{"title":"Do Positive Gatekeeper Training Outcomes Predict Gatekeeper Intervention Behaviours?","authors":"Glenn Holmes, Amanda Clacy, Anita Hamilton, Kairi Kõlves","doi":"10.1080/13811118.2025.2469882","DOIUrl":"https://doi.org/10.1080/13811118.2025.2469882","url":null,"abstract":"<p><strong>Objective: </strong>Evidence for Gatekeeper Training (GKT) has shown that training outcomes are generally maintained at follow-up. Research on how improvements in GKT outcomes translate to intervention behavior is inconclusive, and some studies show that despite significant positive effects on GKT outcomes, there is no effect on GK behaviors.</p><p><strong>Method: </strong>A non-experimental pre-post and follow-up survey design was used with a sample of 60 participants who voluntarily completed one of 12 half-day (4-hour) GKT sessions. Path Analysis was applied to pre- and post-intervention training outcomes, and a third model assessed the behavioral effect of the change in participant scores from pre- to post.</p><p><strong>Results: </strong>Suicide prevention knowledge retained by participants at 6-months after GKT was predictive of increased GK behavior in the 6-months following GKT. Knowledge at follow-up was the only significant predictor of behavior (<i>p</i> < .05), no other regression pathways were significant.</p><p><strong>Conclusions: </strong>Gatekeeper preparedness, efficacy, and reluctance outcomes were not predictive of GK behavior. The findings of this study represent a lack of understanding regarding how the specific aims of GKT are translated into intervention behavior to identify, intervene, support, and refer potentially at-risk individuals.</p>","PeriodicalId":8325,"journal":{"name":"Archives of Suicide Research","volume":" ","pages":"1-14"},"PeriodicalIF":2.5,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jim Schmeckenbecher, Nestor D Kapusta, Christina Alma Emilian, Elmar Brähler, Victor Blüml, Jürgen Fuchshuber, Mareike Ernst
{"title":"Prevalence and Association of Suicidal Ideation and High Risk Drinking in Men and Women: Results from a Representative German Household Survey.","authors":"Jim Schmeckenbecher, Nestor D Kapusta, Christina Alma Emilian, Elmar Brähler, Victor Blüml, Jürgen Fuchshuber, Mareike Ernst","doi":"10.1080/13811118.2025.2464061","DOIUrl":"https://doi.org/10.1080/13811118.2025.2464061","url":null,"abstract":"<p><strong>Background: </strong>Alcohol abuse and suicide are significant public health problems. Specifically, more than three million people die each year from alcohol abuse and 700,000 from suicide. Research indicates that alcohol abuse is associated with suicidality, and that there are significant gender differences in both. By means of a large representative population sample, this study quantifies the associations between suicidal ideation and alcohol misuse in the German population.</p><p><strong>Methods: </strong>Based on a survey of 2,513 individuals from 2015, prevalence estimates and logistic regression models were used to estimate the association between suicidal ideation (i.e., past-year suicidal ideation according to the Suicidal Behavior Questionnaire Revised [SBQ-R] and alcohol consumption (i.e., past year high-risk drinking according to the Alcohol Use Disorders Identification Test [AUDIT-C]).</p><p><strong>Results: </strong>High-risk drinking (24.78%) and suicidal ideation (5.09%) were highly prevalent in this representative German population sample. These estimates differed significantly between men and women: Men were more likely to report high-risk drinking (30.14%) compared to women (20.56%), while a greater proportion of women (5.95%) reported suicidal ideation when compared to men (4.00%). Moreover, the association of suicidal ideation and high-risk drinking was weaker in women (OR = 1.64 CI 95% [1.03-2.62]) than in men (OR = 5.62 CI 95% [2.72-11.60]).</p><p><strong>Conclusion: </strong>The high prevalence of suicidal ideation and high-risk drinking in women and underscores the necessity for low-level interventions and public health initiatives aimed at prevention and intervention against the escalation of high-risk drinking and suicidal behavior. Prevention efforts should consider gender-specific patterns of risk.