Can We Really Prevent Suicide?

Every year, suicide is among the top 20 leading causes of death globally for all ages. Unfortunately, suicide is difficult to prevent, in large part because the prevalence of risk factors is high among the general population. In this review, clinical and psychological risk factors are examined and methods for suicide prevention are discussed. Prevention strategies found to be effective in suicide prevention include means restriction, responsible media coverage, and general public education, as well identification methods such as screening, gatekeeper training, and primary care physician education. Although the treatment for preventing suicide is difficult, follow-up that includes pharmacotherapy, psychotherapy, or both may be useful. However, prevention methods cannot be restricted to the individual. Community, social, and policy interventions will also be essentia

Perceived academic performance as an indicator of risk of attempted suicide in young adolescents

This study investigated perceived academic performance and self-reported suicidal behavior in adolescents (n=2,596), mean age 13 years, from 27 South Australian high schools. Groups perceiving their academic performance as failing, below average, average and above average were significantly different on measures of self-esteem, locus of control, depressive symptoms, suicidal thoughts, plans, threats, deliberate self-injury, and suicide attempts. Multivariate logistic regression analyses revealed that failing academic performance (compared to above average) is associated with a fivefold increased likelihood of a suicide attempt, controlling for self-esteem, locus of control and depressive symptoms. Teachers should note that a student presenting with low selfesteem, depressed mood and perceptions of failure may be at increased risk for suicidal thoughts and behaviors, and need referral for clinical assessment

The geographic distribution of Senecio glastifolius in New Zealand: past, current and climatic potential

Senecio glastifolius (Asteraceae) is an invasive species in New Zealand, where it threatens rare and vulnerable coastal floristic communities. It has expanded its range dramatically over recent years and continues to spread. It is subject to control programs in parts of its distribution. Uncertainty over its future distribution and invasive impacts in New Zealand contribute to the difficulty of its management. To address this knowledge gap, the potential distribution of S. glastifolius in New Zealand was predicted, based on its bioclimatic niche. Existing information on its current distribution and historic spread is incomplete, stored in disparate sources, and is often imprecise or inaccurate. In this study, available information on its distribution and spread was synthesised, processed, and augmented with new data collected in the field by the author. This data set was optimised for use in species distribution modelling. The distribution of S. glastifolius is described in its native range of South Africa, plus invaded regions in Australia, the British Isles and New Zealand. The data set describing its distribution is of higher quality than any known previous data set, is more extensive, and more suitable for use in species distribution modelling. The historic spread of S. glastifolius in New Zealand is presented, illustrating its expansion from sites of introduction in Wellington, Gisborne, plus several subsequent sites, to its now considerable range throughout much of central New Zealand. A predictive model of the potential distribution of S. glastifolius was created based on the three main climatic variables observed to limit its distribution: mean annual temperature range, aridity, and minimum temperature of the coldest month. MaxEnt models were trained on data from all regions for which georeferenced records of the species were available; South Africa, Australia, New Zealand and the Isles of Scilly. Predictions were evaluated using methods appropriate to the special case of range-expanding species. Models performed well during validation, suggesting good predictive ability when applied to new areas. Analysis of the realised niche space of S. glastifolius in the two climatic dimensions most influencing its distribution: Annual Temperature Range and Aridity, indicated that it is exploiting almost totally disjunct niche spaces in New Zealand and South Africa. Of the climate space occupied in New Zealand, almost none is available to the species in its native range of South Africa. Predictions of S. glastifolius’s potential distribution in New Zealand reveal significant areas of suitable habitat yet to be invaded. Much of this suitable habitat is contiguous with the current range and active dispersal front of S. glastifolius, suggesting that invasion is highly likely under a scenario of no management intervention. Specifically, it is suggested that control and surveillance in coastal Taranaki are required to prevent invasion of an area covering most of the northern third of the North Island

Parental psychopathology, adult attachment and risk of 12-month suicidal behaviours

Background: The mechanisms by which parental psychopathology and vulnerability to suicide is transmitted to offspring is not well understood. parental psychopathology and behaviour may impact upon the normal emotional and psychological adjustment of their offspring in various ways. Research shows attachment insecurities may also be a key factor in the facilitation of suicidal behaviours. Objective: To examine adult attachment insecurities as a potential mediating pathway between parental psychopathology and 12- month suicidality. Method: The study utilized data from the National co-morbidity Survey- Replication (NCS-R, N=5692). Parental psychopathology was assessed using items from the Familial History of Psychiatric Disorders section of the NSC-R in conjunction with items designed to capture dimensions of attachment and suicidal behaviours. Results: Resultant analyses demonstrated specificity effects in that, parental psychopathology was associated with specific suicidal components through specific dimensions of attachment. Discussion: The results align with literature linking parental psychopathology to both attachment insecurities and risk of suicide. Crucially, this study bridges these research areas by presenting attachment insecurity as possible risk indicator and intervening factor between parental mental health and behaviour and specific indicators of suicide

Understanding the relationship between suicidality, current depressed mood, personality, and cognitive factors

