The Effect of Parental Remarriage following Parental Divorce on Offspring Suicide Attempt

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.

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.


2017 ◽  
Vol 52 (6) ◽  
pp. 552-560 ◽  
Author(s):  
Katelyn Kerr ◽  
Madeline Romaniuk ◽  
Sarah McLeay ◽  
Andrew Khoo ◽  
Michael T Dent ◽  
...  

Background: Military veterans have higher rates of suicidality and completed suicides compared to the general population. Previous research has demonstrated suicidal behaviour is higher in US combat veterans who are younger, suffer from posttraumatic stress disorder, depression and anxiety and score lower on measures of health. However, research on predictors of suicide for Australian veterans is limited. The aim of this study was to identify significant demographic and psychological differences between veterans with posttraumatic stress disorder who had attempted suicide and those with posttraumatic stress disorder who had not, as well as determine predictors of suicide attempts within an Australian cohort. Methods: A retrospective analysis was conducted on 229 ex-service personnel diagnosed with posttraumatic stress disorder who had attended a Military Service Trauma Recovery Day Program as outpatients at Toowong Private Hospital from 2007 to 2014. Patients completed a battery of mental health self-report questionnaires assessing symptoms of posttraumatic stress disorder, alcohol use, anger, depression, anxiety and quality of life. Demographic information and self-reported history of suicide attempts were also recorded. Results: Results indicated the average age was significantly lower, and the rates of posttraumatic stress disorder, anger, anxiety and depression symptoms were significantly higher in those veterans with history of a suicide attempt. Multivariate logistic regression analyses indicated posttraumatic stress disorder symptom severity, unemployment or total and permanent incapacity pension status significantly predicted suicide attempt history. Conclusion: Among a cohort of Australian veterans with posttraumatic stress disorder, psychopathology severity, unemployment and total and permanent incapacity status are significantly associated with suicidality. This study highlights the importance of early identification of posttraumatic stress disorder and psychopathology, therapeutic and social engagement, and prioritisation of tangible employment options or meaningful and goal-directed activities for veterans deemed unable to work.


Crisis ◽  
2020 ◽  
pp. 1-5
Author(s):  
Caitlin O'Loughlin ◽  
Taylor A. Burke ◽  
Brooke A. Ammerman

Abstract. Background: Nonsuicidal self-injury (NSSI) is a strong predictor of suicide attempts (SA). Characteristics of NSSI have been shown to influence the NSSI–SA relationship; however, the temporal nature of this association is understudied. Aims: This study aimed to elucidate the NSSI-SA relationship by examining the association between NSSI characteristics and time lapsed from NSSI onset to first SA. Method: Participants were 111 individuals with a history of NSSI that preceded their first SA who completed a series of self-report measures. Results: NSSI methods of cutting and burning, and the anti-dissociation function, were associated with a shorter transition time from NSSI to SA. Earlier age of NSSI onset and the interpersonal boundaries function were related to a longer time to transition. Limitations: This sample size was limited, and data were collected cross-sectionally. Conclusion: Findings provide foundational knowledge regarding NSSI characteristics to inform theoretical models of the NSSI–SA association. This information can inform suicide risk assessments among those with a history of NSSI.


2012 ◽  
Vol 60 (3) ◽  
pp. 555-576 ◽  
Author(s):  
J. Christopher Fowler ◽  
Mark J. Hilsenroth ◽  
Michael Groat ◽  
Spencer Biel ◽  
Christina Biedermann ◽  
...  

This study explored a psychodynamic model for suicide risk by examining risk factors for medically serious suicide attempts, including assessments of affect flooding, negative self-schema / fragmentation, and impaired reality testing, closely approximating Maltsberger’s psycho-dynamic formulation of suicide crisis. Baseline risk factors including age, gender, psychiatric symptoms, high-risk behaviors, and the Implicit Risk for Suicide Index (IRSI) were used to detect medically serious suicide attempts monitored for up to a year after the assessment. Twenty-five psychiatric inpatients who made life-threatening suicide attempts after assessment were compared to 25 inpatients and 25 psychotherapy outpatients who made no suicide attempts during follow-up. Statistical analysis revealed that a history of at least one suicide attempt and elevated IRSI scores accounted for 60 percent of the variance in detecting medically serious suicide attempts. Elevated IRSI accurately identified suicide attempt status above and beyond past suicide attempts and other empirically validated risk factors. Results are discussed in light of psychodynamic formulations of suicide risk.


