scholarly journals New Methods for Assessing Rapid Changes in Suicide Risk

2021 ◽  
Vol 12 ◽  
Author(s):  
Elizabeth D. Ballard ◽  
Jessica R. Gilbert ◽  
Christina Wusinich ◽  
Carlos A. Zarate
Keyword(s):  
Suicide Risk ◽  
Suicidal Thoughts ◽  
New Techniques ◽  
Current State ◽  
Digital Phenotyping ◽  
Rapid Changes ◽  
And Behavior ◽  
Ecological Momentary ◽  
Assessment Strategies ◽  
Suicidal Thoughts And Behaviors

Rapid-acting interventions for the suicide crisis have the potential to transform treatment. In addition, recent innovations in suicide research methods may similarly expand our understanding of the psychological and neurobiological correlates of suicidal thoughts and behaviors. This review discusses the limitations and challenges associated with current methods of suicide risk assessment and presents new techniques currently being developed to measure rapid changes in suicidal thoughts and behavior. These novel assessment strategies include ecological momentary assessment, digital phenotyping, cognitive and implicit bias metrics, and neuroimaging paradigms and analysis methodologies to identify neural circuits associated with suicide risk. This review is intended to both describe the current state of our ability to assess rapid changes in suicide risk as well as to explore future directions for clinical, neurobiological, and computational markers research in suicide-focused clinical trials.

Suicidal Ideation and Behavior Among Sexual Minority and Heterosexual Youth: 1995-2017

2021 ◽  
pp. 84-92
Author(s):  
Richard T. Liu ◽  
Rachel F.L. Walsh ◽  
Ana E. Sheehan ◽  
Shayna M. Cheek ◽  
Sarina M. Carter
Keyword(s):  
Suicidal Ideation ◽  
Sexual Minority ◽  
Minority Youth ◽  
Sexual Minority Youth ◽  
Prevalence Rates ◽  
Suicidal Thoughts ◽  
Entire Study ◽  
Heterosexual Youth ◽  
And Behavior ◽  
Suicidal Thoughts And Behaviors

OBJECTIVES In this study, we determined trends in prevalence of suicidal thoughts and behaviors among lesbian, gay, bisexual, and heterosexual youth from 1995 to 2017 using population-based surveillance data. METHODS Data were drawn from the Massachusetts Youth Risk Behavior Survey from 1995 to 2017 (unweighted N = 41 636). The annual percent change (APC) in prevalence of suicidal ideation, plans, and attempts was stratified by sexual orientation as indexed by sexual identity and sexual behavior. RESULTS Among sexual minority youth, prevalence rates declined over the entire study period for suicidal ideation (APCsexual identity = −1.25; APCsexual behavior = 1.83), plans (APCsexual identity = 1.88; APCsexual behavior = –1.95), and attempts (APCsexual identity =–2.64; APCsexual behavior = –2.47). Among heterosexual youth, prevalence rates declined from 1995 to 2007 for suicidal ideation (APCsexual identity = –6.67; APCsexual behavior = 6.77) and plans (APCsexual identity = –5.73; APCsexual behavior = –6.25). These declines in ideation and plans were steeper than those for sexual minority youth. Prevalence of suicide attempts declined across the entire Study period among heterosexual youth (APCsexual identity = –3.66; APCsexual behavior = –4.01). Prevalence of all 3 outcomes remained markedly high among sexual minority youth across the 23-year study period. CONCLUSIONS Although suicidal thoughts and behavior have generally declined among sexual minority and heterosexual youth, disparities in these outcomes persist, and their prevalence among sexual minority youth has remained consistently elevated. Prioritized screening for risk for suicidal thoughts and behaviors in this vulnerable population is imperative to reduce disparities and prevalence of these outcomes.

Mokken Scale Analysis of Lifetime Responses on the Columbia Suicide Severity Rating Scale’s Severity of Ideation Subscale

Assessment ◽  
2020 ◽  
pp. 107319112091362
Author(s):  
Jeffrey V. Tabares ◽  
Jonathan E. Butner ◽  
Craig J. Bryan ◽  
Julia A. Harris
Keyword(s):  
Suicide Risk ◽  
Current Practice ◽  
Rating Scale ◽  
Risk Model ◽  
Functional Equivalence ◽  
Correct Order ◽  
Suicidal Thoughts ◽  
Severity Rating ◽  
Suicidal Thoughts And Behaviors ◽  
Risk Scale

Suicide risk screening assumes that suicidal thoughts and behaviors exist on a continuous, hierarchical spectrum with some suicidal thoughts implicated with greater risk for suicidal behaviors. However, screening measures based on the hierarchical model may not capture the suicide risk construct. This study assessed psychometric properties of the Columbia Suicide Severity Rating Scale (CSSRS) for (a) between- and within-person measurement dimensions, (b) item utility in capturing the suicide risk construct, and (c) tenability of a hierarchical risk model. We found that the CSSRS functions differentially between and within individuals, CSSRS items capture more suicide risk construct, and that CSSRS items in current practice likely appear in the correct order. The current CSSRS reasonably represents within-person suicide risk, but not between-person risk. Scale norms or alternate scoring could facilitate functional equivalence and utility for between- and within-person CSSRS dimensions.

scholarly journals Is it time to abandon suicide risk assessment?

