Suicide rates are higher in veterans compared to the general population, making up a disproportionate 22% of suicides reported annually in the U.S. One factor related to suicidal behavior among veterans is increased exposure to traumatic events. However, not all traumatized veterans engage in suicidal behavior, perhaps due to the presence of protective factors. One such factor, forgiveness (of self, others, and by God), conceptualized as a positive change in cognition, emotion, and behavior, toward a transgressor or transgression, may buffer against suicide risk by facilitating a “letting go” of experienced offenses, and by allowing individuals to respond to trauma in a meaningful way via posttraumatic growth (PTG). This premise has not been tested, however. We hypothesized that forgiveness and PTG would be positively related with each other, and negatively related to suicidal behaviors. We also hypothesized that PTG would mediate the association between forgiveness and suicidal behaviors, such that higher levels of forgiveness would be associated with greater PTG and, in turn, to less suicidal behavior. Participants (N=545; 70.1% male (n=382); 86.4% Caucasian (n=469), Mean Age=49.86, SD=16.78) were community-dwelling veterans who self-identified as having experienced a trauma, and completed the PTG Inventory, the forgiveness subscale from the Fetzer Multidimensional Measure of Religiousness and Spirituality, and Suicide Behaviors Questionnaire-Revised. Bivariate correlations and simple mediation analyses were conducted covarying age, sex, and ethnicity. Supporting bivariate hypotheses (p-values

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Objective: College students may be at heightened risk for suicide and suicidal behavior due to maladaptive cognitive-emotional factors and failure to practice basic health behaviors. However, self-compassion and wellness behaviors may protect against risk. The relation between self-compassion and suicidal behavior and the contributing roles of depressive symptoms and wellness behaviors was examined. Participants: Participants were 365 undergraduate students. Data were collected in April 2015. Methods: A cross-sectional, survey design was employed. Participants completed measures assessing self-compassion, depressive symptoms, wellness behaviors, and suicidal behavior. Serial mediation analyses were conducted covarying age, sex, and ethnicity. Results: Self-compassion was inversely related to suicidal behavior, and this relationship was serially mediated by depressive symptoms and wellness behaviors. Conclusions: Self-compassion may protect against suicidal behavior, in part, due to reduced depressive symptoms and heightened engagement in wellness behaviors. Individual and campus-wide strategies promoting self-compassion and wellness behaviors may reduce suicide risk on college campuses.

Research is burgeoning regarding the beneficial association of forgiveness with numerous health-related outcomes; however, its particular relationship to suicidal behavior has received relatively little attention. Both cynicism and psychache, or agonizing psychological pain, have displayed deleterious associations with suicidal behavior, but have rarely been incorporated into more comprehensive models of suicidal behavior. Consistent with the recent development of a theoretical model regarding the forgiveness–suicidal behavior association, the present study utilized an undergraduate sample of college students (N = 312) to test a mediation-based model of the cross-sectional association of forgiveness with suicidal behavior, as serially mediated by cynicism and psychache. Dispositional forgiveness of self and forgiveness of uncontrollable situations were each indirectly associated with less suicidal behavior via less psychache. Also, dispositional forgiveness of others was indirectly associated with less suicidal behavior via less cynicism and less psychache, in a serial fashion. The present results are consistent with the extent literature on the forgiveness–suicidal behavior association, cynicism, and psychache, and pending future studies, may be utilized to inform further treatment efforts for individuals at a high risk of attempting suicide.

Forgiveness, a cognitive-emotional and behavioral reduction of negative responses to offenses, is directly related to less suicide risk, but may be indirectly related via its relation with future orientation, the ability to envision a positive future. In 100 rural primary care patients, we examined the association between self-forgiveness, other-forgiveness, and forgiveness by God and suicidal behavior, with future orientation as a mediator. Forgiveness was related to greater future orientation and, in turn, to, less suicidal behavior. Addressing the past may promote adaptive views of the future and reduce suicide risk, results suggesting potential temporal and forgiveness-based points for suicide prevention.

Forgiveness, a cognitive-emotional and behavioral reduction of negative responses to offenses, is directly related to less suicide risk, but may be indirectly related via its relation with future orientation, the ability to envision a positive future. In 100 rural primary care patients, we examined the association between self-forgiveness, other-forgiveness, and forgiveness by God and suicidal behavior, with future orientation as a mediator. Forgiveness was related to greater future orientation and, in turn, to, less suicidal behavior. Addressing the past may promote adaptive views of the future and reduce suicide risk, results suggesting potential temporal and forgiveness-based points for suicide prevention.

This study seeks to attain understanding of attempted suicide in young women from non-English speaking backgrounds, constructing meaning(s) of attempted suicide and eliciting information about sociocultural influences and guided by philosophical hermeneutics and narrative inquiry using life story methods. Thematic analysis was used to explicate from the text 30 sub-themes, five themes (being in a gap between cultures and creating space for themselves, being traumatised and diminished by abuse, surviving dangerous relationships, suffering psychic pain, expressing the self by attempting suicide), and a meta-theme (paradoxically asserting the indefinite self). Interpretation was predicated on the belief that life stories are statements about self-identity, and represent coming into being through the interaction of coherence (the ability to establish connections between events, unifying themes, frames of reference and goal states), continuity (a longitudinal and sequential perspective on life) and connectedness (intrapersonal, interpersonal and transpersonal relationships). The paradox is that being unable to overcome the uncertainties of incoherence, discontinuity and problematic connectedness, participants were predisposed to act against self as a means of asserting agency. This understanding of attempted suicide represents a hermeneutic narrative reconceptualisation of the phenomenon, which places it outside discourses that sanction the language of psychopathology and provides a basis for developing alternative nursing theory and informing education and practice / Doctor of Philosophy (PhD)