Author(s):  
Brian Rothberg ◽  
Robert E. Feinstein

All psychiatric assessments should include screening for recent suicidal ideation and past suicide behavior. The Columbia-Suicide Severity Rating Scale (C-SSRS) provides a reliable objective assessment of suicide risk. A history of past suicide attempts is a risk factor for future suicide, and risk is increased by more serious, more frequent, or more recent attempts. Over 90% of individuals who die by suicide have at least one psychiatric disorder. Patients with schizophrenia, alcohol and other substance use disorders, and borderline and antisocial personality disorders are at increased risk for suicide. Familial transmission of suicide risk appears to occur independent of the familial risk for psychiatric disorders; impulsivity seems to be an inherited trait that makes individuals more vulnerable to suicide. Hospitalization should be considered if suicidal ideation is present in a patient who is psychotic or who has a history of past attempts, particularly if near lethal, and may be the safest option in patients with other contributing medical conditions, limited family or social support, or lack of access to timely outpatient follow-up.


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.


2021 ◽  
pp. 1-10
Author(s):  
Maya N. Sohn ◽  
Carly A. McMorris ◽  
Signe Bray ◽  
Alexander McGirr

Abstract Suicide risk assessment involves integrating patient disclosure of suicidal ideation and non-specific risk factors such as family history, past suicidal behaviour, and psychiatric symptoms. A death version of the implicit association test (D-IAT) has been developed to provide an objective measure of the degree to which the self is affiliated with life or death. However, this has inconsistently been associated with past and future suicidal behaviour. Here, we systematically review and quantitatively synthesize the literature examining the D-IAT and suicide attempts. We searched psychINFO, Medline, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL) from inception until 9 February 2021 to identify publications reporting D-IAT scores and suicide attempts (PROSPERO; CRD42020194394). Using random-effects models, we calculated standardized mean differences (SMD) and odds ratios (ORs) for retrospective suicide attempts. We then calculated ORs for future suicide attempts. ORs were dichotomized using a cutoff of zero representing equipoise between self-association with life and death. Eighteen studies met our inclusion criteria (n = 9551). The pooled SMD revealed higher D-IAT scores in individuals with a history of suicide attempt (SMD = 0.25, 95% CI 0.15 to 0.35); however, subgroup analyses demonstrated heterogeneity with acute care settings having lower effect sizes than community settings. Dichotomized D-IAT scores discriminated those with a history of suicide attempt from those without (OR 1.38 95% CI 1.01 to 1.89) and predicted suicide attempt over a six-month follow-up period (OR 2.99 95% CI 1.45 to 6.18; six studies, n = 781). The D-IAT may have a supplementary role in suicide risk assessment; however, determination of acute suicide risk and related clinical decisions should not be based solely on D-IAT performance.


Crisis ◽  
2020 ◽  
pp. 1-8
Author(s):  
Deepak Prabhakar ◽  
Edward L. Peterson ◽  
Yong Hu ◽  
Simran Chawa ◽  
Rebecca C. Rossom ◽  
...  

Abstract. Background: In the US, more than one million people attempt suicide each year. History of suicide attempt is a significant risk factor for death by suicide; however, there is a paucity of data from the US general population on this relationship. Aim: The objective of this study was to examine suicide attempts needing medical attention as a risk for suicide death. Method: We conducted a case–control study involving eight US healthcare systems. A total of 2,674 individuals who died by suicide from 2000 to 2013 were matched to 267,400 individuals by year and location. Results: Prior suicide attempt associated with a medical visit increases risk for suicide death by 39.1 times, particularly for women ( OR = 79.2). However, only 11.3% of suicide deaths were associated with an attempt that required medical attention. The association was the strongest for children 10–14 years old ( OR = 98.0). Most suicide attempts were recorded during the 20-week period prior to death. Limitations: Our study is limited to suicide attempts for which individuals sought medical care. Conclusion: In the US, prior suicide attempt is associated with an increased risk of suicide death; the risk is high especially during the period immediately following a nonlethal attempt.


