BACKGROUND: Both mood and anxiety disorders are more prevalent in women than men with the onset typically occurring during adolescence or early childbearing years. These disorders are particularly prevalent during pregnancy and the postpartum period. While depression during the perinatal period has received significant attention recently, anxiety has not received the same amount of attention. METHODS: The current study was a secondary analysis of a prospective cohort study that followed 91 women with mood disorders through pregnancy and the postpartum period. Our objective was to determine if a correlation existed between anxiety and suicidality. We hypothesized that pregnant women with a history of a mood disorder and comorbid anxiety are more likely to be suicidal than those without comorbid anxiety. The presence of anxiety was determined using the anxiety subscale of the Edinburgh Postnatal Depression Scale, EPDS; a cut off score of six or greater was used to indicate significant anxiety. Suicidality was determined using three separate measures: question ten on the EPDS, question eighteen on the Inventory of Depressive Symptomatology, and question ten on the Montgomery-Asberg Depression Rating Scale. ANALYSIS: Chi square tests were used to compare the demographics of the anxious and non-anxious women based on both diagnosis of anxiety disorders and symptoms of anxiety. Z proportion tests were then used to compare the proportion women with anxiety versus those without anxiety who were suicidal. Lastly, binary logistic regression was used to determine if patients with anxiety were more likely to be suicidal. RESULTS: Among the women in this study, 62 (68.1%) had a diagnosis of major depressive disorder and 29 (31.9%) had a diagnosis of bipolar disorder based on DSM-IV-TR diagnostic criteria. In addition, 45 (49.5%) had a lifetime history of an anxiety disorder. The prevalence of significant anxiety symptoms, as determined by the anxiety subscale on the EPDS, ranged from 9.1-37.5% depending on the time point. Suicidality prevalence also varied depending on both the time point and the scale used: 0-17.5% using the MADRS, 6.7-24.7% using the EPDS, and 2.4-14.7% using the IDS. Using a binary logistic regression, we determined that anxiety was a risk factor for suicidality at time T3 (OR 2.106; 95% CI 1.274-3.481) and M1 (OR 2.057; 95% CI 1.179-3.586) on the MADRS and at T3 (OR1.758; 95% CI 1.219-2.535) on the EPDS.

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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.

Background: Insomnia is a robust correlate of suicidal ideation and behavior. Preliminary research has identified thwarted belongingness (c.f. social disconnection) as an explanatory link between insomnia and suicidal ideation. Objectives: This study replicates and extends previous findings using both cross-sectional and longitudinal designs in four demographically diverse samples. Additionally, the specificity of thwarted belongingness was evaluated by testing anxiety as a rival mediator. Method: Self-report measures of insomnia symptoms, thwarted belongingness, suicidal ideation and behavior, and anxiety were administered in four adult samples: 469 undergraduate students, 352 psychiatric outpatients, 858 firefighters, and 217 primary care patients. Results: More severe insomnia was associated with more severe thwarted belongingness and suicidality. Thwarted belongingness significantly accounted for the association between insomnia and suicidality, cross-sectionally and longitudinally, beyond anxiety. Notably, findings supported the specificity of thwarted belongingness: anxiety did not significantly mediate the association between insomnia and suicidality, and insomnia did not mediate the relation between thwarted belongingness and suicidality. Limitations: This study relied solely on self-report measures. Future studies incorporating objective sleep measurements are needed. Conclusion: Findings underscore the utility of assessing and addressing sleep disturbances and social disconnection to reduce suicide risk.

Associations between the satisfaction of basic psychological needs of autonomy, competence, and relatedness with current suicidal ideation and risk for suicidal behavior were examined. Two logistic regressions were conducted with a cross-sectional database of 440 university students to examine the association of need satisfaction with suicidal ideation and risk for suicidal behavior, while controlling for demographics and depressive symptoms. Suicidal ideation was reported by 15% of participants and 18% were found to be at risk for suicidal behavior. A one standard deviation increase in need satisfaction reduced the odds of suicidal ideation by 53%, OR (95% CI) = 0.47 (0.33–0.67), and the odds of being at risk for suicidal behavior by 50%, OR (95% CI) = 0.50 (0.37–0.69). Young adults whose basic psychological needs are met may be less likely to consider suicide and engage in suicidal behavior. Prospective research is needed to confirm these associations.

