Suicide & Self-Harm Research – focalinterest.net

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Tag: Suicide & Self-Harm Research

  • Youth suicide attempt presentations rose during the pandemic

    What the study found

    Psychiatric emergency presentations after suicide attempts among children and adolescents increased during the COVID-19 pandemic compared with the pre-pandemic period. The increase was not seen in the post-pandemic period, which did not differ significantly from pre-pandemic levels.

    Why the authors say this matters

    The authors conclude that suicide attempts may reflect psychosocial burden that is not captured by mortality data alone. They also suggest that emergency presentations should be monitored and that low-threshold mental health support is needed beyond periods of acute crisis.

    What the researchers tested

    The researchers did a retrospective analysis at a tertiary care center in Vienna, Austria, from January 2019 to December 2023. They compared pre-pandemic, pandemic, and post-pandemic periods, and used the Oxford COVID-19 Government Response Tracker Stringency Index to measure the intensity of government containment measures.

    What worked and what didn't

    There were 6,319 psychiatric emergency presentations in total, including 722 following suicide attempts. Compared with the pre-pandemic period, suicide attempt-related presentations increased during the pandemic (RR = 1.80, p < .001), and higher monthly presentation rates were associated with greater containment stringency (RR per point = 1.007, p < .001). The post-pandemic period did not differ significantly from the pre-pandemic period, and an independent upward temporal trend was also observed across the study period.

    What to keep in mind

    The study was based on one tertiary care center in Vienna, so the findings may not apply everywhere. The abstract does not describe additional limitations beyond the observational, retrospective design.

    • Youth suicide attempt-related psychiatric emergency presentations increased during the COVID-19 pandemic.
    • Post-pandemic presentation levels were not significantly different from pre-pandemic levels.
    • Higher government containment stringency was associated with higher monthly suicide attempt presentation rates.
    • The analysis included 6,319 psychiatric emergency presentations, 722 of which followed suicide attempts.
    • The authors suggest suicide attempts may indicate psychosocial burden not reflected in mortality data alone.

  • Unsecured firearm storage was linked to higher suicide risk

    What the study found

    Among U.S. Army service members who owned firearms, unsecured storage of a firearm, meaning loaded and unlocked, was associated with higher reported suicidal ideation across 30-day, 12-month, and lifetime time frames. Carrying a weapon other than a firearm was also associated with higher suicide attempt risk in the past 12 months.

    Why the authors say this matters

    The authors conclude that firearm storage and carrying behavior of any weapon, not just firearms, may indicate heightened suicide risk among military service members. The study suggests these behaviors could be relevant for identifying people at higher risk.

    What the researchers tested

    The researchers analyzed a cross-sectional survey of U.S. Army soldiers from the Army Study to Assess Risk and Resilience in Servicemembers-Longitudinal Study Wave 2. They examined self-reported suicidal behaviors using the Columbia-Suicide Severity Rating Scale and used multivariable logistic regression to test associations while controlling for mental health disorders, stressful life events, and other background factors.

    What worked and what didn't

    Unsecured firearm storage was associated with increased odds of suicidal ideation at 30 days, 12 months, and lifetime, compared with secure storage such as unloaded storage. It was also associated with a higher odds of a past-12-month suicide attempt. Carrying a weapon other than a firearm was associated with higher odds of a past-12-month suicide attempt.

    What to keep in mind

    This was a retrospective cross-sectional study, so it shows associations rather than cause and effect. The abstract does not describe other limitations beyond the use of self-reported behavior and the specific sample of U.S. Army soldiers.

    • Unsecured firearm storage was linked to higher suicidal ideation across short-, medium-, and long-term time frames.
    • Firearm owners with unsecured storage had higher odds of a suicide attempt in the past 12 months.
    • Carrying a weapon other than a firearm was associated with higher past-12-month suicide attempt risk.
    • The analysis controlled for lifetime mental health disorders and stressful life events.
    • The study used a weighted sample of 12,022 U.S. Army soldiers.

