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Previous research has demonstrated associations between deliberate self-harm (DSH) and perfectionism, although most of that research used retrospective self-report measures of DSH, which are prone to various cognitive biases. Although perfectionism has been associated with alcohol abuse, no research has examined how alcohol intoxication may moderate the relation between perfectionism and DSH. The aims of this experimental study were to determine if perfectionism is associated with a laboratory analogue of DSH (the Self-Aggression Paradigm) and examine the role of alcohol intoxication as a potential moderator. Using archival data, blood alcohol content (BAC) was manipulated by randomly assigning participants to reach one of four target BACs. Results indicated that perfectionism was not associated with DSH (mean self-administered shock or number of “severe” shocks). There was no interaction between perfectionism and BAC. These findings are discussed within the context of the perfectionism measure’s psychometric characteristics and the strength of previous research findings.

The aim of this study is to describe the prevalence of high-risk and social behaviors amongst adolescents in the low- and middle-income country (LMIC) of Guyana, in which suicide ideation is not well understood amongst the indicated population and is holds the second highest rate in the world. The analysis was completed alongside an analysis of these same behaviors among adolescents in the United States alongside with the country of Trinidad and Tobago, to identify possible differences in trends and contribute to an understanding of global best practices. The most recent data available from the Global School-Based Student Health Survey (GSHS) for the LMICs stated and the Youth Risk Behavior Survey for the United States was used. Within the LMICs, there exists a lack of laws, policies, and plans to curb rates in poor high-risk and social behaviors noted. The lack of these action plans correlates to the rates notated. In comparison to the United States where more action plans exist; the correlated rates are not as prevalent. It is also important to note that there are limitations of this study, including differences in the datasets used for each country. In addition, the survey collection process itself might have introduced bias due to the sensitive nature of the questions. However even with these limitations, this study is only the second empirical effort to comprehensively understand suicidal behaviors amongst in-school adolescents in Guyana and the first empirical effort to understand suicidal behaviors amongst in-school adolescents in Trinidad and Tobago as data is limited in these countries are limited but especially amongst adolescents. Although it cannot be extrapolated that the lack of these action plans directly causes high rates of risky behaviors and poor social behaviors; it can be theorized that having more action plans might curb rates and therefore be a key protective factor for future implementation of prevention and intervention programs aimed for this population.

Background: In Taiwan, there were 7,038 reports of attempted suicide among people aged 24 or younger in 2018. Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States age 18 and older. Purpose: In this study, we compared United States (US) and Taiwanese college students’ spiritual well-being, psychological well-being, and suicidal ideation. Methods: A total of 661 college students (481 from the US and 180 from Taiwan) were recruited to complete the survey study. This was a cross-sectional comparative research design. SPSS 28.0 was used to do the data analysis. Chi-square tests, independent t-tests, Pearson Correlations, and Stepwise Multiple Regressions were used to examine the research questions. Results: Compared with Taiwanese college students, US college students had higher scores in spiritual well-being and psychological well-being. US and Taiwanese college students’ spiritual well-being had significant relationships with psychological well-being and suicidal ideation. The significant predictors for the US college students’ psychological well-being were Life Satisfaction/ self-actualization and Life/self-responsibility, while Taiwanese college students had total scores of Spiritual Well-being and Life Satisfaction/ self-actualization. Life Satisfaction/ self-actualization had a significantly negative association with Taiwanese college students’ suicidal ideation. Total scores of Spiritual Well-being and Faith/belief were predictors for US college students’ suicidal ideation and they had significant negative relationships. Conclusions/Implications for Practice: College students’ psychological well-being and suicidal ideation are often cited as important areas. Understanding factors that influence positive psychological well-being is important in order to institute protective factors and provide emotional support.

