Journal of mood and anxiety disorders最新文献

{"title":"Predicting OCD severity from religiosity and personality: A machine learning and neural network approach","authors":"Brian A. Zaboski ,&nbsp;Alixandra Wilens ,&nbsp;Joseph P.H. McNamara ,&nbsp;Gregory N. Muller","doi":"10.1016/j.xjmad.2024.100089","DOIUrl":"10.1016/j.xjmad.2024.100089","url":null,"abstract":"<div><div>Obsessive-compulsive disorder (OCD) affects a significant portion of the United States population. The present study investigated the complex relationships among OCD severity, personality traits, religiosity, and spirituality with a dataset of 229 participants. We applied advanced machine and deep learning techniques to identify key predictors of OCD severity, uncovering nuanced relationships and unexpected findings. Notably, item-level features were more influential than aggregate scores, challenging traditional analytical approaches. Moreover, a neural network model, despite not surpassing a linear regression in predictive accuracy, provided a more comprehensive understanding of OCD’s heterogeneity and of the nonlinear relationships between our variables. The inclusion of demographic factors provided further explanatory power for predicting OCD severity, emphasizing the multifaceted nature of the disorder. Our results show that machine learning models can nearly match traditional linear models in predictive power while retaining nonlinear relationships essential to understanding OCD. Our study advocates for the adoption of sophisticated predictive models in examining complex psychological phenomena, encouraging a reevaluation of conventional analytical approaches when prediction is central to research questions.</div></div>","PeriodicalId":73841,"journal":{"name":"Journal of mood and anxiety disorders","volume":"8 ","pages":"Article 100089"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142416793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eye-tracking measurement of attention bias to social threat among youth: A replication and extension study","authors":"Meghan E. Byrne ,&nbsp;Sara Kirschner ,&nbsp;Anita Harrewijn ,&nbsp;Rany Abend ,&nbsp;Amit Lazarov ,&nbsp;Lucrezia Liuzzi ,&nbsp;Katharina Kircanski ,&nbsp;Simone P. Haller ,&nbsp;Yair Bar-Haim ,&nbsp;Daniel S. Pine","doi":"10.1016/j.xjmad.2024.100075","DOIUrl":"https://doi.org/10.1016/j.xjmad.2024.100075","url":null,"abstract":"<div><p>Attentional bias to social threat cues has been linked to heightened anxiety and irritability in youth. Yet, inconsistent methodology has limited replication and led to mixed findings. The current study aims to 1) replicate and extend two previous pediatric studies demonstrating a relationship between negative affectivity and attentional bias to social threat and 2) examine the test-retest reliability of an eye-tracking paradigm among a subsample of youth. Attention allocation to negative versus non-negative emotional faces was measured using a free-viewing eye-tracking task among youth (<em>N =</em> 185 total, 60 % female, <em>M</em>_age = 13.10 years, <em>SD</em>_age = 2.77) with three face-pair conditions: happy-angry, neutral-disgust, sad-happy. Replicating procedures of two previous studies, linear mixed-effects models compared attention bias between children with anxiety disorders and healthy controls. Bifactor analysis was used to parse shared versus unique facets of general negative affectivity (i.e., anxiety, irritability), which were then examined in relation to attention bias. Test-retest reliability of the bias-index was estimated among a subsample of youth (<em>N</em> = 36). No significant differences in attention allocation or bias emerged between anxiety and healthy control groups. While general negative affectivity across the sample was not associated with attention bias, there was a positive relationship for anxiety and irritability on duration of attention allocation toward negative faces. Test-retest reliability for attention bias was moderate (<em>r</em> = 0.50, <em>p</em> &lt; .01). While anxiety-related findings from the two previous studies were not replicated, the relationship between attention bias and facets of negative affect suggests a potential target for treatment. Evidence for test-retest reliability encourages future use of the eye-tracking task for researchers.