This study tested a psychosocial model of suicide risk in a sample of 156 Latino college students. Specifically, depression and loneliness were hypothesized to be important predictors of suicide risk (namely, hopelessness and suicidal behaviors) in Latino students. Results of conducting regression analyses indicated that, independent of age and gender, depression and loneliness were significant predictors of both indices of suicide risk examined in the present study. It is noteworthy that within the psychosocial predictor set of depression and loneliness, depression was consistently found to be nearly twice as strong a predictor than was loneliness. Moreover, we found evidence for a significant depression–loneliness interaction effect in predicting suicide risk. That is, the highest level of suicide risk was found among dysphoric Latino students who were also socially isolated. Our findings indicate that depression and loneliness are important factors to consider in understanding suicide risk among Latino college students.

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published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

Cirka 800 000 människor världen över avslutade sina liv genom suicid 2014. En psykiatrisk diagnos är en vanligt förekommande bakomliggande orsak. De vanligaste diagnoserna är depression, bipolär sjukdom, post traumatiskt stressyndrom samt substansmissbruk. Tidigare suicidförsök är den enskilt största riskfaktorn för ett fullbordat suicid. Det är komplext att arbeta med suicidnära patienter i öppenvården och det ställs höga krav på specialistkompetens inom psykiatrisk omvårdnad och goda kunskaper kring det suicidpreventiva arbetet. Syftet med studien var att beskriva psykiatrisjuksköterskans erfarenhet av att bedöma suicidrisk på patienter på en vuxenpsykiatriskmottagning. En kvalitativ metod användes med induktiv ansats där fyra intervjuer med  psykiatrisjuksköterskor genomfördes. I resultatet framkom att psykiatrisjuksköterskan dagligen möter och behandlar suicidnära patienter på en öppenvårdsmottagning. Resultatet visade att psykiatrisjuksköterskan trots år av erfarenhet upplevde arbetet med suicidnära patienter som komplext och ansvarsfullt. Det framkom att psykiatrisjuksköterskan arbetade självständigt och stod ofta ensam med att bedöma suicidrisken och vidta åtgärder. Psykiatrisjuksköterskan har en viktig del i det suicidpreventiva arbetet och behöver känna sig trygga och säkra i omvårdnaden kring suicidnära patienter och i att bedöma suicidrisken. Vidare forskning skulle kunna ge fördjupad kunskap om psykiatrisjuksköterskan roll och behov för att ge omvårdnad till suicidnära patienter.

Aim: The aim of this study is to illuminate psychiatric nurses' experiences of suicide assessment in their daily work of a psychiatric inpatient ward. Background: The majority of all suicides are committed by people with some kind of psychiatric diagnosis and suicides within psychiatric hospital departments are increasing. In more than half of the cases where patients have committed suicide in the psychiatric hospital, the patient's suicidal risk assessment has failed and the patient has been able to leave the department and commit suicide. Previous research suggests that suicide risk assessments are important and nurses need more skills and time to be able to pay attention to patients' behavior. Design: This is a qualitative descriptive study based on eight individual semi-structured interviews that have been analyzed using qualitative content analysis by Lundman and Hällgren Graneheim (2012). Method: Data analysis was based on Lundman and Hällgren Graneheim (2012) description of qualitative content analysis. Semi-structured interviews with the addition of narrative questions was conducted. The participants were eight registered psychiatric nurses from four different psychiatric departments at a hospital in Västra Götaland. A male psychiatric nurse and seven female psychiatric nurses participated with at least one years of experience participated. Results: The results showed that the psychiatric nurses had difficulties defining a general suicide behavior. On the other hand, different behavior patterns were identified as more suicidal. Such patterns could be rapid twists in emotional state, strong anxiety, impulsivity and backwardness. Three categories emerged during the analysis process: Clinical Glance, Alliance Work and Experiences Collaboration and Knowledge, and all three had three related subcategories. Conclusion: The suicidal process is complex and the difficulty lies in identifying where in the process the patient is. Psychiatric nurses have responsibility identifying early signs considered by psychiatric nurses to be an important part of suicide assessment. Experience about the patient and knowledge of suicide is something that psychiatric nurses experience as significant to be able to make good suicide risk assessments.

