Sex differences in suicidal ideation in a community sample from China

In a large sample of over 4,000 Chinese residents in the Wuling and Sino-Vietnamese border regions of China, females had a higher incidence of ever wishing that they were dead. This sex difference was found regardless of marital status, age, and occupation.     

The measurement of suicidal ideation

A four-item suicidal ideation subscale of the GHQ-28 has been used previously to assess suicidal ideation on the basis of its face validity. In order to further validate its use, this study compared scores on this scale with scores on a well-established suicidal intent scale. There was a significant correlation between scores of that subscale and the self-report component as well as the overall score of the suicidal intent scale, thereby confirming its validity in providing a standardized method for comparing suicidal ideation in different populations.     

Anguish and despair in adolescents with eating disorders--helping to manage suicidal ideation and impulses

Adolescents struggling against anorexia nervosa or bulimia nervosa often experience self-punishing thoughts and behaviors, including self-mutilation, and suicidal ideation and attempts. These arise out of the profound anguish and despair frequently experienced by these young people. This paper outlines four particularly salient clinical themes underlying this despair that have significant implications for treatment. A practice perspective is discussed which emphasizes empathic listening and the development of a strong therapeutic alliance with the adolescent. Treatment recommendations draw from narrative theory and practice, and from feminist perspectives. The paper also draws on cognitive therapy and on recent developments in the areas of spirituality and motivational enhancement. Involving the distressed adolescent's family is also addressed.     

Therapeutic mechanisms of suicidal ideation: the influence of changes in automatic thoughts and immature defenses

The treatment processes associated with reduced suicidal ideation have received little research attention. This study evaluates the influence on suicidal ideation of theory-based intrapsychic processes: maladaptive cognition and defensive style. Thirty-three community mental health patients completed questionnaires at two time points. Decreases in automatic thoughts were a strong correlate of decreased suicidal ideation, and decreases in immature defenses were a moderate strength correlate. These relationships remained significant even when controlling for initial level of depression. The theorized mechanisms of cognitive-behavioral and psychodynamic therapy had the expected effects on suicidal ideation. The strong association of decreased maladaptive cognitions with decreased suicidal ideation supports further development of cognitive-behavioral suicide interventions and clinical use of cognitive interventions. Psychodynamic processes in suicidal ideation and behavior warrant further exploration.     

Elevated rates of suicidal behavior in gay, lesbian, and bisexual youth

Both clinical and epidemiological literature point to elevated rates of suicidal behaviors in gay, lesbian, and bisexual youth (GLBY). Recent North American and New Zealand studies of large populations (especially the US Youth Risk Behavior Surveys from several states) indicate that gay, lesbian, and bisexual adolescents (males in particular) can have rates of serious suicide attempts at least four times those of apparently heterosexual youth. There are various reasons why this figure is likely to be an underestimate. Reasons for these elevated rates of suicidal behavior include a climate of homophobic persecution in schools, and sometimes in family and community--values and actions that stigmatize homosexuality and that the youth who has not yet "come out" has to endure in silence.     

Risk of suicide ideation associated with problem-solving ability and attitudes toward suicidal behavior in university students

The present paper investigates the risk of lifetime suicide ideation associated with problem-solving ability and attitudes toward suicidal behavior in a sample of 328 university students (41% male, 59% female). The response rate was 77% based on the total number of students registered for the relevant courses. A series of questions assessed lifetime suicide ideation, while problem solving and attitudes toward suicide were measured using the Self-Rating Problem Solving scale and four subscales of the Suicide Opinion Questionnaire, respectively (McLeavey, 1986; Domino et al., 1989). Almost one-third of the students surveyed had lifetime suicide ideation. Both genders were similar in terms of their suicide ideation history, problem solving, and attitudes toward suicidal behavior with the exception that male students were more in agreement with the attitude that suicidal behavior lacks real intent. Compared with 2% of nonideators and ideators, one in four planners reported that they would more than likely attempt suicide at some point in their life. Greater agreement with the attitude that suicidal behavior is normal was associated with significantly increased risk of being an ideator, as was poor problem solving and less agreement with the attitude that suicidal behavior is associated with mental illness.     