</p></div>","PeriodicalId":73841,"journal":{"name":"Journal of mood and anxiety disorders","volume":"8 ","pages":"Article 100075"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950004424000294/pdfft?md5=1b7e7c53ad07458570fd3c413efa2d7e&pid=1-s2.0-S2950004424000294-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141434249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depressive symptoms and suicidal ideation in sexual minority adolescents: An examination of social reward responsiveness and support as moderators","authors":"Yinru Long ,&nbsp;Samantha Pegg ,&nbsp;Christian A.L. Bean ,&nbsp;Andrew Kittleson ,&nbsp;Kirsty Clark ,&nbsp;Autumn Kujawa","doi":"10.1016/j.xjmad.2024.100090","DOIUrl":"10.1016/j.xjmad.2024.100090","url":null,"abstract":"<div><div>Sexual minority (SM) youth are at increased risk of depression and suicidal ideation (SI), due in part to discrimination and other stressors. This raises questions about social factors that may increase risk or resilience to stressors commonly faced by SM youth. The goal of this multimethod study was to examine both neural processing of social feedback and perceived social support as potential moderators of the association between SM identity, depressive symptoms, and endorsement of SI in adolescents. For this study, 165 adolescents aged 14–17 (22.42 % identifying as SM) were oversampled for current depression. Participants self-reported social support, depressive symptoms, and SI. Electroencephalogram (EEG) was recorded while participants completed a computerized peer interaction task in which the reward positivity (RewP) component was measured in response to social acceptance vs. rejection feedback. We tested social RewP and social support as moderators of associations between SM identity, depressive symptoms, and whether SI was reported. SM youth reported lower social support and elevated depressive symptoms and were more likely to endorse SI compared to non-SM youth. Social RewP moderated the associations between SM identity, depressive symptoms, and SI such that SM youth with blunted neural responses to social acceptance had higher depression and were more likely to endorse SI. Lower social support was associated with greater depressive symptoms and SI, but social support was not a significant moderator of the association between SM identity and symptoms. This is among the first studies to use affective neuroscience methods to examine social processes in SGM youth and our findings underscore the role of social factors in SGM youth mental health.</div></div>","PeriodicalId":73841,"journal":{"name":"Journal of mood and anxiety disorders","volume":"8 ","pages":"Article 100090"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the relationship between emotion regulation, sleep quality, and anxiety disorder diagnosis","authors":"Bryana L. Schantz ,&nbsp;Emma R. Toner ,&nbsp;Mackenzie L. Brown ,&nbsp;Nikki Kaiser ,&nbsp;Alan Chen ,&nbsp;Samrachana Adhikari ,&nbsp;Susanne S. Hoeppner ,&nbsp;Eric Bui ,&nbsp;Naomi M. Simon ,&nbsp;Kristin L. Szuhany","doi":"10.1016/j.xjmad.2024.100072","DOIUrl":"https://doi.org/10.1016/j.xjmad.2024.100072","url":null,"abstract":"<div><p>Anxiety disorders are highly comorbid with sleep disturbance and have also been associated with deficits in emotion regulation, the ability to control and express emotions. However, the extent to which specific dimensions of sleep disturbance and emotion regulation are associated with anxiety diagnosis is not well-explored. This study examined dimensions of emotion regulation and sleep disturbance that may predict greater likelihood of anxiety diagnosis using novel machine learning techniques. Participants (Mean(SD) age= 28.6(11.3) years, 62.7% female) with primary anxiety disorders (n = 257), including generalized anxiety disorder (n = 122) and social anxiety disorder (n = 135), and healthy controls (n = 89) completed the Difficulties in Emotion Regulation Scale and Pittsburgh Sleep Quality Index. A conditional inference tree was fit to classify likelihood of current anxiety diagnosis based on predictors. The best model fit included 4 split nodes and 5 terminal nodes. Worse scores on two emotion regulation subscales, strategies directed to manage negative emotions and nonacceptance of negative emotions, were the best predictors of current anxiety diagnosis (99.3% probability of diagnosis). For those with better emotion regulation, poor sleep quality and worse daytime functioning due to sleep were important predictors of anxiety diagnosis. Good emotion regulation and non-disturbed sleep predicted high likelihood of being a non-psychiatric control (88.2%). Limitations include cross-sectional design precluding designating directionality of effects of sleep and emotion regulation on anxiety onset; limited sample size; and self-reported sleep. Facets of emotion regulation and sleep disturbance may be important early targets for brief intervention for anxiety disorders.