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Suicide is a serious public health problem and is the fourth leading cause of death among adolescents. Suicide ideation is the most significant predictor of suicide. However, few empirical studies have examined the relationship between stressful life events, insomnia, depression symptoms, self‐esteem, and suicide ideation among college students. This study builds on O'Connor's The integrated motivational‐volitional model of suicidal behavior theory will verify the relationship between these five factors through a large data study among college students, and further reveal the mechanisms and interventions of suicide ideation among college students. A total of 2717 (mean age = 19.81 years, 22.49% male) college students from South China participated in this behavioral and health survey. Using self‐reported questionnaires which were Adolescent Self Rating Life Events Check‐list, MINI‐C, Insomnia Severity Index, PHQ‐9, and Self‐Esteem Scale to assess the subjects' demographic information, suicide ideation, stressful life events, insomnia, depressive symptoms, and self‐esteem levels as comprehensively as possible. A moderated chain mediation model was used to validate their relationship. The results showed that stressful life events significant positively predicted insomnia symptoms, depressive symptoms, and suicide ideation. The mediating effect of depression between stressful life events and suicide ideation was significant. The chain mediating effect of insomnia and depression between stressful life events and suicide ideation was significant. However, the mediating effect of insomnia between stressful life events and suicide ideation was not significant. Also, the positive prediction of stressful life events and depression on suicide ideation was weaker when the individual's self‐esteem level was higher, and the moderated chain mediating effect was significant. This study developed a moderated chain mediation model, and proposes a new integrated stress coping‐self‐perception model of suicide ideation to discover the important role of self‐esteem levels in adolescent suicide prevention. Practitioner Points: Examined the relationship between stressful life events, suicidal ideation, insomnia, depression, and self‐esteem.Data from 2717 (mean age = 19.81 years, 22.49% male) college students were included.Proposed a new integrated stress coping‐self‐perception model of suicide ideation. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusion Despite evidence that participation in suicide research is not associated with worsening ideation, behaviors, or intent, the rise of intensive longitudinal methods to assess ideation and behaviors necessitates further investigation for potential iatrogenic effects. The present study assessed rates of change in suicide ideation (SI) in a 10‐day daily diary study.Seventy‐two adult participants with ongoing SI participated in 10 daily diary surveys and three follow‐up assessments. One open‐ended item was included to address participant experiences in the study.A multilevel piecewise growth model revealed steady declines in SI for participants over the 10 days. However, rates of SI increased during the follow‐up assessments, indicating that participation in the daily surveys was associated with general reductions in SI. Further, qualitative analyses of experiences in the study revealed the following themes: Useful (n = 34), Heightened Awareness (n = 21), Functional (n = 6), Not Useful (n = 6), and Beneficence (n = 4).This study demonstrated that participation in suicide research, including intensive longitudinal methods such as daily diary studies, did not have iatrogenic effects on participants with SI. Qualitative results demonstrated the numerous benefits participants derived while taking part in this study. [ABSTRACT FROM AUTHOR]

Introduction: Suicide risk assessment based on self-report questionnaires is considered as problematic because risk states are dynamic and at-risk individuals may conceal suicidal intentions for several reasons. Therefore, recent research efforts increasingly focus on implicit risk markers such as the suicide attentional bias (SAB) measured with the Suicide Stroop Task (SST). However, most SST studies failed to demonstrate a SAB in individuals with suicide risk and repeatedly demonstrated insufficient psychometrics of the SST. This study aimed to investigate a SAB using a modified SST (M-SST) and to test its psychometric properties. Method: We compared n = 61 healthy controls and a high-risk inpatient sample of n = 40 suicide ideators and n = 40 suicide attempters regarding interference scores of positive, negative and suicide-related words. Interference scores were calculated by subtracting the mean reaction time (mean RT) of the neutral words from the mean RT of the suicide-related words (mean RT Suicide-mean RT Neutral), resulting in a suicide-specific interference score. Similarly, interference scores were calculated for the positive and negative words by subtracting the mean RT of neutral words from the mean RT of positive and negative words. Results: A Group x Interference ANOVA showed a significant interaction effect (p <.001, ηp2 = .09), indicating that group effects significantly vary across interference type. Post hoc comparisons revealed that both ideators and attempters demonstrated greater interferences only for suicide-related words compared to healthy controls, indicating a SAB in patients, while a difference between ideators and attempters was lacking. The suicide interference score classified with an AUC = 0.73, 95% CI [0.65 - 0.82], p <.001, between controls and patients with STBs. The M-SST demonstrated good internal consistency and convergent validity. Discussion: The study adds evidence to the assumptions of the Cognitive Model of Suicide, viewing a SAB as a cognitive marker of suicide vulnerability independently of the engagement in suicidal behavior. The results' clinical implications are discussed in the context of recommended intervention strategies during an acute suicidal state. Future studies with the M-SST should include non-suicidal patient controls to investigate whether a SAB is uniquely related to suicidality. [ABSTRACT FROM AUTHOR]

AbstractBackground: The linkage between substance use and youth suicidality is less developed due to the predominant focus on certain types of substances (e.g., alcohol consumption, prescription opioid misuse). This study examines polysubstance use and its mutual impact on suicidal thoughts and behaviors among US adolescents. Methods: Data from 2019 Youth Risk Behavior Survey were utilized. Associations between the concurrent use of five substances (cigarette, e-cigarette, alcohol, marijuana, and prescription opioid) and suicidality (suicidal thoughts, suicide plans, and suicide attempts) were measured by logistic regression models. The combined effect of polysubstance use on suicidality was further assessed by structural equation modeling. Results: About two in five (42.1%) adolescents used at least one type of substances in the past month and one in seven (13.5%) used three or more types concurrently (polysubstance use). Adolescents with polysubstance use behaviors were three to five times more likely to experience suicidal thoughts (OR=3.8, p < 0.05), make a suicide plan (OR=3.5, p < 0.05), or attempt suicide (OR=4.6, p < 0.05) than non-users. In the final structural model, polysubstance use and suicidality were significantly correlated with each other (β=0.37, p < 0.05). Collectively, polysubstance use explained about 14% of variance in youth suicidality. Conclusions: Polysubstance use shows a significant impact on youth suicidality. School-based health centers and educational programs are recommended to reduce substance use and suicidal behaviors among adolescents. Accessible mental health services and targeted treatments are needed for polysubstance users to mitigate their risk of suicide. [ABSTRACT FROM AUTHOR]

