While research highlights a number of risk factors for suicide, not all individuals displaying these characteristics will go on to attempt suicide. Depressed mood is a proximal indicator of suicide, with deterioration in already depressed mood increasing the likelihood of a suicide attempt. The overall aim of this thesis was to empirically test the Cognitive Model of Suicide by Wenzel and Beck (2008). This model proposes that each of the three components, dispositional vulnerabilities, mood disturbance and suicide related cognitions, may influence each other to enhance the propensity for a suicidal crisis. The thesis starts by examining the relationship between two personality characteristics (neuroticism and trait aggression) and current depressed mood, and then focuses on the relationship between suicidality and current depressed mood. Although autobiographical memories have been implied as a possible risk factor for suicidality, meta-analytical studies have highlighted discrepancies between sampling techniques which may limit interpretablity. Therefore, the first series of studies aimed to establish a protocol for assessing autobiographical memories. The second and third series of studies aimed to investigate whether the relationships between current depressed mood and specific personality factors (neuroticism and trait aggression) were indirectly influenced by other known risk factors that may affect cognitive processing of information (rumination, overgenerality, impulsivity). Moreover, these studies aimed to determine whether the same cognitive processing factors effected current depressed mood in non-suicidal and suicide attempt groups. The final series of studies aimed to determine whether these risk factors (neuroticism, trait aggression, brooding, impulsivity, and overgenerality) mediated the relationship between suicidality and current depressed mood. Findings indicated that compared to the non-suicidal group, individuals in the suicide attempt group was more likely to be influenced by the effects of trait aggression and brooding, and that the combination of these factors were positively associated with current depressed mood. In contrast, neuroticism and impulsivity appeared to influence individuals who had experienced suicidal ideation more than individuals who report never having suicidal thoughts or attempting suicide. Compared to the non-suicidal group, however, neuroticism and impulsivity did not show a significant association for current depressed mood in the suicidal ideation group. Findings supported the Interacting Sub-Systems model and are discussed in relation to the Cognitive Model of Suicide model.

Au niveau mondial, la mort par suicide occupe fréquemment la deuxième ou troisième place des causes de décès chez les adolescents (AIPS, 2009). Afin de prévenir le suicide chez les jeunes, une meilleure compréhension des facteurs associés s’avère donc nécessaire. La présente étude avait pour but d’identifier les facteurs de protection d’adolescents atteints d’un trouble de l’humeur et présentant un risque suicidaire. Pour ce faire, un questionnaire relatant les habitudes de vie et facteurs psychosociaux a été analysé. Le risque suicidaire a été évalué à partir de la version adaptée pour adolescents du SAD PERSONS Scale (Juhnke, 1994). L’échantillon de l’étude comprenait 101 jeunes de 12 à 17 ans atteints d’un trouble de l’humeur et présentant un risque suicidaire. Des analyses descriptives, des tests de t, des analyses de variance, des corrélations et des régressions ont été utilisées afin de vérifier la relation entre le risque suicidaire et les facteurs de protection. Il ressort que, pour les adolescents de l’étude, être satisfait du soutien reçu, avoir un bon soutien affectif parental, avoir plusieurs sources de lecture par semaine, souper plusieurs fois avec sa famille par semaine, ne pas fumer de cigarette, ne pas avoir beaucoup d’amis qui fument la cigarette, ne pas consommer d’alcool, ne pas consommer de drogue ainsi que de ne pas mélanger la consommation d’alcool et de drogue peuvent tous agir, individuellement, comme facteurs de protection du suicide chez des adolescents atteints d’un trouble de l’humeur et présentant un risque suicidaire. Par ailleurs, les analyses effectuées ne révèlent aucune relation significative entre les habitudes scolaires, l’activité physique, les habitudes de sommeil, l’estime de soi et le risque suicidaire des adolescents de l’étude. Enfin, miser sur les facteurs de protection du suicide identifiés par la présente étude constitue une nouvelle piste intéressante pour les infirmières et des recommandations pour la recherche et la pratique infirmière sont suggérées. / Adolescent suicide often represents the second or third leading cause of death for this age group throughout the