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Patterns of Suicidal Risk and Its Relationship with Suicidal Ideation and Attempt: Practice and Policy ImplicationsDespite efforts to prevent suicide, suicide mortality rate has been increasing since 2000. This dissertation examined distinct patterns of suicidal risk based on the interpersonal-psychological theory of suicide (IPTS; Joiner, 2005), and the most critical patterns of suicidal ideation and suicide attempt were explored using latent class analysis. A nationally representative sample of White, Black, Latinx, and Asian adults from the Collaborative Psychiatric Epidemiology Surveys (Alegria et al., 2016) was used. For White adults, five latent classes were identified, and respondents in the All Three with Alcohol/Drug Dependence, All Three without Alcohol/Drug Dependence, and Thwarted Belongingness + Perceived Burdensomeness classes were more likely to demonstrate suicidal ideation and suicide attempt than those in the Only Acquired Capability for Suicide class. For Black adults, six latent classes were identified, and respondents in the All Three with Alcohol/Drug Dependence and All Three without Alcohol/Drug Dependence classes were significantly more likely to attempt suicide than those in the Low Risk class. For Latinx respondents, four latent classes were identified, and respondents in the Thwarted Belongingness + Acquired Capability for Suicide class were significantly more likely to attempt suicide than respondents in the Low Risk class. For Asian respondents, three latent classes were identified, and respondents in Thwarted Belongingness + (Active) Acquired Capability for Suicide class had a significantly higher risk for suicidal ideation and suicide attempt than those in the Low Risk class. Findings of this dissertation supported the major tenets of the IPTS that individuals are at the greatest risk for suicide attempt when thwarted belongingness, perceived burdensomeness, and acquired capability for suicide coexist. In addition, this dissertation found some variations across the four racial/ethnic groups. Findings suggested that clinicians working with people with higher risk for suicide should explore multiple dimensions of suicidal risk, especially clients’ capability for suicide (e.g., past exposure to trauma and pain- and fear-reducing experiences). Suicide-prevention campaigns and trainings need to include exploration of past exposure to trauma, physical violence, and risk-taking behaviors as well as access to means in training sessions so that trainees can better detect people with higher risk of suicide attempt.
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The relationship between trauma exposure and psychiatric hospitalization for suicide ideation or suicide attempt among patients admitted to a military treatment settingSuicide attempts and psychiatric hospitalization represent the final outcomes of a complex dynamical system of interacting factors that influence a particular individual's likelihood of engaging in suicidal behavior, as well as their ability to seek help prior to acting upon suicidal impulses. This study examined the association between different types of lifetime trauma exposure and the likelihood of psychiatric hospitalization following a suicide attempt (SA) rather than suicidal ideation (SI) alone. Electronic medical records for 1100 U.S. military service members and their dependents admitted to a military psychiatric inpatient setting for SA or SI were reviewed for documented lifetime trauma exposure history. Findings indicated that exposure to at least one childhood trauma of any type, and childhood neglect in particular, increased the likelihood that an individual would be hospitalized for SA rather than SI. Exploratory gender-stratified analyses demonstrated that childhood neglect, childhood sexual abuse, and adulthood traumatic loss may be linked with the likelihood of being hospitalized for SA. These findings demonstrate the importance of developing more detailed and nuanced conception of factors known to be associated with suicide as their effects may depend on details of their timing and nature, as well as their interactions with other systems. Copyright 2020 by the authors.
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Aspiring to a Zero Suicide Mindset at Work: Research-based U.S. National Guidelines for Suicide Prevention and PostventionThis presentation was presented as part of the 2020 Work and Family Researchers Network (WFRN) Annual Conference. The presenters represent leaders in the field of workplace suicide prevention and all worked on developing and disseminating the U.S. National Guidelines for Workplace Suicide Prevention which are described in this presentation. At the end of this presentation, participants will be able to: 1) list reasons why suicide prevention is a workplace health and safety priority; 2) describe the essential elements of the National Guidelines for Workplace Suicide Prevention; and 3) take at least one action step towards building a sustained and comprehensive strategy for their workplace or professional association.
