Suicidality among homeless people: Testing the mediating effects of self-efficacy and depression

ABSTRACT

This cross-sectional study examined the mediating effect of PTSD on suicide ideation and suicide attempt through two mediators, self-efficacy and depression, among homeless adults. We recruited a non-random, purposive sample of 156 homeless adults from seven homeless people shelters in Kansas. SEM results suggest that self-efficacy and depression were significant mediators between PTSD and suicide ideation, but not between PTSD and suicide attempt. This study’s findings can be used to identify risk factors associated with suicidal behaviors that can be used to design service programs aimed at preventing suicidal ideation and attempt among people who are homeless.     

Suicide prevention on college campuses: What works and what are the existing gaps? A systematic review and meta-analysis

Abstract

Objective: To examine the effects of universal and targeted suicide prevention programs on relevant outcomes in college campuses. Methods: College suicide prevention programs published from 2009 to 2018 were assessed on outcomes including knowledge, skills, self-efficacy, suicidal ideation, and suicidal behaviors. Effects of the interventions on outcome variables with sufficient studies to warrant meta-analysis (ie, knowledge, skills, and self-efficacy) were meta-analyzed. Studies reporting on the remaining outcomes (ie, suicidal ideation and behaviors) were systematically reviewed. Results: Significant increases in suicide prevention knowledge, skills, and self-efficacy were observed in universal prevention interventions that typically employed gatekeeper prevention strategies. Evidence of reductions in suicidal ideation and behaviors was observed across targeted suicide prevention programs for at-risk students. Conclusion: Prevention programs are beneficial for training those likely to come in contact with people endorsing suicidality, but further research is needed to show that suicide interventions can consistently have significant effects on suicidal students as well.     

Gender and White College Students' Racial Attitudes

New forms of racial attitudes among whites, including racial resentment, help to uphold institutionalized inequalities in the United States. As a way to dismantle institutionalized forms of racial inequalities, colleges and universities have implemented various curricula and programs designed to expose students to diversity and reduce social inequalities. This study attempts to uncover the extent to which college experiences affect levels of racial resentment among white students, with emphasis on whether the effects differ for women and men. Findings from a representative sample of students at a large Midwestern university revealed that white men showed higher levels of racial resentment than white women and that their attitudes were significantly affected by many college experiences. By contrast, white women are less affected by aspects of their college experience.     

Attachment‐Based Family Therapy With a 13‐Year‐Old Girl Presenting With High Risk for Suicide

This article describes the application of Attachment‐Based Family Therapy (ABFT) to the treatment of a 13‐year‐old female adolescent presenting with high risk of suicide, complicated by a history of depression and sexual trauma. The article begins with an overview of ABFT, including (a) how attachment theory guides treatment; (b) the structure of the clinical model; and (c) the data that provide empirical support. A case example is then presented that exemplifies the primary clinical procedures used to reach therapeutic goals in ABFT, including attachment repair and autonomy/competence promotion. Weekly changes in suicide ideation and depression scores are presented. The article concludes with a discussion about implications for family‐based treatment of suicidal youth.     

A review of school-based suicide prevention interventions in South Korea, 1995–2015

Adolescent suicide behavior is a serious social concern in South Korea, and there is a current lack of knowledge regarding the overall strengths and weaknesses of school-based suicide prevention interventions (SPI) for this group. The aim of this study was to review the benefits of and barriers to effective implementation of existing SPI for adolescents in South Korea. A review of school-based SPI was performed using the PsycINFO, PubMed, ERIC, KoreaMed, RISS, KISS, and NDSL electronic databases. Among the identified publications, 18 were subsequently included in this review and were classified into three approach types: universal (seven studies), selective (four studies), and indicated (seven studies). Major health outcomes associated with adolescent suicide have been suggested, but different outcomes from SPI have been found. The health-related benefits of these interventions were decreases in suicide risk from depression, aggression, and suicide ideation, and increases in the protective factors of self-esteem, confidence, social relationships, and respect for the value of life. Barriers to successful implementation of SPI included less consideration of the effectiveness of SPI treatment duration, minimal or no follow-up monitoring, low participation due to parents' prejudices against mental health, and underdeveloped referral systems. The findings from this review suggest that there is a need to revise existing SPI programs in the future to take into account of cultural sensitivity. The resulting programs should be useful to researchers, therapists, school staff, parents, and legislators in South Korea.     

