Effects of Childhood Trauma, Daily Stress and Emotions on Daily Cortisol Levels in Individuals Vulnerable to Suicide

Objectives: Suicide is a leading cause of mortality worldwide. Dysregulated hypothalamic-pituitary-adrenal axis activity, as measured by cortisol levels, has been identified as one potential risk factor. Evidence has indicated that childhood trauma is associated with dysregulated cortisol reactivity to stress in adulthood. The current study investigated for the first time whether childhood trauma and daily stressors and emotions were associated with diurnal cortisol levels over a 7-day study in individuals vulnerable to suicide. Methods: 142 participants were categorized according to their suicidal history into three groups: suicide attempt, suicidal ideation or control group. Participants completed questionnaires before commencing a 7-day study. Cortisol samples were provided immediately upon waking, at 15 mins, 30 mins, 45 mins, 3 hours, 6 hours, 9 hours and 12 hours on 7 consecutive days. Measures of daily stressors, mood, defeat and entrapment were completed at the end of each day. Results: Participants in the suicide attempt and ideation groups released significantly lower cortisol upon awakening (CAR) and had a tendency towards flatter wake-peak to 12 hour (WP-12) cortisol slopes compared to controls. Childhood trauma was found to be associated with significantly lower CAR and a tendency towards flatter WP-12 cortisol slope. Childhood trauma also had an indirect effect on suicide vulnerability group membership via lower daily CAR levels. Lower CAR was associated with increased suicide ideation at 1-month but not 6-months. Daily stress and emotion measures were not associated with cortisol levels. Conclusions: This is the first 7-day daily diary investigation of naturally fluctuating cortisol levels in individuals vulnerable to suicide. The results indicate that dysregulated hypothalamic-pituitary-adrenal (HPA) axis activity is associated with suicidal ideation and behavior. Childhood trauma appears to be an important distal factor associated with HPA-axis dysregulation.

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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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Distinct effects of over-general autobiographical memory on suicidal ideation among depressed and healthy people

BMC Psychiatry ◽

10.1186/s12888-020-02877-6 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Wen Jiang ◽

Guangtao Hu ◽

Jingxuan Zhang ◽

Ken Chen ◽

Dongni Fan ◽

...

Keyword(s):

Risk Factors ◽

Suicidal Ideation ◽

Autobiographical Memory ◽

Childhood Trauma ◽

Study Data ◽

Path Model ◽

Control Group ◽

Healthy Controls ◽

Healthy Individuals ◽

Healthy Control

Abstract Background Childhood trauma and over-general autobiographical memory (OGM) are crucial risk factors of suicide. This study aimed to investigate whether suicidal ideation was predicted by one’s childhood trauma and OGM and the mechanism of OGM underlying suicidal ideation in depression patients and healthy controls. Methods A total of 180 depression patients and 176 matched healthy individuals were recruited in this study. Data were analyzed using descriptive statistics, and Pearson’s correlation coefficient was obtained. Path analysis was conducted to test a meditational model. The multigroup comparison was applied to find differences between groups. Results Significant differences were detected between depression patients and healthy controls with respect to childhood trauma, OGM, suicidal ideation, and suicidal behavior. OGM was positively correlated with both current and worst-point suicidal ideation in the depression group and significantly correlated with worst-point suicidal ideation in the healthy control group. The path model showed that childhood trauma had a direct impact on the current suicidal ideation directly, and an indirect influence through OGM and worst-point suicidal ideation. Multigroup analysis further demonstrated that OGM affected and mediated the current suicidal ideation due to childhood trauma in depression patients, whereas only worst-point suicidal ideation was affected in healthy controls. Conclusions The OGM mediates suicidal ideation in depression patients, but only affects the worst-point suicidal ideation in the healthy controls. As it is one of the major risk factors of suicidal ideation in depression, amelioration of OGM might be an useful method to reduce or prevent suicidal ideation in depression patients.

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Suicidal Ideation and Associated Factors among Adolescents in Northeastern Brazil

The Scientific World JOURNAL ◽

10.1155/2014/450943 ◽

2014 ◽

Vol 2014 ◽

pp. 1-8 ◽

Cited By ~ 6

Author(s):

Roberto Jerônimo dos Santos Silva ◽

Fabio Alexandre Lima dos Santos ◽

Nara Michelle Moura Soares ◽

Emerson Pardono

Keyword(s):