Background: Suicidal ideation occurs at relatively high rates among adults identifying as sexual minorities compared to those identifying as heterosexual, and minority stress is one explanation for this disparity. Minority stress is known to associate with increased suicidal ideation, but research on how minority stress associates with suicidal ideation in sexual minority adults across the adult lifespan is lacking. Methods: Data were collected online from 284 sexual minority adults ranging in age from 18 to 85. Participants were recruited from Prolific and completed self‐report measures assessing past‐month suicidal ideation and multiple sexual minority stressors. Results: The minority stressors of acceptance concerns, concealment motivation, and difficulty processing one's identity were positively correlated with likelihood of past‐month suicidal deation. Age moderated the relationship between two minority stressors and suicidal ideation: identity uncertainty and internalized homonegativity. These relationships were only significant among older adults, compared to middle‐age and younger adults. Conclusion: Specific internalized minority stressors about one's sexual identity were significantly associated with past‐month suicidal ideation for older adults. More research is needed on how minority stress impacts recent suicidal ideation for sexual minority adults across the lifespan. [ABSTRACT FROM AUTHOR]

Behavioral warning signs (WS) are near-term changes within individuals, which aid in determining imminent risk for suicide attempts. However, those who attempt suicide differ in their engagement of WS, and it is unclear if these differences relate to future risk of suicidal behavior. Using a sample of 132 adults presenting to a hospital following a suicide attempt, the current study sought to determine if differences in engagement in WS for the index attempt prospectively predicted suicide attempt, frequency of ideation, and intensity of suicide ideation 12 months post discharge. Latent class analyses (LCAs) conducted on 6 behaviors (i.e., alcohol use, nightmares, interpersonal negative life events, suicide communication, risky behavior, low sleep, and high sleep) found a 5-class solution optimally fit the data. One identified class, characterized by engagement in risky behaviors the hours before an attempt differed from other identified classes in terms of risk for future suicidal ideation and behaviors. More specifically, participants in "High Risky Behavior" class had higher rates of 12-month suicide reattempt, significantly more frequent suicide ideation, and significantly worse intensity of suicide ideation during the 12 months following their index attempt compared to participants endorsing typical patterns of WS. These results held when adjusting for various traditional baseline covariates (e.g., depressive symptoms). The current study demonstrates that patterns of behavioral WS may be utilized as their own prognostic indicator of future suicidal ideation and behaviors among high-risk individuals reporting a recent suicide attempt, which can inform post-discharge clinical intervention and prevention efforts. • There are distinguishable profiles of behavioral warning signs for suicide attempt. • Profiles of warning signs for an index attempt can predict risk for reattempt. • High Risky Behavior Class predicted future worst suicidal ideation and reattempt. [ABSTRACT FROM AUTHOR]

The relationship between suicide ideation (SI) and distress tolerance (DT) is characterized by inconclusive results. The current study aimed to test the association between tolerance for interpersonal distress and SI in light of the Interpersonal-Psychological Theory of Suicide. 194 participants ranging in SI severity were recruited via Amazon Mechanical Turk and completed a cognitive distress task (Distress Tolerance Task) and an interpersonal distress task (CyberBall) to assess (1) the association between SI severity and persistence with the tasks, and (2) self-reported psychological distress associated with the tasks. A series of multilevel model analyses showed that increased SI predicted greater persistence with the interpersonal-distress task versus the cognitive distress task. In addition, higher SI predicted more distress during the interpersonal task. Individuals with higher SI levels demonstrated a greater capability to persist with the interpersonal distress, despite feeling psychologically worse. These findings further support the central role of interpersonal needs in SI by emphasizing the importance of operationalizing DT in a manner that is relevant to suicide desire. SI is associated with persisting longer in interpersonally distressing situations. SI is also associated with higher levels of distress following social exclusion. In SI research the specific type of distress needs to be accurately operationalized. [ABSTRACT FROM AUTHOR]

Analyzing the 2021 National Survey on Drug Use and Health data with generalized linear models, we examined: (1) COVID pandemic-related and other correlates of mental health treatment use and unmet perceived treatment need among U.S. adults who experienced serious suicidal thoughts (N = 3,177); and (2) correlates of self-reported reasons for not receiving treatment. We found that 61% used any mental health treatment, and 48% of users and 37% of nonusers reported perceived treatment need. Significant correlates of treatment use were demographic factors, insurance, major depressive disorder, and illicit drug use disorder. Significant correlates of perceived treatment need were age 18–34, some college education, and major depressive episode. Perceived negative effect of the COVID pandemic on mental health was a significant factor for both treatment use and perceived need. The most frequent reasons for not getting treatment were the cost of treatment or lack of insurance and stigma-related concerns. [ABSTRACT FROM AUTHOR]

With >1300 civilians murdered, the terrorist attack of October 7 is one of the deadliest terrorist attacks in modern history. Previous research documented a sharp increase in depression in the aftermath of the attacks and the military conflict that followed. In this national prospective cohort study, we examined to what extent perceived belongingness (PB) moderates the association between depression and suicide ideation (SI) in the wake of the October 7th terrorist attack. A representative sample of 710 Israeli adults (of them, 362 females, 51.1 %), Jews (557, 79.9 %), and Arabs (153, 20.1 %), aged 18–85 (M = 41.01 , SD = 13.72) completed questionnaires assessing depression, current SI, and perceived belongingness at two timepoints: T1 (in August 2023) and T2 (in November 2023). Perceived belongingness at T1 predicted SI at T2 beyond demographic and trauma-related characteristics. Importantly, we found a significant interaction in which a PB at T1 moderated the link between depression and current SI at T2. Specifically, the level of depression at T2 contributed to current SI-T2 more strongly for individuals with low PB levels than for individuals with high PB levels. Our study highlights the impact of PB on SI following the October 7th terrorist attack. Clinicians treating individuals coping with depression should attend to their patients' sense of belongingness, as low PB comprises a significant risk factor for current SI. Moreover, community and national initiatives that could increase levels of PB among the citizens may help to diminish suicide risk in the aftermath of the attack. • This is the first prospective study on suicide ideation after the October 7th terrorist attack in Israel. • Belongingness pre-attack predicted suicide ideation post October 7th attack. • Belongingness found to moderate the contribution of depression on current SI following the attack. [ABSTRACT FROM AUTHOR]