BJPsych Open ◽  
2016 ◽  
Vol 2 (1) ◽  
pp. e1-e2 ◽  
Author(s):  
Declan Murray
Keyword(s):  
Risk Assessment ◽  
Perceived Risk ◽  
Suicide Risk ◽  
Psychiatric Patients ◽  
Suicide Risk Assessment ◽  
Emotional Pain ◽  
Suicidal Thoughts ◽  
Risk Rating ◽  
Current State

SummarySuicide risk assessment includes estimating the likelihood of suicide in words such as ‘low, medium or high’. A ‘high suicide risk’ rating can trigger a powerful urge to eliminate risk immediately. But it is far from clear what ‘high suicide risk’ actually means. In the current state of knowledge, suicide reduction measures should apply to all psychiatric patients, irrespective of an individual patient's perceived risk. For patients presenting with suicidal thoughts, feelings and behaviour, assessment and management should focus on reducing or tolerating emotional pain.

MDMA/ecstasy use and psilocybin use are associated with lowered odds of psychological distress and suicidal thoughts in a sample of US adults

2022 ◽  
pp. 026988112110589
Author(s):  
Grant M Jones ◽  
Matthew K Nock
Keyword(s):  
Psychological Distress ◽  
Suicide Risk ◽  
Causes Of Death ◽  
Experimental Studies ◽  
The United States ◽  
Suicidal Thoughts ◽  
Suicidal Thinking ◽  
The Past ◽  
Adult Participants ◽  
Suicidal Thoughts And Behaviors

Background: Suicide is one of the leading causes of death worldwide and rates within the United States have risen over the past two decades. Hence, there is a critical need for novel tools to treat suicidal ideation and related mental health conditions. 3,4-Methylenedioxymethamphetamine (MDMA)/ecstasy and classic psychedelics may be two such tools. Aims: The aim of this study was to assess non-causal associations between MDMA/ecstasy and classic psychedelic use and psychological distress and suicide risk. Methods: In this study, we examined the aforementioned associations among 484,732 adult participants in the National Survey on Drug Use and Health (2008–2019). Results: Lifetime MDMA/ecstasy use was associated with reduced odds of past year suicidal thinking (10% reduced odds; odds ratio (OR) = 0.90; 95% confidence interval, CI = (0.84–0.97); p < 0.01) and past year suicidal planning (OR = 0.88; 95% CI = (0.78–0.99); p < 0.05). Furthermore, lifetime psilocybin use was associated with reduced odds of past month psychological distress (OR = 0.78; 95% CI = (0.73–0.84); p < 0.001) and past year suicidal thinking (OR = 0.90; 95% CI = (0.83–0.96); p < 0.01). Finally, lysergic acid diethylamide (LSD) was associated with increased odds of past year suicidal thinking (OR = 1.07; 95% CI = (1.00–1.15); p < 0.05). Conclusion: MDMA/ecstasy and psilocybin use are associated with reduced odds of suicidal thinking and related outcomes—though experimental studies are needed to determine whether these associations are causal. These findings call for more research into the efficacy of MDMA/ecstasy and classic psychedelics for treating psychological distress and suicidal thoughts and behaviors, and for updated drug legislation that allows for further investigation into these substances.

scholarly journals Suicidal Thoughts, Behaviors, and Event-Related Potentials: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Austin J. Gallyer ◽  
Sean P. Dougherty ◽  
Kreshnik Burani ◽  
Brian J. Albanese ◽  
Thomas E. Joiner ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Suicide Risk ◽  
Suicide Attempts ◽  
Meta Analysis ◽  
Event Related Potentials ◽  
Small Sample ◽  
Effect Sizes ◽  
Suicidal Thoughts ◽  
Related Potentials ◽  
Suicidal Thoughts And Behaviors

