O suicídio é um problema passível de prevenção, com relevante impacto mundial. Os profissionais de enfermagem que atuam em emergências tem papel central no manejo inicial de tentativas de suicídio e a qualidade do cuidado prestado por esses profissionais pode ser influenciada por suas atitudes frente ao comportamento suicida. O conhecimento sobre as atitudes relacionadas ao suicídio e fatores associados é escasso e precisa ser investigado em diferentes países, culturas e épocas. Este investigou, entre profissionais de enfermagem que atuam em emergências, as atitudes relacionadas ao suicídio e fatores associados. Estudo transversal quantitativo desenvolvido com uma população de 146 profissionais de enfermagem de dois serviços de emergência (pré-hospitalar e hospitalar) do interior de São Paulo, Brasil. Os dados foram coletados em 2015 pela autoaplicação de questionário sociodemográfico e do Questionário de Atitudes Frente ao Comportamento Suicida (QACS). Esse questionário não possui pontos de corte e sua análise pode ser feita por meio dos itens isolados e dos fatores \"Sentimentos em relação ao paciente\", \"Percepção de capacidade profissional\" e \"Direito ao suicídio\". Os dados foram analisados com os softwares Statistical Package for the Social Sciences (SPSS), versão 19.0 e R GUI 3.0.1. Foram aplicados os testes de normalidade Kolmogorov-Smirnova e Shapiro-Wilk, o teste de correlação de Spearman e o teste de Mann-Whitney. Os participantes apresentaram baixa exposição educacional sobre o suicídio e foram obtidas as pontuações mínima e máxima em cada um dos itens do questionário. Atitudes mais negativas foram associadas a ter trabalhado em serviço de saúde mental (p=0,00). Maior percepção de capacidade profissional esteve associada a formação específica em saúde mental (p=0,00) ou suicídio (p=0,00) e trabalhar em serviço hospitalar (p=0,01). Atitudes menos moralistas e condenatórias foram associadas a experiência de trabalhar serviços de saúde mental (p=0,01) e ser enfermeiro (p=0,00). Houve correlação positiva fraca entre a percepção da capacidade profissional e atitudes menos negativas. Este estudo é pioneiro na investigação de fatores associados a atitudes frente ao suicídio entre profissionais de enfermagem que atuam em emergências no contexto hospitalar e pré-hospitalar brasileiro. É importante investir em estratégias que promovam a saúde mental dos profissionais, melhores atitudes e preparo para a qualificação da assistência / The suicide is a problem liable of prevention. Nursing professionals who work in emergencies have a central role in the first management of suicide attempts, and the quality of care provided by these professionals may be influenced by their attitudes front of suicidal behavior. The knowledge about the attitudes related to the suicide and its associated factors is scarce and needs to be investigated in differents countries, cultures and times. This study investigated, among the nursing professionals who work in the emergencies, the attitudes related to suicide and associated factors. Quantitative cross-sectional study, developed with a population of 146 nursing professionals from two emergency services (prehospital and hospital services) in the interior of the state of São Paulo, Brazil. The data was collected in 2015 by the self application of a social-demografic questionnaire and Suicide Behavior Attitude Questionnaire (SBAQ). This questionnaire does not have cutoffs and its analysis can be done through the isolated items and factors \"Feelings towards the patient\", \"Professional capacity of perception\" and \"Right to Suicide\". The data was analyzed with Statistical Package for Social Sciences software (SPSS) version 19.0 and R GUI 3.0.1. The Kolmogorov-Smirnov and Shapiro-Wilk normality tests, The Spearman correlation test and Mann-Whitney test were applied. The participants presented low educacional exposure about the suicide and were obtained the maximum and minimum punctuations in each one of the items of the questionnaire. More negative attitudes were associated with have worked in mental health service (p=0,00). More perception of professional capacity was associated with specific formation in mental health (p=0,00) or suicide (p=0,00) and work in hospital service (p=0,01). Attitudes less moralists and condemnatory were associated to experience of working in mental health services (p=0,01) and being nurse (p=0,00). There was a weak positive correlation between the perception of professional capacity and attitudes less negatives. This study is a pioner in the investigation of associated factors front to suicide attitudes among nursing professionals who work in Brazilian prehospital and hospital emergencies. It is important to invest in stratagies that promote professional\'s mental health, better attitudes and preparation for the qualification of care

