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Objectives The purpose of this study was to examine the influences of spiritual well-being and parenting styles on USA nursing students’ psychological well-being and suicidal ideation. Methods This was a cross sectional, descriptive research design. The structured questionnaires were used to do the data collection. There were 404 nursing students were recruited from a Midwest University in the USA. The mean age was 24.53 (SD = 6.14). There were 53 Male (13.1%) and 351 Female (86.9%). The SPSS 28th version was used to do the data analysis. The descriptive data analysis, Pearson Correlation, and Step-wise Multiple Regressions were used to solve the research questions. Results Total score of spiritual well-being, faith/belief, life and self-responsibility, and life satisfaction/ self- actualization had statistically significant positive relationships with nursing students’ psychological well- being. Total score of spiritual well-being, faith/belief, life and self-responsibility, and life satisfaction/ self- actualization had statistically significant reverse relationships with nursing students’ suicidal ideation. Their parents’ rearing attitude: child monitor, inductive reasoning, communication, positive reinforcement, involvement, and the total scores of positive rearing attitude had statistically significant positive relationships with nursing students’ psychological well-being. Their parents’ rearing attitude: communication, positive reinforcement, and the total scores of positive rearing attitude had statistically significant reverse relationships with nursing students’ suicide ideation. Their parents’ harsh discipline and the total scores of negative rearing attitude had statistically significant positive relationships with nursing students’ suicide ideation. Discussion In this study, life satisfaction/self-actualization, life/self-responsibility, positive reinforcement, and faith/belief were the significant predictors of nursing students’ psychological well-being. Total scores of spiritual well-being and positive reinforcement were significant predictors of nursing students’ suicidal ideation. Higher score of total scores of spiritual well-being and positive reinforcement were found to predict decreasing nursing students’ suicidal ideation.

Background Nursing professional health courses have been reported to be very exhaustive and stressful, with most nursing students reporting moderate levels of stress. Purpose This study was designed to compare the spiritual well-being, coping strategies, psychological well-being, anxiety, depression, and suicidal ideation between Taiwanese and Australian nursing students. Methods Three hundred eighty-one nursing students (180 from Taiwan and 201 from Australia) were recruited for this cross-sectional comparative research study. The Psychological Well-being Scale, Spiritual Well-being Scale, Coping Strategies Inventory Short-Form, Hamilton Anxiety Scale, Zung Depression Scale, and Brief Screen for Adolescent Depression Scale were used to collect data. SPSS 27.0 was used for data analysis. Descriptive data analysis, chi-square tests, independent t test, Pearson correlations, and stepwise multiple regressions were used to examine the research questions. Results Students in Australia had higher mean scores than Taiwanese nursing students for psychological well-being, life satisfaction/self-actualization, and using problem-focused disengagement coping strategies, whereas Taiwanese students had higher mean scores for using emotion-focused engagement coping strategies and depression than their Australian nursing students. Spiritual well-being and problem-focused disengagement were shown to be significantly and positively related to psychological well-being and significantly and negatively related to anxiety, depression, and suicidal ideation in both groups. No significant difference between Australian students and Taiwanese students was found in anxiety, suicidal ideation, and negative-emotion-related alcohol use. Conclusions/Implications for Practice The multiple regressions performed in this study support life satisfaction/self-actualization and the emotion-focused disengagement coping strategy as significant predictors of anxiety, depression, and suicidal ideation in both student groups. The findings of this study help nursing program faculty better understand the key factors of influence on nursing student mental health and provide a conceptual framework for using problem-focused coping strategies and spiritual education on students.

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.

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.