AbstractBackgroundSuicidal thoughts and behaviors (STBs) are thought to be the result, at least in part, of abnormalities in various neural systems. Event-related potentials (ERPs) are a useful method for studying neural activity and can be leveraged to study neural deficits related to STBs; however, it is unknown how effective ERPs are at differentiating various STB groups. The present meta-analysis examined how well ERPs can differentiate (a) those with and without suicidal ideation, (b) those with and without suicide attempts, (c) those with different levels of suicide risk, and (d) differences between those with suicide attempts versus those with suicidal ideation only.MethodOur meta-analysis included 208 effect sizes from 2,517 participants from 27 studies. We used a random-effects meta-analysis using a restricted maximum likelihood estimator with robust variance estimation.ResultsOur qualitative review found that for each ERP and STB combination, the literature is highly mixed. Our meta-analyses found a small-to-moderate relationship between ERPs and suicidal ideation, suicide attempt, suicide risk, and differences in ERPs between those with suicide attempts versus those with suicidal ideation only. We also found evidence that the literature may be suffering from small-sample bias and poor statistical power.ConclusionsOur results suggest that ERPs may complement other approaches, such as fMRI, in the study of the neurobiology of individuals with STBs. However, the current literature is severely underpowered to detect the effect sizes estimated in this meta-analysis. We recommend large-scale collaboration and improvements in measurement practices to combat the issues in this literature.

scholarly journals A Digital Companion, the Emma App, for Ecological Momentary Assessment and Prevention of Suicide: Quantitative Case Series Study (Preprint)

2019 ◽  
Author(s):  
Margot Morgiève ◽  
Catherine Genty ◽  
Jérôme Azé ◽  
Jonathan Dubois ◽  
Marion Leboyer ◽  
...  
Keyword(s):  
Case Report ◽  
High Risk ◽  
Ecological Momentary Assessment ◽  
Suicide Risk ◽  
Completion Rates ◽  
Emergency Procedures ◽  
Ecological Momentary ◽  
Suicidal Thoughts And Behaviors ◽  
Suicidal Crisis ◽  
Momentary Assessment

BACKGROUND Many suicide risk factors have been identified, but traditional clinical methods do not allow for the accurate prediction of suicide behaviors. To face this challenge, <i>emma</i>, an app for ecological momentary assessment (EMA), ecological momentary intervention (EMI), and prediction of suicide risk in high-risk patients, was developed. OBJECTIVE The aim of this case report study was to describe how subjects at high risk of suicide use the <i>emma</i> app in real-world conditions. METHODS The Ecological Mental Momentary Assessment (EMMA) study is an ongoing, longitudinal, interventional, multicenter trial in which patients at high risk for suicide are recruited to test <i>emma</i>, an app designed to be used as a self-help tool for suicidal crisis management. Participants undergo clinical assessment at months 0, 1, 3, and 6 after inclusion, mainly to assess and characterize the presence of mental disorders and suicidal thoughts and behaviors. Patient recruitment is still ongoing. Some data from the first 14 participants who already completed the 6-month follow-up were selected for this case report study, which evaluated the following: (1) data collected by <i>emma</i> (ie, responses to EMAs), (2) metadata on <i>emma</i> use, (3) clinical data, and (4) qualitative assessment of the participants' experiences. RESULTS EMA completion rates were extremely heterogeneous with a sharp decrease over time. The completion rates of the weekly EMAs (25%-87%) were higher than those of the daily EMAs (0%-53%). Most patients (10/14, 71%) answered the EMA questionnaires spontaneously. Similarly, the use of the Safety Plan Modules was very heterogeneous (2-75 times). Specifically, 11 patients out of 14 (79%) used the Call Module (1-29 times), which was designed by our team to help them get in touch with health care professionals and/or relatives during a crisis. The diversity of patient profiles and use of the EMA and EMI modules proposed by <i>emma</i> were highlighted by three case reports. CONCLUSIONS These preliminary results indicate that patients have different clinical and digital profiles and needs that require a highly scalable, interactive, and customizable app. They also suggest that it is possible and acceptable to collect longitudinal, fine-grained, contextualized data (ie, EMA) and to offer personalized intervention (ie, EMI) in real time to people at high risk of suicide. To become a complementary tool for suicide prevention, <i>emma</i> should be integrated into existing emergency procedures. CLINICALTRIAL ClinicalTrials.gov NCT03410381; https://clinicaltrials.gov/ct2/show/NCT03410381

Use of Ecological Momentary Assessment to Study Suicidal Thoughts and Behavior: a Systematic Review

2021 ◽  
Vol 23 (7) ◽  
Author(s):  
Alba Sedano-Capdevila ◽  
Alejandro Porras-Segovia ◽  
Hugo J. Bello ◽  
Enrique Baca-García ◽  
Maria Luisa Barrigon
Keyword(s):  
Systematic Review ◽  
Ecological Momentary Assessment ◽  
Suicidal Thoughts ◽  
And Behavior ◽  
Ecological Momentary ◽  
Momentary Assessment

scholarly journals A Digital Companion, the Emma App, for Ecological Momentary Assessment and Prevention of Suicide: Quantitative Case Series Study