</p></div>","PeriodicalId":73841,"journal":{"name":"Journal of mood and anxiety disorders","volume":"8 ","pages":"Article 100072"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950004424000269/pdfft?md5=68381e0495e02dde6359991ed2fca936&pid=1-s2.0-S2950004424000269-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140900996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of mindfulness-based cognitive therapy on PTSD and depression symptoms in trauma-exposed black adults: Pilot randomized controlled trial results","authors":"Malin Au ,&nbsp;Rebecca Lipschutz ,&nbsp;Yara Mekawi ,&nbsp;Emma C. Lathan ,&nbsp;H. Drew Dixon ,&nbsp;Sierra Carter ,&nbsp;Rebecca Hinrichs ,&nbsp;Bekh Bradley ,&nbsp;Nadine J. Kaslow ,&nbsp;Nicole R. Nugent ,&nbsp;Abigail Powers","doi":"10.1016/j.xjmad.2024.100092","DOIUrl":"10.1016/j.xjmad.2024.100092","url":null,"abstract":"<div><div>Low-income, urban-dwelling Black adults are disproportionately affected by traumatic experiences, posttraumatic stress disorder (PTSD), and depression and encounter inequities in treatment access. In addition to the benefits Mindfulness-Based Cognitive Therapy (MBCT) for depression, there is preliminary evidence of successful symptom reduction in PTSD via MBCT across two prior pilot studies in veterans. Studies examining the effects of MBCT among trauma-exposed Black adults remains limited, and examination of effects across specific PTSD clusters is almost nonexistent. We examined the preliminary efficacy of adapted MBCT versus waitlist control (WLC) on PTSD and depression symptoms in a pilot randomized controlled trial (RCT). Black adults (<em>N</em> = 80; 86.10 % women) with repeated trauma exposure, who screened positive for PTSD and depression, were recruited from an urban public hospital and randomized to 8-week adapted MBCT or WLC. Symptoms were measured pretreatment and posttreatment with the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) and the Beck Depression Inventory-II (BDI-II). Mixed model analyses were conducted with an intent-to-treat approach, examining change in PTSD and depression scores between MBCT and WLC over time. There was no significant difference in total PTSD and depression symptom change between MBCT and WLC. CAPS-5 avoidance symptoms showed a nominally significant decrease in the MBCT group (<em>F</em>[1, 68.10] = 5.98, <em>p</em> = .017; <em>t</em>[71.60] = 3.61, <em>p</em> &lt; .001). Findings suggest MBCT might be helpful for addressing avoidance symptoms among Black adults with comorbid PTSD and depression. Although lacking power to draw final conclusions about treatment efficacy, this study provides preliminary data suggesting the importance of future fully powered trials.</div></div>","PeriodicalId":73841,"journal":{"name":"Journal of mood and anxiety disorders","volume":"8 ","pages":"Article 100092"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142654777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between prescriber practices and major depression treatment outcomes","authors":"Sarah Rathnam ,&nbsp;Abhishek Sharma ,&nbsp;Kamber L. Hart ,&nbsp;Pilar F. Verhaak ,&nbsp;Thomas H. McCoy ,&nbsp;Roy H. Perlis ,&nbsp;Finale Doshi-Velez","doi":"10.1016/j.xjmad.2024.100080","DOIUrl":"10.1016/j.xjmad.2024.100080","url":null,"abstract":"<div><p>Practice variability may represent an opportunity to improve care by identifying the differences in outcomes associated with differences in practice. To characterize differences in depression treatment outcomes among individual providers in outpatient psychiatry practices and primary care practices, we examined a longitudinal cohort derived from outpatient electronic health records from two academic medical centers and six community hospitals in Eastern Massachusetts. This cohort included antidepressant-treated individuals with an ICD-9/10 diagnosis of major depressive disorder, and deidentified health care providers treating at least 10 such patients per year between 2008 and 2022. We examined the association between individual provider prescribing characteristics and proportions of treated patients who do not follow up after initial antidepressant prescription or who achieve a stable ongoing prescription. In binomial regression models, among 104 psychiatrists, greater heterogeneity in antidepressant prescribing