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Journal articles on the topic 'Suicidal thoughts and behaviours'
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Lamont-Mills, Andrea, Luke T. Bayliss, and Steven A. Christensen. "Online suicidal thoughts and/or behaviours talk: A scoping review protocol." PLOS ONE 17, no. 10 (October 27, 2022): e0276776. http://dx.doi.org/10.1371/journal.pone.0276776.
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The anonymity that the internet and social media affords users means that suicidal thoughts and/or behaviours can be talked about with a sense of freedom and disinhibition that is often not possible in face-to-face contexts. Better understanding online suicidal thoughts and/or behaviour talk is critical as more people turn to online spaces for support. Without this the potentiality of such spaces as sites for suicide prevention and intervention is likely to remain unrealised. Currently there are no scoping or systematic review syntheses focusing on internet and/or on social media suicidal thoughts and/or behaviour talk. This lack of synthesis is problematic as it makes it more difficult for online suicide prevention and intervention practices, policies, and our understanding of suicide to advance in a coherent and evidence-based manner. A scoping review protocol following Arksey and O’Malley’s six-step modified framework has been developed to address this synthesis gap. It aims to systematically map the empirical literature that has investigated online suicidal thoughts and/or behaviours talk. It is anticipated that review outcomes could inform the training of health practitioners and peer/professional online moderators in how to best talk with people experiencing suicidal thoughts and/or behaviours. Outcomes could also form an evidence-base for developing policies and practices that focus on online places as safe spaces to talk about suicidal thoughts and/or behaviours. Developers of safe language guidelines could also use the outcomes to audit how well current guidelines reflect empirical evidence. Outcomes could enable researchers to design future online suicidal thoughts and/behaviours talk studies that extend our understandings of suicide leading to potential refinements of contemporary suicide theories/models.
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Armstrong, Gregory, Tilahun Haregu, Eric D. Caine, Jesse T. Young, Matthew J. Spittal, and Anthony F. Jorm. "High prevalence of health and social risk behaviours among men experiencing suicidal thoughts and behaviour: The imperative to undertake holistic assessments." Australian & New Zealand Journal of Psychiatry 54, no. 8 (May 23, 2020): 797–807. http://dx.doi.org/10.1177/0004867420924098.
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Objective: We aimed to examine whether suicidal thoughts and behaviour were independently associated with a wide range of health and social risk behaviours. Methods: We conducted cross-sectional analyses of data collected from 13,763 adult males who participated in The Australian Longitudinal Study on Male Health. We fit generalised linear models to estimate the relative risk of engaging in a range of health and social risk behaviours across several domains by suicidal thoughts and behaviour status. Results: Men with recent suicidal ideation (relative risk range, 1.10–5.25) and lifetime suicide attempts (relative risk range, 1.10–7.65) had a higher risk of engaging in a broad range of health and social risk behaviours. The associations between suicidal thoughts and behaviour and health and social risk behaviours were typically independent of socio-demographics and in many cases were also independent of depressive symptoms. Conclusion: Suicidal thoughts and behaviour overlaps with increased risk of engagement in a wide range of health and social risk behaviours, indicating the need for an alignment of broader public health interventions within clinical and community-based suicide prevention activities. The experience of suicidality may be an important catalyst for a broader psychosocial conversation and assessment of health and social risk behaviours, some of which may be modifiable. These behaviours may not carry an imminent risk of premature death, such as from suicide, but they carry profound health and social consequences if left unaddressed.
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Wypiór, M., A. Sobieraj, A. Salomon-Perzyński, W. Dyrda, K. Krzyżowska, A. Matusiak, K. Paluch, M. Seweryn, and M. Janas-Kozik. "Are suicidal thoughts in adolescents dependent on substance abuse?" European Psychiatry 33, S1 (March 2016): S606—S607. http://dx.doi.org/10.1016/j.eurpsy.2016.01.2270.