world (AIPS, 2009). In order to prevent adolescent suicide, a better understanding of the factors associated with suicidal risk is necessary. The aim of this study was to identify the protective factors of adolescents with mood disorders and suicidal risk. Life habits and psychosocial factors were evaluated by an auto-administrated questionnaire. The adapted version of the SAD PERSONS Scale (Patterson, Dohn, Bird & al, 1983) for children and adolescents (Juhnke, 1994) was used to evaluate the suicidal risk. The sample of this study included 101 teenagers, aged between 12 and 17 years old, who had a mood disorder and a suicidal risk. Descriptive analysis, T-tests, variance analysis (ANOVA), correlation analysis and multiple regressions were conducted to examine the relationship between the suicidal risk (dependant variable) and the life habits and psychosocial factors (independent variables). The results indicate that, for 12 to 17 year olds, being satisfied with the support received, having good parental support, having many different sources of reading, eating supper with their family frequently, not smoking cigarettes, not having many friends who smoke cigarettes, not drinking, not doing drugs and not drinking and doing drugs simultaneously can all act as individual protective factors for suicidal risk. On the other hand, the results of this study do not show any statistically significant relations between school habits, physical activity, sleep habits, self-esteem and suicidal risk for teenagers with mood disorders. Finally, examining protective factors seems to be useful in helping teens with mood disorders and suicidal risk. The results of this study encourage nurses to include protective factors in their evaluation of suicidal adolescents and interventions. Research and clinical recommendations are therefore suggested.

The study explored the experiences of nurses regarding in-patients who attempt or succeed in committing suicide in a general hospital. The purpose of the study was to design support guidelines for the nurses who care for patients who attempt or successfully commit suicide whilst admitted at general hospital. A generic qualitative research approach was followed, using an exploratory and descriptive design. Data was collected through in-depth interviews from a purposive sample of six nurses who met the inclusion criteria. Content data analysis was done. The research findings revealed five themes. The findings indicate that the working environment was not safe for both the nurses and the patients; confused patients were unpredictable and withheld their intentions of suicide from the nurses. Nurses blamed themselves for in-patient suicide; as some are still living with feelings of guilt. Nurse unit managers provided support to the affected nurses; however debriefing sessions were not given to the affected employees. There were no clear guidelines on management of confused patients. Support guidelines for the nurses are presented in this study / Health Studies / M.A. (Health Studies)

INTRODUÇÃO: O Transtorno Bipolar (TB) é um transtorno psiquiátrico crônico e debilitante e sua etiologia e patologia ainda não são completamente conhecidos, apesar de um componente genético importante ser evidenciado em estudos de família, adoção e gêmeos. Recentemente, o TB tem sido relacionado a um processo de envelhecimento acelerado, com alguns estudos mostrando telômeros encurtados nesta população. O objetivo do presente estudo foi investigar a associação entre o comprimento telomérico, um dos parâmetros do processo de envelhecimento celular, com a ausência ou presença de TB em famílias com muitos membros afetados, além de associar a sintomatologia clínica e outras variáveis a esse parâmetro. Procurou-se também avaliar as influências genéticas e ambientais sobre o comprimento telomérico nessas famílias, estimando-se a herdabilidade desta característica. MÉTODOS: O comprimento telomérico (T) foi mensurado em uma amostra de 143 indivíduos de 22 famílias (60 deles com TB), em relação a um gene de cópia única (S) - beta-globina, através do método de PCR (Polymerase Chain Reaction) em tempo real quantitativo, no qual forneceu uma proporção do número de cópias de T por S (razão T/S). Considerando a estrutura familiar na análise estatística foi ajustado para cada análise o modelo misto poligênico. RESULTADOS: O efeito do TB no comprimento dos telômeros foi pequeno, não tendo sido observada uma associação estatisticamente significante entre TB e comprimento telomérico quando comparado com familiares saudáveis (p > 0,05). No entanto, observou-se associação do comprimento telomérico à covariável ideação suicida (p = 0,02) e à interação entre ideação suicida e curso da doença (p = 0,02). Associação do comprimento telomérico com idade materna