While research has examined the impact of losing a client to suicide among psychology professionals, its impact among psychology graduate student clinicians is still unknown. Students that experience client suicide loss are suggested to speak about the loss with others; however there is no research on the impact of hearing about other individuals' experiences with client suicide loss. This study examined the prevalence of personal and other exposure to client suicide loss, and their relationship with current confidence and future likelihood of working with individuals expressing suicidal thoughts and behaviors. 166 psychology graduate students with client contact across the United States were recruited. Participants answered questions about whether they had lost a client to suicide or heard of another person losing a client to suicide, their confidence in working with individuals with suicidal thoughts and behaviors, and their likelihood of working with those individuals in the future. T-tests were run comparing those who experienced personal (or other) client suicide loss and those who had not on likelihood and confidence. Less than 2% of students reported personal client suicide loss. 47% of students had heard of another individual experiencing client suicide loss, and this was related to increased future likelihood of taking a suicidal client but not increased confidence. Further research into emotional impacts of client loss, program postvention, and disclosure of client suicide loss among students and faculty is warranted. There may be a positive benefit to hearing of other individuals' experience with client suicide loss. Less than 2% of graduate students had lost a client to suicideAbout 47% of students heard of another individual experiencing client suicide lossOther loss was related to higher rated likelihood of taking future suicidal clients.
Advancing evidence-based theories of suicide is critical for improving prevention efforts. The purpose of this study was to evaluate the Three-Step Theory of Suicide (3ST) in a sample of Iranian students. Participants (N = 1017, mean age = 24.2, 58.2% female, 9.4% with a prior suicide attempt) completed measures of psychological pain, hopelessness, connectedness, suicide capability, suicide ideation, suicide attempt, and demographics. Results largely support the theory's central premises. First, an interactive model of pain and hopelessness accounted for substantial variance (≈51%) in suicide ideation in the overall sample and in women. Among men, the full model (pain, hopelessness, and their interaction) explained similar amount of variance (≈ 52%) in suicide ideation, while the interaction term was not significant and did not explain additional variance over the main effects. Also, as hypothesized, connectedness was protective against escalating suicide ideation severity among those with suicide desire. Finally, suicide capability and its dispositional and practical component predicted suicide attempt history over and above current suicide ideation. These findings support the validity of 3ST of suicide within the context of a middle-income country. Implications for suicide prevention, clinical intervention and future research directions are discussed.
Evidence of the association between previous suicide attempts and psychotherapy outcome is inconclusive because of a lack of transdiagnostic investigations and diverging methodological approaches to treatment success. The present work aimed to address these research gaps. We used routine patient data (N = 706; N = 118 with a lifetime history of suicide attempts) to investigate the relevance of suicide attempts for outcome using validated instruments (Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Screener (GAD-7)), testing the association in different ways: symptom reductions, achievement of subclinical symptom levels, reliable and clinically significant change (RCI, RCSI), subjective evaluations of the therapeutic relationship (Helping Alliance Questionnaire (HAQ)), and regression models of symptoms at discharge adjusted for baseline severity and personality functioning. Although patients with a history of suicide attempts exhibited greater baseline symptom severity, they achieved comparable reductions in depression and anxiety symptoms (in terms of absolute values as well as using the RCI and RCSI). They achieved comparatively greater mean decreases in suicidal ideation but were less likely to be classified as responders on the suicidal ideation item and less likely to report subclinical levels of depression symptoms or the absence of suicidal ideation at discharge. Regression analyses that controlled for baseline symptoms and the level of personality functioning revealed no independent effect of suicide attempts. Treatment satisfaction and perceived success were comparable across groups. Previous suicide attempts are an important marker of clinical severity. While comparable symptom reductions are achieved, reaching the subclinical symptom range might be harder for individuals struggling with suicidality. These findings emphasize the importance of contextualizing treatment success (methodologically and with respect to the individual case).
