide Ideation ◽

Suicide Attempts ◽

Critical Role ◽

Self Report ◽

Future Research ◽

Self Harm

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.

Download Full-text

Suicide Attempts Among Depressed Inpatients with Depressive Disorder in a Malaysian Sample

Crisis ◽

10.1027/0227-5910/a000088 ◽

2011 ◽

Vol 32 (5) ◽

pp. 283-287 ◽

Cited By ~ 14

Author(s):

L. F. Chan ◽

T. Maniam ◽

A. S. Shamsul

Keyword(s):

Risk Factors ◽

Suicidal Ideation ◽

Suicide Attempt ◽

Depressive Disorder ◽

Suicide Attempts ◽

Psychosocial Risk Factors ◽

Psychosocial Risk ◽

Life Event ◽

Axis I ◽

A Current

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.

Download Full-text

Interactive Effects of Acute Suicidal Affective Disturbance and Pain Persistence on Suicide Attempt Frequency and Lethality

Crisis ◽

10.1027/0227-5910/a000588 ◽

2019 ◽

Vol 40 (6) ◽

pp. 413-421 ◽

Cited By ~ 2

Author(s):

Megan L. Rogers ◽

Thomas E. Joiner

Keyword(s):

Suicide Attempt ◽

Suicidal Behavior ◽

Pain Perception ◽

Suicide Attempts ◽

Pain Tolerance ◽

Self Report ◽

Interactive Effects ◽

Physical Pain ◽

Affective Disturbance ◽

The Relationship

Abstract. Background: Acute suicidal affective disturbance (ASAD) has been proposed as a suicide-specific entity that confers risk for imminent suicidal behavior. Preliminary evidence suggests that ASAD is associated with suicidal behavior beyond a number of factors; however, no study to date has examined potential moderating variables. Aims: The present study tested the hypotheses that physical pain persistence would moderate the relationship between ASAD and (1) lifetime suicide attempts and (2) attempt lethality. Method: Students ( N = 167) with a history of suicidality completed self-report measures assessing the lifetime worst-point ASAD episode and the presence of a lifetime suicide attempt, a clinical interview about attempt lethality, and a physical pain tolerance task. Results: Physical pain persistence was a significant moderator of the association between ASAD and lifetime suicide attempts ( B = 0.00001, SE = 0.000004, p = .032), such that the relationship between ASAD and suicide attempts strengthened at increasing levels of pain persistence. The interaction between ASAD and pain persistence in relation to attempt lethality was nonsignificant ( B = 0.000004, SE = 0.00001, p = .765). Limitations: This study included a cross-sectional/retrospective analysis of worst-point ASAD symptoms, current physical pain perception, and lifetime suicide attempts. Conclusion: ASAD may confer risk for suicidal behavior most strongly at higher levels of pain persistence, whereas ASAD and pain perception do not influence attempt lethality.

Download Full-text

Risk for Suicidal Ideation and Suicide Attempts Associated with Co-occurring Depression and Conduct Problems in Early Adolescence

Suicide and Life-Threatening Behavior ◽

10.1111/j.1943-278x.2011.00031.x ◽

2011 ◽

Vol 41 (3) ◽

pp. 316-329 ◽

Cited By ~ 45

Author(s):

Ann Vander Stoep ◽

Molly Adrian ◽

Elizabeth Mc Cauley ◽

Sheila E. Crowell ◽

Andrea Stone ◽

...

Keyword(s):

Suicidal Ideation ◽

Conduct Problems ◽

Early Adolescence ◽

Suicide Attempts

Download Full-text

Frontolimbic brain volume abnormalities in bipolar disorder with suicide attempts

10.1101/2020.05.07.20093245 ◽

2020 ◽

Author(s):

Mbemba Jabbi ◽

Wade Weber ◽

Jeffrey Welge ◽

Fabiano Nery ◽

Maxwell Tallman ◽

...