e TB também foi observada (p < 0,05). Por fim, estimou-se em 68% a herdabilidade do comprimento telomérico nas 22 famílias do estudo. CONCLUSÕES: A teoria do envelhecimento acelerado em TB, vista pela óptica do comprimento dos telômeros, não pôde ser confirmada no presente estudo, pois não foi encontrada diferença no comprimento telomérico entre indivíduos saudáveis e com TB nas famílias. Por outro lado, covariáveis que indicam gravidade da doença, como a ideação suicida e a interação entre ideação suicida e curso da doença foram associadas ao comprimento telomérico (p < 0,05), ou seja, um encurtamento telomérico foi correlacionado à gravidade clínica do TB. Associação do comprimento telomérico com idade materna e TB (p < 0,05) sugeriu que a idade materna avançada não só pode ser um marcador de longevidade, como também o fenótipo TB pareceu reforçar essa condição. Por fim, a alta herdabilidade estimada do comprimento telomérico (0,68) revelou uma importante variabilidade genética desse fenótipo entre as famílias do estudo. Em súmula, este é o primeiro estudo que relatou uma associação entre ideação suicida, curso da doença, idade materna e comprimento telomérico em famílias com vários membros afetados pelo TB. Outras investigações independentes são necessárias para confirmar esses resultados preliminares / BACKGROUND: Bipolar Disorder (BD) is a debilitating and chronic mental illness. It is etiology and pathology are not completely known yet, despite the evidence of an important genetic component from family, twin and adoption studies. Recently, BD has been related to a process of accelerated aging, with some studies showing shortened leukocyte telomeres in this population. The purpose of the present study was to investigate the association between leucocyte telomere length (LTL) in BD patients compared with healthy relatives of 22 families with several affected members by this illness, besides associating clinical symptomatology and other covariates with this parameter. It was also examined the genetic and environmental influences on telomere length trait in these BD families, using a variance component approach, by estimating the heritability of this trait as well as covariate effects. METHODS: Telomere length (T) was estimated in a sample of 143 individuals, including 60 BD patients from 22 families, which was measured in relation to the single copy gene (S) - beta-globin gene, using a singleplex real time PCR (Polymerase Chain Reaction), providing a ratio of number of copies of T by S (T/S ratio). Taking in consideration the family structure, the statistical analysis was adjusted for the polygenic mixed model. RESULTS: The effect of BD illness in telomere length was small and we found no association between BD group and LTL (p > 0.05). However, LTL was associated with the variable suicidal ideation (p = 0.02) and interaction between suicidal ideation and course of disorder (p = 0.02). Association of LTL and maternal age and BD was also observed (p < 0.05). In addition, an important genetic component for telomere length was also observed (heritability = 0.68) in these families. CONCLUSIONS: The hypothesis of accelerated aging in BD, investigating the telomere length as one of its components, was not confirmed in our study. We found no difference between LTL and BD in our family group. However, using covariates that indicate severity of disease, both suicidal ideation and interaction between suicidal ideation and course of disorder were statistically significant with LTL, showing that shorter LTL was associated with worse clinical course (p < 0.05) and suicidal ideation (p < 0.05) in BD patients. Association of LTL with maternal age and BD (p < 0.05) suggests that advanced maternal age may not only be a marker of longevity, but also the BD phenotype may reinforce this condition. A high heritability for telomere length (0.68) also suggests an important genetic variability of this trait presented among those families. To our knowledge, this is the first study that found association between suicidal ideation, course of disorder, maternal age and LTL in families with several members affected by BD. Further investigations, including replication studies in other BD families, are needed to confirm these new findings