Objectives: Links between suicidality and depressed mood are well established. There is, however, little information about the emotional regulation processes that underlie the relationship between suicidality and current low mood, and how these processes differ between groups of never-suicidal (NS), suicidal ideators, and suicide attempters. As suicidality and depression are heterogeneous constructs, this study aimed to conduct within- and between-group comparisons of known suicide risk factors that are associated with emotion regulation (neuroticism, trait aggression, brooding, impulsivity, and overgeneral autobiographical memories). Design: Correlational design using between- and within-group comparisons from self-report measures. Methods: Inter- and intragroup differences were identified using Pearson's correlation coefficients and tests of difference. An analysis of indirect effects was used to investigate whether the relationship between suicidality and current low mood was mediated by neuroticism, trait aggression, brooding, impulsivity, and overgeneral autobiographical memories, and if this relationship varied according to group type. Results:  Brooding appeared to be a consistent feature of all three groups and was closely related to current low mood. Compared to the NS group, the relationship between suicide attempts and current low mood showed greater associations with brooding, trait aggression, and overgeneral autobiographical memories. Compared to the NS group, the suicidal ideation group showed stronger associations with neuroticism and impulsivity, but these factors did not correlate with low mood. Conclusion: These results suggest a need for larger studies to focus on heterogeneity within suicidal populations and consider how different combinations of risk factors may heighten or reduce suicide risk. Practitioner points: * It is well known that the severity and intensity of suicide and depressed presentations vary because of underlying dispositional and contextual factors (Fried & Nesse, ) which, in turn, affect how events are interpreted and responded to. Despite this, there is little research about how these mechanisms operate in different types of suicide groups, and their influence on the relationship between suicidality and current low mood. * Understanding interrelationships that affect current low mood is of clinical significance because past suicidal history and deteriorations in already negative mood are linked to repeated suicide attempts and completion. * Our findings show that ruminative brooding, defined as a tendency to repeatedly think about emotional aspects of an event, consistently correlates with current low mood across different types of suicidal groups (NS, suicidal ideators, and suicide attempters), and across analyses. * Findings also show that suicidal ideation and attempt groups were associated with specific personality characteristics that increased the propensity of emotional responding and interpretation compared to the NS group. The relationship between suicide attempt and current low mood had a higher propensity to be influenced by trait aggression, brooding, and overgenerality compared to the NS group. In contrast, although the suicidal ideation group correlated more strongly with neuroticism and impulsivity, these factors did not influence current low mood. * In terms of clinical practice, these findings imply that specific styles of interpretation and thinking may maintain the relationship between suicidality and current low mood. Given the cross-sectional nature of the study, however, it is not possible to imply causality. Nevertheless, the findings obtained provide some support for transdiagnostic models of cognitive-behavioural processes that could be developed further.PostprintPeer reviewe

Victim, perpetrator, and offense characteristics in filicide and filicide-suicide

The purpose of this paper is to provide a critical review of most recent studies of parental and stepparental filicide. A detailed review of the literature revealed the importance of certain demographic, environmental, and psychosocial factors in the commission of child homicide. Our findings indicate that filicides perpetrated by genetic parents and stepparents differ considerably in terms of underlying motivational factors. Data in the literature suggest that biological parents are more likely to choose methods of killing which produce quick and painless death, whereas stepparents frequently kill their wards by beating. Research results demonstrate the victims of maternal filicides to be significantly younger than the victims of paternal filicides. Additionally, filicide–suicide is most often associated with parental psychopathology. Genetic fathers are at the greatest risk of death by suicide after the commission of familicide. These findings are discussed in relation to theoretical frameworks explaining the occurrence of child murder. Further, limitations of reviewed studies and directions for future research are presented

Serial Monitoring of Lead aVR in Patients with Prolonged Unconsciousness Following Tricyclic Antidepressant Overdose

Severe cardiac and neurologic toxicities of tricyclic antidepressant (TCA) overdose have been reported since the introduction of TCAs in 1950s. Despite the decreased numbers of TCA overdoses, the mortality and morbidity rates of TCA overdose have remained constantly high. Clinical manifestations of TCA overdose are characterized by unconsciousness and specific electrocardiography (ECG) abnormalities such as prolongation of the PR and QTc intervals, widening of the QRS duration, and an increased R wave and R/S ratio in lead aVR. We report a case with unusually prolonged unconsciousness without initial stem reflexes for 7 days and multiple ECG abnormalities following TCA overdose. It is suggested that the serial monitoring of R wave and R/S ratio in lead aVR might be informative in predicting recovery from toxicity following TCA overdose

Psychiatric assessment of suicide attempters in Japan: a pilot study at a critical emergency unit in an urban area

<p>Abstract</p> <p>Background</p> <p>The incidence of suicide has increased markedly in Japan since 1998. As psychological autopsy is not generally accepted in Japan, surveys of suicide attempts, an established risk factor of suicide, are highly regarded. We have carried out this study to gain insight into the psychiatric aspects of those attempting suicide in Japan.</p> <p>Methods</p> <p>Three hundred and twenty consecutive cases of attempted suicide who were admitted to an urban emergency department were interviewed, with the focus on psychosocial background and DSM-IV diagnosis. Moreover, they were divided into two groups according to the method of attempted suicide in terms of lethality, and the two groups were compared.</p> <p>Results</p> <p>Ninety-five percent of patients received a psychiatric diagnosis: 81% of subjects met the criteria for an axis I disorder. The most frequent diagnosis was mood disorder. The mean age was higher and living alone more common in the high-lethality group. Middle-aged men tended to have a higher prevalence of mood disorders.</p> <p>Conclusion</p> <p>This is the first large-scale study of cases of attempted suicide since the dramatic increase in suicides began in Japan. The identification and introduction of treatments for psychiatric disorders at emergency departments has been indicated to be important in suicide prevention.</p