Danielle R. Jahn

An exploratory factor analysis of the Acquired Capability for Suicide Scale in male prison inmates

Prison inmates are exposed to a number of adverse conditions prior to and during incarceration that place them at risk for suicide. The interpersonal theory of suicide may prove useful in better understanding suicide in prisons, allowing for more effective prevention and treatment programs. However, no studies of the interpersonal theory have been conducted in prison populations. Further, there have been no studies examining the factor structure of the assessment of one of the theorys main constructs: the acquired capability for suicide. The current study examined the factor structure of the Acquired Capability for Suicide Scale in a sample of male prison inmates. We found that a 4-factor model provided the best statistical and conceptual fit, though only 3 of these factors were meaningful with an additional method-factor. The 3 resulting factors were each associated with previous exposure to painful and provocative events, but none differentiated suicide attempter status. Results suggest that the interpersonal theory has promise in application to suicide in prison populations, but more work is needed to develop a self-report measure of acquired capability, particularly as it relates to prisoners.

The interactive effects of negative symptoms and social role functioning on suicide ideation in individuals with schizophrenia

Findings regarding the protective effect of social role functioning on suicide ideation in individuals with schizophrenia have been mixed. One reason for such inconsistencies in the literature may be that individuals with prominent negative symptoms of schizophrenia may not experience a desire for social closeness, and therefore social role functioning may not influence suicide risk in these individuals. The aim of this study was to examine the moderating effects of self-reported desire for social closeness and interviewer-rated negative symptoms on the relationship between social role functioning and suicide ideation. Our sample consisted of 162 individuals who had been diagnosed with schizophrenia-spectrum disorders; all participants completed self-report questionnaires and clinician-administered interviews, and moderation hypotheses were tested with a non-parametric procedure. The results indicated that motivation and pleasure-related negative symptoms moderated the relationship between social role functioning and suicide ideation; self-reported desire for social closeness and negative symptoms related to expression did not have such a moderating effect. Specifically, better social role functioning was associated with less suicide ideation only in those individuals who had low motivation and pleasure-related negative symptoms; no significant relationship was observed between social role functioning and suicide ideation among those with elevated motivation and pleasure-related negative symptoms. These findings suggest that assessing for negative symptoms and social role functioning may inform suicide risk assessments in individuals with schizophrenia, and improving social role functioning may reduce suicide ideation among those with few motivation and pleasure-related negative symptoms.

Thwarted interpersonal needs and suicide ideation: Comparing psychiatric inpatients with bipolar and non-bipolar mood disorders

Psychiatric inpatients are at heightened risk for suicide, and evidence suggests that psychiatric inpatients with bipolar mood disorders may be at greater risk for suicide ideation compared to those with non-bipolar mood disorders. There is a paucity of research directly comparing risk factors for suicide ideation in bipolar versus non-bipolar mood disorders in an inpatient sample. The current study sought to clarify the association between two constructs from the interpersonal theory of suicide (i.e., perceived burdensomeness and thwarted belongingness) in leading to suicide ideation among psychiatric inpatients with bipolar and non-bipolar mood disorders. Participants were (N=90) psychiatric inpatients with a bipolar (n = 20) or non-bipolar mood disorder (n=70; per their medical charts). Perceived burdensomeness, but not thwarted belongingness, was significantly associated with suicide ideation after adjusting for other covariates. This suggests perceived burdensomeness may play a key role in suicide ideation among psychiatric inpatients with any mood disorder and highlights the importance of assessment and intervention of perceived burdensomeness in this population. Contrary to our hypothesis, mood disorder group (i.e., bipolar versus non-bipolar) did not moderate the relations between perceived burdensomeness/thwarted belongingness and suicide ideation.

Personal Recovery as a Protective Factor Against Suicide Ideation in Individuals With Schizophrenia.

Abstract Suicide rates are elevated in individuals with schizophrenia, yet evidence is mixed regarding the roles of positive and negative symptoms as risk factors for suicide in this population, suggesting that there may be other influential variables. One such variable may be personal recovery. Therefore, the purpose of this study was to test the hypothesis that personal recovery would moderate the relationship between symptoms of schizophrenia and suicide ideation. This hypothesis was tested in a sample of 169 individuals diagnosed with schizophrenia or schizoaffective disorder using a Poisson regression model. Results suggested that there was no significant interaction between recovery and symptoms of schizophrenia. However, recovery was a significant predictor of suicide ideation after controlling for psychiatric symptoms. These findings indicate that recovery is associated with lower suicide ideation and thus may protect against it. Thus, recovery should be assessed, and potentially intervened upon, to reduce suicide risk in individuals with schizophrenia.

Health conditions, physical disabilities, perceived burdensomeness, and depressive symptoms influence suicidal ideation.