O Estresse precoce pode ocasionar graves consequências na vida adulta. Entre pacientes com Transtorno Afetivo Bipolar sua ocorrência ainda carece de ser avaliada em estudos ampliados que contemplem sua complexidade de maneira mais abrangente, considerando fatores pessoais, ambientais e psicossociais. Com o objetivo de investigar e ampliar a compreensão da relação entre o Estresse precoce, sintomas do humor (depressão e mania), estratégias de enfrentamento e ideação suicida em pacientes com Transtorno Afetivo Bipolar em um serviço comunitário no interior de São Paulo, desenvolveu-se um estudo transversal, analítico, exploratório, de abordagem quantitativa, utilizando os instrumentos: entrevista clínica para confirmação diagnóstica, de acordo com os critérios do DSM-IV; questionário sociodemográfico, de condições clínicas e de saúde, Escala de Depressão de Hamilton (HAM-D); Escala de Mania (YOUNG); Escala de ideação suicida (BSI); Escala de modos de enfrentamento de problemas (EMEP) e Questionário sobre Traumas na Infância (CTQ). Utilizou-se estatística descritiva e analítica, realizando-se testes Qui-quadrado, com coeficiente de correlação de Pearson e regressão logística, considerando níveis de significância de 0,05. Obteve-se aprovação do Comitê de Ética em Pesquisa e a amostra foi de conveniência não probabilística com 50 pacientes com TAB. Prevaleceram mulheres (66,0%), com idade média de 42,7 anos (dp +12,3), 56,0% possuíam ensino médio, 44,0% eram casados ou com companheiro fixo, 90,0% moravam com a família, 88,0% tinham religião, 60,0% estavam afastados ou desempregados, 74,0% viviam com renda mensal de até um salário mínimo, 48,0% tiveram tentativas de suicídio, 58,0% passaram por internações psiquiátricas prévias, 84,0% não praticavam atividade física e 56,0% possuíam comorbidades. A prevalência de Estresse precoce foi de 68,0%, não houve associação estatisticamente significativa entre Estresse precoce, sintomas do humor, estratégias de enfrentamento e ideação suicida entre pacientes com TAB em seguimento em um serviço comunitário. Possivelmente, tais resultados reflitam o impacto que as ações de apoio e suporte social oferecidas pelo CAPS e pela família tem proporcionado a estes pacientes. Os resultados deste estudo indicaram alta prevalência de Estresse precoce que, embora não associado com as demais variáveis, mostra-se relevante na vida destes pacientes. Estudos sobre o Estresse precoce e TAB, relação entre serviço/paciente/família e estratégias de enfrentamento no contexto comunitário podem indicar melhores formas de tratamento e implementação de políticas públicas que garantam melhor qualidade de vida a estes pacientes / Early stress can have serious consequences in adult life. Among patients with Bipolar Affective Disorder, its occurrence still needs to be evaluated in expanded studies that contemplate its complexity in a more comprehensive way, considering personal, environmental and psychosocial factors. With the objective of investigating and broadening the understanding of the relationship between early stress, mood symptoms (depression and mania), coping strategies and suicidal ideation in patients with Bipolar Affective Disorder in a community service in the interior of São Paulo, a cross-sectional, analytical, exploratory, quantitative approach using the instruments: clinical interview for diagnostic confirmation, according to DSM-IV criteria; sociodemographic questionnaire, clinical and health conditions, Hamilton Depression Scale (HAM-D); Mania Scale (YOUNG); Suicidal ideation scale (BSI); Scale of problem coping modes (EMEP) and Trauma Questionnaire in Childhood (CTQ). Descriptive and analytical statistics were used, with Chi-square tests, with Pearson correlation coefficient and logistic regression, considering levels of significance of 0.05. Approval was obtained from the Research Ethics Committee and the sample was of non-probabilistic convenience with 50 patients with BAD. Prevalence of women (66.0%), mean age 42.7 years (dp +12.3), 56.0% had a high school education, 44.0% were married or had a fixed partner, 90.0% lived with the family, 88.0% had religion, 60.0% were retired or unemployed, 74.0% lived with monthly income of up to one minimum wage, 48.0% had attempted suicide, 58.0% had psychiatric hospitalizations 84.0% did not practice physical activity and 56.0% had comorbidities. The prevalence of early stress was 68.0%; there was no statistically significant association between early stress, mood symptoms, coping strategies, and suicidal ideation among patients with BD at follow-up at a community service. These results may reflect the impact that the support and social support actions offered by the CAPS and the family have provided to these patients. The results of this study indicated a high prevalence of early stress that, although not associated with the other variables, is shown relevant in the life of these patients. Studies on early stress and BD, relationship between service / patient / family and coping strategies in the community context may indicate better ways of treatment and implementation of public policies that guarantee a better quality of life for these patients

