Thesis advisor: Thomas O'Hare / Substance use and suicide among adolescents is a pervasive problem in the United States. It is estimated that over 190,000 youth go to the emergency department each year as a result of alcohol related injuries and over 5,000 youth are estimated to die each year from alcohol related incidents. Moreover, suicide is the second leading cause of death for adolescents, resulting in more than one in ten deaths among adolescents. Research has demonstrated that a history of childhood abuse is a strong risk factor for suicidal ideation and alcohol misuse and related problems. It is estimated that 29% of maltreated youth engage in substance use with 9% reporting moderate to high levels of use and 5% reporting risky suicidal behavior. Although prior studies provide a foundation for understanding substance use and suicidal thoughts among maltreated youth, some significant gaps remain in the knowledge base including the use of older data, treating all maltreated youth as a homogenous group, and looking at substance use and suicidal thoughts as independent outcomes. This dissertation fills some of these gaps in the empirical literature by focusing on three specific aims: 1) examine the co-occurrence of substance use and suicidal thoughts among maltreated youth; 2) investigate the longitudinal predictors of substance use and suicidal thoughts among maltreated youth; and 3) assess whether the predictors of substance use and suicidal thoughts are similar or different across placement types (in-home care, kinship care, or foster care). The National Survey on Child and Adolescent Wellbeing (NSCAW II) restricted dataset is used as the primary source for the analyses to address each aim. Policy and practice implications are provided for the fields of addiction, mental health, and child welfare. / Thesis (PhD) — Boston College, 2018. / Submitted to: Boston College. Graduate School of Social Work. / Discipline: Social Work.

Doctor of Philosophy / School of Family Studies and Human Services / Jared A. Durtschi / Each year in the United States, 40,000 individuals die by suicide, 7,000 of whom are young adults between the ages of 25-34. For every death, it is estimated that another 25 suicide attempts are made and that over 8% of young adults experience thoughts of suicide each year. Suicide rates are climbing, but identification of protective factors to reduce suicide risk remains elusive. Using a sample of 4,208 young adults from the National Longitudinal Study of Adolescent to Adult Health, a latent profile analysis was used to test the number of profiles that best fit the data based on indicators that were hypothesized to be risk or protective features, and those profiles were analyzed using logistic regression to assess suicide risk. Hypothesized protective indicators included parent and romantic relationship quality, parental satisfaction, job satisfaction, and religiosity. Hypothesized risk indicators included parental demands, depressive symptoms, job demands, isolation, alcohol use, and adverse childhood experiences. A four-profile solution was optimal for this data and yielded four distinct profiles named: Satisfied with Life (n = 2,442), Relationship Stress (n = 669), Demanding Jobs (n = 658), and Challenging Childhood (n = 427). Individuals in the Satisfied with Life profile reported positive relationship quality with parents, partners, and children, and low depressive symptoms, isolation, and adverse childhood experiences. This profile was associated with a 60% decrease in risk for suicidal ideation. Participants in the Relationship Stress profile reported low relationship satisfaction, lack of confidence that their romantic relationship was going to be permanent, and high alcohol consumption. Individuals in this profile were 104% more likely to experience suicidal ideation compared to those not in this profile. The Demanding Jobs profile included individuals who felt their work interfered with their family time, and vice versa, but still had moderately high satisfaction in each area. This profile was not significantly associated with suicidal ideation. The final profile, Challenging Childhood, included individuals who reported low quality of relationships with their parents, high levels of isolation and depressive symptoms, and significantly higher adverse childhood experiences than other individuals in this sample. Individuals in this profile were associated with 192% increase in risk for suicidal ideation than those not in this profile. The results of this study underscore the importance of positive relationships as a protective factor against suicide, and provide new information about how job satisfaction and demands can also serve as protective features. Therapeutic interventions that address improving social support, coping with traumatic events, and decreasing alcohol consumption are recommended to decrease suicidal thoughts.

Perceived social problem-solving deficits are associated with suicide risk; however, little research has examined the mechanisms underlying this relationship. The interpersonal theory of suicide proposes 2 mechanisms in the pathogenesis of suicidal desire: intractable feelings of thwarted belongingness (TB) and perceived burdensomeness (PB). This study tested whether TB and PB serve as explanatory links in the relationship between perceived social problem-solving (SPS) deficits and suicidal thoughts and behaviors cross-sectionally and longitudinally. The specificity of TB and PB was evaluated by testing depression as a rival mediator. Self-report measures of perceived SPS deficits, TB, PB, suicidal ideation, and depression were administered in 5 adult samples: 336 and 105 undergraduates from 2 universities, 53 homeless individuals, 222 primary care patients, and 329 military members. Bias-corrected bootstrap mediation and meta-analyses were conducted to examine the magnitude of the direct and indirect effects, and the proposed mediation paths were tested using zero-inflated negative binomial regressions. Cross-sectionally, TB and PB were significant parallel mediators of the relationship between perceived SPS deficits and ideation, beyond depression. Longitudinally and beyond depression, in 1 study, both TB and PB emerged as significant explanatory factors, and in the other, only PB was a significant mediator. Findings supported the specificity of TB and PB: Depression and SPS deficits were not significant mediators. The relationship between perceived SPS deficits and ideation was explained by interpersonal theory variables, particularly PB. Findings support a novel application of the interpersonal theory, and bolster a growing compendium of literature implicating perceived SPS deficits in suicide risk.

