Outpatient psychotherapy practice with adolescents following psychiatric hospitalization for suicide ideation or a suicide attempt

Suicide attempts and psychiatric hospitalization represent the final outcomes of a complex dynamical system of interacting factors that influence a particular individual’s likelihood of engaging in suicidal behavior, as well as their ability to seek help prior to acting upon suicidal impulses. This study examined the association between different types of lifetime trauma exposure and the likelihood of psychiatric hospitalization following a suicide attempt (SA) rather than suicidal ideation (SI) alone. Electronic medical records for 1100 U.S. military service members and their dependents admitted to a military psychiatric inpatient setting for SA or SI were reviewed for documented lifetime trauma exposure history. Findings indicated that exposure to at least one childhood trauma of any type, and childhood neglect in particular, increased the likelihood that an individual would be hospitalized for SA rather than SI. Exploratory gender-stratified analyses demonstrated that childhood neglect, childhood sexual abuse, and adulthood traumatic loss may be linked with the likelihood of being hospitalized for SA. These findings demonstrate the importance of developing more detailed and nuanced conception of factors known to be associated with suicide as their effects may depend on details of their timing and nature, as well as their interactions with other systems.

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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.

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The Role of Past Suicidal Behavior on Current Suicidality: A Retrospective Study in the Israeli Military

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18020649 ◽

2021 ◽

Vol 18 (2) ◽

pp. 649

Author(s):

Leah Shelef ◽

Jessica M Rabbany ◽

Peter M Gutierrez ◽

Ron Kedem ◽

Ariel Ben Yehuda ◽

...

Keyword(s):

Suicide Attempt ◽

Suicidal Behavior ◽

Military Service ◽

Suicide Ideation ◽

Rating Scale ◽

Suicide Attempts ◽

Significant Risk ◽

Significant Risk Factor ◽

Severity Rating ◽

Significant Difference

Past suicide attempts are a significant risk factor for future suicidality. Therefore, the present military-based study examined the past suicidal behavior of soldiers who recently made a severe suicide attempt. Our sample consisted of 65 active-duty soldiers (61.5% males), between the ages of 18 and 28 years old (M = 20.4, SD ± 1.3). The inclusion criterion was a recent severe suicide attempt, requiring at least a 24 h hospitalization. This sample was divided into two groups, according to previous suicidal behavior, namely whether their first suicide attempt was before or after enlistment (n = 25; 38.5% and n = 40; 61.5%, respectively). We then examined the lethality and intent of the recent event in regard to this division. Four measures were used to assess the subjects’ suicidal characteristics: the Columbia Suicide Severity Rating Scale, the Self-Harm Behavior Questionnaire, the Suicidal Behaviors Questionnaire-Revised, and the Beck Scale for Suicide Ideation. No significant difference in the severity of the suicide attempts (either actual or potential severity) were found between those who had suicide attempts before enlistment and those who had their first attempt in the service. As a matter of fact, most of the suicide attempts that occurred for the first time during military service had used a violent method (58.3%, n = 21). Finally, using multivariate analyses, we found that current thoughts and behavior, rather than past suicidality, was the strongest predictor for the lethality of suicide attempts.

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The changes and the predictors of suicide ideation and suicide attempt among HIV-positive patients at 6-12 months post diagnosis: A longitudinal study

Journal of Advanced Nursing ◽

10.1111/jan.13883 ◽

2018 ◽

Vol 75 (3) ◽

pp. 573-584 ◽

Cited By ~ 4

Author(s):

Hsing-Fei Lu ◽

Wang-Huei Sheng ◽

Shih-Cheng Liao ◽

Nien-Tzu Chang ◽

Pei-Ying Wu ◽

...

Keyword(s):

Longitudinal Study ◽

Suicide Attempt ◽

Suicide Ideation ◽

Hiv Positive

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The effect of sexual abuse and dissociation on suicide attempt

BMC Psychiatry ◽

10.1186/s12888-021-03662-9 ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

Silje Støle Brokke ◽

Thomas Bjerregaard Bertelsen ◽

Nils Inge Landrø ◽

Vegard Øksendal Haaland

Keyword(s):

Sexual Abuse ◽

Risk Factor ◽

Suicide Attempt ◽

Indirect Effects ◽

Suicide Ideation ◽

Suicide Attempts ◽

Suicidal Thoughts ◽

Dissociative Experiences ◽

Self Harm

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.

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Dimensions of Religion Associated with Suicide Attempt and Suicide Ideation in Depressed, Religiously Affiliated Patients

Suicide and Life-Threatening Behavior ◽

10.1111/sltb.12456 ◽

2018 ◽

Vol 49 (2) ◽

pp. 505-519 ◽

Cited By ~ 4

Author(s):

Matthias Jongkind ◽

Bart Brink ◽

Hanneke Schaap‐Jonker ◽

Nathan Velde ◽

Arjan W. Braam

Keyword(s):

Suicide Attempt ◽

Suicide Ideation ◽

Religiously Affiliated

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Caring Transitions – A Care Coordination Intervention to Reduce Suicide Risk Among Youth Discharged From Inpatient Psychiatric Hospitalization

Crisis ◽

10.1027/0227-5910/a000795 ◽

2021 ◽

Author(s):

Kim Gryglewicz ◽

Amanda Peterson ◽

Eunji Nam ◽

Michelle M. Vance ◽

Lisa Borntrager ◽

...