Suicide is a leading cause of death in prisons worldwide. The objective of this study was to describe the sociodemographic, clinical and criminal characteristics of people incarcerated in France who died by suicide, as well as the circumstances surrounding each suicide. . We included all cases of suicide by people incarcerated in France (i.e., European and overseas territories) over the period 2017-2021. The National Prison Service provided sociodemographic and criminal data, as well as data on the circumstances surrounding the suicides. Health data were collected by health units located in all the country's prisons using a standardized questionnaire. We included 598 suicide cases in the study. Mental disorders were more prevalent during (63.7%) than before (47.8%, p < 0.001) incarceration. In the week before suicide, 60% of cases had visited their prison's health unit and a traumatic criminal-, prison-, familial- or health-related event was identified in 61% of all cases. Persons who died during the SARS-CoV2 pandemic were more likely to have children (77.7% vs 61.1%, p = 0.001). The overall suicide rate was 17.5 [CI95% 16.1-18.9] per 10,000 person-years. It increased (p < 0.05) with age, was twice as high during pretrial incarceration and six times higher during the first week of imprisonment. In terms of gender, it was 9.9 [9.1-10.7] and 41.0 [27.0-59.7] times higher among men and women, respectively, than among their counterparts in the general population. Suicide in prisons is a major health issue. Suicide prevention measures must be reinforced. In prison, the suicide rate is 6 times higher during the first week than afterThe suicide rate of women in prison is 40 times higher than in general populationPrisoners who died during the SARS-CoV2 pandemic were more likely to have children.
Combat has been related to suicidal thoughts and behaviors via increased PTSD and depression in prior work; however, such studies have been limited by sample size, reliance on self-report, failure to account for other disorders, and a limited focus on ideation and attempts. The objective of this study was to overcome these limitations by examining the association between combat and suicide ideation, attempts, and deaths in a large and diverse sample of veterans (N = 324,510) using survey data, electronic health records, and National Death Index data. As expected, combat was positively associated with PTSD and depression, which were, in turn, positively associated with suicide ideation, attempts, and death. Combat was indirectly associated with all three outcomes via PTSD-depression after accounting for the influence of other psychiatric disorders, although the effects were small in magnitude. Combat exposure, PTSD-depression, and other psychiatric disorders collectively accounted for 30-35% of the variance in suicide attempts and suicidal ideation, respectively. In contrast, combat exposure, PTSD-depression, and other psychiatric disorders collectively accounted for only a small fraction of the variance (2%) in suicide deaths. Taken together, our findings suggest that combat is primarily associated with suicidal ideation and suicide attempts (as opposed to suicide deaths) via PTSD and depression (as opposed to other psychiatric conditions). More research is needed to identify predictors of suicide death among military veterans. Combat was primarily associated with suicidal ideation and suicide attempts (as opposed to suicide deaths) via PTSD and depression (as opposed to other psychiatric conditions).The presence of PTSD and depression diagnoses partially explained the association between combat exposure and suicide ideation, attempts, and deaths.Whereas combat and PTSD-depression had significant associations with all three suicide-related outcomes, they appeared to play a comparatively modest role in risk for suicide deaths in this study of military veterans.
Suicide claims thousands of Americans' lives every year. A leading theory explaining suicide is the Interpersonal Theory of Suicide (ITS), yet little is known about how well this theory applies to suicide deaths. We assessed how well the ITS fit suicide deaths, followed by exploratory theoretical examination, in a national dataset using psychosocial variables. The sample (N = 289,329) comprised individuals who died by suicide or by undetermined intent in the National Violent Death Reporting System (NVDRS). Factor analyses were conducted to examine how well ITS-supported indicators fit the data, and to identify novel theoretical patterns, for the group who died by suicide. Measurement invariance compared the resulting model across groups. The ITS was a poor fit to the data. Exploratory analyses suggested a 2-factor model (i.e., justice-involvement and substance misuse) best fit the data. Model fit was found to vary at the configural level, indicating the 2-factor model was not the same for those who died by suicide and for those who died by deaths of undetermined intent. Results identified a unique subset of suicide decedents characterized by justice involvement and substance use. Further work should explore the validity and clinical utility of the combination of justice involvement and substance misuse for suicide for those involved with the legal system. Interpersonal Theory of Suicide-aligned psychosocial variables in the NVDRS dataset do not support the traditional theory applied to suicide decedentsA unique suicide decedent pattern featuring justice-involvement and substance misuse emerged in the NVDRS.