Rationale: The severity of insomnia symptoms, including difficulty falling asleep and returning to sleep when awakened in the night, are major risk factors for more severe suicidality including suicidal ideation, suicide attempts, and death by suicide. As a modifiable risk factor, insomnia is a potential target for suicide prevention. There are several commonly observed gaps in the literature studying the association between insomnia and suicidality including little exploration of potential mediators, limited assessments of insomnia and suicidality, and a lack of sample diversity and representativeness. As such, the models that explain the association between insomnia and suicidality remain unclear and understudied. The purpose of this study is to investigate potential mediators that are associated with both insomnia severity and suicidality severity including emotion dysregulation, thwarted belongingness, and perceived burdensomeness with the use of validated measures in a nationally representative sample. Background: Evidence suggests that insomnia severity is related to suicidality severity, even when accounting for common risk factors of suicidality such as depression. Several models have been developed to explain the association between insomnia and suicidality severity. Neurocognitive models propose that insomnia prevents natural recuperative functions of sleep, thereby contributing to daytime impairment such as emotion dysregulation. Joiner’s suicide risk model may also outline potential psychosocial components that facilitate the association between insomnia and suicidality severity including thwarted belongingness and perceived burdensomeness. Emotion dysregulation, thwarted belongingness, and perceived burdensomeness have been individually associated with both insomnia and suicidality severity. Methods: We collected data on demographics, insomnia severity, depression, anxiety, suicidality severity, emotional regulation, thwarted belongingness, and perceived burdensomeness from 428 participants through an online survey. Our first aim was to replicate previous findings of the insomnia-suicidality severity association through regression analyses between self-reported insomnia and suicidality severity whilst controlling demographic variables, self-reported depression severity, and self-reported anxiety severity. Our second aim is to understand the role emotion dysregulation, thwarted belongingness, and perceived burdensomeness play in the insomnia and suicidal severity association, even when accounting for depression, through testing our proposed mediation models using structural equation modeling. Results: Insomnia severity was related to greater suicidality, but not when accounting for depression severity. Emotion dysregulation and perceived burdensomeness partially mediated the association between insomnia severity and suicidality severity. When accounting for depression severity, emotion dysregulation and perceived burdensomeness fully mediated the association between insomnia severity and suicidality severity. Conclusions: Depression, perceived burdensomeness, and emotion dysregulation may explain the association between insomnia and suicidality severity. These difficulties may serve as potent markers for suicide risk and potential targets for treatment and suicide prevention.

Each year, about 800,000 individuals die by suicide globally, affecting millions more. Mitigating suicide risks by targeting modifiable factors such as the sleep disturbances of insomnia and nightmares, which are prevalent and linked to suicidality is important. This study investigated the structural and functional brain differences related to sleep disturbances and suicidality, with the anterior cingulate (caudal and rostral), insula, middle frontal gyrus, posterior cingulate, thalamus, amygdala, and orbitofrontal cortex as seed regions. Participants had no history of suicidal ideation (NSI; n=43) or suicidal ideation within the past two weeks (SI; n=25). Measures for analyses included the Insomnia Severity Index (ISI), Disturbing Dream and Nightmare Severity Index (DDNSI), and Frequency of Suicidal Ideation Inventory (FSII). The relationships between group (control vs suicidal ideation), structural measurements (cortical surface area, cortical thickness, gray matter volume), insomnia and nightmares across the eight regions in each hemisphere were examined. Functional connectivity-change differences were measured across wake and sleep with the eight regions as seeds. The SI group had smaller cortical surface area and gray matter volumes in the left insula (t= 2.58, p = 0.012; t = 2.44, p = 0.017); however, not after adjusting for multiple comparisons. ISI and FSII total scores correlated with each other and the surface area and gray matter volume of the left insula. In a mediation model, ISI total score was significantly related to insula surface area and FSII total score (p = 0.023; p =0.027), but the insula surface area was not significantly associated with FSII total score (p = 0.075). The indirect effect of ISI on FSII through the left insula surface area was not significant (p =0.161). The SI group had smaller changes from wake to sleep than the NSI group in the functional connectivity of the right thalamus to the left and right superior/middle temporal regions. Other neurological mechanisms could be at play as only the cortical surface area and gray matter volume in the left insula had implied differences between groups and the structural differences did not mediate the relationship between insomnia and suicidality. Smaller functional connectivity-changes differences across wake and sleep for SI compared to NSI, potentially indicate deficits in auditory inhibition.