É importante investigar os atendimentos a pessoas com comportamento suicida, pois uma tentativa de suicídio é o principal preditor de futuro óbito por suicídio. Há uma carência de estudos que analisem sobre o assunto no Brasil. Este estudo teve como objetivo investigar os atendimentos relacionados ao comportamento suicida em 2014, em um serviço de atendimento móvel de urgência e fatores associados. Estudo quantitativo, transversal, documental. Foi realizada consulta manual de fichas de atendimento de enfermagem geradas por Unidades de Suporte Básico nas quais estivessem documentados chamados por comportamento suicida no ano de 2014. Os dados foram registrados em roteiros elaborados pelas pesquisadoras e analisados por meio de estatística descritiva, teste qui-quadrado, teste exato de Fisher, testes de correlação e testes de comparação de média. O estudo foi aprovado por Comitê de Ética em pesquisa. Nas 313 fichas analisadas, houve predomínio de mulheres adultas, que tentaram suicídio por intoxicação medicamentosa, na própria residência e foram encaminhadas para um serviço pré-hospitalar de atendimento a urgências. Na maioria das fichas não havia sinais, sintomas ou agravos documentados. As intervenções mais executadas pela enfermagem estiveram relacionadas à monitorização de parâmetros clínicos. Houve diferenças relacionadas ao sexo da vítima e letalidade do comportamento suicida, método da tentativa de suicídio, encaminhamento para serviços de emergência e semestre da ocorrência. As tentativas de suicídio por intoxicação ou por lesões autoprovocadas diferiram em relação ao horário do chamado, tempo de espera pelo atendimento, letalidade, documentação de avaliação clínica e intervenções, encaminhamento para serviços de emergência. Este estudo permitiu o melhor mapeamento das demandas relacionadas ao comportamento suicida, conhecimento relevante para o planejamento dos cuidados de enfermagem e compreensão sobre as competências necessárias para tais atendimentos / It is important to investigate the attendance of people with suicidal behavior, since suicide attempt is the main predictor of future suicide death. There is a lack of studies that analyze on the subject in Brazil. This study aimed to investigate the attendances related to suicidal behavior in 2014, in an emergency mobile service and associated factors. Quantitative study, transversal, documentary. A manual consultation of nursing care records generated by Basic Support Units in which they were documented called suicidal behavior in the year 2014. The data were recorded in scripts prepared by the researchers and analyzed by means of descriptive statistics, chi-square test , Fisher\'s exact test, correlation tests, and mean comparison tests. The study was approved by the Research Ethics Committee. In the 313 files analyzed, there was a predominance of adult women, who attempted to commit suicide due to drug intoxication, at home and were referred to a pre-hospital emergency room service. Most signs had no documented signs, symptoms, or complaints. The interventions most performed by nursing were related to the monitoring of clinical parameters. There were differences related to the sex of the victim and lethality of the suicidal behavior, suicide attempt method, referral to emergency services and half of the occurrence. Attempts to commit suicide due to intoxication or self-inflicted injuries differed in relation to the time of the call, waiting time for care, lethality, documentation of clinical evaluation and interventions, referral to emergency services. This study allowed the best mapping of the demands related to suicidal behavior, knowledge relevant to the planning of nursing care and understanding of the skills required for such care

Abstract Seasonal variations of events are apparently playing an important part in various psychiatric conditions. To study the seasonal variation of a condition appears to be one useful approach to clarify the aetiology of a mental disorder and phenomena to which mental disorders are associated. In the present study the seasonal variations of suicides during the period of 1980-95 (n=21279) and homicides during the years 1957-95 (n=4553) in Finland were analysed. In addition, the use of statistical techniques for seasonality and some important characteristics of study samples were evaluated from 44 original suicide seasonality studies published between 1970-97. Special attention was paid to statistical methods for seasonality and these were reviewed in the summary part of this dissertation. A statistically significant spring peak of suicides was found in both genders, in all age groups (aged 39 years or below, 40-64 years, and 65 years or more) and in violent (hanging, drowning, shooting, wrist-cutting, jumping from a height) and non-violent suicides (poisoning, gas, other methods). A secondary autumn peak of suicides was present in females and also associated with non-violent methods. The rate of violent suicides had increased significantly during 1980-90 and decreased thereafter, while the non-violent suicides had kept steadily increasing over the whole 16-year study period. The seasonal variation of violent suicides had remained stable and statistically significant over the whole study period, but the seasonality in non-violent suicides has diminished over time. The seasonal pattern of homicides showed a statistically significant peak in summer and a trough in winter. The observed rate of homicides was about 6% higher in summer and 6% lower in winter than expected under the null hypothesis of a uniform distribution. Both the crude numbers of homicide and the rate of homicides per 100 000 population increased significantly over the 39-year study period. The increasing rate of homicides in Finland