ABSTRACT The roles of perceived burdensomeness and depressive symptoms in the relationship between physical disabilities or health conditions and suicidal ideation warrant examination. The authors examined indirect effects using cross-sectional data from adults who answered questions online. The serial indirect effect of the number of physical disabilities on suicidal ideation through perceived burdensomeness and depressive symptoms was not significant, but the serial indirect effects of the combined number of physical disabilities and health conditions and number of health conditions on suicidal ideation through perceived burdensomeness and depression were each significant. For those with disabilities or health conditions, perceived burdensomeness may precede depressive symptoms in the development of suicidal ideation.

Explanatory risk factors in the relations between schizotypy and indicators of suicide risk

Schizotypy has been linked to suicide risk, but it is not known whether established suicide-related risk factors mediate this relation. The aim of this study was to assess the mediating effects of depressive symptoms, social anxiety, self-esteem, and intimate disclosure in peer relationships in the relation between interpersonal schizotypy and suicide ideation or lifetime suicide attempts. This aim was tested in 590 young adults using a nonparametric bootstrapping procedure. After inclusion of the mediators, interpersonal schizotypy was no longer directly associated with either suicide ideation or lifetime suicide attempts. Depression and self-esteem mediated the relation between interpersonal schizotypy and suicide ideation. No variables mediated the relation between interpersonal schizotypy and lifetime suicide attempts, and there were no significant direct relations when mediators were included. Schizotypy appears to be a distal risk factor for suicidal behavior; assessing depressive symptoms and self-esteem may provide more proximal information about suicide risk, and may be targets for mitigating suicide risk in individuals with schizotypy.

Predictors of suicidal ideation among college students: A prospective cohort study

ABSTRACT This prospective cohort study investigated longitudinal predictors of suicidal ideation among college students. A non-clinical cohort of college students (N = 171) completed baseline and 3-month follow-up surveys. Depressive symptoms, worst-point suicidal ideation, and suicide attempt history significantly predicted follow-up suicidal ideation severity after adjusting covariates. Similarly, depressive symptoms and worst-point suicidal ideation (but not attempt history) were significant predictors of follow-up suicidal ideation intensity in an adjusted model. The results suggest that current depressive symptoms and lifetime worst-point suicidal ideation are independently valuable constructs that may provide relatively short-term predictive information when screening for suicidal ideation among college students.

Consumer satisfaction with antipsychotic medication-monitoring appointments: the role of consumer–prescriber communication patterns

Abstract Objective: The study was designed to explore patterns of prescriber communication behaviors as they relate to consumer satisfaction among a serious mental illness sample. Methods: Recordings from 175 antipsychotic medication-monitoring appointments between veterans with psychiatric disorders and their prescribers were coded using the Roter Interaction Analysis System (RIAS) for communication behavioral patterns. Results: The frequency of prescriber communication behaviors (i.e., facilitation, rapport, procedural, psychosocial, biomedical, and total utterances) did not reliably predict consumer satisfaction. The ratio of prescriber to consumer utterances did predict consumer satisfaction. Conclusions: Consistent with client-centered care theory, antipsychotic medication consumers were more satisfied with their encounters when their prescriber did not dominate the conversation. Practice implications: Therefore, one potential recommendation from these findings could be for medication prescribers to spend more of their time listening to, rather than speaking with, their SMI consumers.

Differences in suicide and death ideation among veterans and nonveterans with serious mental illness

Individuals with serious mental illness and veterans are two populations at elevated risk for suicide; however, research has not examined whether veterans with serious mental illness may be at higher suicide risk than nonveterans with serious mental illness. Additionally, overlapping risk factors for suicide in these populations may account for differences in suicide-related outcomes between these groups. Therefore, the aim of this study was to identify differences in death ideation and suicide ideation among veterans and nonveterans with serious mental illness. We also aimed to explore these effects after adjusting for potentially shared risk factors. We found that veterans with serious mental illness reported death ideation and suicide ideation more than twice as often as nonveterans with serious mental illness. After adjusting for demographic, psychiatric, and theory-driven risk factors, the effect of veteran status on death ideation remained significant, though the effect on suicide ideation was no longer significant. Depressive and psychotic symptoms were significant predictors of death ideation; depressive symptoms and hostility were significant predictors of suicide ideation. Clinicians should particularly monitor death ideation and suicide ideation in veterans with serious mental illness, as well as associated clinical risk factors such as depression, psychotic symptoms, and hostility.

Potential Moderators of Racial Differences in Responses to Traumatic Events

ABSTRACT Research regarding the influence of race on outcomes after trauma has been mixed, and we aimed to identify potential moderators of the relation between race and posttraumatic stress disorder (PTSD)–related outcomes. We conducted a secondary analysis of data from 477 participants in the Collaborative Psychiatric Epidemiology Surveys. African American individuals reported a shorter duration of and less frequent PTSD symptoms than Caucasian individuals, and also endorsed a greater number of reexperiencing and avoidance symptoms. Education, socioeconomic status, and social support did not significantly moderate relations between age of worst trauma and PTSD-related outcomes. Clinical and research implications are discussed.