2017 ◽  
Vol 27 (4) ◽  
pp. 28026
Author(s):  
Luísa Weber Bisol ◽  
Letícia Rodrigues Porciúncula ◽  
Elisa Fasolin Mello ◽  
Eduardo Lopes Nogueira ◽  
Irênio Gomes ◽  
...  

***Prevalence of bipolar disorder in a sample of older adults***AIMS: To estimate the prevalence of bipolar disorder in a sample of older adults and to examine associated socio-demographic and clinical factors.METHODS: Cross-sectional population-based study of individuals aged 60 years or older registered with the Family Health Strategy in Porto Alegre, Rio Grande do Sul, Brazil, selected randomly from 30 different basic health units. Participants were subjected to diagnostic assessment for bipolar disorder and suicide risk using the Mini International Neuropsychiatric Interview Plus 5.0.0. Categorical variables were described as absolute and relative frequencies. Quantitative variables were expressed as means and standard deviations. The Pearson chi-square or Fisher’s exact tests were used as appropriate to evaluate potential associations between the independent variables suicide attempt and risk of suicide. To control for possible confounders and assess variables independently associated with the outcome of interest, the strength association among different risk factors was assessed by means of prevalence ratios, which were estimated with a controlled Poisson model or multivariate Poisson regression. The significance level was set at 5% (p≤0.05).RESULTS: The sample comprised 550 older adults. The lifetime prevalence of bipolar disorder in the sample was 5.8% and the point prevalence was 1.5%. In those with bipolar disorder, 59.4% were type I and 40.6% type II. Significant associations were observed between bipolar disorder regardless of type and female gender (prevalence rate [PR] 2.42, 95% confidence interval [CI] 1.01-5.81), living with a partner (PR 2.52, 95%CI 1.21-5.24), history of suicide attempt (PR 3.16, 95%CI 1.53-6.25), and suicide risk (PR 2.98, 95%CI 1.47-6.06). When analyzed each type of bipolar disorder, statistically significant associations were found between age under 70 years and type I bipolar disorder; having companion and type II bipolar disorder; and risk of suicide was associated with both types of bipolar disorder.CONCLUSIONS: Regardless of the type of bipolar disorder, women and those living with a partner were more affected. History of suicide attempts and suicide risk were more frequent in elderly subjects with bipolar disorder than in those without the disorder.


Crisis ◽  
2016 ◽  
Vol 37 (4) ◽  
pp. 310-313 ◽  
Author(s):  
Erin F. Ward-Ciesielski ◽  
Julie A. Schumacher ◽  
Courtney L. Bagge

Abstract. Background: Although nonsuicidal self-injury (NSSI) is known to be associated with increased risk of death by suicide and suicide attempts, minimal research has focused on comparing recent suicide attempters with and without NSSI on suicide attempt characteristics (frequency and severity of suicide attempts). Understanding how NSSI impacts suicide attempt characteristics can help providers to enhance their assessment and treatment strategies so as to prevent future suicidal behaviors. Aims: The present study investigated the extent to which a history of NSSI was related to the frequency and severity of suicide attempts in a sample of recent suicide attempters. Method: Participants included 171 adult patients who presented to the hospital within 24 hr of a suicide attempt. Information about their suicide attempts and NSSI was gathered using self-report questionnaires and interviews. Results: Suicide attempters with a history of NSSI reported significantly more suicide attempts and more suicide attempts requiring medical attention, after controlling for important clinical covariates. Conclusion: NSSI was uniquely associated with suicide attempt characteristics, highlighting the importance of NSSI in suicide assessment, prevention, and treatment efforts.


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