was accompanied by decreasing homicide seasonality. The seasonal trends in homicides correlated significantly (positive correlation) with the seasonal trends in the violent suicides over the period of 1980-95. The use of particular statistical techniques was specified in the majority of the 44 reviewed suicide seasonality articles. This was considered as satisfactory, although in subgroup analyses and in comparisons of the seasonal pattern of suicides with phenomena other than suicides, researchers tended to interpret their study findings without a statistical significance test. In those 37 articles, which had actually examined the seasonal pattern of suicides with a statistical test, statistical methods varied from simple standard tests like the chi-square test (14 articles, 38%) to sophisticated time series analyses such as a spectral analysis (4 articles, 11%). The calendar effect (i.e. effect due to the unequal lengths of months and leap years) was reported to have been taken into account in only 10 out of 44 (22%) reviewed studies. The lack of reporting the size of a sample (12 articles, 27%) or monthly values of suicides (17 articles, 54%) was found to be a major deficit in the reviewed studies. On the basis of these findings it is recommended to carry out further surveys, which evaluate statistical content and use of statistical methods in published medical articles. These kinds of surveys remind researchers to consider more thoroughly methodological and statistical issues in their investigations.

Appendices A-D were not provided by the author. The goal of the study was to explore the perceptions of the station commissioners of Waterberg District regarding the Suicide Prevention Workshops targeted at police officers. The study was conducted with the station commissioners of Waterberg District in Limpopo. The population in this study was composed of 15 station commissioners who were regarded as the sample due to the fact that the population is small. The research approach used in the applied study was a qualitative approach. A semi-structured interview schedule was used to collect data from the station commissioners in order to uncover their perceptions regarding the Suicide Prevention Workshops. A theoretical background about suicide in general and police suicide was provided through a literature study. In the literature study the background information about factors contributing towards police suicide were indicated, together with methods used to commit suicide. Causes of suicide in general as compared to those of police members, were also clarified. The focus in the literature was also on gender whereby an indication was mentioned about who exactly are at risk of committing suicide. The attitude of police officers and the society’s expectations and perceptions regarding police members has been discussed. The empirical study focused on the perceptions of station commissioners of Waterberg District in Limpopo regarding the Suicide Prevention Workshops targeted at police officers. A semi-structured one-on-one interview was held with each station commissioner on individual basis where by questions were asked about his or her perception of the Suicide Prevention Workshops. The findings of the study revealed that station commanders appreciate the role played by social workers, chaplains and psychological services in presenting suicide prevention programmes to police officers. They indicated that at some point they fail to nominate police officers to attend the workshops because some of the subordinates are not cooperative and they might even submit sick notes in order to be excused from attending. It was also reported that if there is a shortage of personnel due to other core business of SAPS, police officers might not be nominated. Based on the findings of the study, conclusions and recommendations were made with regard to how the suicide prevention program and workshops can be improved in SAPS. Copyright / Dissertation (MSW)--University of Pretoria, 2013. / Social Work and Criminology / unrestricted

Research suggests that reporting suicide has the potential to influence vulnerable individuals to emulate suicide behaviour. Media guidelines for the responsible reporting of suicide have been developed and disseminated worldwide, but with mixed success. One factor that may influence guideline uptake is the degree to which health professionals have collaborated with the media professionals in guideline development, dissemination and implementation. The study used semi-structured interviews with media professionals to understand attitudes towards the guidelines, to explore the ways in the media were engaged in communication regarding the guidelines, and to identify whether this engagement bears upon media attitudes toward the guidelines. Findings indicate that media professionals view the guidelines as useful information within the bounds of normal reporting, but find them difficult to implement. Excellence theory indicates that the predominantly one-way and asymmetrical strategies used to engage the media in communication around the guidelines may play a role in these attitudes. The study echoes literature suggesting that collaborative guideline development and implementation is essential to meaningfully change suicide reporting practices.

