Suicide embodies a considerable but often preventable loss of life. As the second leading cause of death for young people in Canada between the ages of 15 and 24, nearly one-quarter of all annual deaths for this age group are accounted for by those who have died by suicide. Greater still is the prevalence of suicidal behaviour. Annually, suicide and suicidal behaviours across the age span are estimated to cost the Canadian economy $2.2 billion. Given the high personal costs to victims, survivors, and taxpayers, it seems crucial that prevention strategies be implemented to reduce the high rate of suicide and suicidal behaviours, as well as to promote mental health, particularly in youth. The promotion of positive mental health and well-being is especially relevant for youth living in rural areas. Fewer mental health resources are available in rural communities than in urban centres. Moreover, youth living in rural, low population density areas often do not believe that their anonymity and right to privacy would be protected if they were to seek mental health services. The present research was carried out to provide a potential foundation for stimulating mental health promotion and suicide prevention approaches, differing by rural and urban community and by gender, before such concerns emerge. Through a survey of 813 (459 rural youth; 354 urban youth) secondary school youth in Eastern Ontario, we examined the inverse association between suicidal ideation and engagement in extracurricular activities, such as sports, music, drama, or community groups. Who is at greatest risk: It was found that rural youth reported significantly more suicidal thoughts than did urban youth (p < .01). Perceived social support accounted for rural and urban differences, while difficulties coping with daily stressors accounted for gender differences, in self-reported suicidal ideation. Thus, “red flags” for communities at risk could include perceived deficits in social support within a given community, as well as having a number of young females who indicate poor coping with daily stressors. What factors to target: Depressive symptoms, risk behaviours, self-esteem, and social support differed in importance in the prediction of suicidal ideation based on rural-urban setting and gender. Results reflecting differences underscore the importance of examining such factors in mental health research. A “one size fits all” approach to youth mental health promotion and suicide prevention does not appear to be a prudent strategy. How to intervene: Youth engagement was explored as one possible means of intervention. In rural youth, personally meaningful engagement and engagement in a number of activities was directly inversely related to suicidal ideation. Regression analyses involving interaction analyses were carried out with youth engagement as a moderator for mental health indicators such as depressive symptoms, risk behaviours, self-esteem, and social support in the prediction of suicidal ideation. Through simple slope analyses, it was found that youth engagement significantly reduces the relationships between suicidal ideation and mental health indicators, particularly for males (p < .001). Therefore, youth engagement appears to be more universally beneficial for rural youth, given that rural dwelling appears to be a risk factor for suicidal ideation. Moreover, for male youth at risk for suicidal ideation, given depressive symptoms, risk behaviours, low self-esteem, and low perceived social support, youth engagement may be of particular benefit. With knowledge of who is at greatest risk for suicidal ideation, what factors to target, and a possible intervention road map, we can reach youth and foster resiliency before suicidal thoughts emerge.

bgelaye@hsph.harvard.edu / Article / Objective: To examine the independent and joint relationships of poor subjective sleep quality and antepartum depression with suicidal ideation among pregnant women. Methods: A cross-sectional study was conducted among 641 pregnant women attending prenatal care clinics in Lima, Peru. Antepartumdepression and suicidal ideationwere assessed using the Patient Health Questionnaire-9 scale. Antepartumsubjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Logistic regression procedures were performed to estimate odds ratios (aOR) and 95% confidence intervals (95% CI) adjusted for confounders. Results: Overall, the prevalence of suicidal ideation in this cohort was 16.8% and poor subjective sleep qualitywas more common among women endorsing suicidal ideation as compared to their counterpartswho did not (47.2% vs. 24.8%, Pb.001). After adjustment for confounders including maternal depression, poor subjective sleep quality (defined using the recommended criteria of PSQI global score of N5 vs. ≤5) was associated with a 1.7-fold increased odds of suicidal ideation (aOR=1.67; 95% CI 1.02–2.71). When assessed as a continuous variable, each 1-unit increase in the global PSQI score resulted in an 18% increase in odds for suicidal ideation, even after adjusting for depression (aOR=1.18; 95% CI 1.08–1.28). Women with both poor subjective sleep quality and depression had a 3.5-fold increased odds of suicidal ideation (aOR=3.48; 95% CI 1.96–6.18) as compared with those who had neither risk factor. Conclusion: Poor subjective sleep quality was associated with increased odds of suicidal ideation. Replication of these findings may promote investments in studies designed to examine the efficacy of sleep-focused interventions to treat pregnant women with sleep disorders and suicidal ideation. / This research was supported by an award fromtheNational Institutes of Health (NIH; R01-HD-059835, T37-MD000149 and K01MH100428). The NIH had no further role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication. The authors wish to thank the dedicated staff members of Asociacion Civil Proyectos en Salud (PROESA), Peru and Instituto Especializado Materno Perinatal, Peru, for their expert technical assistance with this research. / Revisión por pares

