Suicidal ideation in military veterans with alcohol dependence and PTSD: The role of hostility

Alcohol use disorder is a chronically relapsing disorder that involves (1) compulsivity to seek and take alcohol, (2) difficulty in limiting alcohol intake, and (3) emergence of a negative emotional state (e.g., dysphoria, anxiety, irritability) in the absence of alcohol. Alcohol addiction encompasses a three-stage cycle that becomes more intense as alcohol use progresses: binge/intoxication, withdrawal/negative affect, and preoccupation/anticipation. These stages engage neuroadaptations in brain circuits that involve the basal ganglia (reward hypofunction), extended amygdala (stress sensitization), and prefrontal cortex (executive function disorder). This chapter discusses key neuroadaptations in the hypothalamic and extrahypothalamic stress systems and the critical role of glucocorticoid receptors. These neuroadaptations contribute to negative emotional states that powerfully drive compulsive alcohol drinking and seeking. These changes in association with a disruption of prefrontal cortex function that lead to cognitive deficits and poor decision making contribute to the chronic relapsing nature of alcohol dependence.

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Trauma-Related Guilt and Posttraumatic Stress Disorder Symptoms in Military Veterans: The Role of Psychological Inflexibility

Journal of Psychiatric Research ◽

10.1016/j.jpsychires.2021.02.022 ◽

2021 ◽

Author(s):

Lorig K. Kachadourian ◽

Robert Lyons ◽

Brittany Davis ◽

Moira Haller ◽

Sonya Norman

Keyword(s):

Posttraumatic Stress Disorder ◽

Posttraumatic Stress ◽

Stress Disorder ◽

Military Veterans ◽

Psychological Inflexibility ◽

Posttraumatic Stress Disorder Symptoms

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Role of SES on the association between childhood parental death and adulthood suicidal ideation: a mediation analysis using longitudinal dataset in South Korea

BMC Psychiatry ◽

10.1186/s12888-021-03146-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jaehong Yoon ◽

Ja Young Kim ◽

Ji-Hwan Kim ◽

Seung-Sup Kim

Keyword(s):

Suicidal Ideation ◽

South Korea ◽

Mediation Analysis ◽

Household Income ◽

Parental Death ◽

Middle Adulthood ◽

Late Adulthood ◽

Mediating Role ◽

Direct Association

Abstract Background We sought to examine the association between childhood experience of parental death (CEPD) and adulthood suicidal ideation, and the mediating role of adulthood SES in the association. Methods We analyzed a nationally representative dataset of 8609 adults from the Korea Welfare Panel Study, which is a longitudinal cohort dataset in South Korea. CEPD was measured using a question: “During your childhood (0-17 years old), have you experienced the death of parents?” We classified responses of CEPD during 2006–2011 into ‘yes,’ and the others into ‘no.’ Suicidal ideation over the past year was assessed annually during 2012–2019. As a potential mediator, adulthood educational attainment and household income in 2011 were included in the analysis. Logistic regression was applied to examine the association of CEPD with adulthood suicidal ideation across age groups (early adulthood, 19–39 years old; middle adulthood, 40–59 years old; late adulthood, ≥60 years old), after excluding people who reported lifetime suicidal ideation in 2011. Causal mediation analysis using a parametric regression model was applied to examine the mediating role of adulthood SES in the association between CEPD and adulthood suicidal ideation. Results After adjusting for potential confounders including childhood SES, CEPD was significantly associated with adulthood suicidal ideation among the late adulthood group (OR: 1.43; 95% CI: 1.13–1.81), while the association was not statistically significant among the early; and middle adulthood groups. In mediation analysis of adulthood household income, both indirect association (ORNIE: 1.05; 95% CI: 1.02–1.09) and direct association (ORNDE: 1.37; 95% CI: 1.09–1.73) were statistically significant among the late adulthood group. In the mediation analysis of adulthood education attainment among the late adulthood, only a direct association was statistically significant (ORNDE: 1.43; 95% CI: 1.14–1.80). Conclusions These results suggest that CEPD could be a risk factor for adulthood suicidal ideation. Furthermore, the findings imply that income security policy might be necessary to reduce suicide among the late adulthood group.

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Suicidal Ideation and Eating Disorder Symptoms in Adolescents: The Role of Interoceptive Deficits

Behavior Therapy ◽

10.1016/j.beth.2021.03.005 ◽

2021 ◽

Author(s):

Natalie M. Perkins ◽

Shelby N. Ortiz ◽

April R. Smith ◽

Amy M. Brausch

Keyword(s):

Eating Disorder ◽

Suicidal Ideation ◽

Eating Disorder Symptoms

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African American adolescent suicidal ideation and behavior: The role of racism and prevention

Journal of Community Psychology ◽

10.1002/jcop.22543 ◽

2021 ◽

Author(s):

W. LaVome Robinson ◽

Christopher R. Whipple ◽

Leonard A. Jason ◽

Caleb E. Flack

Keyword(s):

African American ◽

Suicidal Ideation ◽

African American Adolescent ◽

And Behavior

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Association of the OPRM1 A118G polymorphism and Pavlovian-to-instrumental transfer: Clinical relevance for alcohol dependence

Journal of Psychopharmacology ◽

10.1177/0269881121991992 ◽

2021 ◽

pp. 026988112199199 ◽

Cited By ~ 1

Author(s):

Miriam Sebold ◽

Maria Garbusow ◽

Deniz Cerci ◽

Ke Chen ◽

Christian Sommer ◽

...