BackgroundSuicidal ideation serves as a sensitive predictive indicator for non-suicidal self-injury （NSSI） behavior， and NSSI behavior brings profound effects to both mental and physical health of senior high school students. Existing studies have made exploration on the relationship among insomnia， anxiety and NSSI behavior in the general population， but the internal mechanism of NSSI behavior in senior high school students with suicidal ideation requires further study.ObjectiveTo explore the pathway of anxiety between insomnia and NSSI behavior in senior high school students， so as to provide references for the intervention on NSSI behavior in such demographic.MethodsFrom December 10 to 15， 2021， cluster sampling was adopted to select 2 572 senior high school students across three senior high schools in Hubei Province as the research objects. Assessment was conducted by using Insomnia Severity Index （ISI）， Generalized Anxiety Disorder Scale-7 item （GAD-7） and Adolescents Self-Harm Scale. Spearman correlation analysis was conducted to examine the correlation among scores of scales finished by senior high school students with suicidal ideation. Model 4 from the SPSS 20.0 Process 4.2 was employed to test the mediating path of anxiety between insomnia and NSSI behavior.ResultsA total of 2 421 valid questionnaires （94.13%） were recovered， which revealed 554 cases （22.88%） with suicidal ideation and 408 cases （16.85%） with NSSI behavior. The scores of ISI， GAD-7 and Adolescents Self-Harm Scale of senior high school students with suicidal ideation were higher than those of students without suicidal ideation （Z=17.124， 20.611， 21.314， P

Abstract Aim There is limited evidence regarding predictors of changes in suicidal ideation (SI) in patients with major depressive disorder (MDD). The objective of this study was to describe changes in SI over a 6‐month period and identify their predictors from naturalistic observations of MDD patients. Methods In the cross‐sectional analysis, we examined 257 patients with MDD at the first‐visit assessment. Among the patients, 119 who completed the 6‐month assessment (completers) were included in the longitudinal analysis. For the evaluation of depressive symptoms, including SI, the Quick Inventory of Depressive Symptomatology‐Japanese version was administered at both the first‐visit and follow‐up assessments. At baseline, we also administered the Japanese version of the Ten Item Personality Inventory to assess personality traits and the PRIME Screen‐Revised to assess psychotic symptoms. Results In the cross‐sectional analysis of first‐visit patients, 36.2% (93/257) exhibited SI. Among completers, 14.3% (17/119) had prolonged SI. Among the completers with SI at the first‐visit assessment, 38.6% (17/44) had SI at the follow‐up assessment (prolonged SI). In linear regression models including all completers, prolonged SI was positively associated with endorsement of suspiciousness/persecutory ideas and negatively associated with higher age. Conclusion More than one‐third of completers who had SI at the first‐visit assessment experienced prolonged SI (SI at follow‐up). Our findings can help clinicians predict the course of MDD by identifying associated demographic and clinical characteristics.

Introduction People living with HIV are at increased risk of suicidal behaviors. It is critical to assess risk factors in resource-poor settings. Our study aimed to quantitatively assess the prevalence, pattern, and risk factors for suicidal behaviors among HIV-positive adults. Material and methods Facility-based cross-sectional study among 412 HIV-positive adults over nine months was conducted. Data on participants’ characteristics, prevalence and pattern of suicidal idea­tion, plan and attempt, and risk factors for suicidal behaviors using structured interviews with closed-ended questionnaires were obtained. Crude and specific prevalence, 95% confidence intervals of suicidal behaviors, and risk factors were computed. Subsequently, we conducted bivariate analyses and binary logistic analysis to assess relevant associations, with statistical significance at 5%. Results About two out of every three (68.4%) participants were women. The crude prevalence of suicide behaviors was 7.3%, 6.1%, and 5.8% for suicide ideation, suicide planning, and suicide attempt, respectively. Several risk factors for suicide behaviors were common, such as perception of suicide as a crime (59.7%), lack of access to healthcare (44.7%), social isolation (34.7%), anxiety (32.8%), psychological distress (32.3%), separation or divorce (29.4%), widowhood (23.3%), intimate partner violence (15.5%), and co-existing major medical conditions (14.8). Suicidal behaviors were associated (p < 0.05) with an­xiety, alcohol consumption, co-existing major medical conditions, rape, and lack of access to healthcare. Conclusions Suicidal behaviors and their risk factors are common among people living with HIV. It is critical to prioritize screening for suicide behaviors and their risk factors in HIV care.

Abstract Background Major depressive disorder (MDD) is the most disabling and burdensome mental disorder, negatively affecting an individual’s quality of life and daily functioning. the current study was conducted with the aim of investigating the clinical effects of intravenous ketamine on symptoms of MDD and suicidal ideation. Methods The current randomized clinical trial was carried out on 64 patients diagnosed with treatment-resistant major depressive disorder between April and August 2022. The participants were randomly assigned to two groups: the intervention group received a dose of 0.5 mg/kg of ketamine, while the control group received normal saline. The Montgomery-Asberg Depression Scale and Beck’s Suicidal Ideation Scale were utilized to assess depression and suicidal ideation, respectively. Results One hour after the administration of ketamine treatment, there was a notable and significant improvement in both depression symptoms (35.16 ± 8.13 vs. 14.90 ± 10.09) and suicidal ideation (6.74 ± 6.67 vs. 0.42 ± 1.52). Moreover, there were statistically significant differences in depression scores between the two groups at one hour, four hours, one day, three days, one week, one month, and two months after the administration of ketamine (p-value

AbstractMental health problems and suicide risk among veterinarians and veterinary nurses are well documented in the literature. Data on veterinary assistants have been overlooked, however. In addition, information on Portuguese veterinary professionals is lacking. An online sample of 833 Portuguese veterinary professionals (443 veterinarians, 287 nurses, and 103 assistants) completed self-report questionnaires about suicide risk and mental health between December 2022 and March 2023. Descriptive analysis revealed that 3.5% of respondents attempted suicide during their lifetime; 17.2% experienced extremely severe depression and suicidal ideation; 17.8% and 27.0% experienced extremely severe stress and anxiety, respectively; and 27.4% and 27.7% reported burnout and compassion fatigue, respectively. Multiple linear regression analysis revealed that professionals with a history of mental illness history; with current clinical symptoms of depression, anxiety, and stress; and working more than 40 hours per week experienced greater levels of burnout, compassion fatigue, and suicide ideation. Other variables such as being a woman, being a veterinary assistant, and disagreeing with motives for euthanasia also predicted some mental health problems. Mental health problems in the Portuguese veterinary professionals are a major health concern. These professionals are at higher risk for suicide, and clinical implications and guidelines are discussed. [ABSTRACT FROM AUTHOR]