  • Neuroticism mediates the link between mood symptoms and NSSI

    What the study found

    The study found that neuroticism, a personality trait linked to emotional instability, mediated the relationship between emotional symptoms and non-suicidal self-injury (NSSI). Thyroid hormones also moderated the depression-NSSI link, with TT3 and FT3 showing positive moderation and TSH showing negative moderation.

    Why the authors say this matters

    The authors conclude that these findings integrate psychological and neuroendocrine mechanisms for identifying and intervening in NSSI risk in youths. They present neuroticism and thyroid hormones as factors that may help explain how mood symptoms relate to NSSI.

    What the researchers tested

    The researchers studied 104 Han Chinese adolescents and young adults aged 12–22 years who had NSSI behaviors. Participants completed questionnaires for NSSI severity, depression symptoms, anxiety symptoms, and personality traits, and venous blood was collected for thyroid function tests; mediation and moderation analyses were then performed using SPSS PROCESS.

    What worked and what didn't

    Neuroticism mediated the relationship between emotional symptoms and NSSI. For anxiety symptoms, neuroticism fully mediated the association with NSSI; for depression symptoms, TT3, FT3, and TSH significantly moderated the relationship in the full sample after FDR correction, while the negative effect of TSH remained significant in the high-neuroticism subgroup.

    What to keep in mind

    The sample was limited to 104 Han Chinese adolescents and young adults with NSSI behaviors, so the findings are based on a specific group. The abstract does not describe other limitations beyond the reported subgroup and correction results.

    • Neuroticism mediated the link between emotional symptoms and NSSI.
    • Anxiety symptoms were fully mediated by neuroticism in relation to NSSI.
    • TT3 and FT3 positively moderated the depression-NSSI relationship.
    • TSH negatively moderated the depression-NSSI relationship in the full sample and in the high-neuroticism subgroup.
    • No significant thyroid-hormone moderation was found for the anxiety-NSSI pathway.

  • Virtual learning circles supported culturally grounded school suicide prevention

    What the study found

    Participants in virtual PC CARES sessions actively discussed ways to support student wellbeing and suicide prevention in rural Alaska school settings. Their discussions focused on culturally grounded actions, trusted relationships, and small acts of kindness as protective factors.

    Why the authors say this matters

    The authors conclude that PC CARES may serve as a strengths-based, culturally relevant platform for school-based suicide prevention. They also say the findings highlight the need for institutional support to sustain these efforts.

    What the researchers tested

    The researchers used qualitative data from virtual PC CARES sessions delivered with three rural Alaskan school districts from 2020 to 2022. Participants included school staff, administrators, and behavioral health professionals, and notes and written responses from seven online facilitated sessions were deductively analyzed for themes.

    What worked and what didn't

    Across 28 sessions totaling 56 hours over two academic years, participants discussed integrating Alaska Native Elders into school activities, modeling healthy behaviors, creating space for youth expression, and incorporating cultural identity into programming. They also noted institutional challenges, including inconsistent policies and limited resources.

    What to keep in mind

    The abstract does not report student-level outcomes or long-term sustainability results. It also does not describe a comparison group, so the findings reflect participant perceptions and thematic analysis from the sessions.

    • Participants discussed culturally grounded actions for school-based suicide prevention in rural Alaska.
    • Trusted relationships and small acts of kindness were described as protective factors for youth.
    • Institutional challenges included inconsistent policies and limited resources.
    • The study analyzed notes and written responses from seven virtual facilitated sessions.
    • The authors say PC CARES may be a strengths-based, culturally relevant platform.

  • Younger patients with prior self-harm were more likely to present after suicide attempts

    What the study found

    The study found that, in this hospital-based psychiatry sample, patients evaluated after a suicide attempt were more often younger and had more prior self-harm-related history than patients seen for other psychiatric reasons. The authors also report that previous non-suicidal self-injury, previous suicide attempt, depressive disorder, personality disorder, and recent life stressors were associated with suicide attempts.

    Why the authors say this matters

    The authors conclude that psychiatric consultation in a general hospital is a crucial opportunity for comprehensive assessment of suicide risk factors and early intervention. They suggest that younger people with a history of suicidal behaviors and non-suicidal self-injury should be prioritized for targeted preventive strategies.