Les conduites suicidaires (CS) sont considérées comme des entités pathologiques à part entière avec une neurobiologie propre, abordées selon un modèle stress-vulnérabilité et pouvant bénéficier de la recherche de biomarqueurs. Nous proposons l'ébauche d'un modèle clinico-biologique de la vulnérabilité aux CS en considérant la douleur au coeur du processus suicidaire. Les stress psychosociaux sont sources de douleur psychologique. Leur maintien ou leur émergence perpétuerait ou majorerait la douleur psychologique via un dysfonctionnement du système vasopressinergique et des régions cérébrales impliqués dans les cognitions sociales. Nos données suggèrent une modification du seuil douloureux chez les sujets vulnérables pour le suicide qui percevraient une douleur psychologique accrue, associée aux idées suicidaires. Aussi les difficultés interpersonnelles sont associées une altération de prise de décision sous tendue par un dysfonctionnement du cortex préfrontal, associé à la vulnérabilité suicidaire. Ceci entrainerait le sujet à favoriser un choix (suicide) associé à une récompense immédiate (sédation de la douleur), même s'il est associé à les conséquences délétères (mort). Ainsi la douleur psychologique serait centrale dans les CS en tant que conséquence immédiate des stress psychosociaux, et en influençant les facteurs de vulnérabilité, qui favorisent sa perception et augmentent la sensibilité à certains événements sociaux via des processus neuroanatomiques et biochimiques. Nos travaux ouvrent de nouvelles voies de compréhension physiopathologiques et permettent d'envisager la douleur psychologique comme une potentielle cible thérapeutique de prévention suicidaire. / Current knowledge suggests that suicidal behavior: 1) are pathological entities per se, with a specific neurobiology, 2) may be studied according to a stress-diathesis model, 3) may be better characterized by identifying biomarkers. Emphasizing that pain is the core of the suicidal process, we propose an outline of a model of suicide based on clinical neuropsychological and neuroimaging data. Psychosocial stressors cause psychological pain. Through dysfunctional vasopressinergic system and cerebral regions involved in social cognitions, psychosocial stress would be maintained or give rise to new stresses, perpetuating or increasing psychache. We suggest a modification of pain thresholds in vulnerable subjects for suicide leading to an increased perception of psychache, which is associated with suicidal ideation. Then, interpersonal difficulties are associated with impaired decision-making underpinned by prefrontal dysfunction that has been associated with suicidal vulnerability. This would cause the subject to promote a choice (suicide) associated with immediate reward (pain relief), although it is associated with deleterious consequences (death). Thus, psychological pain is central to suicidal behavior as an immediate consequence of psychosocial stressors, and influencing the suicidal vulnerability favoring pain perception and increasing susceptibility to social events, based on neuroanatomical and biochemical bases. Finally the hypothesis that a change of pain perception is involved in the suicidal process would open new avenues for understanding suicidal pathophysiology. It allows considering the psychological pain as a potential therapeutic target to prevent suicide

Etude 1- Objectif: Explorer les contributions relatives des facteurs socioculturels et psychopathologiques aux idéations suicidaires dans un échantillon d’adolescents issus de l’immigration (N=292). Bien que les événements de vie négatifs, les symptômes dépressifs, et l'individualisme sont des facteurs de risque, et l'attachement aux parents un facteur de protection chez les garçons et les filles, des différences de genre sont observées. Les traits limites (facteur de risque), l'assimilation et la marginalisation (les deux facteurs de protection) étaient des prédicteurs significatifs de l’idéation suicidaire chez les filles uniquement.Etude 2- Objectif: Explorer les différences ethniques (717 Français vs. 251 issus de l’immigration) concernant les facteurs de risques et de protection associés à l’idéation suicidaire dans une population d’adolescents. Les garçons issus de l’immigration rapportaient une sévérité d’idéation suicidaire plus importante que les garçons Français alors que les filles issues de l’immigration rapportaient une moyenne plus élevée à l’échelle de l’idéation suicidaire que leurs pairs Françaises. Des différences ethniques sont apparus significatives pour l’âge chez les garçons et pour les cognitions délinquantogènes, les traits limites et l’anxiété sociale chez les filles. Etude 3- Objectif : Explorer l’idéation suicidaire et les symptômes dépressifs en France par des analyses centrées sur les variables et sur les personnes dans un échantillon d’adolescents issus de l’immigration. La marginalisation prédisait significativement les idéations suicidaires alors que la discrimination perçue prédisait les symptômes dépressifs. Quatre classes latentes ont émergés de l’analyse : « Séparés-Intégrés », « Intégrés », « Indifférenciés » et « Individualisés ». Des différences significatives sont apparues entre les quatre profils culturels pour