This scoping review maps the range of surveillance technologies being implemented and proposed for suicide prevention in public locations, and explores the reported feasibility of implementing surveillance technologies for suicide prevention. Searches were conducted via EBSCO (PsycINFO, MEDLINE, CINAHL, Computer Source), Ovid (SPP), Web of Science, PTSDpubs, CENTRAL (Cochrane), and IEEE Xplore. Grey literature searches were conducted through Overton, preprint databases (e.g., PsyArXiv), and industry/government websites. Studies were included if they were written in English and described surveillance technologies in public locations that could identify possible suicide-related incidents. 169 reports were included, mostly from academia. Around half of the reports described technology that had already been implemented. CCTV was the most discussed technology, and the railways were the most common location referenced. 111 reports discussed the feasibility of implementing these technologies. Key factors which determined feasibility included the processes and procedures involved in installing or using the technology, legal and ethical issues, staff and public attitudes toward technology, the appropriateness of the technology for particular contexts or locations, and cost-effectiveness. Key gaps in the current research include a lack of lived experience involvement and ethical consideration being reported, and a disparity in research coming from high and low/middle income countries. Future research needs to prioritize transparency around ethical implications, consulting people with lived experience, and sharing findings internationally to further the global suicide prevention imperative. Having a clear response pathway to respond to an incident is key following an alertThe technology must be appropriate and suitable for the intended location/contextEthical implications and lived experience involvement are priorities for future work.
This study examines the relationship between objectively measured social media use and non-suicidal self-injury (NSSI) and suicidal behaviors, addressing the limitations of prior research that relied on self-reported data. Conducted across six universities in Shaanxi, China, the study tracked weekly social media usage using smartphone monitoring, with a sample size of 7,401 participants. Social media types were classified into social networking applications (SNA), text messaging and messaging applications (TMMA), online forums and community applications (OFCA), and short video applications (SVA). Logistic regression and cubic spline curves were used to estimate the relationships of the overall social media duration or its sub-types with the odds of NSSI and suicidal behaviors. Each one-hour increase in social networking applications was significantly associated with increased odds of both NSSI (OR = 1.018; 95% CI: 1.007-1.028) and suicide ideation (OR = 1.016; 95% CI: 1.007-1.025). In addition, each one-hour increase in online forums and community applications was linked to increased odds of suicide ideation (OR = 1.063; 95% CI: 1.029-1.097), while text messaging and messaging applications was associated with higher odds of NSSI (OR = 1.010; 95% CI: 1.002-1.017). In contrast, prolonged duration in short videos applications was observed to be associated with decreased odds of NSSI (OR = 0.983; 95% CI: 0.975-0.991) and suicide ideation (OR = 0.988; 95% CI: 0.981-0.995). However, no statistically significant association was found between suicide attempt and the total time spent on social media, nor with any of its subtypes. Furthermore, the restricted cubic spline analysis showed linear associations of social networking applications and text messaging and messaging applications with the prevalence of NSSI, but U-shaped relationships of text messaging and messaging applications and short videos applications duration with suicide ideation was observed (P for non-linearity < 0.05). Social networking applications are linked to a higher odd of NSSI and suicidal ideation, with the odds increasing linearly. Text messaging and messaging applications are also associated with NSSI, while online forums and community applications is related to suicide ideation.There is a U-shaped relationship between text messaging and messaging applications use and suicide ideation. Notably, the use of short video applications appears to reduce the odds of both NSSI and suicide ideation.A significant interaction between social networking applications and sex affects the outcomes of suicide ideation.
Cancer patients are at increased risk for suicidal crises, making suicide prevention a pertinent issue for clinical practice. However, international research suggests that healthcare providers are anxious and, for example, do not actively inquire about suicidality. Such avoidance does not follow expert recommendations and puts patients at risk. First international investigations have reported diverse barriers standing in the way of the recommended clinical care. The present study aimed to expand this investigation to the German context. A preregistered qualitative study following a semi-structured interview guide was conducted with healthcare professionals (HCPs) (N = 20) working in the oncological setting. The interviews were transcribed and analyzed using qualitative content analysis, following an explorative theory-generating approach. The main result was a category system giving insight into both barriers and resources HCPs experienced concerning suicide prevention in their practice. Barriers comprised structural (e.g., scarcity of resources) and personal ones (e.g., lack of knowledge, difficult feelings). Resources were distinguished into work-related support, self-efficacy and skills, and private life/after work as an important equalizer. Along with the mentioned personal and structural dimensions, HCPs also highlighted possibilities for improvement. The results provide an important basis for the development of needs-based solutions to strengthen suicide prevention in oncology. The study highlights that this can be achieved by both individual-level interventions (e.g., specific training) as well as organization-level changes (e.g., better implementation of standard operating procedures and shared responsibility). Addressing the reported shortcomings will support practitioners and improve clinical practice for patients. In-depth qualitative interviews with oncology practitioners on suicide preventionBarriers to suicide prevention/exploration pertain on a structural/personal levelPossibilities for improvement concern practical changes and strengthening resources.