Suicidal Ideation ◽

Suicide Attempt ◽

Attempted Suicide ◽

Suicide Ideation ◽

Illicit Drug ◽

Violent Behavior ◽

Northeastern Brazil ◽

Significance Level ◽

Factors Associated ◽

Suicide Planning

This study aimed to identify the prevalence and factors associated with suicidal ideation among Brazilian adolescents. The instrument designed for the research was used considering three models with outcomes that identified the following: (a) adolescent had considered suicide, (b) adolescents have planned suicide, and (c) adolescents have attempted suicide. Logistic Regression was used in all models with significance level of 5%. An association between being female and suicidal ideation(OR=2.18, CI 95% 1.60 to 2.97), suicide planning(OR=1.80, CI 95% = 1.26–2.56), and suicide attempt(OR=2.91, CI 95% 1.79 to 4.75) was found. Violent behavior/involvement in fights was associated with thinking about suicide(OR=2.00, CI 95% = 1.43 to 2.81), suicide planning(OR=1.65, CI 95% = 1.10–2.46), and suicide attempt(OR=2.35, CI 95% = 1.49 to 3.70). For cigarette consumption, association was found with suicide ideation(OR=1.62, CI 95% 1.03 to 2.55), planning(OR=1.88, CI 95% = 1.15 to 3.08), and attempt(OR=2.35, CI 95% 1.37 to 4.03). For alcohol consumption, association was found with suicide ideation(OR=1.93, CI 95% 1.47 to 2.54), planning(OR=2.22, CI 95% 1.61 to 3.08), and attempt(OR=1.73, CI 95% 1.15 to 2.59). It was concluded that suicidal ideation was associated with female sex, involvement in fights, and illicit drug use.

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Hypothalamic-pituitary-adrenal axis function in patients with bipolar disorder

The British Journal of Psychiatry ◽

10.1192/bjp.184.6.496 ◽

2004 ◽

Vol 184 (6) ◽

pp. 496-502 ◽

Cited By ~ 227

Author(s):

Stuart Watson ◽

Peter Gallagher ◽

James C. Ritchie ◽

I. Nicol Ferrier ◽

Allan H. Young

Keyword(s):

Bipolar Disorder ◽

Hpa Axis ◽

Cortisol Response ◽

Hypothalamic Pituitary Adrenal ◽

The Core ◽

Basal Cortisol ◽

Suppression Test ◽

Cortisol Levels ◽

Dexamethasone Suppression ◽

Pituitary Adrenal Axis

BackgroundHypothalamic-pituitary-adrenal (HPA) axis function, as variously measured by the responses to the combined dexamethasone/ corticotrophin-releasing hormone (dex/ CRH) test, the dexamethasone suppression test (DST) and basal cortisol levels, has been reported to be abnormal in bipolar disorder.AimsTo test the hypothesis that HPA axis dysfunction persists in patients in remission from bipolar disorder.MethodSalivary cortisol levels and the plasma cortisol response to the DST and dex/CRH test were examined in 53 patients with bipolar disorder, 27 of whom fulfilled stringent criteria for remission, and in 28 healthy controls. Serum dexamethasone levels were measured.ResultsPatients with bipolar disorder demonstrated an enhanced cortisol response to the dex/CRH test compared with controls (P=0.001). This response did not differ significantly between remitted and non-remitted patients. These findings were present after the potentially confounding effects of dexamethasone levels were accounted for.ConclusionsThe dex/CRH test is abnormal in both remitted and non-remitted patients with bipolar disorder. Thismeasure of HP Aaxis dysfunction is a potential trait marker in bipolar disorder and thus possibly indicative of the core pathophysiological process in this illness.

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Association of Thyroid Function With Suicide Ideation/Attempt -A Systematic Review and Meta-analysis

Journal of the Endocrine Society ◽

10.1210/jendso/bvab048.1680 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. A824-A825

Author(s):

Freddy Jean Karlo Toloza Bonilla ◽

Yuanjie Mao ◽

Lakshmi P Menon ◽

Gemy Maria George ◽

Madhura Borikar ◽

...

Keyword(s):

