scholarly journals Suicidal behaviors among American Indian/Alaska Native firefighters: Evidence for the role of painful and provocative events

2019 ◽  
Vol 57 (2) ◽  
pp. 275-287 ◽  
Author(s):  
Ian H Stanley ◽  
Melanie A Hom ◽  
Austin J Gallyer ◽  
Jacqueline S Gray ◽  
Thomas E Joiner

Firefighters represent a group at elevated suicide risk. Identifying segments of the fire service at increased risk may facilitate the targeted provision of suicide prevention initiatives. Among the general population, American Indian/Alaska Native (AI/AN) individuals report higher rates of suicide attempts. This study sought to examine suicide attempt rates among AI/AN firefighters and to determine if greater exposure to painful and provocative events and/or fearlessness about death explains the relationship between AI/AN identity and suicidal behaviors. A total of 917 US firefighters completed a web-based mental health survey (6.2% AI/AN). Participants completed a modified version of the Self-Injurious Thoughts and Behaviors Interview-Short Form, the Painful and Provocative Events Scale, and the Acquired Capability for Suicide Scale–Fearlessness About Death scale. Bootstrap mediation analyses were conducted, controlling for years of service as a firefighter. Although AI/AN firefighters accounted for only 6.2% of the sample, they accounted for 34.4% of the career suicide attempts. AI/AN firefighters were 16.31 (95% CI = 7.96, 33.42) times more likely to report a career suicide attempt history than non-AI/AN firefighters, adjusting for years of service as a firefighter. Painful and provocative events, but not fearlessness about death, was a statistically significant mediator of the relationship between AI/AN identity and suicide attempts. Firefighters identifying as AI/AN represent a subgroup within the fire service at increased risk for suicide. Findings suggest that greater exposure to painful and provocative events among AI/AN firefighters may explain the elevated suicide risk among this population.

2010 ◽  
Vol 91 (2) ◽  
pp. 186-192 ◽  
Author(s):  
Dana M. Lizardi ◽  
Ronald G. Thompson ◽  
Katherine M. Keyes ◽  
Deborah S. Hasin

Parental divorce during childhood is associated with an increased risk of suicide attempts for male but not female offspring. This study examines whether parental remarriage has a differential effect on suicide risk for male and female adult offspring. Using the 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), the sample consists of respondents who experienced parental divorce ( N = 6,436). Multivariable regressions were estimated. Females who lived with a stepparent were significantly more likely to report a lifetime suicide attempt compared with females who had not. Clinicians should note that female depressed patients who have a history of childhood parental divorce and remarriage may be at more risk for suicide attempt than previously recognized.


2021 ◽  
Vol 18 (1) ◽  
pp. 88-93
Author(s):  
Kounseok Lee ◽  
Hyesun Kim ◽  
YoungHo Kim

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.


Crisis ◽  
2019 ◽  
Vol 40 (6) ◽  
pp. 413-421 ◽  
Author(s):  
Megan L. Rogers ◽  
Thomas E. Joiner

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.


2010 ◽  
Vol 106 (3) ◽  
pp. 785-790 ◽  
Author(s):  
Maurizio Pompili ◽  
David Lester ◽  
Marco Innamorati ◽  
Paolo Girardi ◽  
Roberto Tatarelli

To verify the hypothesis that suicide attempts are associated with lower serum cholesterol and triglyceride levels of patients with mood disorders, 26 patients with mood disorders (bipolar disorder and major depressive disorder) were admitted after a medically serious suicide attempt to the emergency department and then hospitalized in the psychiatric unit of the Sant'Andrea Hospital (Rome, Italy). Controls were 87 patients who had not made a recent suicide attempt. Attempters and nonattempters did not differ in the levels of serum cholesterol or triglycerides. Indeed, attempters had nonsignificantly higher serum levels of cholesterol and lower serum levels of triglycerides. The use of biologic indicators such as levels of serum cholesterol and triglycerides in the prediction of suicide risk in mood disorders was not fully supported from this small sample.