Background: Recent analyses have described metabolomic markers for depression and suicidal ideation in non-pregnant adults. We examined the metabolomic profile of antepartum depression and suicidal ideation during mid-pregnancy, a time of high susceptibility to mood disorders. Methods: We collected fasting blood from 100 pregnant Peruvian women and profiled 307 plasma metabolites using liquid chromatography-mass spectrometry. We used the Patient Health Questionnaire 9 to define antepartum depression (score ≥ 10) and suicidal ideation (having thoughts that you would be better off dead, or of hurting yourself). Logistic regression was used to calculate odds ratios (ORs). Results: Three triacylglycerol metabolites (C48:5 triacylglycerol [OR = =1.89; 95% confidence interval (CI): 1.14–3.14], C50:6 triacylglycerol [OR = =1.88; 95%CI: 1.13–3.14], C46:4 triacylglycerol [OR = =1.89; 95%CI: 1.11–3.21]) were associated with higher odds of antepartum depression and 4 metabolites (betaine [OR = =0.56; 95%CI:0.33–0.95], citrulline [OR = =0.58; 95%CI: 0.34–0.98], C5 carnitine [OR = =0.59; 95%CI: 0.36–0.99], C5:1 carnitine [OR = =0.59; 95%CI: 0.35–1.00]) with lower odds of antepartum depression. Twenty-six metabolites, including 5-hydroxytryptophan (OR = =0.52; 95%CI: 0.30–0.92), phenylalanine (OR = =0.41; 95%CI: 0.19–0.91), and betaine (OR = =0.53; 95%CI: 0.28–0.99) were associated with lower odds of suicidal ideation. Limitations: Our cross-sectional study could not determine whether metabolites prospectively predict outcomes. No metabolites remained significant after multiple testing correction; these novel findings should be replicated in a larger sample. Conclusions: Antepartum suicidal ideation metabolomic markers are similar to markers of depression among non-pregnant adults, and distinct from markers of antepartum depression. Findings suggest that mood disorder in pregnancy shares metabolomic similarities to mood disorder at other times and may further understanding of these conditions’ pathophysiology. / Revisión por pares

No study to date has simultaneously examined the commonalities and unique aspects of positive psychological factors and whether these factors uniquely account for a reduction in suicide risk. Using a factor analytic approach, the current study examined the relationships between grit, hope, optimism, and their unique and overlapping relationships in predicting suicide ideation. Results of principle axis factor analysis demonstrated close relationships between these variables at both the construct and item level. Item-level analyses supported a five-factor solution (Stick-to-Itiveness, Poor Future, Consistency of Interest, Positive Future, and Poor Pathways). Four of the five factors (excluding Stick-to-Itiveness) were associated with suicide ideation. Additionally, results of a multiple regression analysis indicated that two of the five factors (Consistency of Interest and Positive Future) negatively predicted suicide ideation while Poor Future positively predicted suicide ideation. Implications regarding the interrelationships between grit, hope, and optimism with suicide ideation are discussed.