</p>","PeriodicalId":8325,"journal":{"name":"Archives of Suicide Research","volume":" ","pages":"1-13"},"PeriodicalIF":2.5,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Examining Trajectories of Momentary Affect Surrounding NSSI and Alcohol Use: A Network Analysis and Bayesian Approach.","authors":"Miguel Blacutt, Brooke A Ammerman","doi":"10.1080/13811118.2025.2462532","DOIUrl":"https://doi.org/10.1080/13811118.2025.2462532","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to identify specific affective antecedents of non-suicidal self-injury (NSSI) and alcohol use, and to examine affective trajectories before and after these behaviors.</p><p><strong>Method: </strong>Fifty-six undergraduates (71% female, 25% non-White, 20.2 ± 1.3 years old) meeting criteria for probable alcohol or substance use disorder participated in 28-days of ecological momentary assessment, completing four daily surveys assessing affect, self-punishment cognitions, and engagement in NSSI and alcohol use. Contemporaneous and time-lagged graphical vector autoregressive (GVAR) models were used to examine affect dynamics surrounding NSSI and alcohol use. Zero-inflated Bayesian binomial regression was used to investigate the relationship between momentary affect and likelihood of engaging in either NSSI or alcohol at the next prompt. Multilevel modeling was used to examine trajectories of affective states pre- and post-engagement in NSSI and alcohol use.</p><p><strong>Results: </strong>GVAR models revealed significant relationships between jitteriness and being afraid with next timepoint NSSI, and excitement with next timepoint alcohol use. Bayesian regression with horseshoe priors identified self-punishment and loneliness as predictors of NSSI. Moreover, Bayesian regression revealed that excitement predicted alcohol use among those without alcohol use disorder (AUD), while belongingness predicted alcohol use among those with AUD. Multilevel models revealed self-punishment and loneliness followed a negative quadratic trajectory around NSSI events. Excitement and belongingness did not relate to slopes of time.</p><p><strong>Conclusions: </strong>The findings suggest NSSI is used to reduce negative emotional states, whereas alcohol consumption initially enhances positive emotional states in individuals without an AUD and may be used to increase belongingness in those with an AUD.</p>","PeriodicalId":8325,"journal":{"name":"Archives of Suicide Research","volume":" ","pages":"1-19"},"PeriodicalIF":2.5,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Leslie B Adams, Aubrey DeVinney, Dahlia Aljuboori, Jasmin Brooks Stephens, Thomasina Watts, Benjamin Lê Cook, Sean Joe, Holly C Wilcox, Roland J Thorpe
{"title":"Investigating the Role of Racism in Black Men's Suicide: Revisiting the Interpersonal-Psychological Theory of Suicide.","authors":"Leslie B Adams, Aubrey DeVinney, Dahlia Aljuboori, Jasmin Brooks Stephens, Thomasina Watts, Benjamin Lê Cook, Sean Joe, Holly C Wilcox, Roland J Thorpe","doi":"10.1080/13811118.2025.2462528","DOIUrl":"https://doi.org/10.1080/13811118.2025.2462528","url":null,"abstract":"<p><strong>Objective: </strong>The Interpersonal-Psychological Theory of Suicide (IPTS) is a well-established framework to assess suicide risk, yet few studies have applied the framework to examine relevance and applicability to suicide phenomenology in Black American men. We address this gap by qualitatively exploring the suitability of the IPTS framework using a psychiatric sample of Black men.</p><p><strong>Method: </strong>We conducted semi-structured interviews with 15 Black adult men (Mean age = 32.1, min:18, max: 79) with a history of suicidal thoughts and behaviors (STBs). We conducted thematic analysis using an inductive and deductive coding approach using Dedoose v. 8.</p><p><strong>Results: </strong>Overall, IPTS constructs were represented in participant narratives. Thwarted belongingness emerged as the most prominent construct of the theory, followed by hopelessness, and suicide capability. Participants noted the role of racism in their STB from multiple levels, including internalized, interpersonal, and structural racism.