10.2196/15741 ◽  
2020 ◽  
Vol 8 (10) ◽  
pp. e15741 ◽  
Author(s):  
Margot Morgiève ◽  
Catherine Genty ◽  
Jérôme Azé ◽  
Jonathan Dubois ◽  
Marion Leboyer ◽  
...  
Keyword(s):  
Case Report ◽  
High Risk ◽  
Ecological Momentary Assessment ◽  
Suicide Risk ◽  
Completion Rates ◽  
Emergency Procedures ◽  
Ecological Momentary ◽  
Suicidal Thoughts And Behaviors ◽  
Suicidal Crisis ◽  
Momentary Assessment

Background Many suicide risk factors have been identified, but traditional clinical methods do not allow for the accurate prediction of suicide behaviors. To face this challenge, emma, an app for ecological momentary assessment (EMA), ecological momentary intervention (EMI), and prediction of suicide risk in high-risk patients, was developed. Objective The aim of this case report study was to describe how subjects at high risk of suicide use the emma app in real-world conditions. Methods The Ecological Mental Momentary Assessment (EMMA) study is an ongoing, longitudinal, interventional, multicenter trial in which patients at high risk for suicide are recruited to test emma, an app designed to be used as a self-help tool for suicidal crisis management. Participants undergo clinical assessment at months 0, 1, 3, and 6 after inclusion, mainly to assess and characterize the presence of mental disorders and suicidal thoughts and behaviors. Patient recruitment is still ongoing. Some data from the first 14 participants who already completed the 6-month follow-up were selected for this case report study, which evaluated the following: (1) data collected by emma (ie, responses to EMAs), (2) metadata on emma use, (3) clinical data, and (4) qualitative assessment of the participants' experiences. Results EMA completion rates were extremely heterogeneous with a sharp decrease over time. The completion rates of the weekly EMAs (25%-87%) were higher than those of the daily EMAs (0%-53%). Most patients (10/14, 71%) answered the EMA questionnaires spontaneously. Similarly, the use of the Safety Plan Modules was very heterogeneous (2-75 times). Specifically, 11 patients out of 14 (79%) used the Call Module (1-29 times), which was designed by our team to help them get in touch with health care professionals and/or relatives during a crisis. The diversity of patient profiles and use of the EMA and EMI modules proposed by emma were highlighted by three case reports. Conclusions These preliminary results indicate that patients have different clinical and digital profiles and needs that require a highly scalable, interactive, and customizable app. They also suggest that it is possible and acceptable to collect longitudinal, fine-grained, contextualized data (ie, EMA) and to offer personalized intervention (ie, EMI) in real time to people at high risk of suicide. To become a complementary tool for suicide prevention, emma should be integrated into existing emergency procedures. Trial Registration ClinicalTrials.gov NCT03410381; https://clinicaltrials.gov/ct2/show/NCT03410381

Differences in Suicidal Thoughts and Behaviors Among Three Racial Groups

Crisis ◽  
2020 ◽  
Vol 41 (3) ◽  
pp. 172-178
Author(s):  
Brooke A. Ammerman ◽  
Martha K. Fahlgren ◽  
Kristen M. Sorgi ◽  
Michael S. McCloskey
Keyword(s):  
Suicide Attempts ◽  
Health Concern ◽  
Future Research ◽  
Racial Groups ◽  
Contributing Factors ◽  
Suicidal Thoughts ◽  
Final Sample ◽  
And Behaviors ◽  
Assessment Procedures ◽  
Suicidal Thoughts And Behaviors

Abstract. Background: Despite being a major public health concern, it is unclear how suicidal thoughts and behaviors differentially impact separate racial groups. Aims: The aim of the current study was to examine the occurrence of nonlethal suicide events, in addition to suicide attempt characteristics and factors contributing to suicide attempts. Method: A final sample of 7,094 undergraduates from a large northeastern university, identifying as members of three racial groups (White [67.30%], Black [17.30%], and Asian [15.40%]), completed online questionnaires. Results: White participants reported increased likelihood of endorsing lifetime suicidal ideation and plan, whereas Black participants reported decreased likelihood of these events; no differences were found in rates of lifetime suicide attempts. Black participants' suicidal behavior may involve greater ambivalence of intent. A higher proportion of Asian participants endorsed interpersonal factors as contributing to their suicide attempts, whereas a greater percentage of White participants reported internal contributing factors. Limitations: Findings are limited by the sample size and assessment of lifetime suicidal thoughts and behaviors. Conclusion: The findings present a more nuanced look at attitudes and actions related to suicidal thoughts and behaviors that may inform future research and risk assessment procedures.

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