Självmord, eller suicid som det också kallas, är i vårt samhälle ett tabubelagt ämne där en känsla av utanförskap har belysts hos den suicidnära patienten som ibland upplever sin vård som otillräcklig. Syftet med följande studie är därför att belysa sjuksköterskans upplevelse av att vårda den suicidnära patienten och för att genomföra detta har en litteraturstudie genomförts på fyra kvalitativa- samt fem kvantitativa artiklar där resultatet visar att sjuksköterskans syn på patienten, på sig själv samt på sin kompetens i stor utsträckning påverkar patientens upplevelse av vårdandet. Vidare beskrivet är att sjuksköterskan tycks vara benägen att sätta etiketter på patienten där vissa grupper upplevs som svårare att vårda. Sjuksköterskan uppfattar vårdandet som tungt, då den vård som förmedlas inte upplevs ge önskad effekt. Eftersom relationen mellan sjuksköterskan och patienten är av stor vikt för att främja en framtida patienthälsa anses det att en bredare utbildning bör erhållas den grundutbildade sjuksköterskan för att underlätta förmågan att sätta sin förförståelse åt sidan och därmed öka förutsättningen för den psykiskt sjuka patienten. En minskad arbetsbelastning anses även vara av stor vikt då sjuksköterskan tycks uppleva en stress under sin arbetsdag där administrativa arbetsuppgifter tvingas ta utrymme framför patientkontakten. Psykisk sjukdom och ohälsa tros i framtiden utvecklas till den näst ledande folkhälsosjukdomen och ett preventivt arbete, där en vårdande relation sätts i fokus, anses i mötet med denna patientgrupp vara av ytterst vikt för att i framtiden minska antalet suicidförsök och fullbordad suicid vilket anses ge en hållbar utveckling av samhället. Abstract: Society tends to meet the suicidal patient with a lack of understanding. The general taboo nature of the subject, as well as feelings of alienation is factors that lead patients to perceive their healthcare as inadequate. The purpose of this study is therefor to survey the experiences of nurses in their meetings with suicidal patients and to this end the authors have carried out literary studies of four qualitative and five quantitative articles. The analysis of the studies led to the conclusion that the nurse&apos;s perception of the patient, herself and her own competence greatly affect the patients’ healthcare experience. Additionally, the studies show that nurses are inclined to perceive their work as difficult when treatment does not have the desired effect and thereby categorize the patients similarly. The relationship between nurse and patient is of great importance for successful healthcare and this study shows the need for a broader education to provide the nurse tools to manage her preconceived notions and thereby provide better conditions for the suicidal patient. Nurses, in their stressful work environment, are often forced to choose between administrative duties and patient contact which highlights the need for a decreased work load. Mental illness is believed to become the next largest public health threat and a preventative approach, with focus on the nurse-patient relationship is central to effectiveness of suicide prevention. / Program: Sjuksköterskeutbildning

O Estresse precoce pode ocasionar graves consequências na vida adulta. Entre pacientes com Transtorno Afetivo Bipolar sua ocorrência ainda carece de ser avaliada em estudos ampliados que contemplem sua complexidade de maneira mais abrangente, considerando fatores pessoais, ambientais e psicossociais. Com o objetivo de investigar e ampliar a compreensão da relação entre o Estresse precoce, sintomas do humor (depressão e mania), estratégias de enfrentamento e ideação suicida em pacientes com Transtorno Afetivo Bipolar em um serviço comunitário no interior de São Paulo, desenvolveu-se um estudo transversal, analítico, exploratório, de abordagem quantitativa, utilizando os instrumentos: entrevista clínica para confirmação diagnóstica, de acordo com os critérios do DSM-IV; questionário sociodemográfico, de condições clínicas e de saúde, Escala de Depressão de Hamilton (HAM-D); Escala de Mania (YOUNG); Escala de ideação suicida (BSI); Escala de modos de enfrentamento de problemas (EMEP) e Questionário sobre Traumas na Infância (CTQ). Utilizou-se estatística descritiva e analítica, realizando-se testes Qui-quadrado, com coeficiente de correlação de Pearson e regressão logística, considerando níveis de significância de 0,05. Obteve-se aprovação do Comitê de Ética em Pesquisa e a amostra foi de conveniência não probabilística com 50 pacientes com TAB. Prevaleceram mulheres (66,0%), com idade média de 42,7 anos (dp +12,3), 56,0% possuíam ensino médio, 44,0% eram casados ou com companheiro fixo, 90,0% moravam com a família, 88,0% tinham religião, 60,0% estavam afastados ou desempregados, 74,0% viviam com renda mensal de até um salário mínimo, 48,0% tiveram tentativas de suicídio, 58,0% passaram por internações psiquiátricas prévias, 