</p><p><strong>Conclusions: </strong>Black men reported aspects of the Interpersonal Psychological Theory of Suicide (IPTS), notably experiences of social isolation, which were often attributed to racism. Our findings highlight the relative importance of certain IPTS constructs among Black men, namely the significance of thwarted belongingness and its relationship with social marginalization. Our findings identify future areas of expansion for the IPTS framework to capture broader sociocultural dynamics in racialized populations.</p>","PeriodicalId":8325,"journal":{"name":"Archives of Suicide Research","volume":" ","pages":"1-14"},"PeriodicalIF":2.5,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M Canal-Rivero, D Tordesillas-Gutiérrez, M Ruiz-Veguilla, V Ortiz-García de la Foz, E Marco de Lucas, R Romero-Garcia, J Vázquez-Bourgon, R Ayesa-Arriola, B Crespo-Facorro
{"title":"Suicidal Behaviour Prior to First Episode Psychosis: Wider and More Widespread Grey-Matter Alterations.","authors":"M Canal-Rivero, D Tordesillas-Gutiérrez, M Ruiz-Veguilla, V Ortiz-García de la Foz, E Marco de Lucas, R Romero-Garcia, J Vázquez-Bourgon, R Ayesa-Arriola, B Crespo-Facorro","doi":"10.1080/13811118.2025.2454581","DOIUrl":"https://doi.org/10.1080/13811118.2025.2454581","url":null,"abstract":"<p><strong>Introduction: </strong>The prodromal phase preceding the onset of First Episode Psychosis (FEP) is associated with an increased risk of Suicidal Behaviors (SBs). The aim of this study was to identify specific structural brain abnormalities linked to SBs that occur prior to the onset of FEP.</p><p><strong>Methods: </strong>Voxel-based morphometry analyses were used to investigate differences in brain Grey Matter (GM) volume using the CAT12 toolbox within SPM12. Covariates, including gender, age, handedness, intracranial volume, depression severity, and global cognitive functioning, were controlled for as confounding factors.</p><p><strong>Results: </strong>Significant reductions in GM were observed in the left superior temporal gyrus, dorsal posterior cingulate cortex, precuneus, cuneus, anterior cerebellum (p-FWE corrected < 0.05, <i>k</i> > 50) as well as in the right amygdala (0.96 ± 0.06 vs. 1.01 ± 0.05; F = 4.78; <i>p</i> < 0.05) and left amygdala (0.97 ± 0.06 vs. 1.02 ± 0.05; F = 8.97; <i>p</i> = 0.01).</p><p><strong>Conclusions: </strong>History of SB prior to the onset of the psychotic disorder was related to wider and more widespread brain GM alterations. The regions identified are involved in cognitive and emotional processes such as emotional regulation, social cognition, perseverative thinking, and pain tolerance. These findings suggest that structural brain abnormalities related to SB occurring before FEP onset may serve as early biomarkers for identifying individuals at increased risk of suicide.</p>","PeriodicalId":8325,"journal":{"name":"Archives of Suicide Research","volume":" ","pages":"1-15"},"PeriodicalIF":2.5,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sexual Fluidity and Suicidal Thoughts and Behaviors in Early and Middle Adulthood: Evidence From the National Longitudinal Study of Adolescent to Adult Health.","authors":"John F Gunn, Zoe Brown, James Ambron","doi":"10.1080/13811118.2024.2445244","DOIUrl":"10.1080/13811118.2024.2445244","url":null,"abstract":"<p><strong>Objective: </strong>The present study seeks to explore the relationship between sexual fluidity and suicidal thoughts (STs) and behaviors (STBs) among adults in early and middle adulthood.</p><p><strong>Methods: </strong>This study utilized data from Waves IV and V of the National Longitudinal Study of Adolescent to Adult Health (ADD Health). Participants were categorized into four groups: (1) heterosexual at both waves, (2) sexual minority (SM) at Wave IV but heterosexual at Wave V, (3) heterosexual at Wave IV and SM at Wave V, and (4) SM at Wave IV and Wave V.