Non-suicidal self-injury (NSSI), the deliberate and direct damage of one’s body tissue without suicidal intent, is a pervasive public health concern often leading to clinically significant long-term consequences (e.g., permanent scarring, hospitalization) that is theorized to be facilitated by negative affect and emotion dysregulation. The Emotional Cascade Model proposes that NSSI partially functions to disrupt the reciprocal and rapid amplification of negative affect driven by rumination. However, limited research has focused on state rumination and the distinct contribution of maladaptive and adaptive rumination subtypes, as well as the role of positive affect within this framework. Thus, the purpose of the current study was to replicate and explore the independent influences of overall and momentary (1) positive and negative affect and (2) rumination on NSSI acts and urges, as well as (3) the extent to which rumination moderates the relationship between affect and NSSI. To do so, rumination, affect, and NSSI urges and acts were assessed 4 times daily via ecological momentary assessment for 21-days among thirty undergraduate participants with past month NSSI. Our results partially replicated existing literature, such that overall negative affect was associated with greater overall NSSI urge strength and momentary negative affect and rumination predicted stronger NSSI urges at the next alert, with increased momentary rumination strengthening the relationship between momentary negative affect and NSSI urge. Exploratory investigations of overall and momentary positive affect showed some negative associations with NSSI urges and behaviors, with no moderating effect of rumination. Data did not support the independent examination of maladaptive and adaptive rumination subtypes. Taken together, this study highlighted the importance of exploring state rumination (in addition to trait) and affect in understanding NSSI thoughts and behaviors, and calls for future studies to further investigate distinct properties of rumination to understand its impact on specific emotions that maintain NSSI engagement. / Psychology

Borderline personality disorder (BPD) is an impairing mental illness and has a core component of emotional dysregulation. Evidence suggests the emotional cascade model describes how this emotional dysregulation leads to engaging in risky and life-threatening behaviors, such as non-suicidal self-injury (NSSI). Specifically, this model describes rumination as a cognitive component that links the emotional and behavioral dysregulation. The current study aimed to expand the model by investigating how individuals with heightened BPD traits engage in NSSI and in cognitive strategies to cope with their negative affect. Specifically, it was investigated whether behaviors like suicide attempts and cognitions differentiated between those with mild/moderate and severe NSSI. Criterion for severe NSSI was hospitalization or medical care because of NSSI. Participants (N = 292) were screened to endorse a history of NSSI and then self-selected to take a self-report survey through Mturk. Correlations and a binomial logistic regression were completed. Results indicated suicide attempts, BPD symptoms, and anger rumination differentiated mild/moderate and severe NSSI. Evidence reinforces the strong relationships between NSSI, suicide attempts, and BPD. Additionally, it reinforces anger rumination as a potential cognitive mechanism in NSSI. Future research can continue to test this model and include other potential thought processes to increase efficiency in assessment and treatment of BPD and NSSI.