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Substance abuse is common issue in youth and may influence youth's suicide thoughts or actions. It can lead to social isolation, low self-esteem, loss of work or school, estrangement from family and friends – all these may create a core of stresses that may lead to suicidal tendencies.Analysis addictive factors correlating with occurrence of suicidal thoughts and behaviours among adolescents at the age of 18–20.Study was based on authorial, previously validated questionnaire, included 16 questions about suicidal thoughts. Questionnaires were filled by adolescents (age 18–20) of 21 Secondary Schools in Katowice.From the group of 965 adolescents, 28.8% had suicidal thoughts. From all respondents: 31.3% smoked, 92.7% drunk alcohol, 16.0% used legal hights and 30.9% – drugs; 35.8% of smoking adolescents had suicidal thoughts. In group of non-smoked adolescents – 25.6%. There was statistical significant difference (P = 0.0012) between these groups. Among adolescents who drunk alcohol, 28.8% had suicidal thoughts. In the group of non –drinking alcohol adolescents – 27.9%. There was no statistical significant differences (P = 0.88233) between these groups. There were 43.7% adolescents with suicidal thoughts who used legal hights. In the group of non-users of legal hights, 26.0% adolescents had suicidal thoughts.Adolescents that are using examined stimulants are in the group risk of suicidal thoughts and autodestructive behaviours. Results show the need of psychiatric and psychotherapeutic support that is aiming to prevent suicides and autodestructive behaviours in this group. Screening questionnaires that are assessing the problem of addiction within the adolescent may help to identity persons with suicidal tendencies.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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van Velzen, Laura S., Yara J. Toenders, Aina Avila-Parcet, Richard Dinga, Jill A. Rabinowitz, Adrián I. Campos, Neda Jahanshad, Miguel E. Rentería, and Lianne Schmaal. "Classification of suicidal thoughts and behaviour in children: results from penalised logistic regression analyses in the Adolescent Brain Cognitive Development study." British Journal of Psychiatry 220, no. 4 (February 9, 2022): 210–18. http://dx.doi.org/10.1192/bjp.2022.7.
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BackgroundDespite efforts to predict suicide risk in children, the ability to reliably identify who will engage in suicide thoughts or behaviours has remained unsuccessful.AimsWe apply a novel machine-learning approach and examine whether children with suicide thoughts or behaviours could be differentiated from children without suicide thoughts or behaviours based on a combination of traditional (sociodemographic, physical health, social–environmental, clinical psychiatric) risk factors, but also more novel risk factors (cognitive, neuroimaging and genetic characteristics).MethodThe study included 5885 unrelated children (50% female, 67% White, 9–11 years of age) from the Adolescent Brain Cognitive Development (ABCD) study. We performed penalised logistic regression analysis to distinguish between: (a) children with current or past suicide thoughts or behaviours; (b) children with a mental illness but no suicide thoughts or behaviours (clinical controls); and (c) healthy control children (no suicide thoughts or behaviours and no history of mental illness). The model was subsequently validated with data from seven independent sites involved in the ABCD study (n = 1712).ResultsOur results showed that we were able to distinguish the suicide thoughts or behaviours group from healthy controls (area under the receiver operating characteristics curve: 0.80 child-report, 0.81 for parent-report) and clinical controls (0.71 child-report and 0.76–0.77 parent-report). However, we could not distinguish children with suicidal ideation from those who attempted suicide (AUROC: 0.55–0.58 child-report; 0.49–0.53 parent-report). The factors that differentiated the suicide thoughts or behaviours group from the clinical control group included family conflict, prodromal psychosis symptoms, impulsivity, depression severity and history of mental health treatment.ConclusionsThis work highlights that mostly clinical psychiatric factors were able to distinguish children with suicide thoughts or behaviours from children without suicide thoughts or behaviours. Future research is needed to determine if these variables prospectively predict subsequent suicidal behaviour.