l’identité ethnique, la discrimination perçue et le stress acculturatif. En revanche, bien que la prévalence de l’idéation suicidaire et des symptômes dépressifs était élevée dans l’échantillon total et dans les profils culturels, aucune différence significative n’est apparue. Etude 4- Objectif : Identifier les aspects cognitifs et comportementaux qui sous-tendent les conduites suicidaires de 15 jeunes issus de l’immigration. Le suicide représente « un moyen de se libérer de la contrainte à simuler une identité » et « une reprise du contrôle ». Les dissonances culturelles, les distorsions cognitives, les cognitions identitaires favorisent l’émergence de comportements autodestructeurs et de stratégies de coping. Les aspects cognitifs et comportementaux, sous-tendus par des éléments culturels contradictoires, amènent ces adolescents à anticiper un possible rejet, qui susciterait une angoisse d’abandon. / Study 1- Aim: Explore the contributions of sociocultural and psychopathological factors to suicidal ideation among of 292 adolescents with an immigrant background. Although stressful life events, depressive symptoms, and individualism were risk factors, and attachment to parents a protective factor for both boys and girls, some gender differences emerged. Borderline traits (risk factor), assimilation and marginalization (both protective factors) were significant predictors only among girls.Study 2- Aim: Explore ethnic differences (717 French vs. 251 with an immigrant background) regarding risk and protective factors associated to suicidal ideation among adolescents. The frequency of serious suicidal ideation was higher among the ethnic minority males group compared to the French males group. The mean of suicidal ideation however was higher among the ethnic minority group of females. Ethnic differences were observed regarding the age among males in the prediction of suicidal ideation and self-serving cognitive distortions, borderline traits, and social anxiety among females. Study 3- Aim: Examine suicidal ideation and depressive symptoms in France, both across variables and across persons in a non-clinical sample of adolescents with an immigrant background. Marginalization significantly predicted suicidal ideation whereas perceived discrimination significantly predicted depressive symptoms. Four latent classes emerged from analysis—“Separated-Integrated”, “Integrated”, “Undifferentiated” (characterized by adolescents who were not associated with any of the acculturation categories), and the “Individualized-Assimilated”. Significant differences appeared between the four classes for the indices of ethnic identity, perceived discrimination, and acculturative stress. Prevalence and mean score of suicidal ideation and depressive symptoms were high among both the sample and the four acculturative profiles; however no differences between the four classes emerged.Study 4- Aim: Identify cognitive and behavioral aspects which underline suicidal ideation and attempts of 15 adolescents with an immigrant background. Suicide represents “a way to release itself from the constraint to feign an identity”, and to “regain control”. Cultural dissonance, cognitive distortions, identity cognitions emphasize the emergence of self-destructive behaviors and coping strategies. These cognitive and behavioral aspects, underlined by contradictory cultural elements, lead these adolescents to anticipate a possible rejection, which may cause a fear of abandonment.

La recherche sur l'association entre l'expérience traumatique et la suicidalité est un domaine en pleine expansion dans la littérature depuis vingt ans. Cette thèse avait originalement pour but d’identifier les conditions suffisantes ou nécessaires de différents types de suicidalité chez les personnes traumatisées. Une procédure d'extraction de règles d'association a été mise en œuvre sur une base de données issue d'une enquête nationale française. Considérant le manque de conditions suffisantes ou nécessaires de suicidalité, deux autres questions liées à la suicidalité ont été envisagées. La première étude porte sur l'ordonnancement empirique des profils de suicidalité et la détection des symptômes qui modèrent les niveaux de risque. En utilisant la tentative de suicide dans le mois passé comme critère prédictif, trois niveaux de risque ont été établis. Tous les niveaux de suicidalité sont systématiquement modérés par le symptôme d'anxiété chronique. La deuxième étude visait à tester la robustesse de l'association entre les niveaux de traumatisme et la fréquence de la tentative de suicide dans le mois passé par l'identification des symptômes modérateurs de l'incidence de tentative de suicide dans chaque niveau de trauma. Sept symptômes concernant l'envie de mourir, l’intention d’automutilation, l’idéation suicidaire, la tentative de suicide au cours de la vie, l'humeur dépressive, la perte d'intérêt, et l'expérience de l'attaque de panique ont démontré un effet «d’éventail». Un examen détaillé de la littérature a révélé la difficulté d'obtenir une vue d'ensemble des types de suicidalité et leurs facteurs de risque dans le contexte «traumatisme-suicidalité». La troisième étude met en avant l’idée d’une plate-forme graphique visant à récapituler les connaissances