</p><p><strong>Results: </strong>Hierarchical logistic regression revealed that sexual fluidity between Waves IV and V was associated with STs. Those who were heterosexual-identifying at Wave IV but identified as an SM at Wave V were close to four times as likely to report STs at Wave V than were those who identified as heterosexual at both waves. Those who were an SM at Waves IV and V were almost twice as likely to report STs compared to those who were heterosexual at both waves. Additionally, <i>χ</i><sup>2</sup> results showed that suicide attempts (SAs) and sexual fluidity were associated. Similarly, SA prevalence was highest during periods in which participants identified as SMs.</p><p><strong>Conclusions: </strong>Transitioning into a sexually minoritized status is associated with increased risk of STBs, whereas transitioning into a nonminoritized status was not.</p>","PeriodicalId":8325,"journal":{"name":"Archives of Suicide Research","volume":" ","pages":"1-13"},"PeriodicalIF":2.5,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142919589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jessica Stubbing, David F Tolin, Kimberly S Sain, Kate Everhardt, M David Rudd, Gretchen J Diefenbach
{"title":"Borderline Personality Traits Do Not Moderate the Relationship Between Depression, Beliefs, and Suicidal Thoughts and Behaviors.","authors":"Jessica Stubbing, David F Tolin, Kimberly S Sain, Kate Everhardt, M David Rudd, Gretchen J Diefenbach","doi":"10.1080/13811118.2024.2345168","DOIUrl":"10.1080/13811118.2024.2345168","url":null,"abstract":"<p><p>Adults with clinically significant borderline personality disorder traits (BPTs) are at high risk of experiencing suicidal thoughts and behaviors (STBs). STBs among those with BPTs have been associated with suicidal beliefs (e.g., that one is unlovable or that distress is intolerable). However, the extent to which suicidal beliefs uniquely mediate the relationship between emotional distress and STBs among individuals with BPTs is not known. Individuals admitted to an inpatient unit (<i>N</i> = 198) with recent STBs completed assessments of BPTs, depression, suicidal beliefs, suicidal ideation, and suicide attempt history. Moderated mediation models were used to explore whether suicidal beliefs mediated the relationship between depression and STBs conditional on BPTs. Suicidal patients with versus without BPTs reported stronger suicidal beliefs and more severe STBs (i.e., suicidal ideation, lifetime attempts). Exploratory moderated mediation analysis demonstrated that suicidal beliefs mediated the relationship between depression and suicidal ideation as well as suicide attempts. The mediation effect of suicidal beliefs on the depression-ideation and depression-attempt relationship was not significantly moderated by BPTs. This study was cross-sectional and therefore the estimated mediation models must be considered exploratory. Longitudinal research will be needed to assess the potential causal mediation of suicidal beliefs on the relationship between depression and STBs. The results of this study suggest that suicidal beliefs may play a significant role in the relationship between depression and STBs for inpatients with a history of suicidality regardless of BPTs. This suggests suicidal beliefs may be an important treatment target for adults with a history of STBs.</p>","PeriodicalId":8325,"journal":{"name":"Archives of Suicide Research","volume":" ","pages":"223-237"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ragy R Girgis, Hannah Hesson, Gary Brucato, Jeffrey A Lieberman, Paul S Appelbaum, J John Mann