Keyword(s):

Alcohol Dependence ◽

Opioid Receptor ◽

Mechanistic Model ◽

Critical Role ◽

Opioid System ◽

Operant Behaviour ◽

Oprm1 Gene ◽

Potential Biomarker ◽

A118g Polymorphism

Background: Pavlovian-to-instrumental transfer (PIT) quantifies the extent to which a stimulus that has been associated with reward or punishment alters operant behaviour. In alcohol dependence (AD), the PIT effect serves as a paradigmatic model of cue-induced relapse. Preclinical studies have suggested a critical role of the opioid system in modulating Pavlovian–instrumental interactions. The A118G polymorphism of the OPRM1 gene affects opioid receptor availability and function. Furthermore, this polymorphism interacts with cue-induced approach behaviour and is a potential biomarker for pharmacological treatment response in AD. In this study, we tested whether the OPRM1 polymorphism is associated with the PIT effect and relapse in AD. Methods: Using a PIT task, we examined three independent samples: young healthy subjects ( N = 161), detoxified alcohol-dependent patients ( N = 186) and age-matched healthy controls ( N = 105). We used data from a larger study designed to assess the role of learning mechanisms in the development and maintenance of AD. Subjects were genotyped for the A118G (rs1799971) polymorphism of the OPRM1 gene. Relapse was assessed after three months. Results: In all three samples, participants with the minor OPRM1 G-Allele (G+ carriers) showed increased expression of the PIT effect in the absence of learning differences. Relapse was not associated with the OPRM1 polymorphism. Instead, G+ carriers displaying increased PIT effects were particularly prone to relapse. Conclusion: These results support a role for the opioid system in incentive salience motivation. Furthermore, they inform a mechanistic model of aberrant salience processing and are in line with the pharmacological potential of opioid receptor targets in the treatment of AD.

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Suicidal Ideation Among International Students: The Role of Cultural, Academic, and Interpersonal Factors

The Counseling Psychologist ◽

10.1177/00110000211002458 ◽

2021 ◽

pp. 001100002110024

Author(s):

Andrés E. Pérez Rojas ◽

Na-Yeun Choi ◽

Minji Yang ◽

Theodore T. Bartholomew ◽

Giovanna M. Pérez

Keyword(s):

International Students ◽

Suicidal Ideation ◽

Structural Equation ◽

Structural Equation Models ◽

The United States ◽

Cross Cultural ◽

Thwarted Belongingness ◽

Perceived Burdensomeness ◽

Using Data

We examined two structural equation models of international students’ suicidal ideation using data from 595 international students in two public universities in the United States. The models represented competing hypotheses about the relationships among discrimination, cross-cultural loss, academic distress, thwarted belongingness, perceived burdensomeness, and suicidal ideation. The findings indicated there were direct, positive links between discrimination, cross-cultural loss, and academic distress to perceived burdensomeness; a direct, positive link between perceived burdensomeness and suicidal ideation; and indirect, positive links between discrimination, cross-cultural loss, and academic distress to suicidal ideation via perceived burdensomeness. The only predictors that related to thwarted belongingness were cross-cultural loss and academic distress, and there were no indirect links to suicidal ideation via thwarted belongingness. In fact, with all other variables in the model, thwarted belongingness was unrelated to suicidal ideation. Finally, academic distress was directly related to suicidal ideation. We discuss implications of the findings.

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Mental health and suicidal ideation in US military veterans with histories of COVID-19 infection

BMJ Military Health ◽

10.1136/bmjmilitary-2021-001846 ◽

2021 ◽

pp. bmjmilitary-2021-001846

Author(s):

Peter Na ◽

J Tsai ◽

I Harpaz-Rotem ◽

R Pietrzak

Keyword(s):

Suicidal Ideation ◽

Protective Factors ◽

Community Integration ◽

Military Veterans ◽

Risk And Protective Factors ◽

Stress Disorders ◽

Us Military ◽

Increased Risk ◽

Psychiatric Conditions ◽

Internalising Disorders

IntroductionThere have been reports of increased prevalence in psychiatric conditions in non-veteran survivors of COVID-19. To date, however, no known study has examined the prevalence, risk and protective factors of psychiatric conditions among US military veterans who survived COVID-19.MethodsData were analysed from the 2019 to 2020 National Health and Resilience in Veterans Study, which surveyed a nationally representative, prospective cohort of 3078 US veterans. Prepandemic and 1-year peripandemic risk and protective factors associated with positive screens for peripandemic internalising (major depressive, generalised anxiety and/or posttraumatic stress disorders) and externalising psychiatric disorders (alcohol and/or drug use disorders) and suicidal ideation were examined using bivariate and multivariate logistic regression analyses.ResultsA total of 233 veterans (8.6%) reported having been infected with COVID-19. Relative to veterans who were not infected, veterans who were infected were more likely to screen positive for internalising disorders (20.5% vs 13.9%, p=0.005), externalising disorders (23.2% vs 14.8%, p=0.001) and current suicidal ideation (12.0% vs 7.6%, p=0.015) at peripandemic. Multivariable analyses revealed that greater prepandemic psychiatric symptom severity and COVID-related stressors were the strongest independent predictors of peripandemic internalising disorders, while prepandemic trauma burden was protective. Prepandemic suicidal ideation, greater loneliness and lower household income were the strongest independent predictors of peripandemic suicidal ideation, whereas prepandemic community integration was protective.ConclusionPsychiatric symptoms and suicidal ideation are prevalent in veterans who have survived COVID-19. Veterans with greater prepandemic psychiatric and substance use problems, COVID-related stressors and fewer psychosocial resources may be at increased risk of these outcomes.

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