In 2018, Veterans Health Administration (VHA) mandated adoption of the Columbia-Suicide Severity Rating Scale (C-SSRS) for health system suicide screens. This study evaluates the predictive validity of C-SSRS screens in VHA specialty mental health (SMH) and emergency department (ED) settings. For 867,023 patients screened in SMH clinics from 10/1/2018-11/30/2020 and 1,035,317 screened in EDs from 11/1/2019-11/30/2020, proportional hazards analyses evaluated whether C-SSRS screens (rated as minimal, low, moderate, or high risk) were associated with non-fatal suicide attempts and with suicide deaths within the subsequent 7, 30, and 365 days. Analyses adjusted for patient characteristics, prior year mental health treatment, prior year suicide attempts, and most recent VHA REACH VET suicide prediction algorithm risk score. For the SMH cohort, 61.27% of those who died by suicide and 78.29% of those who attempted suicide within a year initially screened as low, moderate, or high risk; for the ED cohort, 15.39% of those who died by suicide and 46.29% of those who attempted suicide within a year initially screened low, moderate, or high. In both settings, C-SSRS risk level was positively associated with risk of suicide attempts and deaths (hazard ratios ranged from 1.76 to 6.62 depending on outcome, setting, and risk level), adjusting for covariates. In VHA SMH and ED populations, the C-SSRS identifies patients who are at increased risk of suicide deaths and attempts. Follow-up should be completed for patients who screen at low risk or higher on the C-SSRS, particularly in EDs.
Adolescents who experience a peer or relative's suicidal behavior can feel alienated from their peers and are at increased risk of suicidal thoughts and attempts. However, it is unclear whether loneliness is a risk factor for suicidal behavior in this vulnerable group. We analyzed data from 5,259 participants in the US National Longitudinal Study of Adolescent to Adult Health (Add Health) reporting past-year experience of the suicide or suicide attempt of a friend or relative at either Wave I or II. We examined the longitudinal association between past-week loneliness (exposure, captured at cohort entry) and suicidal ideation and attempt (outcomes, captured in subsequent waves, to Wave IV) among adolescents. Loneliness was significantly associated with probability of later suicidal ideation (odds ratio [OR] = 1.95, 95% CI [1.46, 2.60], p < 0.001) and attempt (OR = 1.72, 95% CI [1.10, 2.68], p = 0.017), also when adjusted for sociodemographic variables (adjusted OR [AOR] = 2.01, 95% CI = [1.50, 2.68], p < 0.001; AOR = 1.76, 95% CI [1.11, 2.80], p = 0.016, respectively) but these associations were non-significant in our final models accounting for baseline depression (AOR = 1.17, 95% CI [0.83, 1.64], p = 0.377; AOR = 1.22, 95% CI [0.70, 2.11], p = 0.468, respectively). A priori interaction tests suggested that the influence of loneliness on suicidal ideation was more pronounced at one-year follow-up than after 6-13-year follow-up. These findings emphasize the need for targeted strategies to address loneliness in adolescents who experience the suicidal behavior of a close contact, with a focus on proactive early intervention to address loneliness and depression to reduce suicidal distress. After a peer or relative’s suicide or suicide attempt, 15% of adolescents report high loneliness.Loneliness after peer/relative suicide or suicide attempt is associated with suicidal ideation and attempt.No associations are observed when accounting for baseline depressive symptoms.The influence of loneliness on suicidal ideation is strongest in the early aftermath of peer/relative suicide or suicide attempt.