Bakgrund Psykisk ohälsa ökar bland ungdomar över hela världen och risken för suicidala handlingar till följd av detta. Fysiologiska och psykologiska förändringar under tonåren bidrar till en omtumlande period i livet som kan leda till ökad skörhet för utvecklandet av psykisk ohälsa. Sjuksköterskors bemötande har stor betydelse för vården av dessa patienter och ofta upplever patienterna att de möts av fördomar och okunskap kopplat till stigma. Dessa patienter måste fångas upp i ett tidigt skede för att reducera risken för utveckling av långvarigt lidande och suicidalt beteende. Syfte Att beskriva sjuksköterskors erfarenheter av att arbeta med ungdomar med suicidalt beteende. Metod För studien genomfördes en litteraturöversikt med systematisk ansats och som grund för resultatet ligger elva artiklar som redovisar kvalitativa data. Materialet sammanställdes och analyserades med stöd av Thomas och Hardens metod för tematisk syntes. Resultat Resultatet visade att sjuksköterskorna upplevde olika utmaningar i arbetet med ungdomar med suicidalt beteende. Sjuksköterskorna blev ofta frustrerade och känslomässigt berörda och egna föreställningar och attityder visade sig ha betydelse för omvårdnaden. Utmaningarna varierade till viss del beroende på sjuksköterskornas bakgrund och brist på tilltro till den egna kompetensen. Efterfrågan om utbildning inom området var vanligt förekommande, oavsett tidigare kunskap eller erfarenheter. Slutsats Det fanns en efterfrågan och ett behov av kompetensutveckling hos sjuksköterskor som arbetar med ungdomar med psykisk ohälsa och suicidalt beteende. Genom ökad kompetensutveckling, ökad förståelse för patienterna och större fokus på att etablera goda relationer kan vården bli mer säker, effektiv och personcentrerad för denna växande patientgrupp. / Background Mental illness is increasing amongst adolescents and the risk of suicidal acts can be seen as a result. Physiological and psychological changes during adolescence make this a turbulent period in life which can contribute to increased fragility and pose a risk of developing mental illness. Nurses' attitudes are important for the care of these patients, as the patients are often met with prejudice and ignorance linked to stigma. Patients with mental illness must be taken care of in an early stage to minimize the risk of developing suicidal behavior. Aim To describe nurses' experiences of working with adolescents with suicidal behavior. Methods A literature review with a systematic approach. Eleven primary studies of qualitative research were found and analyzed using Thomas and Harden´s thematic synthesis. Results The results of the study showed that the nurses experienced different challenges in working with adolescents with suicidal behavior. The nurses often became emotionally affected and frustrated, based on their own beliefs and attitudes towards this behavior. This also affected the care of the patients. What was most challenging in working with adolescents with suicidal behavior varied due to the nurses´ background and to their level of competence. They also requested additional education, regardless of previous experience. Conclusions Professional development was requested and needed by all nurses. By increasing the level of education and professional development, this will lead to a greater understanding of the unique experience of the patient. As a result of this, nurses are capable of delivering safer, more efficient and person-centered care for these patients.

The present study compared the suicidal behaviour and related measures of adolescents in high school in Germany (N=318) and South Africa (N=299). Participants completed a series of self-report measures of the SPS (Suicide Probability Scale), PSS-Fa (Perceived Social Support From Family Scale), PSS-Fr (Perceived Social Support From Friends Scale), SIB (Scale Of Interpersonal Behaviour) and a number of demographic questions. Analyses were conducted using content analysis, correlation coefficients and logistic regression to determine variables related to previous suicide attempts, stepwise multiple regression to account for variables predicting currents suicidal risk; and multivariate analysis of variance (MANOVA) to examine differences among the groups and among suicide attempters and non-attempters. 36 German (11.3%) and 48 South African (16.1%) adolescents reported that they had made previous suicide attempts. German adolescents reported 45 (14.2%) suicide attempts in the family and 82 (25.8%) suicide attempts by friends. South African adolescents reported 43 (14.4%) suicide attempts in the family and 92 (30.7%) suicide attempts by friends. The following variables were associated with previous suicide attempts in the German sample: attempted suicide by friends, a life-threatening event, previous psychiatric contact, the death of a friend, low perceived family support, female gender, attempted suicide in the family, suicide of a friend, and low perceived friend support. The following variables were associated with previous suicide attempts in the South African sample: low perceived family support, death of a friend, attempted suicide by friends, female gender, a life-threatening event, previous psychiatric contact, suicide of friends, and attempted suicide in the family. The following variables for the German sample were found to be significant predictors of current suicidal risk: low perceived family and friend support, previous suicide attempts, suicide attempts in the family, a life-threatening event, suicide attempts of friends, suicide of friends, female gender, and previous psychiatric contact. The following variables for the South African sample were found to be significant predictors of current suicidal risk: previous suicide attempts, low perceived family and friend support, death of a friend, a life-threatening event, previous psychiatric contact, suicide attempts in the family, suicide of friends, and suicide attempts of friends. These findings show that suicidal behaviour is frequent in both countries. Suicidal deaths of friends and family is more prevalent in Germany, whereas religion or belief in god does not protect against suicide attempts in both countries. Results indicate that perceived support from family is a strong protective factor against suicide attempts. / Psychology / M.A. (Psychology)