Suicide Ideation Among College Students Evidencing Subclinical Depression

Abstract

Identifying elevated suicide ideation in college students is a critical step in preventing suicide attempts and deaths by suicide on college campuses. Although suicide ideation may be most prominent in students with severe depression, this should not suggest that only students with severe depression experience significant risk factors for suicide. Objective: The purpose of these 3 studies was to explore the relation between suicide ideation and severity of depressive symptoms in college students. Participants: In each study a sample of college students were recruited for participation. Methods: Participants completed self-report assessments of depressive symptoms and suicide ideation. Results: The results of these studies suggest that although the greatest elevation in suicide ideation occurs at the highest depressive symptoms, significant suicide ideation is also experienced by college students with mild and moderate depressive symptoms. Conclusions: The implications of these findings for the assessment of suicide ideation are discussed.     

Measles: Current Status and Outbreak Control on Campus

Abstract

This study is part of a nationwide research project dealing with all suicides in Finland. It includes all suicides among university students during the 1-year period from April 1, 1987, to March 31, 1988. Ten students (6 men and 4 women) committed suicide during the period studied. The observed suicide rates per 100,000 students per year were 13.8 (95% CI = 5.1–30.1) for men and 9.0 (95% CI = 2.4–22.8) for women. The difference between the observed and expected suicide rate for men (13.8 v 47.7, standard mortality rate [SMR] = 29) was statistically significant. For women (9.0 v 8.3, SMR = 108), the difference was not statistically significant. Most of the suicides had experienced serious difficulties since early childhood, including narcissistic problems, difficulties in human relations, severe depressive periods, previous suicidal behavior, and alcohol problems; they had also had earlier psychiatric treatment.     

Young people's explanations for youth suicide in New Zealand: a thematic analysis

New Zealand has one of the highest youth suicide rates in the developed world and dominant approaches to prevention do not always take into account the views of young people. The purpose of this research was to update our understanding of young people's explanations of suicide in order to inform suicide prevention efforts. Focus groups were conducted with 38 young people, including 30 young women and 8 young men aged 15–22. The data was analysed thematically to identify the range of explanations young people ascribe to youth suicide. Five themes were identified by the analysis including that suicide could be explained by inescapable difficulties, constant pressure, emotional distress and could also be seen as a cry for help. In contrast to these normalised experiences, participants also expressed the view that mental illness might also account for suicide. The findings suggest that young people recognise suicide as a complex problem with multiple causes. While they recognised mental health problems as contributing, youth suicide was primarily understood by young people as a normal response to emotional distress and pressure. Prevention programmes should address the full range of explanations that young people give for suicide in order to promote their engagement in prevention programmes.     

Child Sexual Abuse and Adult Mental Health,Sexual Risk Behaviors,and Drinking Patterns Among Latino Men Who Have Sex With Men

One in five Latino men who have sex with men has experienced child sexual abuse. Although concerning in itself, child sexual abuse may increase an individuals’ likelihood of depression and risk-taking in adult life, including engagement in HIV risk behaviors and alcohol and substance use. It is therefore urgent that researchers and practitioners better understand the long-term effects of child sexual abuse. We utilized logistic and linear regression to assess associations between child sexual abuse (operationalized as forced or coerced sexual activity before age 17) and depression, sexual behaviors, and drinking patterns in a sample of 176 adult Latino men who have sex with men from New York City. Over one-fifth (22%) of participants reported child sexual abuse. In multivariable models, participants with histories of child sexual abuse were significantly more likely than participants without such histories to screen for clinically significant depressive symptoms and heavy drinking and reported more anal sex acts, male sexual partners, and incidents of condomless anal intercourse in the previous three months. These findings confirm a high prevalence of child sexual abuse among Latino men who have sex with men and associations between child sexual abuse and adulthood depressive symptoms, high-risk alcohol consumption, and sexual risk behaviors. We recommend that providers who serve Latino men who have sex with men incorporate child sexual abuse screenings into mental health, HIV prevention, and substance use treatment programs, utilizing approaches that are inclusive of resilience.     

Bullying and suicide in high school students: Findings from the 2015 California youth risk behavior survey

ABSTRACT

School bullying and cyberbullying have been linked to suicidal behaviors through depression and alcohol, tobacco, marijuana, and other drug use. However, how these associations may differ across racial/ethnic groups remains relatively unknown. Using data from the 2015 California Youth Risk Behavior Survey, this study aims to examine two questions in different racial/ethnic subgroups: (1) Does bullying affect suicide? and (2) Does bullying have an indirect effect on suicide through depression and use of alcohol, tobacco, marijuana and other drugs? The sample consisted of 1,765 Californian youth attending grades 9–12. Logistic regression analyses indicate that being bullied is associated with increased odds of suicide across all racial/ethnic groups; depression mediates the effect of bullying on suicide for all racial/ethnic groups; alcohol use mediates the effect only for Hispanic youth; other drug use mediates the effect only for White youth; marijuana and tobacco use have no mediating role. These findings suggest that bullying may lead to suicide through different risk behaviors for youths of different racial/ethnic groups. Professionals who work with bullied youths need to treat depression more effectively to prevent suicide in service planning and provision. They also need to be aware of the racial/ethnic differences in the risk behaviors intercorrelated with bullying and suicide and provide appropriate treatment to the youth of specific race/ethnicity.     