Suicide is a significant public health issue in the US. Despite national and international prioritization since 1996, little definitive progress has been made in terms of identification and intervention in cases of elevated suicide risk. Forty percent of those who died by suicide attended an emergency department within a year of death. Therefore, universal suicide risk screening in emergency departments could prove a vital component to a national suicide prevention strategy. The present study empirically evaluated the universal suicide risk screening program recently implemented at Parkland Health and Hospital System. The sample consisted of patients over 18 years of age (N=333,855; Mage=42.7, 32% male) screened as part of routine clinical care from May 4th, 2015, through November 3rd, 2015. The Parkland Algorithm for Suicide Screening (PASS) is part of a clinical decision support system for responses to Columbia - Suicide Severity Rating Scale Clinical Practice Screener (C-SSRS) items, leading to an automated clinical response via three suicide risk stratification levels: no action for no risk identified, psychiatric social worker assessment for moderate risk identified, and psychiatrist/psychologist interview for high risk identified. The present study used receiver operating characteristic (ROC) curve analysis, which found the PASS predicted disposition (z=30.46, p<.001, AUC=.78, CI95=.77, .81). This study also evaluated the cutpoints separating suicide risk stratification and levels of clinical response. The results supported the first cutpoint and highlighted a need for additional data to address the second cutpoint. The results of the present study suggest that the universal suicide risk screening program at Parkland Health and Hospital System is an important step toward addressing suicide prevalence in the US.

Suicide is a national public health concern, and unmet interpersonal needs (i.e., perceived burdensomeness, thwarted belongingness) may contribute to enhanced risk. However, mechanisms of action and certain protective variables are not well understood. The present study examined simple mediation models, with internal hostility as a mechanism of action between interpersonal needs and suicide risk. Additionally, our study examined the moderating role of various aspects of receiving forgiveness on the association between interpersonal needs and internal hostility in these simple mediation models. A community-based convenience sample was surveyed (N=712). Our findings indicated that internal hostility partially mediated the association between perceived burdensomeness/thwarted belongingness and suicide risk, such that higher levels of interpersonal needs variables were associated with higher levels of internal hostility, and in turn, higher levels of suicide risk. No evidence was found for a buffering effect of feeling forgiven on these statistical models. Our findings suggest that negative, internalized self-perception contributes to suicide risk above and beyond that of interpersonal needs alone. Implications are discussed for both theory and practice.

It is common for people to search for health information on the internet, share their health issues through social media, and ask for advice from people in online communities. Some people reported feeling more comfortable sharing their psychological stress online and anonymously asking for advice from people. As such, people disclose not only their suicide risk but also their suicidal risk-associated drivers (e.g., suicide ideation, relational stress, financial crisis). This study aims to identify suicidal drivers from narratives extracted from social media, synthesize findings and suicide theories, and provide insights into future suicide prevention policies and practices. This research gathered and analyzed 128,587 posts written by 76,547 people worldwide. The posts were written in English from January 2021 to December 2022 on the r/SuicideWatch of Reddit. Natural Language Processing and topic modeling, specifically Latent Dirichlet Allocation (LDA), were used to identify clusters of posts based on similarities and differences between posts. Thematic analysis was used to identify suicidal drivers across clusters of posts. The web crawler developed by Brandwatch was used in data collection, and Python was used for all analyses.  Six theme clusters of posts were identified. The first theme was Disclosure of Repetitive Suicide Ideation (i.e., “I want to die. I want to die, I want to die…(repeated)”), and 36.4% of posts had this theme. The second theme was Disclosure of Relational Stress (i.e., “I don’t have any friends”), and 31.9% of posts had this theme. The third theme was Disclosure of Suicide Attempts and Negative Healthcare Experiences (i.e., “I’ve had a suicide attempt before”, “The nurses ignored me”), and 9.9% of posts had this theme. The fourth theme was Disclosure of Abuse (i.e., “He would beat me black and blue”), and 8.8% of posts had this theme. The fifth theme was Disclosure of Contextual Stress, including finance and legal matters (i.e., “every moment was a living fear of the debt collector knocking on the door”), and 7.2% of posts had this theme. The last theme was Philosophical and Informative Discussions around suicide (i.e., “After death, the physical begins to deteriorate and life/energy is simply moved to another being”), and 5.8% of posts had this theme. Understanding different suicidal drivers is an essential component in designing individualized intervention plans for people at suicide risk. The current research identified the idiosyncrasies in the suicide drivers people talked about when disclosing their suicidality. Furthermore, the findings from this study’s data-inspired and exploratory approach provided additional evidence supporting existing suicide theories and frameworks. This research has the potential to lay the groundwork for designing suicide intervention strategies that target individuals’ self-disclosures of their struggles online.

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