Purpose: Currently, 1 in 5 college students struggle with suicidal ideation while 7% to 44% engage in nonsuicidal self-injury. Illinois has one of the highest teenage and college student suicide rates in the United States. This pilot study assessed suicide ideation and self-harm behaviors at a public Illinois university. This is the first study to use 5 standardized psychological instruments to investigate these 2 crises in freshmen college students who are all required to reside in dormitories. The main hypothesis was to determine if the independent effects of freshmen students' depression, Five-Factor Model, and Reasons for Living affected the dependent variables, self-harm behaviors and suicide ideation. Methods: Forty first-year college dormitory students completed the Beck Depression Inventory-II, Scale of Suicidal Ideation, Five-Factor Model, Inventory of Statements About Self-Injury, and Reasons for Living Scale in person. Results: Participants were 18 to 19 years old, predominantly female (65%), and non-White (62%). Forty percent reported self-harm behaviors and 19% reported suicidal ideation. The top reasons for contemplated suicide attempts included the inability to solve problems (33%) and attention/revenge (28%). Students experienced high levels of anxiety (55%), self-consciousness (43%), and depression (18%). Depression was associated with suicide ideation (β = 0.05, P =.006), while neuroticism and openness were associated with self-harm behaviors (aOR = 3.36, P =.02, aOR = 0.48, P =.047, respectively). Ninety-five percent reported "responsibility to family" as a Reason for Living. Conclusions: Preliminary evidence necessitates an examination of self-harm and suicide ideation among all freshmen, investigating both risk and protective factors. In the future, a prevention intervention should be implemented campus-wide (and eventually nationwide) for all first-year dormitory students to enhance their mental well-being. [ABSTRACT FROM AUTHOR]

Aim: To synthesize research investigating suicide, suicide attempts, self‐harm and suicide ideation in nursing and midwifery students, a group of interest due to high rates of suicide among qualified nurses. Specific areas of interest for this review included prevalence, factors which may contribute to or mitigate risk and suicide prevention interventions. Design: A systematic review was conducted, and Preferred Reporting Items for Systematic Reviews and Meta‐Analysis (PRISMA) guidelines were followed. Data Sources: Three electronic databases were searched, and additional articles identified using hand‐searching. Studies were included if they examined suicide, suicide attempts, self‐harm or suicide ideation in nursing or midwifery students. Review Methods: Studies were deduplicated and assessed for inclusion. Data from included studies were extracted, quality of studies assessed and data synthesized, informed by study focus, design and assessed quality. Results: About 46 studies of largely moderate to low quality were identified. A high‐quality study demonstrated increased risk of suicide in Swedish female nursing students, and increased risk of self‐harm in nursing students of both sexes. Prevalence of suicide ideation did not appear to differ across course year, or between nursing students and students on other programmes. Psychiatric conditions, particularly depression, were associated with suicide ideation. Three studies related to suicide prevention interventions were identified. Integration of wellness initiatives into the curriculum and peer support were preferred interventions among nursing students and teaching staff. Conclusions: To understand the extent of suicide and self‐harm among nursing and midwifery students there is a need for further epidemiological research stratified by programme of study. To develop prevention interventions and initiatives for nursing students, high‐quality longitudinal studies should examine characteristics associated with suicide and self‐harm. Impact: Current findings suggest interventions could include support for students experiencing mental health difficulties, foster peer support, and help develop wellness. No patient or public contribution. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to investigate the mechanisms of the development of suicidal ideation and its moderating and protective factors. Drawing on the Interpersonal‐psychological theory of suicide, we proposed that disruptions to belongingness, in conjunction with tolerance of health risk, may influence the development of suicidal ideation above and beyond psychosocial changes such as disruptions to finances and work. Methods: The study involved a longitudinal investigation of an Australian representative sample reporting suicidal ideation fortnightly for 12 weeks between March and June 2020. Results: The results indicated that participants who reported higher levels of belongingness, mastery, and intolerance of health risk were less likely to experience suicidal ideation and had lower severity of suicidal ideation. Mastery significantly strengthened the negative link between belongingness and the incidence of suicidal ideation, while agreeableness significantly strengthened the negative link between belongingness and the severity of suicidal ideation over time. Conclusion: The findings suggest that supporting effective social connectedness during times of isolation and promoting self‐efficacy, mastery, and regulation of risk tolerance, may be crucial for suicide prevention and therapeutic intervention. [ABSTRACT FROM AUTHOR]

This research studies university undergraduate students' perceptions of the causes of suicide and suicidality among the youths in Zimbabwe with reference to the case of Midlands State University. The research also examined the contribution of COVID-19 to suicide and suicidality and the role of the family and church in suicide and suicidality causation or prevention. A qualitative methodology was used to collect data through semi-structured interviews, key informant interviews and a focus group discussion using a sample of 31 participants. Thomas Joiner's Interpersonal theory of suicide is utilised and adapted to explain suicide ideation among Zimbabwean youths. Abusive, fractured family and romantic relationships, economic frustrations, stigmatisation, loneliness, drug abuse and the pressure to conform were some of the causes of suicide ideation. The research recommends increased regular mental health and suicide prevention awareness campaigns to inform the students on the available services. Supportive, stable and positive relationships and interactions within families and churches are necessary to build resilience against suicide ideation and suicidality. [ABSTRACT FROM AUTHOR]