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Dalum, Helene Seljenes, Reidar Tyssen, and Erlend Hem. "Prevalence and individual and work-related factors associated with suicidal thoughts and behaviours among veterinarians in Norway: a cross-sectional, nationwide survey-based study (the NORVET study)." BMJ Open 12, no. 1 (January 2022): e055827. http://dx.doi.org/10.1136/bmjopen-2021-055827.
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ObjectivesSeveral studies have shown increased suicide rates among veterinarians. We investigated the self-reported prevalence of suicidal thoughts and behaviours and contributing and independent factors associated with suicidal thoughts and behaviours among veterinarians in Norway.DesignCross-sectional, nationwide survey.Participants2596 veterinarians in Norway (response rate: 75%).Main outcome measurePaykel’s five-item questionnaire.ResultsIn total, 27% (n=682/2567) of veterinarians in Norway felt that life was not worth living during the last year, 5% (n=139/2562) had serious suicidal thoughts, and 0.2% (n=6/2537) had attempted suicide. Female veterinarians reported significantly higher prevalence of suicidal feelings and thoughts than males. For serious suicidal thoughts, women had nearly twice the prevalence as their male colleagues (6.2% (n=108/1754) vs 3.6% (n=28/766), χ2: 6.5, p=0.011). Independent factors associated with serious suicidal thoughts were being single (OR 1.76, 95% CI 1.13 to 2.72, p<0.05), negative life events (OR=1.43, 95% CI 1.22 to 1.68, p<0.001) and the presence of mental distress (OR 2.75, 95% CI 2.14 to 3.52, p<0.001). The veterinarians related their serious suicidal thoughts to work and personal problems, and a lesser degree to family, social and other problems. Nearly twice as many women (53%, n=57/108) as men (28%, n=7/25) reported work problems as the most important contributing factor to their serious suicidal thoughts (χ2: 4.99, p=0.03). 4% (n=6/139) reported work problems as the only factor of importance.ConclusionsVeterinarians in Norway have relatively high prevalence of suicidal feelings and thoughts, including serious suicidal thoughts. In multivariable analyses, the individual factors were more important than work-related ones, while work problems were the most reported contributing factor to serious suicidal thoughts by the veterinarians themselves. The role of gender and specific work-related factors should be further investigated to better understand the complexity of suicidal behaviour among veterinarians.
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MacDonald, Carol, Charlotte Caimino, Georgina Burns-O’Connell, Douglas Hartley, Joanna Lockwood, Magdalena Sereda, William Whitmer, Rilana Cima, Laura Turton, and Derek J. Hoare. "Tinnitus, Suicide, and Suicidal Ideation: A Scoping Review of Primary Research." Brain Sciences 13, no. 10 (October 23, 2023): 1496. http://dx.doi.org/10.3390/brainsci13101496.
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Tinnitus (the perception of sound in the absence of any corresponding external source) is highly prevalent and can be distressing. There are unanswered questions about how tinnitus, suicidal thoughts, and suicidal behaviours co-occur and interact. To establish the extent of scientific literature, this scoping review catalogued primary reports addressing the associations between tinnitus, suicidal ideation, attempted suicide, and death by suicide. We searched OvidSP, Medline, EMBASE, PsycINFO, CINAHL, Google Scholar, EThoS, and ProQuest for all studies and case reports on ideation and/or attempted and/or completed suicide in the context of tinnitus. Twenty-three studies were included, and data were charted according to study type. Several epidemiological and other observational studies gave evidence of risk factors and an association between suicidal ideation, suicidal behaviour, and tinnitus. However, there was no evidence of the direction of causality. Qualitative studies are indicated to explore the patient’s experience and understand the dynamics of any interaction between tinnitus and suicidal thoughts and behaviours. A theory-informed model of tinnitus and suicide needs to be developed to inform the development of interventions and how tinnitus patients are supported clinically.
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Lindberg, Elisabeth. "I (o)kunskapens frånvaro. Kön och självmordsbeteenden inom suicidologi." Tidskrift för genusvetenskap 26, no. 1 (June 14, 2022): 9–26. http://dx.doi.org/10.55870/tgv.v26i1.4030.