Suicidal ideation and behaviors in preteens have increased in recent years. This study sought to describe clinical issues related to suicide prevention in children younger than 10 years old by clinicians who serve children. Data were collected as part of the evaluation of the Zero Suicide initiative in New York State outpatient mental health clinics. Participants (N = 177 mental health clinicians) responded to the question of how working with suicidal children under the age of 10 yrs. differed from working with suicidal adolescents or adults. Clinician's open ended text responses to this question underwent thematic analysis using an inductive approach. The identified themes included: (1) child's characteristics, e.g., impulsivity, limited insight, limited verbal skills, immature understanding of the death and suicide concepts, and general developmental differences; and (2) environmental factors, e.g., perception of a child's suicidality by others and complicated environment; both in the context of their effect on assessment and prevention methods. Additionally, (3) suicide risk assessment-barriers, such as ambiguity in the child's suicidal statements, difficulty evaluating suicide risk level, and problems with current assessment instruments; and facilitators, including use of age-appropriate language or other communication modalities, and use of collateral sources of information; as well as (4) suicide prevention interventions-barriers, including limited coping skills and child and parent engagement in treatment; and facilitators, such as psychoeducation, parent involvement, and modifying existing interventions. Clinician responses indicate the need for evidence-based practice guidelines tailored to this population's characteristics. Recommendations for clinicians are discussed.
Objective: Suicidal thoughts and behaviors (STB) constitute high public health concerns. Understanding the longitudinal trajectories of STB from adolescence to adulthood as a function of sex, ancestry, and genetic liability would improve our knowledge and the design of population-based prevention/intervention. Methods: We used data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) and included participants of European (EA, N = 4,905) and African (AA, N = 1,654) ancestry. We evaluated the growth trajectories of suicide ideation and suicide attempt from age 12 to 40 separately in participants of EA and AA and assessed the roles of sex and genetic liability, indexed using polygenic scores (PGS). Results: Quadratic growth models including an age-by-sex interaction fit the data best in both ancestral groups. Results indicated an overall decrease of STB from adolescence to adulthood, a stabilization between ages 25-35, and a tendency to increase after age 35. Sex differences were evidenced by higher baseline levels of STB and sharper decreases across ages in females. Including PGS improved the model fit and was related to baseline levels of STB. Conclusions: Adolescence constitutes a high-risk period for the development of STB, particularly in females and those with high genetic liability. Though we observed a stabilization of STB in adulthood, another risk period may arise after age 35. We evaluate the trajectories of suicide ideation/attempt from 12–40 across ancestryThe best-fitting models included sex and showed the role of genetic liabilityIdeation/attempt decrease from adolescence to adulthood and increase after age 35.
Suicide is a complex public health issue influenced by a range of psychological, social, and environmental factors. It displays marked spatial and temporal variation, with certain regions consistently experiencing higher rates, while temporal trends fluctuate over years and seasons. Understanding both dimensions is important; therefore, adopting a spatio-temporal approach enables a more comprehensive analysis. Geocode data on suicide-related calls (N = 82,816) from the Valencian Community, Spain, between 2013 and 2023 were provided by the Valencian Regional Government. We used a Bayesian spatio-temporal Poisson regression modeling with an integrated nested Laplace approximation (INLA) to identify the spatial and temporal distribution of suicide-related calls. The study revealed a higher incidence of suicide-related calls in urban areas with a lower aging index, greater residential instability, and a higher percentage of one-person households. A clear seasonal pattern emerged, with the fewest calls occurring in the winter months, particularly in February, and most calls occurring from May to September. The spatial distribution of relative risk is presented in the corresponding map, highlighting marked geographic disparities. The observed spatial clustering, sociodemographic correlates, and strong seasonal peaks in suicide-related calls highlight the importance of incorporating spatio-temporal evidence into the design of timely, place-based suicide prevention and community response efforts. Suicide-related calls were more frequent in urban areas with younger populations and higher residential instability.Suicide-related calls peak in late spring–summer, with February showing the lowest rates.Identifying spatial and temporal trends in suicide-related calls may guide prevention strategies.
Adolescent suicidality is a pressing global health concern, yet group-based therapeutic interventions for this population remain underexplored. This scoping review aimed to systematically map the existing literature on group therapy for adolescents and young adults aged 10-25 years experiencing suicidal ideation or behaviors. Ten peer-reviewed studies were identified through a comprehensive database search and analyzed across key dimensions, including participant demographics, interventions' theoretical frameworks, therapeutic mechanisms, intervention structure, clinical outcomes, and implementation challenges. The findings reveal that group therapy for adolescents at risk of suicide is applied using a variety of theoretical orientations, including cognitive-behavioral, dialectical-behavioral, psychodynamic, and narrative approaches, and across diverse clinical settings. Most interventions were short and time limited. Interventions generally yielded positive outcomes, including reductions in suicidal ideation, depressive symptoms, anxiety, and emotional dysregulation. Despite promising results, studies also had methodoligocal limitations, including small samples and most studies lacked control group or randomization. Furthermore, few interventions included cultural adaptation or addressed the potential risk of suicide contagion in group settings. Taken together, findings underscore the need for further research employing rigorous designs and culturally informed practices. Nonetheless, group therapy appears to be a potentially effective component in the continuum of care for adolescents at risk of suicide.