Aim: There is limited evidence regarding predictors of changes in suicidal ideation (SI) in patients with major depressive disorder (MDD). The objective of this study was to describe changes in SI over a 6‐month period and identify their predictors from naturalistic observations of MDD patients. Methods: In the cross‐sectional analysis, we examined 257 patients with MDD at the first‐visit assessment. Among the patients, 119 who completed the 6‐month assessment (completers) were included in the longitudinal analysis. For the evaluation of depressive symptoms, including SI, the Quick Inventory of Depressive Symptomatology‐Japanese version was administered at both the first‐visit and follow‐up assessments. At baseline, we also administered the Japanese version of the Ten Item Personality Inventory to assess personality traits and the PRIME Screen‐Revised to assess psychotic symptoms. Results: In the cross‐sectional analysis of first‐visit patients, 36.2% (93/257) exhibited SI. Among completers, 14.3% (17/119) had prolonged SI. Among the completers with SI at the first‐visit assessment, 38.6% (17/44) had SI at the follow‐up assessment (prolonged SI). In linear regression models including all completers, prolonged SI was positively associated with endorsement of suspiciousness/persecutory ideas and negatively associated with higher age. Conclusion: More than one‐third of completers who had SI at the first‐visit assessment experienced prolonged SI (SI at follow‐up). Our findings can help clinicians predict the course of MDD by identifying associated demographic and clinical characteristics. [ABSTRACT FROM AUTHOR]

Sleep disturbance may exacerbate the risk of suicide among youth with depression, but whether this association is independent of psychopathology requires further study. This cross-sectional study included 576 youths (13–25 years old) recruited from January 2022 to May 2023. The patients were first divided into two groups by the presence of suicidal ideation according to the Columbia-Suicide Severity Scale (C-SSRS). Sleep quality was assessed by the Athens Insomnia Scale (AIS) and mental health with the Hamilton Depression Rating Scale (HAMD) and Hamilton Anxiety Rating Scale (HAMA). Logistic regression was conducted to analyze the association between sleep disturbance and suicidal ideation, adjusted for depressive symptoms severity. The suicidal ideation group exhibited more severe sleep disturbances, anxiety symptoms, and depressive symptoms than the non-suicidal ideation group. Pearson correlation showed that sleep disturbance (AIS) was significantly correlated with the severity of anxiety symptoms, depressive symptoms, and suicidal ideation. Logistic regression analysis revealed that the AIS factor "daytime dysfunction" (β = 0.145; OR = 1.156, 95 % CI: 1.02, 1.309; p = 0.023) was significantly associated with suicidal ideation after adjusting for demographic characteristics and depressive symptoms severity. Due to the cross-sectional nature of the data, no causal inference can be made regarding the observed associations between sleep disturbance and suicidal ideation. Sleep disturbance, particularly in the realm of daytime dysfunction, is associated with increased suicidal ideation among depressed youth. Clinicians need to assess and manage sleep disturbance in the context of suicidal ideation for young depression patients. • Sleep disturbances are common in youth with depression • Youth with suicidal ideation have more severe depressive and anxiety symptoms • Individuals who experience suicidal ideation may have an increased burden of sleep disturbance and related issues • Sleep disturbance may be an important element of suicide risk assessment [ABSTRACT FROM AUTHOR]

Insomnia symptoms have been shown to be associated with suicide ideation/behavior. However, the underlying mechanism is unclear and studies on protective factors that might mitigate the association between sleep-related problems and suicide ideation/behavior are largely missing. On this background the aim of the current study was to investigate, whether positive mental health (PMH) accounts for the association between insomnia symptoms and suicidal ideation/behavior. A total of 913 participants (72.2% women; age: M (SD) = 25.91 (7.08)) completed measures on insomnia symptoms, PMH and suicide ideation/behavior via an online survey. The results reveal a significant association between insomnia symptoms and PMH. Both variables were significantly linked to lifetime suicide ideation/behavior and 12-month suicide ideation. Moreover, the association between insomnia symptoms and suicide-related outcomes was significantly mitigated by PMH. The current findings complement previous studies on the association between insomnia symptoms and suicide ideation/behavior. Furthermore, they demonstrate that PMH can mitigate the risk of suicide-related outcomes. Therapeutic intervention targeting insomnia symptoms and fostering PMH might be useful in the prevention of suicide ideation/behavior. • Insomnia symptoms are positively linked to lifetime suicide ideation/behavior. • Insomnia symptoms are positively linked to 12-month suicide ideation. • Insomnia symptoms are negatively linked to positive mental health (PMH). • PMH mitigates the link between insomnia symptoms and suicide-related outcomes. [ABSTRACT FROM AUTHOR]

The present work explored the independent and joint consequences of multiple factors that prior work indicated were central to suicide risk among a sample of public safety personnel. Of key interest relevant to the experience of suicidal thoughts and behaviors were the roles of sleep disturbance, social support, and agency stigma discouraging discussion of mental health. These risk factors and relevant demographic variables were measured in a nationally representative sample of law enforcement and correctional officers at time 1. Their suicidal thoughts and behaviors were assessed one year later at time 2. Officers who reported sleep disturbances at time 1 were more likely to report suicidal thoughts and behaviors at time 2. Mediation analyses indicated that the effect of sleep on the officers' suicidal responses was partially accounted for by their lower social support. For officers, sleep disturbances may contribute to loneliness and interfere with social relationships, which has negative mental health consequences. However, social support was only a partial mediator suggesting that sleep disturbances have additional influences on suicidal responses for officers beyond their impact on social support. Perceived stigma from the agency regarding the discussion of psychological problems was also an independent predictor of suicidal thoughts and behaviors. The stigma that these officers perceived likely exasperated the suicidal reactions because it may have interfered with their tendency to seek help and benefit from any ongoing treatment. The implications of these findings for treatment and future research building on the present work are discussed. [ABSTRACT FROM AUTHOR]

Malaysian pervasive climate places its LGBTQ+ residents at heightened risk for suicidal behaviors (SB). This cross-sectional study aimed to elucidate connections between minority stressors (discrimination), types of social supports, and suicidality in this marginalized population. Utilizing online surveys, 317 LGBTQ+ Malaysians aged 18–49 provided data regarding experienced discrimination, perceived social support from family, friends, and significant others, suicidal ideation (SI), and SB. Quantitative analyses illuminated several key findings. First, discrimination is positively associated with SB, while all support types are inversely related to SB, with family support demonstrating the strongest correlation. Regression modeling revealed family support as the sole unique predictor of reduced SB. Serial mediation analysis uncovered nuanced indirect pathways from discrimination to SB, with SI, but not family support alone, significantly mediating this relationship. However, reduced family support resulting from discrimination sequentially heightened SI and SB. Despite pervasive societal bias, family and friend acceptance may curb the LGBTQ+ community’s elevated suicide risk by mitigating resultant ideation. These insights highlight the need for public health initiatives promoting social support and LGBTQ+ inclusivity laying the groundwork to safeguard this population’s psychological wellbeing. [ABSTRACT FROM AUTHOR]