Suicide ideation,anxiety, and depression: Are children a protective factor for male Veterans?

ABSTRACT

Numerous mental health disorders plague our veterans when they return from deployment including anxiety and depressive disorders, which have been linked to elevated suicide risk when left untreated. Family factors, such as parenthood status, may serve as a protective factor against these mental health issues. This study examined the role of parenthood status of male veterans (N = 234) based on age of the child in order to determine whether a child’s age (minor children v. adult children) affects the likelihood of meeting diagnosis criteria for anxiety, depression, and suicide ideation after controlling for marital status. Three hierarchical binary logistic regression models were constructed to assess the predictive influence of children 18 years old and younger, children older than 18, and no children with the results indicating that parenthood status did meaningfully enhance the prediction of suicide ideation. Complete findings, clinical implications, and future considerations are discussed.     

Commentary: Male Osteoporosis—Policy Gaps in Prevention and Treatment

Osteoporosis is a disabling disease affecting 10 million Americans, leading to increased risk of fractures and poor functional ability. Although typically thought of as a women's disease, millions of men are diagnosed with osteoporosis or low bone mass, and the risk for osteoporotic fractures is increasing. To address undetected and untreated osteoporosis among men, public health education should be targeted to males. Insurance programs, including Medicare, should add the heel qualitative ultrasound (QUS) for age-eligible men with follow-up every 2 years. Policy changes should address funding of targeted education and prevention programs for aging males, including coverage of screening tests.     

Prevalence of DSM-IV major depression among Spanish university students

OBJECTIVE: The authors' purpose in this study was to estimate prevalence and correlates of Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), major depressive episodes (MDEs) among Spanish university students. PARTICIPANTS AND METHODS: In October and November 2004, interviewers administered a screening tool to a sample of 554 students aged 18-34 years (65.9% women). RESULTS: The prevalence of MDEs was 8.7% (95% confidence interval = 6.5%-11.3%). The most common symptoms were depressed mood (81.3%) and altered sleep (79.2%). MDEs were more prevalent among women than men (p < .05). The mean number of previous episodes of depression among currently depressed students with previous episodes was 2.2 (SD = 1.4). Of depressed students, 0.6% had considered suicide and 0.2% had attempted suicide. CONCLUSIONS: Depression was highly prevalent among university students. The results suggest the need to develop some type of program or service for university students with the aim of preventing depression and improving their adaptation to university life.     

Testing a path model of relationships between gender,age, and bullying victimization and violent behavior,substance abuse,depression, suicidal ideation,and suicide attempts in adolescents

The goal of this study was to test a path model for the relationships between age, gender, traditional bullying and cyberbullying victimization, and violent behavior, substance abuse, depression, suicidal ideation and suicide attempts in adolescents. A hypothesized path model was fit to data from the 2011 Youth Risk Behavior Surveillance System (YRBSS) on a nationally representative sample of 15,425 high-school students from across the United States. Results suggested that the effects of traditional and cyberbullying victimization on suicidal thinking, suicide planning, and suicide attempts were mediated by violent behavior, substance abuse, and depression. Results also suggested reciprocal paths between substance abuse and violent behavior. There were statistically significant indirect paths from both traditional and cyberbullying victimization to suicide attempts without the involvement of depression, suicidal thinking, or suicide planning, findings suggesting a model for spontaneous, unplanned adolescent suicides. Results suggested that female adolescents who reported cyberbullying victimization also reported higher rates of depression and suicidal behaviors compared to their male counterparts, and that as adolescents got older, depression and substance abuse tended to increase, while violent behavior and suicidal thinking tended to decrease. The implications of these findings for social workers, school counselors, and others who work with adolescents are considered.     

How does discharge status impact suicide risk in military veterans?