    What the researchers tested

    The researchers analyzed psychiatric consultation data from the University Hospital of Perugia. They used the Columbia Suicide Severity Rating Scale to assess suicidal ideation, suicide attempts, and non-suicidal self-injury, then compared patients referred after a suicide attempt with those referred for other psychiatric reasons using bivariate analyses and a logistic regression model with Firth's penalized likelihood.

    What worked and what didn't

    Among 373 patients, 129 were evaluated after a real, interrupted, or aborted suicide attempt. In the suicide-attempt group, females and younger patients were more common, and there were higher rates of family psychiatric history, previous suicide attempt, previous non-suicidal self-injury, recent life stressors, and current depressive or personality disorders. In the regression model, previous non-suicidal self-injury, previous suicide attempt, depressive disorder, personality disorder, and recent life stressors were positively associated with suicide attempt, while age was negatively associated.

    What to keep in mind

    This was a single-center analysis from one hospital psychiatric consultation setting, so the findings are specific to that sample. The abstract does not describe follow-up, treatment outcomes, or whether the identified risk markers improve prevention when used in practice.

    • In this sample of 373 psychiatric consultations, 34.6% were for a suicide attempt.
    • Patients seen after a suicide attempt were more often younger and female.
    • Previous non-suicidal self-injury and previous suicide attempt were associated with suicide attempt status.
    • Depressive disorder, personality disorder, and recent life stressors were also associated with suicide attempt status.
    • The authors say hospital psychiatric consultation is an important point for suicide risk assessment.

  • Guideline recommendations on self-harm tools rest on limited evidence

    What the study found

    The authors argue that the NICE guideline on self-harm made definitive recommendations against using risk assessment tools to predict repeat self-harm or suicide, even though the evidence base was very limited. They say the guideline also did not adequately acknowledge uncertainty about model impact, acceptability, and feasibility.

    Why the authors say this matters

    The authors conclude that future updates to the guideline should be informed by higher-quality evidence. They also say that well-developed and validated prediction models could have the potential to improve clinical care for people who self-harm, but should not be used in practice before adequate validation and impact assessment.

    What the researchers tested

    This perspective article examines the NICE guideline development process for self-harm and suicide prevention. The authors discuss the guideline's evidence review, the committee's role in drawing conclusions, and newer evidence on implementation and cost-effectiveness of prediction models.

    What worked and what didn't

    According to the authors, the NICE evidence review included very little evidence, which limited the basis for the recommendations. They say the recommendations relied almost entirely on committee expertise and experience, while evidence on model impact, acceptability, and feasibility was not fully addressed. The authors also note new evidence since the 2022 guideline, including international work on implementation and cost-effectiveness.

    What to keep in mind

    This is a perspective article, not a new primary study of patient outcomes. The abstract does not describe a formal new experiment or provide detailed data on effect sizes, and it does not specify the full scope of the newer evidence it mentions.

    • The authors say the NICE self-harm guideline advised against using risk assessment tools to predict repeat self-harm or suicide.
    • They argue the guideline's evidence review contained very little evidence.
    • They say the recommendations were based largely on committee expertise and experience.
    • They highlight missing discussion of model impact, acceptability, and feasibility.
    • They note newer evidence on implementation and cost-effectiveness has appeared since the 2022 guideline.

  • Harsh parenting profiles were linked to non-suicidal self-injury

    What the study found

    The study found three profiles of harsh parenting: consistently high, medium, and low. Across these profiles, harsh parenting was indirectly associated with non-suicidal self-injury through parental alienation and core self-evaluation, and the indirect patterns differed in size and pathway by profile.

    Why the authors say this matters

    The authors conclude that the findings may inform tailored intervention efforts. They suggest the profile-specific risk patterns could be useful for understanding links between harsh parenting and non-suicidal self-injury among young adults.

    What the researchers tested

    The researchers studied 5,742 college students recruited through convenience sampling at three time points, each three months apart. They used latent profile analysis, a method for grouping people with similar patterns, and profile-specific serial mediation analysis to examine whether parental alienation and core self-evaluation explained the associations.

    What worked and what didn't

    Three parenting profiles were identified: consistently high harsh parenting, medium harsh parenting, and low harsh parenting. Harsh parenting showed indirect associations with non-suicidal self-injury through parental alienation and core self-evaluation across all profiles, but the magnitude and specific indirect pathways varied by profile.