Background: Lockdowns and other health protective measures, such as social distancing, imposed during the COVID-19 pandemic nurtured unprecedented levels of stress and social isolation around the world. This scenario triggered an increase in suicide thoughts and self-harm behaviours among children and young people. However, the longer-term impact of the pandemic on children's and adolescents' mental health, especially with regard to self-harm, is still to be fully discovered. Methods: We carried out a retrospective study where we collected data related to suicide ideation and self-harm behaviours in all patients aged under 18 that required on-call psychiatric services at the General Hospital Accident and Emergency (A&E) department in Salamanca, Spain, during 2019 (pre-pandemic) and in both 2021 and 2022 to capture possible variation at different time points during the post-pandemic period. Results: A total of 316 patients aged under 18 were seen by on-call psychiatric services at the A&E department during the three time periods: 78 in 2019, 98 in 2021 and 140 in 2022. The mean age was 15.12 (SD 2.25) and females represented more than twice the number of males each year. More than half of all patients assessed during 2022 disclosed suicide thoughts, whilst in 2019, it was near 25%. This increase in suicide ideation rates was more marked among females (X2 = 15.127; p = 0.001), those aged over 15 (X2 = 16.437; p < 0.001) and/or those with a previous history of mental health problems (X2 = 17.823; p < 0.001). We identified an increase in the proportion of males with suicide ideas, especially between 2021 and 2022 (X2 = 8.396; p = 0.015). Conclusions: Our study suggests that children's and adolescents' demand for urgent mental healthcare and their clinical presentations in A&E departments with suicide thoughts and/or self-injuries do not seem to be declining after the pandemic but increasing over time. More research is warranted to understand possible factors involved in this sustained upward trend. [ABSTRACT FROM AUTHOR]

Background: Major depressive disorder (MDD) is the most disabling and burdensome mental disorder, negatively affecting an individual's quality of life and daily functioning. the current study was conducted with the aim of investigating the clinical effects of intravenous ketamine on symptoms of MDD and suicidal ideation. Methods: The current randomized clinical trial was carried out on 64 patients diagnosed with treatment-resistant major depressive disorder between April and August 2022. The participants were randomly assigned to two groups: the intervention group received a dose of 0.5 mg/kg of ketamine, while the control group received normal saline. The Montgomery-Asberg Depression Scale and Beck's Suicidal Ideation Scale were utilized to assess depression and suicidal ideation, respectively. Results: One hour after the administration of ketamine treatment, there was a notable and significant improvement in both depression symptoms (35.16 ± 8.13 vs. 14.90 ± 10.09) and suicidal ideation (6.74 ± 6.67 vs. 0.42 ± 1.52). Moreover, there were statistically significant differences in depression scores between the two groups at one hour, four hours, one day, three days, one week, one month, and two months after the administration of ketamine (p-value < 0.001). However, ketamine recipients frequently experienced side effects such as increased heart rate, headache, dizziness, and dissociative syndrome symptoms. Conclusion: The observed rapid onset of action and sustained effect demonstrate the potential of ketamine to provide relief from depressive symptoms in a shorter timeframe compared to traditional treatment approaches. These findings contribute to the growing body of evidence supporting the use of ketamine as a valuable therapeutic option for patients with treatment-resistant depression. IRCT registration: IRCT registration number: IRCT20210806052096N1; IRCT URL: https://www.irct.ir/trial/62243; Ethical code: IR.ZUMS.REC.1400.150; Registration date: 2022-04-09. [ABSTRACT FROM AUTHOR]

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that disrupts brain functioning and is characterized by hyperactivity, impulsivity, and inattention. With varying presentations and complex etiological factors contributing to the development of ADHD, along with its persistence into adulthood, ADHD must be studied. Researchers have taken an interest in the relationship between ADHD and suicide, which is a serious public health concern with increasing prevalence rates in the Americas. The current literature reveals conflicting views on the importance of psychiatric comorbidities in the development of suicidal behaviours in ADHD patients. Therefore, this study aimed to determine whether there were significant differences between adult ADHD patients with suicide risk and adult ADHD patients without suicide risk. This study was a naturalistic retrospective chart review pilot study that used a sample of adults with a confirmed diagnosis of ADHD from January 2023 to August 2023. Using convenience sampling and sets of inclusion and exclusion criteria, patient data were sequentially collected from Med Access electronic medical records. The control and experimental groups each consisted of 50 patients (100) ranging from 19 to 58 years old. Our quantitative data were analyzed using non-parametric statistical tests, including the Chi-Square test and the Mann–Whitney U test. The results showed significant associations between ADHD patients with suicide risk and (1) borderline personality disorder; (2) binge eating disorder; (3) seven specific psychosocial risk factors; and (4) a higher number of antidepressant medication trials. No significant associations were found with other psychiatric disorders; however, there are important sex differences in terms of the risk factors. Our pilot study reveals several significant differences between adult ADHD patients with suicide risk and those without suicide risk. However, given our limited sample size and limitations, we hope our study encourages larger-scale studies to further investigate this relationship to improve its generalizability. [ABSTRACT FROM AUTHOR]

Purpose: Adolescents are particularly vulnerable to suicide attempts, which is a major risk factor for completed suicide in this age group. However, most research on suicide prevention interventions comes from high-income countries with predominantly white participants and English protocols. This study examines interventions that have been tested in Latin America and Spain. Methods: A systematic review was conducted to include interventions aimed at reducing suicide ideation, attempts, and increasing knowledge about it in these regions. Results: Sixteen articles were selected, and Dialectical Behaviour Therapy, Problem Solving Therapy, and Trauma-Focused Cognitive Behavioural Therapy were found to be more effective than standard treatments or wait-list conditions in reducing the outcomes. Discussion: This review highlights the need for more research on preventive interventions in Latin America and Spain. While all interventions evaluated were effective, further research and replication studies are necessary to strengthen the evidence base for these interventions. [ABSTRACT FROM AUTHOR]