and lesser proportion of serotonin reuptake inhibitors (SSRIs)¹ prescribed were associated with greater rates of achieving stability (for heterogeneity, adjusted odds ratio AOR, 1.55 [95 % CI, 1.22 – 2.06]; for proportion of SSRIs, AOR, 0.01 [95 % CI, 0.00–0.59]). Among 369 primary care physicians, greater volume of depression encounters per year, but not prescribing heterogeneity, was associated with greater rates of achieving stability (for encounters, AOR, 2.15 [95 % CI, 1.61 – 2.89]; for heterogeneity, AOR, 0.99 [95 % CI, 0.85 – 1.15]). Primary care and psychiatry predictors are not the same and therefore suggest potentially distinct strategies to improve clinical outcomes in each setting. <strong>Trial Registration</strong>: N/A</p></div>","PeriodicalId":73841,"journal":{"name":"Journal of mood and anxiety disorders","volume":"8 ","pages":"Article 100080"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950004424000348/pdfft?md5=7f358efa07edf57de3e43d7cdb14a667&pid=1-s2.0-S2950004424000348-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141963825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “North American open-label 16-week trial of the MindShift smartphone app for adult anxiety” [J Mood Anxiety Disord 4C (2023) 100036]","authors":"Lance M. Rappaport ,&nbsp;Emily Jerome ,&nbsp;Michael Van Ameringen ,&nbsp;Maureen Whittal ,&nbsp;Carmen P. McLean","doi":"10.1016/j.xjmad.2024.100093","DOIUrl":"10.1016/j.xjmad.2024.100093","url":null,"abstract":"","PeriodicalId":73841,"journal":{"name":"Journal of mood and anxiety disorders","volume":"8 ","pages":"Article 100093"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143097365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing in-session rumination during CBT for depression: Replication and further evaluation of an observational measure","authors":"J.C. Kennedy ,&nbsp;B.W. Dunlop ,&nbsp;S.E. Baldwin ,&nbsp;C.J. Liu ,&nbsp;H.S. Mayberg ,&nbsp;W.E. Craighead","doi":"10.1016/j.xjmad.2024.100060","DOIUrl":"10.1016/j.xjmad.2024.100060","url":null,"abstract":"<div><p>This study sought to further evaluate an observational measure of rumination that occurs during psychotherapy (i.e., in-session rumination). Specifically, the study aimed to replicate the reliability of an observational rating procedure in new therapy sessions and a new sample, clarify the relationship between in-session rumination and depressive symptoms, and evaluate for the first time the relationship between in-session rumination and self-reported rumination. A team of trained research assistants produced observational ratings of in-session rumination occurring during video-taped sessions of CBT from two separate treatment studies. Thirty-five patients with major depressive disorder (MDD) from one study had their final session rated, and 17 patients with MDD from another study had their first session rated. Results showed that the observational ratings were reliable, and that in-session rumination generally correlated with depressive symptom severity as expected, with higher in-session rumination predicting higher depressive symptom levels both cross-sectionally and longitudinally. Preliminary evidence also found that in-session rumination correlated with self-reported rumination, and exploratory analyses provided preliminary evidence supporting the incremental validity of in-session rumination for predicting depression severity after treatment. The results indicate that in-session rumination can be reliably identified during CBT sessions and consistently predicts higher depressive severity, both of which support efforts to develop treatments that specifically target rumination.</p></div>","PeriodicalId":73841,"journal":{"name":"Journal of mood and anxiety disorders","volume":"7 ","pages":"Article 100060"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950004424000142/pdfft?md5=3276c6e51d2c0e72c230a96edef924aa&pid=1-s2.0-S2950004424000142-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140087560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between experiences of discrimination, anxiety, and mood symptoms in Black women: Investigating the mediating role of attentional control","authors":"Courtney C. Louis ,&nbsp;NiCole T. Buchanan ,&nbsp;Jason S. Moser","doi":"10.1016/j.xjmad.2024.100070","DOIUrl":"https://doi.org/10.1016/j.xjmad.2024.100070","url":null,"abstract":"<div><p>A recent study found that attentional control is a key mechanism that accounts for the association between discriminatory experiences and health