Suicidal ideation and suicide attempts among Australian adults

Too little is known about suicidal thoughts and behaviors at a population level to recommend appropriate preventive strategies. Using data from the Australian National Survey of Mental Health and Wellbeing (NSMHWB), this study examined rates of, and risk factors for, suicidal ideation and suicide attempts. For 10,641 respondents, the 12-month and lifetime cumulative incidence rates of suicidal ideation were 3.4% and 16.0%, respectively; the 12-month and lifetime cumulative incidence rates of suicide attempts were 0.4% and 3.6%, respectively. 12-month ideation was associated with anxiety disorders (relative risk ratio [RRR] = 3.51; population attributable risk percent [PAR%] = 19.6%), affective disorders (RRR = 11.94; PAR% = 38.8%) and substance abuse disorders (RRR = 1.85; PAR% = 6.1%). Attempts in the past 12 months were also associated with anxiety disorders (RRR = 7.06; PAR% = 37.0%), affective disorders (RRR = 12.24; PAR% = 39.5%), and substance abuse disorders (RRR = 2.09; PAR% = 7.7%). Age, marital status, and disability were associated with ideation; marital status and employment status with attempts. Approximately 12% of ideators in the sample progressed to making an attempt; employment status was the only significant predictor. Reducing suicidal ideation and attempts requires a multi-faceted approach that targets those with mental illness but also adopts population-based strategies that address other factors, such as unemployment.     

Outcome of suicidal ideation and behavior in a young, help-seeking population over a 2-year period

Suicidal behavior is associated with negative outcomes, including completed suicide. This study examined the prevalence of suicidal behavior in a sample of referrals to a youth psychiatric service and investigated the stability of suicidality over 2 years. Of the 140 people (mean age 17.8) who were referred to a youth psychiatric service, 82 who were accepted for treatment (RA group) and 58 who were not accepted (RNA group) were assessed; 57% reported considering suicide and 39% reported attempting suicide in the 12 months prior to referral. Participants who reported suicidal ideation were significantly more likely than nonsuicidal participants to have multiple Axis I diagnoses and lower levels of functioning. At the 2-year follow-up there was a significant reduction in suicidality in the RA group, but not in the RNA group. In conclusion, suicidality is prevalent among young people referred to psychiatric services. Even brief contact with services results in a reduction in suicidality over 2 years.     

The relationship between psychological buffers, hopelessness, and suicidal ideation: identification of protective factors

In this study we examined the role of psychological buffers (life satisfaction, self-esteem, perception of family cohesion, and perception of social support) in the development of hopelessness and suicidal ideation. The participants were 314 university students, 71 males and 243 females, who were asked to complete a battery of instruments measuring the psychological buffers mentioned above. The results of a set of hierarchical multiple regression analyses suggested that life satisfaction and self-esteem are independent predictors of lower levels of hopelessness, while perception of social support seems to be the major predictor of lower levels of suicidal ideation independent of depression and hopelessness severity. Thus, hopelessness seems to be minimized by the level of life satisfaction and level of self-esteem exhibited by the individuals, while the key factor to the mitigation of suicidal ideas seems to be perception of social support.     

Familial study of suicidal behavior among adolescents in Slovenia

The number of adolescents who attempt or complete suicide is increasing. Risk factors range from mental disorders, to problems at school, family problems, or difficulties in establishing relationships. A further important, and too often underestimated, risk factor for adolescent suicide is the presence of suicidal behavior in the adolescent's family. We investigated 184 high school adolescents in a region in Slovenia with a high suicide rate (30/100,000/year). They were questioned by means of an anonymous questionnaire about the presence of suicidal behavior in their relatives and about the presence of suicidal thoughts, plans, and acts in themselves. The results revealed that 13% of the adolescents studied had a relative who had attempted suicide and a further 9% of the adolescents had lost a relative due to suicide. About half of all females and almost a third of males had had suicidal thoughts (differences between sexes were statistically significant: chi2 = 6.13; p < .01). Attempted suicide among relatives was positively correlated with the presence of suicidal plans among adolescents (phi = 0.15; p < .05). This correlation proved to be even stronger and statistically more significant in men when we split the sample by gender. All variables (suicidal thoughts, suicidal plans, and suicide attempts) in the adolescent males positively correlated with attempted suicide among their relatives ((phi = 0.28, p < .01; phi) = 0.26, p < .05; phi = 0.34, p < .01; respectively). Our results speak in favor of a higher risk of suicidal behavior among adolescents with suicidal behavior in their families.     

社会失范与青少年道德教育困境

本文以个体社会化的研究视角,分析了目前与青少年道德教育困境密切联系的三种社会失范现象,即权威失范、社会主导价值混乱和角色失范,并试图找出三种社会失范现象与青少年道德发展的内在依存关系。在此基础上,笔者提出了如何应对三种社会失范的一些浅见。     

Suicidal ideation and self-determination in institutionalized elderly

The right to self-determination is central to the current debate on rational suicide in old age. The goal of this exploratory study was to assess the presence of self-determination in suicidal institutionalized elderly persons. Eleven elderly persons with serious suicidal ideations were matched according to age, sex, and civil status with 11 nonsuicidal persons. The results indicated that suicidal persons did not differ from nonsuicidal persons in level of self-determination. There was, however, a significant difference between groups on the social subscale. Suicidal elderly persons did not seem to take others into account when making a decision or taking action. The results are discussed from a suicide-prevention perspective.