Suicidal Ideation ◽

Thyroid Function ◽

Suicide Ideation ◽

Meta Analysis ◽

Risk Of Bias ◽

Control Group ◽

Thyroid Disorders ◽

Thyroid Function Tests ◽

Inclusion Criteria ◽

The Mean

Abstract Background: Thyroid disorders are very prevalent and could affect virtually the entire human body, including cognitive and psychiatric domains. However, the relationship between thyroid dysfunction and suicide is still controversial. Material and Methods: A systematic review and meta-analysis was conducted to describe the association of thyroid function with suicide ideation/attempt in adults. A comprehensive search from databases’ inception (MEDLINE, EMBASE, Cochrane, PsycINFO, PsycArticles, PSYNDEX and Scopus) to July 20, 2018 was conducted with no language restrictions. We included studies that reported mean values and standard deviation (SD) of thyroid hormone levels [Thyroid-stimulant hormone (TSH), free T4 (FT4), free T3 (FT3), total T4 (TT4), and total T3 (TT3)] in patients with suicide ideation/attempt compared with controls. Four reviewers worked independently and in duplicate for assessment of inclusion criteria, data extraction, and assessment of risk of bias. The mean value and SD of the thyroid function tests were used to calculate the mean difference for each subgroup. Random-effects models for meta-analyses were applied. Results: Overall, 2278 articles were identified, and 13 observational studies met the inclusion criteria. These studies involved 2651 participants, including 817 participants diagnosed with suicidal ideation/attempt. Group sizes of patients with suicide ideation/attempt ranged from 7 to 122 participants with mean age ranging from 23 to 49 years. Control group sizes ranged from 8 to 464 participants with mean age ranging from 24 to 50 years. Two studies included only women, two studies included only men, and 9 studies included both (% female range: 29 to 78%). Patients with suicide ideation/attempt had lower levels of FT3 (-0.19 pg/mL; P=0.04) and TT4 (-0.23 µg/dL; P=0.05) compared to controls. There were no differences in TSH, TT3 or FT4 levels between groups. In a subgroup analysis comparing current suicidal ideation vs current suicidal attempt vs history of suicidal ideation/attempt with the control group, there were no differences in any of the thyroid function tests. None of the included studies compared rates of overt/subclinical thyroid disease among groups. The overall risk of bias of the included studies was low-to-moderate. Conclusions: There is scarce evidence regarding the association of thyroid disorders and suicide. We found statistically significant lower thyroid hormone levels in patients with suicidal ideation/attempt. The clinical implications of this finding remain unknown and further research is needed to evaluate the association of thyroid disorders with suicide.

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Effects of childhood trauma, daily stress, and emotions on daily cortisol levels in individuals vulnerable to suicide.

Journal of Abnormal Psychology ◽

10.1037/abn0000482 ◽

2020 ◽

Vol 129 (1) ◽

pp. 92-107 ◽

Cited By ~ 6

Author(s):

Daryl B. O'Connor ◽

Dawn Branley-Bell ◽

Jessica A. Green ◽

Eamonn Ferguson ◽

Ronan E. O'Carroll ◽

...

Keyword(s):

Childhood Trauma ◽

Daily Stress ◽

Cortisol Levels

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Associations of Discrimination, Suicide Ideation Severity and Attempts, and Depressive Symptoms Among Sexual and Gender Minority Youth

Crisis ◽

10.1027/0227-5910/a000718 ◽

2020 ◽

pp. 1-8

Author(s):

Adeline Wyman Battalen ◽

Ethan Mereish ◽

Jennifer Putney ◽

Christina M. Sellers ◽

Melinda Gushwa ◽

...

Keyword(s):

Depressive Symptoms ◽

Suicidal Ideation ◽

Childhood Trauma ◽

Suicide Ideation ◽

Suicide Attempts ◽

Thwarted Belongingness ◽

Perceived Burdensomeness ◽

Sociodemographic Variables ◽

Sexual And Gender Minority ◽

And Gender

Abstract. We examined the unique associations among discrimination, suicidal thoughts, suicide attempts, and depressive symptoms in a sample of sexual and gender minority (SGM) youth as well as interpersonal mediators of these associations. Participants included 94 SGM youth ( Mage = 18; SD = 2.88) recruited from SGM-specific drop-in centers. We used mediation analyses to test the mediating effects of perceived burdensomeness and thwarted belongingness on the associations between discrimination and suicidal ideation, suicide attempts, and depressive symptoms, accounting for childhood trauma and sociodemographic variables (age, gender identity, race, and sexual orientation). Within our nonclinical community sample of SGM youth, 49% reported a lifetime suicide attempt, 84% reported current suicide ideation, and 82% reported current depressive symptoms. Experiencing discrimination was associated with greater likelihood of suicide attempts and depressive symptoms, and greater perceived burdensomeness and thwarted belongingness, over and above the effects of childhood trauma and sociodemographic variables. Discrimination was indirectly associated with greater depressive symptoms through perceived burdensomeness and thwarted belongingness, and with greater severity of suicidal ideation through perceived burdensomeness. Findings suggest clinicians should assess for discrimination and include a focus on perceived burdensomeness and thwarted belongingness as targets of intervention for suicide and depression.