A growing international concern has emerged regarding a novel suicide method involving the ingestion of a toxic substance, particularly after the arrest of Kenneth Law. Better surveillance and understanding of the profiles of individuals who adopt the method are critical to improving the effectiveness of suicide prevention efforts. This review aims to summarize the existing epidemiological evidence on suicide attempts and deaths by self-poisoning with the substance. This study followed Guidance for Conducting Systematic Scoping Reviews, and the searching process was in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses - Scoping Reviews (PRISMA-ScR). A literature search was conducted in MEDLINE, EMBASE and SCOPUS for articles published until March 16, 2026, using the search terms related to this substance AND (suicid* OR 'suicide attempt' OR 'self-harm' OR 'self-poisoning' OR 'intentional' OR 'deliberate'). Case reports, case series, and research articles reporting suicide attempts or deaths involving the substance were included. A total of 67 studies were included in the review, the majority of which were case reports or case series. Several cases reported that individuals learned about and/or purchased the substance online. A rising trend in suicide involving this substance has been observed globally. The findings support a targeted, evidence-based public health response that addresses the online supply chain directly, improves the accuracy of surveillance and coding, equips clinicians and investigators with the awareness needed to identify cases, and coordinates regulatory action across jurisdictions in restricting its access. A rising trend of suicide involving a novel toxic substance is observed globally.Most of the existing literature is case reports or case series.Many individuals learned about/obtained the substance online.
Few interventions target suicide in people identifying as lesbian, gay, bisexual, trans, queer, intersex, asexual, and other gender identities (LGBTQIA+). This systematic review examined interventions addressing suicide or depression among LGBTQIA+ people and conducted an intervention component analysis to assess effectiveness of design components, implementation, and alignment with existing evidence. We screened 8, 046 abstracts from PubMed, PsycINFO, and Embase for relevance, and assessed full text against inclusion criteria. Eligible studies had to target LGBTQIA+ people, and the primary outcome had to be suicidal thoughts or behaviors, or depression (or related constructs, such as hopelessness). Studies were synthesized narratively and according to the intervention component analysis method. Risk of bias was assessed using the RoB-2 and ROBINS-I tools. 4,400 individuals were represented across 39 included studies. While some single-group designs showed reductions in suicidal thoughts and behaviors, no studies demonstrated significantly greater reductions relative to treatment as usual/waitlist groups. In contrast, many interventions which targeted depression reported significantly greater reductions compared to control conditions. Analysis of intervention components revealed little attention to concepts which may be effective for those experiencing minority stress, and of those pertinent to preventing suicide, such as safety planning. Findings highlighted the value of shared experiences, yet also revealed that LGBTQIA+ adaptation alone may be insufficient to reduce suicidality. Across studies, there were notable gaps between components used and mediators of suicide in LGBTQIA+ populations. We discuss implications for research, particularly recommendations for interventions designed to reduce suicidal ideation in LGTBQIA+ people. There is little evidence supporting the effectiveness of existing interventions to prevent suicide in LGBTQIA+ peopleIntervention components are diverse but there is little evidence of their effectiveness. At the same time, it is apparent that some components which are considered pivotal to suicide prevention are absent, such as safety planning.There appears to be a divergence between the literature’s understanding of LGBTQIA+ experiences of suicide, and what interventions to prevent suicide in this population are attempting to address.