1998 ◽  
Vol 173 (6) ◽  
pp. 531-535 ◽  
Author(s):  
Erkki T. Isometsä ◽  
Jouko K. Lönnqvist

BackgroundThis study investigated three questions with major implications for suicide prevention: the sensitivity of the history of previous suicide attempt(s) as an indicator of suicide risk, the time interval from a preceding suicide attempt to the fatal one, and switching of suicide methods by those eventually completing suicide.MethodThe lifetime history of suicide attempts and the methods the victims (n=1397) used were examined in a nationwide psychological autopsy study comprising all suicides in Finland within a 12-month research period in 1987–1988.ResultsOverall, 56% of suicide victims were found to have died at their first suicide attempt, more males (62%) than females (38%). In 19% of males and 39% of females the victim had made a non-fatal attempt during the final year. Of the victims with previous attempts, 82% had used at least two different methods in their suicide attempts (the fatal included).ConclusionsMost male and a substantial proportion of female suicides die in their first suicide attempt, a fact that necessitates early recognition of suicide risk, particularly among males. Recognition of periods of high suicide risk on the grounds of recent non-fatal suicide attempts is likely to be important for suicide prevention among females. Subjects completing suicide commonly switch from one suicide method to another, a finding that weakens but does not negate the credibility of restrictions on the availability of lethal methods as a preventive measure.


2013 ◽  
Vol 7 (1) ◽  
pp. 16 ◽  
Author(s):  
Terryann C. Clark ◽  
Elizabeth Robinson ◽  
Sue Crengle ◽  
Theresa Fleming ◽  
Shanthi Ameratunga ◽  
...  

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.


Author(s):  
Elise Paul

Specific populations at risk for suicide differ considerably according to region, country, sex, age, and the most common suicide methods used, highlighting the need for ongoing systematic surveillance to inform prevention efforts. The magnitude of the problem is not limited to suicide deaths. It is estimated that for every suicide, there are 20 more persons who have made an attempt. Individuals who have made a suicide attempt are at increased risk for dying by suicide. This chapter explores differences in the suicide and suicide attempt rates in the general population on different continents, by examining data from the World Health Organization (WHO) Global Health Estimates and the World Mental Health Survey Initiative. Differences across contexts in suicidal behaviours and the need for ongoing monitoring are emphasized.


SLEEP ◽  
2019 ◽  
Vol 43 (3) ◽  
Author(s):  
Hyewon Kim ◽  
Yuwon Kim ◽  
Woojae Myung ◽  
Maurizio Fava ◽  
David Mischoulon ◽  
...  

Abstract Objectives To investigate the association between zolpidem prescription and suicide attempts in people with depression Methods A nationwide, population-based electronic medical records database from the Health Insurance Review & Assessment Service of South was used to investigate the incidence rate ratios (IRRs) of suicide attempts and probable suicide attempts in people with depression before and after zolpidem prescription using self-controlled case series design. Results In a total of 445 people who attempted suicide and 23 141 people who attempted probable suicide attempt, the IRRs of suicidal behavior during the risk periods before and after zolpidem prescription increased compared with those at the baseline. The IRRs gradually increased and peaked immediately before the prescription of zolpidem. The IRR was 70.06 (95% CI: 25.58–191.90) on day 2 before zolpidem prescription and 63.35 (95% CI: 22.99–174.59) on day 1 after zolpidem prescription in the suicide attempt group. The IRR was 24.07 (95% CI: 20.50–28.26) on the day before zolpidem prescription and 14.96 (95% CI: 12.21–18.34) on the day after zolpidem prescription in the probable suicide attempt group. The ratios declined eventually after zolpidem was prescribed. Conclusions Although zolpidem prescription was associated with an increased risk of suicide attempts in people with depression, the risk increased and peaked immediately before zolpidem prescription. The risk declined gradually thereafter. This result indicates that the risk of suicide attempts increases at the time of zolpidem prescription. However, zolpidem prescription does not contribute to additional increase in the risk of suicide attempts.


Author(s):  
Kirstie J M O′Hare ◽  
Richie Poulton ◽  
Richard J Linscott

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.


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