In 2005, suicide was the third leading cause of death among youth 10-24 years of age in the U.S. —accounting for 4,482 deaths. Youth suicide is an important public health problem in the U.S. and research focusing specifically on gender differences is needed and warranted since recent research shows that rates of suicide attempts have increased specifically among young girls. Analyses of the recently released 2007 YRBS data (n=14,041; girls=7,036; boys=6,992) of high school students in 9-12th grades, show that 6.9% of adolescents attempted suicide (9.3% of girls versus 4.6% of boys) and 14.5% seriously considered a suicide attempt (18.7% of girls versus 10.3% of boys). Girls are 2.89 (95% CI: 2.31-3.61) times more likely than boys to report attempting suicide in the past 12 months. Moreover, girls who reported attempting suicide were significantly more likely to also report other risk factors such as depression (OR= 5.74), weapon carrying (OR= 1.48), experiencing intimate partner violence (OR=1.60), being forced to have sexual intercourse (1.72), huffing glue (OR=2.04), and being a minority (OR 1.65). However, boys who reported attempting suicide were significantly more likely to also report weapon carrying (OR=1.66), being forced to have sexual intercourse (OR=2.60), huffing glue (OR=1.63), participating in sports (OR=1.52), depression (OR=10.96), hard drug use (OR=2.18), and being a minority (OR=1.93). Furthermore, analyses of 1991 – 2007 YRBS data revealed that these gender specific risks have remained fairly constant over time. These findings will help guide prevention and intervention strategies to prevent suicide and suicidal behaviors among both girls and boys.

Incidence of suicide has been shown to increase dramatically during adolescence. Despite an established pattern of depression and hopelessness leading to suicide in adults, no such pattern emerges in the adolescent literature. Recent investigations suggest that impulsivity may play a key role in adolescent suicide attempts. This study examined the role of impulsivity in adolescent suicidal gestures, as well as the relationships among demographic variables, anger expression, impulsivity, and suicidal behavior. A total of 100 participants (ages 11-17; 71 females and 29 males) were recruited from 2 inpatient crisis centers for children. The Children's Depression Inventory, Hopelessness Scale for Children, Adolescent Behavior Checklist, Pediatric Anger Expression Scale, and Suicide Intent Scale were administered to inpatients, and demographic information was obtained (age, gender, ethnicity, income, and structure of family). It was hypothesized that patterns of depression, anger, hopelessness, and impulsivity would vary by age, gender, ethnicity, and suicidality (e.g., suicidal gesture vs. no gesture). The large majority of hypotheses were not supported. Results are explained in terms of alternative theories for the role of impulsivity in adolescent suicidal gestures.

Introduction Suicidality and excessive alcohol use are both important public health issues. Various risk factors including alcoholism have been studied and identified to be associated with suicidality. Increasing evidence has shown that excessive alcohol use is associated with a wide range of physical and mental health issues. There is a lack of local study to study the association between alcohol consumption and suicidality in details including the association of different patterns of alcohol use with suicidal thoughts and behaviors. The aim of this study is to study the association between alcohol use and suicidality, taking into account of possible differences between different pattern of alcohol use and various possible confounding factors. Methods This study was based on analysis of data collected in Population Health Survey (PHS) conducted in 2003/04, which was conducted by the Department of Health (HKSAR) and the Department of Community Medicine (HKU). A total of 5600 respondents between the age of 18 to 64 were included in this study. The primary outcome was current suicidal ideation. Association between history of suicidal attempt with the other variables was also studied. The primary predictors variables included alcohol-related variables (presence of drinking, age of first drink, type of drink, amount of drinking, presence of binge drinking), history of mental illness (self-reported known history of depression, anxiety disorder and schizophrenia), level of depression and anxiety (STAI and CES-D scores), quality of life (WHOQOL-BREF score), exercises, stress management and various demographic variables including age, sex, place of birth, marital status, education level and income level. Logistic regression was used to analyze the association between suicidality and alcohol use. Results The prevalence of lifetime history of suicidal attempts is 5.1% in this population. 17.3% has lifetime history of suicidal ideations, 1.3% has a suicidal attempt in the past 1 year and 11.9% have suicidal ideations in the past one week. Being divorced or separated, being female, being a smoker, considering themselves having need for emotional support, having more severe depressive symptoms, having chronic diseases, depression and anxiety disorder were associated with presence of a history of suicidal attempt. The presence of current suicidal ideations was found to be associated with more severe depressive symptoms, poorer quality of life as reflected by a lower physical domain score of WHOQOL-BREF, being single, having history of binge drinking, having recent suicidal thoughts and lifetime history f suicidal thought. The presence of alcohol drinking and larger amount of alcohol intake were not shown to be significantly associated with presence of suicidal ideations and behaviors in the binary logistic regression models. Only the association between presence of current suicidal ideation and binge drinking was shown to be statistically significant. Conclusion This study did not find a strong association between alcohol consumption and suicidality. Among the alcohol-related variables, only binge drinking was found to be statistically significantly associated with current suicidal ideations. Further study to further explore association between alcohol and suicidality should be considered. / published_or_final_version / Public Health / Master / Master of Public Health