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Background: Implicit identification with death, measured by the Death-Suicide-Implicit Association Test (D/S-IAT), has been found to predict long-term suicide risk among adolescents. However, previous studies did not examine the predictive utility of D/S-IAT on short-term suicide risk trajectories among adolescents, especially during the critical period following discharge from the emergency room (ER) due to suicide behaviors., Objective: This study examined the ability of the D/S-IAT to discriminate and predict suicide risk trajectories during the month following initial suicide risk assessment, among adolescents recently discharged from the ER., Methods: One hundred and fifteen adolescents aged 9-18 years (77.4% female) were assessed at clinic intake. All participants completed D/S-IAT and self-report measures for suicide risk, depression, and anxiety during intake and 1-month follow-up., Results: The D/S-IAT distinguished and predicted participants with continued heightened suicide risk at follow-up, above and beyond depression, anxiety, and suicide risk level at intake., Conclusions: Along with conventional measures, D/S-IAT may be utilized to predict short-term suicide risk during post-ER discharge., (© 2023 The Authors. Suicide and Life-Threatening Behavior published by Wiley Periodicals LLC on behalf of American Association of Suicidology.)

Background: The suicide of a pupil impacts survivors greatly, but most studies on the subject do not consider school staff, and do not differentiate between the various professional domains. Our aim was to investigate the existence of differences in symptoms of complicated grief as well as post-trauma symptoms after a pupil's suicide, among school staff in four domains: counsellors, psychologists, principals and home-room teachers., Method: Eighty-four staff members from schools that lost pupils to suicide within the past five years were assessed for symptoms of complicated grief and trauma. All reported their symptoms using self-report scales., Results: Principals and home-room teachers had significantly higher complicated grief and post-trauma symptoms. The main limitations of this study are that the data were collected via self-report questionnaires, which can introduce bias. Additionally, the sample is relatively small and comprises mainly women., Conclusions: School professionals in domains receiving less coping and crisis training, and those with supervisory responsibilities (principals and home-room teachers) show more symptoms of trauma and complicated grief after a pupil's suicide, and require special attention. More preparatory training would surely benefit them and assist them in coping with such crises.

Objective: Suicide is the second leading cause of death among individuals with anorexia nervosa (AN) and is also elevated in bulimia nervosa (BN). We carried out a systematic review in which we analyzed the relationship between AN and/or BN and suicidality (i.e. suicidal ideation or attempted and/or death by suicide) and the major risk factors for suicidal behavior among AN and BN patients by synthesizing the qualitative data from relevant studies., Evidence Acquisition: According to PRISMA guidelines, we conducted a systematic search of the literature on PsycNET, PubMed, Google Scholar, and ScienceDirect. Search terms were "eating disorders" "OR" "anorexia" "OR" "bulimia" combined with the Boolean "AND" operator with "suicide.", Evidence Synthesis: The initial search identified 8,590 records, of which 38 research reports met the predefined inclusion criteria and were analyzed. Eating disorders (EDs) were found to be associated with a marked increase in suicidal behaviors and ideation. ED type, impulsivity, and specific interpersonal features were associated with suicidal behavior., Conclusions: Our findings highlight the importance of the combined role of socio-demographic and psychological factors to the co-occurrence of EDs and suicidal behavior. It is imperative that a thorough suicide assessment be conducted routinely for individuals with past and current EDs, and that clinicians be aware that this risk may be ongoing and occur throughout treatment, even after ED symptoms appear to be remitting., Limitations: Study limitations include diagnostic definitions of and criteria for EDs, and the different terminology used by researchers to define suicide, including non-suicidal behaviors, which weakens the ability to draw conclusions regarding actual suicidal behaviors versus other self-harm behaviors., (Copyright © 2018. Published by Elsevier B.V.)

Background: This study examined the role of aggressive-impulsive variants, and suicide history in predicting the medical severity of follow-up suicide attempts., Methods: 97 consecutive psychiatric in-patients who participated in earlier study 2-5 years previously. Thirty-three had a history of a medically serious suicide attempt (MSSA), 29 had a history of a medically non-serious suicide attempt (MNSSA), and 35 had no history of suicide. Participants completed a battery of instruments measuring aggressive-impulsive variables, hopelessness and communication difficulties. Findings were analyzed in relation to follow-up suicide attempts and their severity., Results: 32 patients (33%) had attempted suicide: 9 (9.27%) (including one death) MSSSA. Of these, 7 patients were MSSAs in the index attempt and 2 were MNSSAs in the index attempt. 23 (23.7%) MNSSA: Of these, 6 were MSSAs in the index attempt; 13, MNSSAs in the index attempt and 4 from the non-suicidal psychiatric group. 65 patients (67%) did not attempt suicide during the period since the index studies. Anger-out, violence impulsivity and hopelessness had significant positive correlations with medical severity of follow-up suicide attempts. Similar correlations were found between anger-out, violence and the amount of follow-up suicide attempts. A hierarchical regression analysis was conducted to determine contribution of study variables to severity of future suicide attempts. Severity of index attempt, hopelessness aggressive-impulsive variants and two interactions (medical severity of index suicide attempt X impulsivity and self-disclosure X anger-in) accounted for 44.7% of the variance of the medical severity of follow-up suicide attempts., Limitations: (i) Possibly incomplete patient information, as some of the patients who participated in the index studies could not be located. (ii) Relatively small group of patients with an index MSSA., Conclusions: The major findings of this paper are the predictive value of MSSA vs. MNSSA. The Lethality of future suicide attempt is closely linked to the lethality of former suicide attempt, impulsivity and hopelessness. Thus, patients who have made a suicide attempt should be assessed for medical severity of the attempt, impulsive-aggressive measures hopelessness, and communication difficulties, which are important factors in follow-up attempts., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Although the study of medically serious suicide behavior is an important strategy for understanding the nature of suicide, little is known about its underlying psychological mechanisms. This gap is addressed here by applying insights from attachment theory to severe suicidal behavior. The results show that both anxious and avoidant attachment patterns predict medical lethality. Path analysis indicated that interpersonal difficulties mediated the paths between insecure attachment patterns and lethality of suicide attempts. These results suggest that the psychological mechanisms of medically serious suicide behavior involve high levels of mental pain amplified by insecure attachment patterns and interpersonal difficulties. Implications for prevention and therapeutic intervention strategies are discussed., (© 2013 The American Association of Suicidology.)

This article reviews the literature on the association between impulsivity aggression and suicide. The key words impulsivity, aggression, and suicide were entered into the pubmed, psychlit, and proqest databases. Significant articles were scrutinized for relevant information. Impulsivity and aggression are highly correlated with suicidal behavior across psychiatric samples, nosological borders, and non-psychiatric populations. Impulsivity and aggression are related but the nature of this relationship remains unclear. The literature is confusing and contradictory. This is probably due to the difficulty in defining and separating out these concepts and the fact that there is much overlap between them. Future research should aim at clarifying and refining these concepts as well as their link to all the different forms of suicidal behavior.