Patients presenting to the emergency department (ED) often suffer from more than physical ailments when seeking care and treatment. Some of these patients have emotional ailments and suicidal ideation when they come to the local ED. The lack of recognition of at-risk patients by health care providers can lead to poor patient outcomes and death. The focus of this project was to understand which valid and reliable suicide assessment tools described in the literature were considered the best evidence-based instruments to identify ED patients who were at risk for suicide. Peplau's theory of interpersonal relations guided this project. A systematic review of the literature was conducted to assess tools that were used for the identification of at-risk patients. Analysis of the included literature was conducted using Melnyk's levels of evidence and a preferred reporting items for systematic reviews and meta-analyses tool to catalog the articles retrieved. Ten articles were included in the study. Final analysis of the articles identified the need for 100% of patients to be assessed for suicide risk upon arrival at the ED. The instrument identified to meet the need for the local organization was the Columbia-Suicide Severity Rating Screening tool. The findings of this project might promote social change by providing insights into best practice assessment tools to support improved assessment of suicide risk for ED patients.

Suicide has immediate and long-term negative effects on surviving family members and adverse effects in the school and community. Suicide rates for children and adolescents have increased in the United States since 2009. As part of suicide prevention efforts, information about risk factors and warning signs are typically addressed in schools, private organizations, and communities. In addition to academic literature for professional audiences, various therapeutic resources are available to assist those who grieve the suicide of a loved one. In particular, practical and easy-to-implement interventions are needed by those who offer support to suicidal individuals and survivors of suicide. Practical resources are needed to address suicide prevention, intervention, and postvention needs. This study is based on a questionnaire that was given to 250 registered individuals at an annual state suicide prevention training conference. Of those attending, 60 (24%) completed the questionnaire. Participants who did not have experience working with suicidal youth did not participate, so the actual participation rate was influenced by this factor. Questions explored the recommendations of mental health professionals (N=60) who worked with (a) suicidal youth, (b) siblings of youth who completed suicide, and/or (c) youth whose parent completed suicide. More specifically this study investigated specific strategies and resources for working with these three specific groups of survivors. Findings from this study indicated that mental health professionals recommend a variety of suicide prevention resources and strategies such as implementing evidenced-based prevention programs, accessing community resources, offering individual and group counseling for survivors, involving or creating support systems, and listening to the affected youth. Also, recommended therapeutic approaches should include an action plan where students are able to receive appropriate mental health services. Based on this study, mental health professionals may be more effective as they acquaint themselves with available resources such as counselors, school psychologists, and community services to comprehensively care for struggling individuals. Mental health professionals, educators, and staff members should obtain relevant information and utilize effective intervention models in order to better address the prevention, intervention, and postvention needs of surviving individuals.Recommendations are made for future research in identifying the combination of resources that are most helpful. Recommendations are also made regarding specific content and training strategies to more effectively prepare and equip professionals to engage more fully in effective and supportive suicide prevention efforts.

Among indigenous populations, there is significant evidence that the rates of completed suicide are much higher than in the general population. The current study examines whether the prevalence and risk factors of suicidal ideation, plans and attempts differ when comparing an American Indian reservation sample to a US general population sample. Data were from the National Comorbidity Survey (n = 5,877) and the American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project (N = 3,084). The current findings indicate that there are few differences in the likelihood of suicidal behavior in conjunction with particular disorders or traumas. However, American Indians appeared more likely to make a suicide attempt and less likely to have suicidal thoughts in their lifetime when compared with the general population. Although preliminary and exploratory, findings provide evidence that suicide interventions for indigenous populations may require modification based on differential risk factors for suicide. / October 2008