Keyword(s):

Depressive Symptoms ◽

Service Utilization ◽

Care Coordination ◽

Suicide Risk ◽

Suicide Ideation ◽

Psychiatric Hospitalization ◽

Medication Management ◽

Individual Therapy ◽

Inpatient Hospitalization ◽

Crisis Services

Abstract. Background: Suicide risk following youth psychiatric hospitalization is of significant concern. This study evaluated Linking Individuals Needing Care (LINC), a theory-driven, comprehensive care coordination approach for youth discharged from crisis services. Aims: To pilot LINC's potential effectiveness in increasing service utilization and decreasing suicide risk. Method: Participants were 460 youth patients who received LINC for approximately 90 days following discharge from crisis services. Service utilization, depressive symptoms, and suicide-related variables were measured at baseline and 30, 60, and 90 days after baseline. Results: Patients significantly increased the use of various beneficial, least restrictive services (individual therapy, medication management, and non-mental health supports) over the 90-day intervention. Significant decreases were observed in depressive symptoms, suicide ideation, and engagement in suicide-related behaviors. Limitations: Absence of a comparison group and nonparticipating families limit causal conclusions and generalizability. Conclusions: LINC may be a promising new approach following inpatient hospitalization that can engage and retain youth in services, likely resulting in improved treatment outcomes. This approach was designed emphasizing patient engagement, suicide risk assessment and management, safety planning, community networking, referral/linkage monitoring, coping and motivational strategies, and linguistic/culturally responsive practices to meet service and support needs of high-risk suicidal youth.

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A Retrospective Chart Review Examination of Demographic, Military, and Psychiatric Differences among Psychiatric Inpatients Admitted for Suicide-Ideation versus Suicide Attempt with an Emphasis on Gender

10.21236/ad1012832 ◽

2014 ◽

Author(s):

Brianne J. George

Keyword(s):

Suicide Attempt ◽

Chart Review ◽

Suicide Ideation ◽

Retrospective Chart Review ◽

Psychiatric Inpatients

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Psychosocial job stressors and suicidality: a meta-analysis and systematic review

Occupational and Environmental Medicine ◽

10.1136/oemed-2017-104531 ◽

2017 ◽

Vol 75 (4) ◽

pp. 245-253 ◽

Cited By ~ 40

Author(s):

Allison Milner ◽

Katrina Witt ◽

Anthony D LaMontagne ◽

Isabelle Niedhammer

Keyword(s):

Systematic Review ◽

Suicide Attempt ◽

Suicide Ideation ◽

Longitudinal Research ◽

Common Mental Disorders ◽

Job Insecurity ◽

Meta Analysis ◽

Job Stressors ◽

Cross Sectional ◽

Job Stressor

ObjectivesJob stressors are known determinants of common mental disorders. Over the past 10 years, there has been evidence that job stressors may also be risk factors for suicidality. The current paper sought to examine this topic through the first comprehensive systematic review and meta-analysis of the literature to date.MethodsWe used a three-tier search strategy of seven electronic databases. Studies were included if they reported on a job stressor or job-related stress as an exposure and suicide ideation, self-harm, suicide attempt or suicide as an outcome. Two researchers independently screened articles. All extracted effect estimates were converted to log-transformed ORs.ResultsThere were 22 studies that were included in meta-analysis. Overall, exposure to job stressors was associated with elevated risk of suicide ideation and behaviours. The OR for suicide ideation (14 studies) ranged from 1.45 (95% CI 1.01 to 2.08) for poor supervisor and colleague support to 1.91 (95% CI 1.22 to 2.99) for job insecurity. For suicide (six studies), exposure to lower supervisor and collegial support produced an OR of 1.16 (95% CI 0.98 to 1.38), while low job control resulted in an OR of 1.23 (95% CI 1.00 to 1.50). There were only two studies that examined suicide attempt, both of which suggested an adverse effect of exposure to job stressors.ConclusionsThis study provides some evidence that job stressors may be related to suicidal outcomes. However, as most studies in the area were cross-sectional and observational in design, there is a need for longitudinal research to assess the robustness of observed associations.

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Suicide and Aggression

Psychological Reports ◽

10.2466/pr0.1967.21.3.745 ◽

1967 ◽

Vol 21 (3) ◽

pp. 745-751 ◽

Cited By ~ 2

Author(s):

Sherman Eisenthal

Keyword(s):

Suicide Attempt ◽

Repeated Measures ◽

Suicide Ideation ◽

Psychiatric Patients ◽

Significant Degree ◽

Viewing Time ◽

Control Groups ◽

Content Analyses ◽

Suicidal Patients

Suicide-attempt, suicide-ideation, and non-suicidal control groups of VA neuro-psychiatric patients were divided into psychotic and neurotic subgroups ( ns = 15). Ss viewed two classes of slides, a series of death scenes and one of unpleasant scenes. Each series contained both aggressive and non-aggressive content. Analyses of this 3 × 2 × 2 factorial design, with repeated measures, were based on measures of viewing time, rated tension, and rated liking. Aggressive slides induced greater threat than non-aggressive slides to a significant degree in the death slide series and to a lesser degree in the unpleasant slide series. Suicidal patients did not manifest a consistent style of response to aggressive slides in either series. The measure of aggressive mood also was not different for suicidal and non-suicidal patients. Suicide ideators did not differentiate aggressive and non-aggressive slides but attempters and controls did. The role of anxiety level was discussed.

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