84,0% não praticavam atividade física e 56,0% possuíam comorbidades. A prevalência de Estresse precoce foi de 68,0%, não houve associação estatisticamente significativa entre Estresse precoce, sintomas do humor, estratégias de enfrentamento e ideação suicida entre pacientes com TAB em seguimento em um serviço comunitário. Possivelmente, tais resultados reflitam o impacto que as ações de apoio e suporte social oferecidas pelo CAPS e pela família tem proporcionado a estes pacientes. Os resultados deste estudo indicaram alta prevalência de Estresse precoce que, embora não associado com as demais variáveis, mostra-se relevante na vida destes pacientes. Estudos sobre o Estresse precoce e TAB, relação entre serviço/paciente/família e estratégias de enfrentamento no contexto comunitário podem indicar melhores formas de tratamento e implementação de políticas públicas que garantam melhor qualidade de vida a estes pacientes / Early stress can have serious consequences in adult life. Among patients with Bipolar Affective Disorder, its occurrence still needs to be evaluated in expanded studies that contemplate its complexity in a more comprehensive way, considering personal, environmental and psychosocial factors. With the objective of investigating and broadening the understanding of the relationship between early stress, mood symptoms (depression and mania), coping strategies and suicidal ideation in patients with Bipolar Affective Disorder in a community service in the interior of São Paulo, a cross-sectional, analytical, exploratory, quantitative approach using the instruments: clinical interview for diagnostic confirmation, according to DSM-IV criteria; sociodemographic questionnaire, clinical and health conditions, Hamilton Depression Scale (HAM-D); Mania Scale (YOUNG); Suicidal ideation scale (BSI); Scale of problem coping modes (EMEP) and Trauma Questionnaire in Childhood (CTQ). Descriptive and analytical statistics were used, with Chi-square tests, with Pearson correlation coefficient and logistic regression, considering levels of significance of 0.05. Approval was obtained from the Research Ethics Committee and the sample was of non-probabilistic convenience with 50 patients with BAD. Prevalence of women (66.0%), mean age 42.7 years (dp +12.3), 56.0% had a high school education, 44.0% were married or had a fixed partner, 90.0% lived with the family, 88.0% had religion, 60.0% were retired or unemployed, 74.0% lived with monthly income of up to one minimum wage, 48.0% had attempted suicide, 58.0% had psychiatric hospitalizations 84.0% did not practice physical activity and 56.0% had comorbidities. The prevalence of early stress was 68.0%; there was no statistically significant association between early stress, mood symptoms, coping strategies, and suicidal ideation among patients with BD at follow-up at a community service. These results may reflect the impact that the support and social support actions offered by the CAPS and the family have provided to these patients. The results of this study indicated a high prevalence of early stress that, although not associated with the other variables, is shown relevant in the life of these patients. Studies on early stress and BD, relationship between service / patient / family and coping strategies in the community context may indicate better ways of treatment and implementation of public policies that guarantee a better quality of life for these patients

Approximately 43% of college students report experiencing suicidal ideation in the past year, and suicide is the 2nd leading cause of death among college students, making it a significant public health concern. Development of successful suicide intervention and prevention strategies is predicated on identification of risk (e.g. negative life events, hopelessness) and protective factors (e.g. self-compassion) that may be targeted for treatment. A well-established linkage exists between life stressors and suicidal behavior; however, potential mechanisms of action underlying this association are under-researched. It may be that negative life events contribute to feelings of hopelessness, which is conceptualized as negative beliefs and expectations about one’s self and future. However, not all persons who experience negative life events and hopelessness become suicidal, perhaps due to protective factors such as self-compassion. Comprised of self-kindness, mindfulness and sense of common humanity, self-compassion may contribute to emotional resilience when negative life events occur; however, this premise has not been previously examined. We hypothesized that hopelessness would mediate the relation between negative life events and suicidal behaviors, such that negative life events would be related to increased feelings of hopelessness and, in turn, to greater risk for suicidal behavior. We also hypothesized that self-compassion would beneficially moderate the mediating effect of hopelessness. Our sample of college students (n=338) were primarily female (67%; n=227) and White (89.6%; n=294), with a mean age of 21.8 years (SD=4.7). Participants completed self-report measures including the Life Events Scale, the Beck Hopelessness Inventory, the Suicide Behaviors Questionnaire - Revised, and the Self-Compassion Scale. Supporting our hypotheses, hopelessness fully mediated the relation between negative life events and suicidal behavior (DE=.07, SE=.06, 95% CI=.05,.28,p