Issues Addressed Methods Results Conclusions So What? There is a paucity of data regarding depression and thoughts of self‐harm or suicide among gender and sexually diverse (GSD) people living within Australian regional/rural locations. This study aims to elucidate these issues and fill a critical gap.The sample included 91 GSD people from a regional community in South‐West Queensland utilising the PHQ‐9 to determine presence/severity of depression and self‐harm/suicide ideation. These data were drawn from a larger health and wellbeing survey. Raw mean scores were calculated to determine prevalence/severity of clinical symptoms. Bayesian ordinal regression models were employed to analyse between‐subgroup differences in depression and self‐harm/suicide ideation.Overall, 80.2% of GSD sample experienced depression (35.2% severe, 45.1% mild/moderate) and 41.8% experienced self‐harm/suicide ideation in the past two‐weeks. Trans and nonbinary people experienced higher levels of depressions than sexually diverse cisgender people. Pansexual and bisexual people experienced higher levels of depression than gay people. Trans people experienced higher prevalence of self‐harm/suicide ideation than cisgender and nonbinary people, with no differences between sexuality subgroups.These findings contribute to deeper and more nuanced insights regarding clinically salient depressive and self‐harm/suicide ideation symptoms among trans, nonbinary, bisexual, pansexual and queer people in regional Australian communities, with the aim to ultimately reduce mental health prevalence, improve mental health outcomes and health promotion among GSD people.The current findings revealed GSD people experience high prevalence of depression and self‐harm/suicide ideation indicating tailored mental health awareness‐raising, training and health promotion is warranted to enhance psychological support. [ABSTRACT FROM AUTHOR]

The relationship between emotion dysregulation and suicide ideation may depend on the level of internalizing and externalizing symptoms. It was expected that both internalizing and externalizing symptoms would moderate the relationship between emotion dysregulation and suicide ideation, such that greater symptoms would strengthen the relationship between emotion dysregulation and suicide ideation. Adolescent participants (n = 559, Mage = 15.40, 85.0% white, 57.2% female) completed self-report measures that assessed emotion dysregulation, internalizing and externalizing symptoms, and recent suicide ideation. Both internalizing and externalizing symptoms moderated the relationship between emotion dysregulation and suicide ideation; this relationship strengthened as internalizing and externalizing symptoms increased. The results of this study indicate that internalizing and externalizing symptoms may both affect the connection between emotion dysregulation and suicide ideation. Future research should focus on targeting both internalizing and externalizing symptoms in treatment to help reduce emotion dysregulation and suicide ideation in adolescents. [ABSTRACT FROM AUTHOR]

Introduction: Borderline personality disorder (BPD) is a disorder of pervasive emotion dysregulation associated with high rates of self‐injurious thoughts and behaviors (SITB). Understanding specific emotion states in relation to SITB is important for effective intervention. Methods: The current study examined whether, and how, the specific emotion of shame contributes to suicide ideation and urges to engage in non‐suicidal self‐injury (NSSI) both directly, and indirectly via anger, among individuals with BPD. Participants (N = 100) were enrolled in a 6‐month comprehensive dialectical behavior therapy (DBT) program and provided daily ratings of shame, anger, suicide ideation, and urges for NSSI. Results: We found that higher daily ratings of shame and anger were directly associated with higher same‐day ratings of both suicidal ideation and urges for NSSI. Furthermore, anger partially mediated the relationships between shame and both suicidal ideation and urges for NSSI. Conclusion: These findings highlight shame and anger as potential antecedents of SITB among individuals with BPD. Clinical approaches, such as DBT, that include personalized, ongoing, clinical assessment of these specific affective states may be particularly important for treatment of SITB. [ABSTRACT FROM AUTHOR]

Background: Suicide ideation has high prevalence in adolescents, better future time perspective is considered a protective role for anxiety, depression, and suicide ideation. However, the impact of future time perspective on suicide ideation remains unclear, especially when anxiety and depression as mediating roles. Methods: A cross-sectional study of college students was performed in Chongqing, China. There are 851 students enrolled in this study and we distribute questionnaires through the WeChat platform to obtain data in 2023. We conducted Pearson correlation analysis and descriptive statistics. Model 6 in PROCESS 4.0 was used to test the multiple mediating effect. Results: College students who have higher future time perspective are associated with a lower risk of anxiety, depression, and suicide ideation. Future time perspective not only affects suicide ideation directly, but also influence it by means of two mediating pathways: ①depression, the mediation effect is 37.41 %; ②the multiple mediating effects of anxiety and depression with a mediating effect of 29.68 %. Conclusion: Higher future time perspective functions as a protective role in anxiety, depression, and suicide ideation; future time perspective can affect and predict the occurrence of suicide ideation by influencing anxiety and depression in college students. This conclusion will be a novel and insightful part of adolescent mental health research, and provide a new perspective to prevent college students from committing suicide in the future.

Background: Studies using tasks that measure suicide-specific attentional biases have not specified which attentional processes are related to risk for suicidal thoughts and behaviors. This study distinguished suicide-specific engagement and disengagement biases from other forms of cognitive processing and investigated under which affective conditions suicide-specific biases emerged. Method: An ethnoracially and socioeconomically diverse sample of 153 young adults (87 % female; 52 % Non-Hispanic White), ages 18–34, with moderate-to-high symptoms of anxiety, depression, or recent suicide ideation were randomly assigned to experience positive, negative, or neutral affect, completed cognitive tasks of attention, construct accessibility, and threat bias, and self-report measures. Results: Individuals with recent ideation displayed facilitated disengagement from suicide-specific stimuli irrespective of affective state. Those with distal ideation showed slower disengagement from suicide-specific stimuli in the sad condition only. Conclusions: Individuals with recent suicide ideation display automatic processing of suicide-related information, perhaps due to recent rehearsal of suicide-related content. In contrast, individuals with distal ideation experiencing negative affect appear to have difficulty disengaging attention from suicide-related content. Limits to generalizability of the findings include a predominantly female sample, although the sample’s racial, ethnic, and socioeconomic diversity increase generality of the research.