There is an absence of investigations and knowledge of the pathways from suicidal ideation to attempt among individuals with schizophrenia spectrum disorders (SSDs). This study explored suicide attempt experiences and identified pathway steps and timeframes among adults with SSDs. Quantitative and qualitative data were collected from adults with SSDs in a community mental health setting of the United States who had a history of suicide attempt and 6-month history of suicidal ideation (n = 19). The Pathway to Suicidal Action Interview (PSAI) was administered and data from qualitative questions were analyzed using a hybrid analytic approach with inductive and deductive coding. Transition toward suicide attempt occurred often within minutes or seconds of the decision point (mode of 30 minutes) and first step of attempt action (mode of 30 seconds). Most participants did not engage in preparatory behavior (68%) or mull in contemplation (53%) prior to their attempt. Symptoms of depression (89%) and psychosis symptoms (63%) were endorsed by most participants at the time of attempt, with 47% reporting hearing auditory hallucinations to kill themselves or die. Suicide attempt experience themes pertained to impulsivity, access to means, psychosis symptoms, survival ambivalence, attempt antecedents, attempt location, travel, and role of others. Findings underscore the heterogeneity of suicide attempt pathways and reveal opportunities for prevention efforts related to lethal means safety, management of acute emotional distress, and targeting psychosis symptoms that can impact suicide risk for those with SSDs. Future research is needed among larger and more diverse samples. Transition from suicidal ideation to attempt among individuals with schizophrenia spectrum disorders was often rapid, occurring within minutes or seconds and often without preparatory behaviors.Depressive symptoms (including low mood and anhedonia), acute emotional distress, and psychosis symptoms (particularly auditory hallucinations) were frequently present at the time of suicide attempt.Findings highlight opportunities for suicide prevention in SSD populations focused on lethal means safety, acute distress intervention, and targeted management of psychosis symptoms contributing to suicide risk.
Childhood trauma is a potent predictor of suicide risk in university students, yet the longitudinal mechanisms and protective factors that are associated with this trajectory are not fully understood. This study aimed to elucidate the pathway from childhood trauma to suicide risk by examining the mediating role of depression and, critically, to test whether self-compassion functions as a protective factor that moderates these direct and indirect relationships. A longitudinal design was employed, drawing from a large cohort of Chinese university students. From an initial sample of 24,548 students, 3,712 individuals with a history of childhood trauma provided complete data at baseline (T1: childhood trauma, self-compassion, depression) and at a one-year follow-up (T2: depression, suicide risk). A longitudinal moderated mediation model was tested to analyze the data. Childhood trauma was a significant direct predictor of suicide risk. Crucially, the mediating effect of depression on the relationship between trauma and suicide risk was significantly moderated by self-compassion. The moderated mediation analysis revealed that the indirect pathway from trauma to suicide risk via depression was non-significant at low and mean levels of self-compassion but became a significant protective pathway at high levels of self-compassion. Childhood trauma exerted both direct and indirect influences on suicide risk, with depression serving as a key mediating mechanism. Self-compassion emerged as a vital resilience factor that buffered both the direct effect of childhood trauma on suicide risk and the pathway from trauma to depression.
The aim of this study is to examine the relationships between defeat, entrapment, and suicidal ideation among emerging adults (operationally defined as ages 18-26) within the framework of the Motivational Phase of the Integrated Motivation-Volitional (IMV) Model and to test the moderating roles of self-critical rumination and social ostracism and its forms (ignored and excluded) in these relationships. The study used a cross-sectional design with self-report data from 503 emerging adults in Türkiye. Mediation and moderating analyses were conducted using IBM SPSS 22 (PROCESS macro). In the association between defeat and suicidal ideation, entrapment functioned as a partial mediator. In the association between defeat and entrapment, self-critical rumination functioned as a buffering moderator. In the association between entrapment and suicidal ideation, being ignored functioned as a reinforcing moderator, whereas excluded and social ostracism did not moderate this association. The motivational stage of the IMV Model is empirically validated in the emerging adult sample in Türkiye and provides a functional framework for explaining the process leading to suicidal ideation. The study adds an additional cognitive layer to the model through self-critical rumination, revealing the dynamics of the defeat-entrapment relationship in a more nuanced way. Furthermore, by examining social ostracism and its forms (ignored and excluded), it makes an important contribution to how social threats and relational vulnerabilities intersect with the motivational processes conceptualized in the model. Entrapment constitutes a central motivational mechanism linking defeat to suicidal ideation, underscoring its pivotal role within the motivational phase of the IMV Model.Self-critical rumination attenuates the defeat-entrapment association, indicating a buffering process that shapes how experiences of defeat are cognitively internalized.Ignored, but not excluded and social ostracism, intensifies the impact of entrapment on suicidal ideation, highlighting the distinctive role of subtle social invisibility in motivational suicide risk.