    What to keep in mind

    The study used convenience sampling of college students, so the abstract does not indicate how broadly the findings apply beyond this group. The available summary also does not describe other limitations.

    • Three harsh parenting profiles were identified: consistently high, medium, and low.
    • Harsh parenting was indirectly associated with non-suicidal self-injury in all profiles.
    • Parental alienation and core self-evaluation statistically explained parts of the association.
    • The indirect pathways differed in magnitude and pattern across profiles.
    • The sample included 5,742 college students assessed at three waves over nine months.

  • Health workers were skeptical of standardized suicide risk assessments

    What the study found

    The study found that health workers in Norwegian hospitals were generally skeptical about the emphasis placed on standardized suicide risk assessments. Respondents also viewed suicide as at least partly preventable.

    Why the authors say this matters

    The authors say understanding health workers’ perspectives is important for understanding how clinicians think about suicide risk assessments, their attitudes toward guidelines, and their adherence to current guidelines. They also suggest these findings may have implications for future guideline development and suicide-prevention policy.

    What the researchers tested

    The researchers conducted an electronic survey of 183 health workers from three Norwegian hospitals. Participants included psychologists, doctors, nurses, and social workers, and they answered 18 questions about suicide risk assessments, suicide prevention, suicide risk factors, and Norwegian guidelines for suicide risk assessment.

    What worked and what didn't

    The responses differed significantly by professional group. There were also significant differences between hospitals in how staff perceived risk factors and standardized questions. The abstract says respondents were skeptical of standardized suicide risk assessments, but it does not report a specific intervention or comparison that worked better than another.

    What to keep in mind

    The abstract notes that there were some differences between professions and hospitals, which may be due to cultural and educational aspects. It also states that suicide risk prevention is complex and that methodological limitations should be considered. Future research is recommended to further explore health workers’ concerns about standardized suicide risk assessments.

    • Health workers in the survey were generally skeptical of standardized suicide risk assessments.
    • Respondents viewed suicide as at least partly preventable.
    • Responses differed significantly among professional groups.
    • Hospitals also differed significantly in perceptions of risk factors and standardized questions.
    • The study involved 183 health workers from three Norwegian hospitals.

  • NSSI location patterns differ by visibility and function

    What the study found

    The study found three distinct patterns of anatomical location and visibility in non-suicidal self-injury (NSSI), which is self-injury without suicidal intent. The most concealed pattern was linked to greater intrapersonal functions and expectancies, while the most visible pattern was linked to higher NSSI frequency, broader bodily involvement, and stronger anti-suicide functions.

    Why the authors say this matters

    The authors conclude that their findings advance understanding of NSSI location and provide a theoretically meaningful way to describe anatomical location. They also suggest the results have clinical and theoretical relevance for assessing and intervening in NSSI.

    What the researchers tested

    The researchers analyzed online self-report data from 1,103 people with a lifetime history of NSSI. They used latent class analysis to group participants by anatomical location and visibility of NSSI, then used post hoc ANOVAs and chi-square tests to compare functional, cognitive, and behavioral features across groups.

    What worked and what didn't

    Three latent classes emerged: a most concealed group (32.6%), a most visible group (20.2%), and an intermediate group (47.2%). The concealed group showed the greatest endorsement of intrapersonal functions and expectancies; the visible group did not show stronger interpersonal functions, but did show greater NSSI frequency, broader bodily involvement, and stronger anti-suicide functions. The intermediate group fell between the other two on probabilities of NSSI and visibility.

    What to keep in mind

    The abstract describes an online self-report study, so the findings are based on participant reports rather than direct observation. The summary does not describe other limitations.

    • Three distinct NSSI location-and-visibility groups were identified.
    • The most concealed group showed the strongest intrapersonal functions and expectancies.
    • The most visible group was linked to higher NSSI frequency, broader bodily involvement, and stronger anti-suicide functions.
    • The visible group was not associated with stronger interpersonal functions.
    • The intermediate group had probabilities of NSSI and visibility between the other two groups.