Suicide represents a major problem for all members of society. Findings from studies have shown that suicide risk is among the highest in young adult populations. Although a variety of factors have been identified in trying to predict suicide risk in young adults, one variable that has received considerable attention has been social disconnectedness. For example, according to Joiner’s (2005) theory of suicide, being socially disconnected from others represents a critical factor that heightens a person’s risk for suicide. Consistent with this view, findings from numerous studies have shown a reliable association between loneliness and suicide risk (Hatcher & Stubbersfield, 2013). For example, Chang and his colleagues (Chang et al., 2015; Chang, Muyan, & Hirsch, 2015; Muyan & Chang, 2015) have found a reliable association between loneliness and greater suicide risk (e.g., hopelessness, suicidal behaviors) in diverse cultural groups. Indeed, in one study, Chang, Hirsch, Sanna, Jeglic, and Fabian (2011) found that loneliness was an important predictor of suicide risk in Latina college students. Although these findings are important and point to the potential value of loneliness as a predictor of suicide risk in diverse adult groups, they do not take into account more culture- specific variables. Accordingly, we conducted the present study to examine the extent to which culture- specific (emic) variables might play an important role in predicting suicide risk, and to also determine if the inclusion of a general (etic) explanatory variable would add to the prediction of suicide risk, namely, hopelessness and suicidal behaviors, in a sample of 155 Latino college students. We conducted a pair of regression analyses including demographic variables (viz., age & sex) in the First Step, ethnic identity variables (ethnic affirmation, ethnic identity achievement, ethnic behaviors, & other group orientation; Phinney, 1992) in the Second Step, and loneliness (Russell, Peplau, & Curtrona, 1980) in the final Third Step, in predicting hopelessness and suicidal behaviors. Results of these analyses for both outcomes indicated that demographic variables did not account for significant variance in suicide risk. However, ethnic identity variables, as a set, were found to account for a significant 11% of the variance in hopelessness, and a significant 10% of the variance in suicide behaviors. Noteworthy, the inclusion of loneliness was found to account for an additional 19% of unique variance in hopelessness, and an additional 13% of unique variance in suicidal behaviors. Taken together, our findings underscore the importance of considering both emic and etic factors in trying to identify variables that may place Latinos at heightened risk for suicide. Additionally, our findings also point to the potential value of targeting specific ethnic identity variables (e.g., ethnic identity achievement) as well as loneliness when working with Latinos at risk for suicide.

Background: Suicidal young adults often confide their distress to peers. It is unclear, however, what types of assistance a friend may offer in response to various symptoms of distress as well as whether the sex of either individual affects responses. Aims: We examined open-ended responses to e-mail vignettes from a fictitious friend exhibiting depressed, irritable, or overtly suicidal communications. Method: College student participants (n = 106) read e-mail messages from a fictitious friend, to which they composed a reply. Replies were coded to reflect the presence/absence of mention of professional help, problem-oriented (personal) help, and social support. Results: Problem-oriented help was offered the most across conditions; professional help was offered least in response to depressed or irritable vignettes. Women were more likely to offer any type of help than men. Patterns of help-giving and sex differences in help-giving varied by condition. Conclusions: Results indicate students’ preferences for solving peer problems personally rather than professionally. Campus prevention and intervention efforts should focus on enhancing students’ peer support and referral skills.