outcomes in Black women. We replicate and extend this finding by testing the mediating role of attentional control in the association between discrimination and symptoms of anxiety and depression symptoms. A total of 128 Black women completed an online survey that assessed experiences of discrimination, anxiety, depression and attentional control. Three models were conducted to examine associations between experiences of discrimination and three outcomes (worry, anxious arousal, and anhedonic depression), and whether attentional control mediated these effects. Our findings revealed that more frequent discrimination predicted less attentional control and heightened anxiety symptoms. In support of our hypotheses, we found that attentional control mediated the association between discrimination and anxious arousal and anhedonic depression. Attentional control did not mediate the association between experiences of discrimination and worry, however. Our findings dovetail with previous research suggesting that experiences of discrimination tax prefrontal regions associated with attentional control and could be a pathway that leads to somatic anxiety and depression. Our findings also amplify the need to assess experiences of discrimination in therapeutic assessment and intervention with Black women.</p></div>","PeriodicalId":73841,"journal":{"name":"Journal of mood and anxiety disorders","volume":"7 ","pages":"Article 100070"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950004424000245/pdfft?md5=a49a327ac352df4f87be89943e064087&pid=1-s2.0-S2950004424000245-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140645951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suicide without warning: Results from the Army Study to Assess Risk and Resilience in Servicemembers (STARRS)","authors":"Catherine L. Dempsey ,&nbsp;Jingning Ao ,&nbsp;Matthew W. Georg ,&nbsp;Pablo A. Aliaga ,&nbsp;David A. Brent ,&nbsp;David M. Benedek ,&nbsp;Kelly L. Zuromski ,&nbsp;Matthew K. Nock ,&nbsp;Steven G. Heeringa ,&nbsp;Ronald C. Kessler ,&nbsp;Murray B. Stein ,&nbsp;Robert J. Ursano","doi":"10.1016/j.xjmad.2024.100064","DOIUrl":"10.1016/j.xjmad.2024.100064","url":null,"abstract":"<div><h3>Objectives</h3><p>The rate of suicide increased in members of the United States Army since 2011 after the Iraq and Afghanistan wars and continues to be a major concern. In order to reverse this disturbing trend, it is vital to understand the risk and protective factors for suicide death in servicemembers.</p></div><div><h3>Methods</h3><p>Data were obtained from a case-control psychological autopsy study, which compared U.S. Army suicide decedent cases (n = 135) to a probability sample of living controls (n = 255) who are also service members weighted to be representative of the Army. Interviews were conducted with next-of-kin (NOK) and supervisor (SUP) informants. Multivariable logistic regressions models were constructed using predictors significant after controlling for multiple comparisons.</p></div><div><h3>Results</h3><p>The most parsimonious multivariable model controlling for deployment status, as reported by SUP predicting suicide death consisted of four significant variables: a spouse or partner left him or her in the past month (OR = 28.5 [95% CI = 1.8, 442.7] χ² = 5.72, <em>p</em> = .0168); a smaller social network (OR = 4.2 [95% CI = 1.0, 17.3] χ² = 3.97, <em>p</em> = .0462), less likely to seek help from a mental health counselor (OR = 3.4 [95% CI = 1.2, 9.7] χ² = 5.35, <em>p</em> = .0207) and more likely to be described as incautious (OR = 3.8 [95% CI = 1.2, 11.7] χ² = 5.42, <em>p</em> = .0199). The AUC = .88 [95%CI = 0.82, 0.94] for this regression model suggests strong prediction.</p></div><div><h3>Conclusions</h3><p>Our findings suggest that recent relationship problems, especially in soldiers who are less likely to seek out support from others, may be warning signs for detection and prevention of imminent risk of suicide and according to supervisor informant surveys, had neither evidence of a mental health disorder, nor disclosed suicidal ideation or self-harm. Implications for suicide prevention are discussed.</p></div>","PeriodicalId":73841,"journal":{"name":"Journal of mood and anxiety disorders","volume":"7 ","pages":"Article 100064"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S295000442400018X/pdfft?md5=5d8332cbaf9f1926576b2e3d2357881d&pid=1-s2.0-S295000442400018X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140270739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}