{"title":"Changes in Rates of Suicide by Mass Shooters, 1980-2019.","authors":"Ragy R Girgis, Hannah Hesson, Gary Brucato, Jeffrey A Lieberman, Paul S Appelbaum, J John Mann","doi":"10.1080/13811118.2024.2345166","DOIUrl":"10.1080/13811118.2024.2345166","url":null,"abstract":"<p><strong>Objective: </strong>The rate of worldwide mass shootings increased almost 400% over the last 40 years. About 30% are followed by the perpetrator's fatal or nonfatal suicide attempt.</p><p><strong>Method: </strong>We examined the rate of fatal and nonfatal attempts among 528 mass shooters over the last 40 years and their relationship to detected mental illness to better understand this specific context of suicide. We collected information on U.S.-based, personal-cause mass murders that involved one or more firearms, from online sources.</p><p><strong>Results: </strong>A greater proportion of mass shooters from 2000 to 2019 took or attempted to take their own lives (40.5%) compared with those from 1980 to 1999 (23.2%, <i>p</i> < 0.001). More than double the proportion of perpetrators who made a fatal or nonfatal suicide attempt had a history of non-psychotic psychiatric/neurologic symptoms (38.9%), compared with perpetrators who did not make a fatal or nonfatal suicide attempt (18.1%; <i>p</i> < 0.001). Among mass shooters who made fatal or nonfatal suicide attempts, 77 of 175 (44%) did not have any recorded psychiatric, neurologic, or substance use condition. Of the 98 mass shooters who made fatal or non-fatal suicide attempts and had a psychiatric, substance use, or neurologic condition, 41 had depressive disorders.</p><p><strong>Conclusion: </strong>It is possible that a lack of information about the perpetrators' mental health or suicidal ideation led to an underestimation of their prevalence. These data suggest that suicide associated with mass shootings may represent a specific context for suicide, and approaches such as psychological autopsy can help to ascertain when psychiatric illness mediates the relationship between mass shootings and suicide.</p>","PeriodicalId":8325,"journal":{"name":"Archives of Suicide Research","volume":" ","pages":"317-326"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141465856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ryan E Lawrence, Chaya Jaffe, Yinjun Zhao, Yuanjia Wang, Terry E Goldberg
{"title":"Clinical Trials Studying Suicide Risk Reduction: Who is Excluded From Participation.","authors":"Ryan E Lawrence, Chaya Jaffe, Yinjun Zhao, Yuanjia Wang, Terry E Goldberg","doi":"10.1080/13811118.2024.2322128","DOIUrl":"10.1080/13811118.2024.2322128","url":null,"abstract":"<p><strong>Objective: </strong>The use of exclusion criteria in clinical trials can cause research participants to differ markedly from clinical populations, which negatively impacts generalizability of results. This study identifies and quantifies common and recurring exclusion criteria in clinical trials studying suicide risk reduction, and estimates their impact on eligibility among a clinical sample of adults in an emergency department with high suicide risk.</p><p><strong>Method: </strong>Recent trials were identified by searching PubMed (terms suicide, efficacy, effectiveness, limited to clinical trials in prior 5 years). Common exclusion criteria were identified using Qualitative Content Analysis. A retrospective chart review examined a one-month sample of all adults receiving psychiatric evaluation in a large urban academic emergency department.</p><p><strong>Results: </strong>The search yielded 27 unique clinical trials studying suicide risk reduction as a primary or secondary outcome. After research fundamentals (e.g. informed consent, language fluency), the most common exclusion criteria involved psychosis (77.8%), cognitive problems (66.7%), and substance use (63.0%). In the clinical sample of adults with high suicide risk (<i>N</i> = 232), psychosis exclusions would exclude 53.0% of patients and substance use exclusions would exclude 67.2% of patients. Overall, 5.6% of emergency psychiatry patients would be eligible for clinical trials that use common exclusion criteria.</p><p><strong>Conclusions: </strong>Recent clinical trials studying suicide risk reduction have low generalizability to emergency psychiatry patients with high suicide risk. Trials enrolling persons with psychosis and substance use in particular are needed to improve generalizability to this clinical population.</p>","PeriodicalId":8325,"journal":{"name":"Archives of Suicide Research","volume":" ","pages":"77-90"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139989122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}