IntroductionSuicide risk assessment based on self-report questionnaires is considered as problematic because risk states are dynamic and at-risk individuals may conceal suicidal intentions for several reasons. Therefore, recent research efforts increasingly focus on implicit risk markers such as the suicide attentional bias (SAB) measured with the Suicide Stroop Task (SST). However, most SST studies failed to demonstrate a SAB in individuals with suicide risk and repeatedly demonstrated insufficient psychometrics of the SST. This study aimed to investigate a SAB using a modified SST (M-SST) and to test its psychometric properties.MethodWe compared n = 61 healthy controls and a high-risk inpatient sample of n = 40 suicide ideators and n = 40 suicide attempters regarding interference scores of positive, negative and suicide-related words. Interference scores were calculated by subtracting the mean reaction time (mean RT) of the neutral words from the mean RT of the suicide-related words (mean RT Suicide –mean RT Neutral), resulting in a suicide-specific interference score. Similarly, interference scores were calculated for the positive and negative words by subtracting the mean RT of neutral words from the mean RT of positive and negative words.ResultsA Group × Interference ANOVA showed a significant interaction effect (p

Background: Self-injurious thoughts and behaviors (SITBs) are a major problem worldwide and continue to be a serious public health concern. Research investigating risk factors for suicide has shown that reward processes, such as the inability to feel pleasure, may confer risk for SITBs. However, less work has examined how different dimensions of trait reward relate to SITBs. Accordingly, the present study investigated the unique and interactive effects of trait anticipatory and consummatory reward for explaining SITBs. Methods: 260 community adults ages 18–55 (M/SD = 32.79/10.54, females = 49.6 %, males = 50.4 %) completed an interview, neuropsychological tests, and questionnaires. We used hierarchical multivariate multiple regression analysis to assess cross-sectional associations between trait anticipatory and consummatory reward and different types of SITBs [self-injurious thoughts, nonsuicidal self-injury (NSSI), and suicide attempts] from the Risky, Impulsive, and Self-destructive Behavior Questionnaire. Results: The unique variance associated with anticipatory and consummatory reward were differentially related to self-injurious thoughts but unrelated to self-injurious behaviors (NSSI/suicide attempts). The interaction of anticipatory and consummatory reward was associated with self-injurious behavior, such that the inability to experience both anticipatory and consummatory reward was associated with higher frequency of NSSI. Limitations: Limitations of the study include its cross-sectional nature and reliance on self-reported measures. Conclusions: Low anticipatory reward and high consummatory reward may confer risk for self-injurious thoughts. Low levels of both trait anticipatory and consummatory reward may confer risk for NSSI. Findings suggest reward sensitivity may be an understudied risk factor for a range of SITBs.

Qi Wang,1,2,&ast; Min Wen,2,3,&ast; Shaohang Fan,2,4 Jinning Liu,2 Xiaowen Wang,5 Wentao Guo,2 Jinyun Hu,6 Jialan Zhang,2 Bing Li,2,7 Lili Zhang,2,7 Yunshu Zhang,1,2,7 Keqing Li2,7 1Clinical Medicine College, Hebei University, Hebei, People’s Republic of China; 2Hebei Provincial Mental Health Center, Hebei, People’s Republic of China; 3Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China; 4School of Psychology and Mental Health, North China University of Science and Technology, Tangshan, People’s Republic of China; 5Psychosomatic Medicine Department, Jiangxi Provincial People’s Hospital, Nanchang, People’s Republic of China; 6Psychiatric Department, The Second People’s Hospital of Yuxi, Yunnan, People’s Republic of China; 7Hebei Provincial Key Laboratory of Major Mental and Behavioral Disorders, Hebei, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Keqing Li, Hebei Provincial Mental Health Center, Hebei, People’s Republic of China, Email like2125@sina.com Yunshu Zhang, Hebei Provincial Mental Health Center, Hebei, People’s Republic of China, Email yunshucoffee@sina.comObjective: Suicidal behavior is strongly correlated with depressive symptoms and the degree of suicidal ideation. Cognitive impairment may have varying degrees of influence on suicidal ideation (SI) and suicidal attempts (SA). The aim of this study was to identify the cognitive biomarkers that distinguish suicidal ideation from suicidal attempts in adolescents.Methods: The cross-sectional sample comprised 54 adolescents with major depressive disorder (MDD) and 32 healthy controls (HC). The THINC-it was utilized to assess cognitive function of all the samples. Suicidal ideation was examined by the Positive and Negative Suicide Ideation Scale (PANSI). Based on the type of data, one-way ANOVA or Kruskal–Wallis was performed to investigate group differences. Bonferroni post-hoc analysis was employed for regulating type I error for pairwise comparisons. Network analysis was used to compare the networks associated with suicidal ideation, depression symptoms, and cognitive function between SA and SI.Results: The depression symptoms (HAMD-17) (F=72.515, P< 0.001) and suicidal ideation (PANSI) (F=267.952, P< 0.001) in the SA were higher than those in the SI. Analysis of between-group differences showed SA performed worse in THINC-it, especially in “Spotter (SP)” (P=0.033), “Objective cognition score (OS)” (P=0.027) and “Composite score (CS)” (P=0.017). Compared with SI, network analysis revealed that SA had a unique network of cognitive function, depressive symptoms, and suicidal ideation. Nevertheless, both networks exhibit comparable performance concerning the node strength of cognitive function. Within their separate networks, the aspects of CS, OS, and SP have emerged as the three most crucial elements.Conclusion: Adolescents with SI or SA exhibit a broad spectrum of cognitive impairments. Attention impairment can be beneficial in discerning between SI and SA. Future interventions for adolescent suicide can center on attention and the comprehensive cognitive ability that it represents.Keywords: attention impairment, suicide ideation, suicide attempts, adolescent, THINC-it tool, network analysis

Abstract Background Although the disturbance of circadian rhythms represents a significant clinical feature of major depressive disorder (MDD), the relationship between biological rhythm disturbances and the severity of suicidal ideation in individuals with MDD remains unclear. We aimed to explore the characteristics of different biological rhythm dimensions in MDD and their association with the severity of depressive symptoms and suicidal ideation. Methods A total of 50 MDD patients and 50 healthy controls were recruited and their general information was collected. The severity of depressive symptoms was assessed with the 17-item Hamilton Depression Rating Scale (HDRS17). The intensity of suicidal ideation was evaluated with the Beck Scale for Suicide Ideation (BSS). The Chinese version of the Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN) scale was utilized to assess the participants’ biological rhythm dysregulation. Multiple logistic regression analysis was conducted to explore the relationship between biological rhythm and the risk of MDD. Multiple linear regression analysis was performed in the MDD group to investigate the relationship between different biological rhythm dimensions and suicide ideation. Results Significant differences were observed between the MDD group and the control group in total BRIAN score (Z=-5.41, P