Little is known about over 125,000 veterans who received non-honorable military discharges since 2001, even though these veterans face substantial barriers to obtaining services and are likely to be at high risk for negative mental and behavioral health outcomes including suicide. Seven-hundred twenty-two veterans living the in the San Francisco Bay Area participated in the study. The sample comprised honorably discharged (n = 508) and non-honorably discharged veterans (n = 214). T-tests were used to compare means on predictors of suicide risk including Posttraumatic Stress Disorder (PTSD), depression, alcohol use, somatic symptoms, and physical disability. A series of regression models tested relationships between predictors, discharge status, and suicide risk. Non-honorably discharged veterans demonstrated higher mean scores than honorably discharged veterans on all predictors. In regression models, somatic symptoms (β = 0.22, p < 0.001), physical disability (β = 0.16, p < 0.05), and discharge status (β = 0.33, p < 0.001) were associated with suicide risk. The final model showed an interaction effect for discharge status on the relationship between somatic symptoms and suicide risk (β = 0.16, p < 0.05). Non-honorably discharged veterans showed higher rates of mental and physical health problems and suicide risk compared to honorably discharged veterans. The magnitude of the relationship between somatic symptoms and suicide risk was significantly greater in non-honorably discharged veterans.     

Kinship structure and suicide: a theoretical link

L'état du mariage diminuent le risque q'uon se suicide; spécialment c 'est vrai avec les hommes. Nous proposons que la rôle particuliere des femmes en maintenant la sociabilité et les obligations avec les parents explique cet fait. Cette explication s' accorde avec les théories de la parenté et du suicide.
La proportion du suicide q'uest enregistrée dans toute la Canada pendant les années 1951,1956,1961,1966, et 1971 révélent cet effet être la même chose durant tous les années. Les comparisons préliminaire entre des Canadiens anglais et français et entre des societées matrilinéal et patrilinéal s' accordent aussi avec les théories que nous présen-tons ici.
Marriage lowers the risk of suicide for men more than it does for women. It is proposed that the particular role of women in maintaining both normative and interactive integration of kinship systems on behalf of men best accounts for this particular finding. Such an explanation is compatible with existing theories of both kinship and suicide.
Rates of reported suicide for all Canada for the years 1951,1956,1961,1966, and 1971 were used to show that the extra protection of men is consistent through time, and the theoretical explanation offered was shown to receive support from a preliminary comparison of suicide rates in English and French Canada, in which kinship structure differs, as well as from suicide rates in matrilineal and patrilineal societies.     

Gambling as an emerging health problem on campus

OBJECTIVE: The authors documented the prevalence of gambling and correlates to health among undergraduates. METHODS: The authors analyzed data from a health-habit questionnaire (gambling questions included) given to students enrolled in a university-required course. RESULTS: Gambling and problems with gambling were more frequent among men than women regardless of venue. Athletes more frequently bet on sports and played games of chance, had gambling debt, and sought help for gambling than did nonathletes. More than 50% of fraternity members gambled and had a higher prevalence of gambling debt than did other men. Several gambling practices were correlated with failure to use seatbelts, driving or riding with someone under the influence, and using drugs (including cigarettes). Twice as many students who had gambling problems reported considering or attempting suicide than did those who did not report gambling problems, and gambling was correlated with depression. CONCLUSION: These results indicate that gambling is correlated with high-risk health behaviors and indicates the need for intervention for college students with gambling problems.     

Women Who Have Taken Their Lives Back from Compulsive Gambling: Results from an Online Survey

ABSTRACT

Although up to half of all gamblers and at least one-third of all problem gamblers are women in the United States, they are underrepresented and overlooked in research studies, treatment, and in the minds of the American public. This paper describes the results of an online survey of women in recovery from compulsive gambling, including demographics, family history, gambling activities, and consequences, and recovery patterns. The results indicate that the primarily white, middle-class, and professional women who responded (N = 178) experienced a high rate of co-occurring substance abuse and depression, troubled family histories, and an array of serious consequences to their gambling. Recovery was primarily supported through Gamblers Anonymous (GA), although 24% recovered without professional or GA help. Their experiences present a compelling case for professional helpers to become informed about this growing problem.     

A Case Series of 44 Completed Gambling-Related Suicides

This paper presents an analysis of 44 case records of suicide occurring between 1990 and 1997 in the State of Victoria, Australia, in which the State Coroner identified the presence of a putative gambling problem. Analysis of demographic data revealed that the majority of suicidal gamblers were male with a mean age of 40 years with 84% of the sample being either unemployed or from lower socioeconomic backgrounds. The most common method of suicide was carbon monoxide poisoning. A quarter of the victims left a suicide note. Evidence was found indicating that almost a third (31.8%) of cases had previously attempted suicide and one in four had sought some form of mental health assistance for their gambling problem. A number of putative risk factors were identified including comorbid depression, large financial debts and relationship difficulties. The relationship between crime, suicide and gambling and gender differences among suicidal gamblers was also examined. The authors conclude that further research is required to substantiate these initial findings which are based on retrospective accounts and secondary sources of evidence.