empiriques obtenues par 26 études portant sur 20 facteurs de risque de six types de suicidalité dans différents échantillons de personnes traumatisées. Les principaux facteurs de risque sont la dépression majeure et le trouble de stress post-traumatique. Cette étude souligne l'importance d'un cadre descriptif commun et de la disponibilité des bases de données recueillies dans les études précédentes. / Research on the association between the experience of trauma and suicidality has been a growing field in the literature since two decades. The current dissertation was originally aimed at identifying sufficient or necessary conditions of suicidality outcomes among individuals exposed to trauma. A procedure of association rule extraction was implemented on a database from of a French national survey. Considering lack of sufficient or necessary conditions of suicidality outcomes, two other suicidality related issues were addressed. The first study focuses on the evidence-based ordering of the suicidality profiles and the detection of symptoms that moderate suicidality levels. Using ‘past month suicide attempt’ as the criterion, three suicidality levels were established. All suicidality levels were systematically moderated by the chronic anxiety symptom. The second study aimed at testing the robustness of the association between the trauma levels and the frequency of past month suicide attempt by identification of the symptoms moderating the incidence of outcome in every trauma level. Seven symptoms regarding desire for death, self-harm intention, suicidal ideation, lifetime suicide attempt, depressed mood, loss of interest, and panic attack exhibited a moderating effect with the fan-shaped pattern. A comprehensive review of the literature revealed the difficulty to obtain an overall picture of the investigated outcomes and their risk factors in the trauma-suicidality background. The third study puts forward a graphical platform aimed at recapitulating the evidence found by 26 studies concerning 20 risk factors of six suicidality outcomes among traumatized individuals. The main risk factors are major depression, and post-traumatic stress disorder. This review highlighted the importance of a common descriptive framework and the availability of the databases collected in previous studies.

Background: Transitioning to college life in young adulthood can represent a challenging developmental period and college students are at heightened risk for engaging in suicidality. Aims: We aimed to investigate the roles dispositional optimism and coping strategies play in suicide risk (viz., suicidality) and suicide protection (viz., reasons for living) in college students. Method: A sample of 252 American college students were surveyed using anonymous questionnaires and hierarchical regression analyses were conducted to analyze the data. Results: Coping strategies, as a set, played an important role in both suicidality and reasons for living, after controlling for demographic factors (age and sex). When dispositional optimism was entered into the model, it was found to account for a significant amount of additional unique variance in both suicidality and reasons for living, even after accounting for coping. Limitations: It is unknown whether optimism remains meaningful in its association with suicide risk and protection beyond coping in other populations. Conclusion: Effective coping and optimism are associated with decreased suicide risk and increased suicide protection. Our findings point to the consistent role of dispositional optimism, over coping, in both suicide risk and protection.

Sleep problems are robust suicide risk correlates. According to the interpersonal theory of suicide, thwarted belongingness (TB) and perceived burdensomeness (PB) may explain the link between sleep problems and suicide risk. This study examined these relationships among 331 community-dwelling adults identifying as sexual and/or gender minorities. Self-report measures of sleep problems, TB, PB, suicide risk, and anxiety were completed. Bootstrap mediation analyses were conducted to test TB and PB as interacting, individual, and parallel explanatory factors linking sleep problems and suicide risk. Sleep problems were associated with greater TB, PB, and suicide risk. TB and PB, in parallel and individually, accounted for the relationship between sleep problems and suicide risk, beyond age and anxiety. In contrast to the interpersonal theory, the indirect effect of PB was stronger at lower levels of TB and the indirect effect of TB was stronger at lower levels of PB. Exploratory analyses indicated significant differences between sexual minorities, gender minorities, and individuals identifying as both sexual and gender minorities: the indirect effect of sleep problems on suicide risk through PB was descriptively strongest among sexual minorities, and the indirect effect through TB was descriptively stronger among gender minorities and individuals identifying with both minority groups. Findings suggest that intervening upon TB and PB may thwart the trajectory from sleep problems to suicide risk among sexual and gender minorities. Further work is needed to determine whether suicide risk pathways differ across minority groups.