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Suicide Attempt History, Self-Esteem, and Suicide Risk in a Sample of 116 Depressed Voluntary Inpatients

Psychological Reports ◽

10.2466/pr0.95.3f.1092-1094 ◽

2004 ◽

Vol 95 (3_suppl) ◽

pp. 1092-1094 ◽

Cited By ~ 11

Author(s):

Charles James Palmer

Keyword(s):

Suicidal Ideation ◽

Suicide Attempt ◽

Suicide Risk ◽

Suicide Ideation ◽

Self Esteem ◽

Significant Difference ◽

History Of ◽

Group 3 ◽

Group 2 ◽

Group 1

116 consecutively admitted depressed inpatients were divided into three groups based on self-reported history of suicidal ideation and history of suicide attempt. Participants in Group 1 ( M age 34.0, SD = 14.0), 13 men and 24 women, reported no history of suicidal ideation or history of suicide attempt. Group 2 ( M age 34.0, SD = 8.6), 14 men and 25 women, reported having a history of suicidal ideation but no history of suicide attempt. Group 3 ( M age 34.0 yr., SD = 6.3), 14 men and 26 women, reported a history of suicidal ideation and at least one suicide attempt. Each participant completed the Suicide Risk Scale and the Self-esteem Scale. Analysis of variance with Tukey post hoc comparisons yielded a significant difference between Groups 1 and 2, between Groups 1 and 3, and between Groups 2 and 3 on the Suicide Risk Scale. There was a significant difference between Group 1 and Group 2 and between Group 1 and Group 3 on the Self-esteem Scale. These data indicated that suicide ideation and suicide attempt history significantly elevated suicide risk. Self-esteem was significantly decreased by suicide ideation and suicide attempt history.

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A salivary biochemical analysis of certain recruits associated with suicidal ideation

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.2271 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S607-S607

Author(s):

W. Xiaomei

Keyword(s):

Suicidal Ideation ◽

High Risk ◽

Statistical Difference ◽

Biochemical Analysis ◽

Suicide Ideation ◽

Control Group ◽

Early Screening ◽

Biochemical Indicators ◽

Competing Interest ◽

New Recruits

ObjectiveTo explore the biochemical indicators of the persons at high risk of suicide.AimsTo achieve early screening of the persons at high risk of suicide.MethodsSuicide ideation of new recruits was generally investigated with self-rating idea of suicide scale (SIOSS). Twenty-five recruits whose scores were more than 12 were recognized as the suicide ideation group. Another 25 recruits without suicide ideation were randomly selected as the control group. Saliva samples of each group were collected for biochemical analysis after one month and three months. The SIOSS was used again for evaluation of suicide ideation.ResultsAfter one month, the concentrations of Ca, Mg, Amy and SA in saliva were demonstrated to be statistically different between the two groups. After three months, the concentrations of Ca, Mg, Amy and SA in saliva between the two groups showed no significantly difference. According to SIOSS results, only 7 persons of the original suicidal ideation group were recognized as suicidal ideation group, the other 18 people's SIOSS scores were less than 12. And the SIOSS scores of the control group (without suicidal ideation group) were also less than 12. There was no statistical difference in the three groups for comparison of salivary Ca, Mg, Amy and SA.ConclusionThe biochemical indicators l of saliva lack specificity for suicidal ideation screening.Disclosure of interestThe author has not supplied his declaration of competing interest.

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Depression and Suicide in Early Onset Schizophrenia

European Psychiatry ◽

10.1016/s0924-9338(11)73715-4 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 2012-2012

Author(s):

G. Zalsman

Keyword(s):

Suicidal Ideation ◽

Suicidal Behavior ◽

Criminal Behavior ◽

Suicide Risk ◽

Suicide Ideation ◽

First Episode ◽

Control Group ◽

Gender And Age ◽

Actual Suicide ◽

First Episode Schizophrenia

PurposeSuicide is a major cause of death in adolescents with first-episode schizophrenia (FES). We compared suicide-related traits between subjects with FES and with other psychopathologies in order to evaluate risk factors for suicidal behavior.Subjects and methodsTwenty-five inpatient adolescents with FES and a control group of 28 psychiatric inpatients matched for gender and age were assessed for depression, anger, criminal behavior, aggression, and suicidal ideation, risk and potential.ResultsThe adolescents with FES had significantly lower depression (p=0.003) anger (p=0.025) and criminal behavior (p=0.022) than did the controls. However, while suicide ideation was greater in the subjects with FES (p=0.003), suicide risk was significantly lower than controls (p=0.004).DiscussionDecreased levels of both depression and anger as part of affective constriction in the schizophrenia group could explain why the increased suicide ideation did not lead to a higher suicide risk in these inpatients.ConclusionThis study highlights the importance of distinguishing between suicidal ideation and actual suicide risk. We demonstrated that thoughts of suicide do not necessarily translate into an actual risk of suicidal behavior in adolescents with schizophrenia.

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