Keyword(s):

Bipolar Disorder ◽

Suicidal Ideation ◽

Suicide Attempt ◽

Suicide Attempts ◽

The United States ◽

Anterior Cingulate ◽

Type I ◽

Brain Volumes ◽

Major Health Problem ◽

Dorsolateral Prefrontal

ABSTRACTOver 2.3 million people in the United States live with bipolar disorder. Sixty percent of those with a bipolar disorder diagnosis attempt suicide at least once in their lifetime, and up to 19% die by suicide. However, the neurobiology of suicide attempts in bipolar disorder remains unclear. Here, we studied the neuroanatomical basis for suicide attempt history in bipolar disorder by measuring gray matter volumes (GMV) to identify differences in brain-volumes in 121 participants with bipolar disorder type I, and healthy participants (n=40). The bipolar group consisted of individuals with suicide attempt history (n=23) and no suicide attempt history (n=58). All participants completed behavioral/diagnostic assessments and MRI measures of GMV. We focused on a predefined frontolimbic circuitry in bipolar disorder versus (vs.) healthy to first identify diagnostic GMV markers and to specifically identify markers for suicide attempt history. We found reduced GMV markers for bipolar diagnosis (i.e., bipolar<healthy) in the anterior cingulate cortex (ACC), and dorsolateral prefrontal cortices (DLPFC). Our observed frontolimbic GMV abnormalities were associated with suicide attempt history and measures of individual variations in current suicidal ideation at the time of scanning. These results identified a frontolimbic-GMV marker for bipolar diagnosis and suicidal behavioral risk tendencies.HighlightsSuicide is a major health problem especially in bipolar disorder but the neurobiological basis for suicide attempts remains obscure. We identified an anterior cingulate and dorsolateral prefrontal cortical volume correlate for suicide attempt history and suicidal ideation and thereby demonstrates a convergent brain marker for suicidal behaviors.

Download Full-text

Risk and Protective Factors for Suicide Attempt Among Indigenous Māori Youth in New Zealand: The Role of Family Connection

International Journal of Indigenous Health ◽

10.18357/ijih71201112350 ◽

2013 ◽

Vol 7 (1) ◽

pp. 16 ◽

Cited By ~ 7

Author(s):

Terryann C. Clark ◽

Elizabeth Robinson ◽

Sue Crengle ◽

Theresa Fleming ◽

Shanthi Ameratunga ◽

...

Keyword(s):

Logistic Regression ◽

Depressive Symptoms ◽

New Zealand ◽

Suicide Attempt ◽

Protective Factors ◽

Suicide Attempts ◽

Risk And Protective Factors ◽

Factors Associated ◽

The Relationship ◽

Family Connection

The purpose of this study was to (1) describe risk and protective factors associated with a suicide attempt for Māori youth and (2) explore whether family connection moderates the relationship between depressive symptoms and suicide attempts for Māori youth. Secondary analysis was conducted with 1702 Māori young people aged 12–18 years from an anonymous representative national school-based survey of New Zealand (NZ) youth in 2001. A logistic regression and a multivariable model were developed to identify risk and protective factors associated with suicide attempt. An interaction term was used to identify whether family connection acts as a moderator between depressive symptoms and a suicide attempt. Risk factors from the logistic regression for a suicide attempt in the past year were depressive symptoms (OR = 4.3, p < 0.0001), having a close friend or family member commit suicide (OR = 4.2, p < 0.0001), being 12–15 years old (reference group: 16–18 years) (OR = 2.7, p < 0.0001), having anxiety symptoms (OR = 2.3, p = 0.0073), witnessing an adult hit another adult or a child in the home (OR = 1.8, p = 0.001), and being uncomfortable in NZ European social surroundings (OR = 1.7, p = 0.0040). Family connection was associated with fewer suicide attempts (OR = 0.9, p = 0.0002), but this factor did not moderate the relationship between depressive symptoms and suicide attempt (χ2 = 2.84, df = 1, p = 0.09). Family connection acts as a compensatory mechanism to reduce the risk of suicide attempts for Māori students with depressive symptoms, not as a moderating variable.