The purpose of this study was to examine reasons for living in young adults (17 to 24) from divorced and non-divorced homes. Participants included 281 individuals (128 men, 153 women). Eighty-nine subjects were reared in divorced homes. The Reasons for Living Inventory, a Suicide Ideation Questionnaire, and a demographic questionnaire with items to assess age, gender, parental marital status, and various questions related to being reared in a divorced home were administered to all participants. Results of the study revealed a main effect for suicide ideation status on the total score of the RFL, with non-ideators reporting significantly higher reasons for living than ideators. No main effects were found for gender or parent marital status. Thus, the adaptive cognitive characteristics which are measured by the RFL were no different in young adults who were reared in divorced homes when compared to those reared in non-divorced homes.

The purpose of the current study was to investigate the relative importance of diagnostic and psychosocial factors in the prediction of adolescent suicidal ideation. Previous research has shown both sets of variables to be significantly related to suicidality but has failed to compare their relative efficacy in explaining suicidal ideation. It was hypothesized that diagnostic variables would afford better prediction of suicidal ideation than psychosocial variables, diagnostic variables would predict suicidal ideation above and beyond psychosocial variables, and psychosocial variables would predict suicidality after controlling for the effects of diagnostic variables. This study included valid diagnostic and psychosocial variables, employed independent diagnoses as opposed to diagnostic groupings, and utilized continuous measures of psychiatric symptomatology, in series of regression analyses to test these hypotheses. Results revealed that diagnostic variables, in particular, severity of major depressive disorder symptomatology, afforded the strongest prediction of suicidal ideation, even after controlling for psychosocial variables. The comorbid combination of mood disorder and generalized anxiety disorder was found to be the most strongly linked to suicidal ideation of all diagnostic combinations. However, social support added to the prediction of suicidal ideation above and beyond that offered by all diagnostic variables. Moreover, the interaction of social support and family environment predicted suicidality above and beyond severity of major depressive disorder symptomatology. It was concluded that optimal prediction of suicidality is likely obtained through the utilization of continuous measures of psychiatric symptomatology in suicide research. Moreover, suicide research and clinical practice should include examinations of both diagnostic and psychosocial variables to increase prediction and understanding of suicidal ideation in adolescents. / Ph. D.

Indiana University-Purdue University Indianapolis (IUPUI) / Using data from the 2007-2017 cycles of the national Youth Risk Behavior Survey (YRBS), this researcher aimed to understand how weapons carrying mediates the association between bullying and mental health outcomes. I dichotomized four bullying outcomes to create one new carried a weapon after bullied (CWB) (no/yes; e.g. did not carry a weapon post-bullying vs. did carry a weapon post-bullying) for each bullying type. Mental health outcomes included (all dichotomized, past 2 weeks, no/yes): felt sad or hopeless, seriously considered suicide, had a plan for suicide and attempted suicide. I used descriptive statistics and binary logistic regression adjusted for YRBS sampling methods and weighting (Stata 15.0). Initial results showed that weapons carrying has a complex relationship with mental health after bullying. One notable finding is that individuals who had been in a physical fight were the most likely to carry a weapon (N = 268), followed by those who had been threatened at school (N = 233). Additionally, more students who had been bullied at school (N = 185) carried a weapon than those who were victims of cyberbullying (N = 166). Another interesting result found that across all bullying types, males were 2 to 3 times more likely to carrying a weapon as a result of being bullied. In terms of mental health, being threatened at school was the most significant bullying type in relation to suicidal ideation.

During early stages of the design process, ideation methods are used to generate a set of potential solutions based on a particular need. Solutions to design problems generally require both technology and user actions (or tactics) of some sort, although solution ideas may omit explicit mention of either technology or tactics. Previous research suggests that an explicit consideration of tactics in early-stage ideation enables design teams to improve the quantity, quality, variety, and novelty of their idea sets. In this paper, a novel ideation method known as the Random Prompts method is presented, and its performance is evaluated against a Brainwriting method. The results show that the Random Prompts method improves the overall quantity, novelty, and variety of idea sets over the Brainwriting method. In addition, the techniques used to encourage tactics ideation in both methods cause a significant increase in the fraction of ideas containing tactics when compared to sample ideation results from the literature. These conclusions hold value for improving design space exploration and co-development of tactics and technology.

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