The prevalence of sexual harassment among college women has been reported to range from 33% to 97% (Klein, Apple, & Khan, 2011; Yoon, Funk, & Kropf, 2010) across the lifespan. In any one year of college, the prevalence of sexual harassment reported by women ranges from 33% to 57% (Crown & Roberts, 2007; Huerta, Cortina, Pang, Torges, & Magley, 2006). The severity and frequency of sexual harassment has been found to be related to reports of psychological distress (Nielsen & Einarsen, 2012), feelings of shame (Yoon et al., 2010), anxiety and depression symptoms (Murdoch, Pryor, Polusny, & Gackstetter, 2007), and social isolation (Pershing, 2003). These consequences of sexual harassment are concerning given the association between depression, isolation, and suicidality (Boardman, Grimbaldeston, Handley, Jones, & Willmott, 1999; DeWall, Gilman, Sharif, Carboni, & Rice, 2012). While there are numerous studies documenting the negative consequences experienced by women who are sexually harassed, little is known about the relationship of sexual harassment to the more severe negative outcomes of suicidal ideation and self-harm behaviors and what variables might facilitate this hypothesized relationship. Thus, the purpose of this study is to explore whether the experience of sexual harassment is related to increased suicidality and if this hypothesized relationship is mediated or moderated by other factors such as an individual’s response style and/or degree of connection to or isolation from others.

Background: Suicidal thoughts affect 12% of Canadian adolescents. Previous research has linked many factors to suicidality but has not considered how these factors may act together or their effect on non-mental health outcomes. Methods: I used the National Longitudinal Survey of Children and Youth to construct predictive models for suicidal thinking. Recursive partitioning models were constructed and the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for suicidal thoughts and secondary outcomes was calculated. I tested the models in the Avon Longitudinal Survey of Parents and Children. Results: Predictive model sensitivity was 24.2%, specificity was 89.8%, PPV was 24.7%, and NPV was 89.5% and had similar accuracy in the second dataset. The models were better at predicting other adverse outcomes compared to suicidal ideas. Conclusion: Exposure to multiple risk factors is predictive of several poor outcomes in adolescence including suicidal thoughts.

Individuals who identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ) are at a higher risk for suicide compared to the general population, but little is known about why this is. Many LGBTQ individuals face some form of discrimination or victimization in their lifetime, and some evidence suggests these experiences may contribute to this group’s higher suicide risk. Unfortunately, research has only examined the impact of direct discrimination/victimization on suicidality and has neglected to examine how ambient discrimination/victimization relates to suicidality. Additionally, although some links exist between discrimination, victimization, and suicide, the mechanisms by which these are related are unknown. This study aims to address these gaps in the literature by exploring the effect of ambient discrimination/victimization on suicidal ideation and examining psychological pain as a mediator and social connectedness as a moderator between various forms of discrimination and victimization and suicidal ideation. Regression, mediation, and moderation analyses were conducted in order to examine these relationships in a sample of 200 LGBTQ-identified individuals. Results of this study may provide insight into why the LGBTQ community is at an increased risk for suicide.

No description available.

Suicide remains a global cause of mortality, presenting challenges in detection and prevention despite known warning signs. This work aimed to improve personal security management by leveraging machine learning advancements to identify suicidal ideation in written communications. Using a design science approach, six machine learning models based on the RoBERTa model were developed with different hyperparameter values. These models were trained on a well-balanced dataset comprising 1,114 instances of suicide letters and social media posts. The model achieving the highest accuracy (0.919) and F1 score (0.919) during training was evaluated on a dataset consisting of posts from the subreddits r/terraluna and r/Terra_Luna_crypto. These posts were published during a period when the cryptocurrency Terra Luna experienced a crash, leading to reported cases of alleged suicides. The fine-tuned model demonstrated a reasonably high accuracy (0.841) and weighted F1 score (0.913) when tested on this real-world dataset. Additionally, a smaller test was conducted on selected posts (34 posts) from this dataset containing mentions of specific words. The model achieved an accuracy of 0.852, and a weighted F1 score of 0.887 when classifying these posts. There exist a considerable potential for further research and development in this field. By expanding and improving the dataset used in this project, incorporating additional features and contextual information, the accuracy and practicality of the model in real-life situations can be greatly enhanced. The ultimate objective is to create a resilient system that genuinely assists in the prevention of suicide. The results of this work offer hope and optimism for a future where advanced technology, combined with human compassion, addresses one of the most pressing public health issues of our time.

No description available.

Suicide is the second leading cause of death worldwide for adolescents and emerging adults. Despite knowledge of distal risk factors for suicide (i.e., childhood maltreatment), there is a dearth of developmentally informed psychobiological theories of suicide that test potentially modifiable proximal risk factors. Utilizing a multi-method design, this study integrates cognitive and biological risk factors into a model of suicide risk following maltreatment. Undergraduates completed a screener assessing medical history, trait reward and threat sensitivities, history of suicidal thoughts and behaviors (STBs), and childhood maltreatment. Participants without a history of autoimmune disease completed a reward and threat-salient acute stress task with pre- and post-task blood draws to measure peripheral inflammatory biomarkers. Utilizing ecological momentary assessment, a subset of participants with a history of suicidal ideation completed daily measures (three per day) of STBs and state reward and threat sensitivities for two-weeks before completing follow-up measures of STBs. Mediation models found that inflammatory reactivity to acute stress did not explain the relationship between maltreatment and ideation across the two-week follow-up, but those participants with greater TNF-α reactivity to an acute stress task reported more severe ideation at the study visit. Moderated mediation models showed that the association between inflammatory reactivity and suicidality was not significantly amplified by reward or threat sensitivity. But, at trait and state levels, those with histories of maltreatment who were less sensitive to rewards and more aware of potential threats experienced the most severe ideation. This investigation aimed to understand the processes that immediately precede STBs to inform future prevention and intervention efforts. / Psychology