Download Full-text

Association of Psychotic Experiences With Subsequent Risk of Suicidal Ideation, Suicide Attempts, and Suicide Deaths

JAMA Psychiatry ◽

10.1001/jamapsychiatry.2018.3514 ◽

2019 ◽

Vol 76 (2) ◽

pp. 180 ◽

Cited By ~ 38

Author(s):

Kathryn Yates ◽

Ulla Lång ◽

Martin Cederlöf ◽

Fiona Boland ◽

Peter Taylor ◽

...

Keyword(s):

Suicidal Ideation ◽

Suicide Attempts ◽

Psychotic Experiences ◽

Subsequent Risk

Download Full-text

Perception of Health, Suicidal Ideation, and Suicide Attempt Among Adults in the Community

Crisis ◽

10.1027/0227-5910/a000104 ◽

2011 ◽

Vol 32 (6) ◽

pp. 346-351 ◽

Cited By ~ 12

Author(s):

Renee D. Goodwin ◽

Andrej Marusic

Keyword(s):

Suicidal Ideation ◽

Mental Disorders ◽

Suicide Attempt ◽

The United States ◽

Poor Health ◽

Sociodemographic Characteristics ◽

Final Model ◽

Perception Of Health ◽

The Relationship ◽

Comorbid Mental Disorders

Background: There is a well-known association between perception of poor physical health and higher rates of physical and psychological morbidity. However, little is known about the possible link between perception of health and suicidality. Aims: The study examines the relationship between perception of poor health and suicidal ideation and suicide attempt among adults in the community. Methods: Data were drawn from the National Comorbidity Survey (n = 5,877), a representative sample of individuals 15–54 years of age in the United States. Multiple logistic regression analyses were used to determine the relationship between perception of poor health and the likelihood of suicidal ideation and suicide attempt. Sociodemographic characteristics, comorbid mental disorders, and physical illnesses were adjusted for in the final model. Results: Perception of poor health was associated with a significantly increased likelihood of suicidal ideation (OR = 2.14 (1.36, 3.35) and suicide attempt (OR = 2.03 (1.06, 3.91)), which persisted after adjusting for differences in sociodemographic characteristics, mental disorders, and self-reported physical illnesses. Conclusions: Our findings provide initial evidence that perception of poor health is associated with a significantly increased likelihood of suicidal ideation and suicide attempt among adults in the community.

Download Full-text

Correlates of Suicidal Ideation and/or Behavior in Bariatric-Surgery-Seeking Individuals With Severe Obesity

Crisis ◽

10.1027/0227-5910/a000115 ◽

2012 ◽

Vol 33 (3) ◽

pp. 137-143 ◽

Cited By ~ 18

Author(s):

E. Y. Chen ◽

K. C. Fettich ◽

M. S. McCloskey

Keyword(s):

Bariatric Surgery ◽

Suicidal Ideation ◽

Suicide Attempt ◽

Severe Obesity ◽

Suicide Attempts ◽

Cross Sectional Study ◽

Cross Sectional ◽

Related Stigma ◽

Severely Obese ◽

And Control

Background: Approximately 10% of severely obese bariatric-surgery-seeking individuals report a lifetime history of suicide attempts, a higher rate than in the general community. Being overweight is associated with weight-related stigma, making an individual more vulnerable to social isolation, a potential risk factor for suicidal ideation and/or behavior. Aims: In this cross-sectional study of surgery-seeking adults with severe obesity, we examined whether weight-related stigma increases (1) the likelihood of suicidal ideation and/or behavior or (2) the degree of loneliness; and whether hypotheses (1) and (2) are supported (3) if loneliness mediates the effect of weight-related stigma on suicidal ideation and/or behavior. Methods: Online questionnaires were administered to 301 women and 95 men seeking bariatric surgery. Results: Approximately 30.3% reported having at least a passing thought of suicide, and 5.55% a suicide attempt during their lifetime. The suicide attempt rate appears lower than other bariatric surgery samples, but possibly higher than community and other surgery sample rates. For severely obese surgery-seeking women, weight-related stigma was associated with suicidal ideation and/or behavior, though this was not mediated by loneliness. Conclusions: Future studies are needed to model and compare suicidal ideation and/or behavior in bariatric-surgery-seeking individuals and control groups.

Download Full-text