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We still lack knowledge about what implications gender has in suicidal behaviours. This is particularly true when it comes to women's suicides and suicidal attempts. In this article I argue that one reason for this is that suicidology has had a "gender neutral" approach to it's research object. This has often meant that studies on men have been generalized to the whole "suicide population". When gender has been on the agenda, it has been treated in a problematic way. Through a critical analyses of the studies that have been done in this field, the article is able to show that the knowledge gap existing in suicidology is filled with traditional theories of gender roles. That is, mythology enters the knowledge-empty spaces. The article also discusses the serious consequenses this has for women seeking help fortheir suicidal thoughts. In spiteofthefact that women are overrepresented concerning both suicidal attempts and serious sucicidal thoughts, suicidology still doesn't picture womens suicidal behaviours as one of its primary issues.
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Ross, Virginia, Anoop Sankaranarayanan, Terry J. Lewin, and Mick Hunter. "Mental health workers’ views about their suicide prevention role." Psychology, Community & Health 5, no. 1 (March 24, 2016): 1–15. http://dx.doi.org/10.5964/pch.v5i1.174.
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AimMental Health workers bear responsibility for preventing suicide in their client group. Survey studies have indicated that staff can be seriously adversely affected when a client suicides. The aim of the current study is to describe and evaluate the effects on mental health (MH) workers of their ongoing role in managing suicidal behaviours and to identify the thoughts and feelings associated with this role.MethodA survey was administered to 135 MH workers via an on-line self-report vehicle. The survey comprised standardised measures of anxiety and burnout as well as a questionnaire developed for this study concerning perceptions and attitudes to suicide and suicide prevention.ResultsFactor analysis of 12 retained items of the questionnaire identified three factors: 1) preventability beliefs (beliefs about suicide being always and/or permanently preventable); 2) associated distress (stress/anxiety about managing suicidal behaviour); and 3) the prevention role (covering views about personal roles and responsibilities in preventing suicidal behaviours). Analysis of these factors found that many MH workers experience an elevation of stress/anxiety in relation to their role in managing suicidal behaviours. This distress was associated with the emotional exhaustion component of burnout. Measures showed adverse responses were higher for outpatient than inpatient workers; for those who had received generic training in suicide prevention: and for those who had experienced a workplace related client suicide.ConclusionThere is a need for the development of appropriate self-care strategies to alleviate stress in MH workers exposed to suicide.
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Harrison, Ruth, Marcus R. Munafò, George Davey Smith, and Robyn E. Wootton. "Examining the effect of smoking on suicidal ideation and attempts: triangulation of epidemiological approaches." British Journal of Psychiatry 217, no. 6 (April 15, 2020): 701–7. http://dx.doi.org/10.1192/bjp.2020.68.
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BackgroundPrevious literature has demonstrated a strong association between cigarette smoking, suicidal ideation and suicide attempts. This association has not previously been examined in a causal inference framework and could have important implications for suicide prevention strategies.AimsWe aimed to examine the evidence for an association between smoking behaviours (initiation, smoking status, heaviness, lifetime smoking) and suicidal thoughts or attempts by triangulating across observational and Mendelian randomisation analyses.MethodFirst, in the UK Biobank, we calculated observed associations between smoking behaviours and suicidal thoughts or attempts. Second, we used Mendelian randomisation to explore the relationship between smoking and suicide attempts and ideation, using genetic variants as instruments to reduce bias from residual confounding and reverse causation.ResultsOur observational analysis showed a relationship between smoking behaviour, suicidal ideation and attempts, particularly between smoking initiation and suicide attempts (odds ratio, 2.07; 95% CI 1.91–2.26; P < 0.001). The Mendelian randomisation analysis and single-nucleotide polymorphism analysis, however, did not support this (odds ratio for lifetime smoking on suicidal ideation, 0.050; 95% CI −0.027 to 0.127; odds ratio on suicide attempts, 0.053; 95% CI, −0.003 to 0.110). Despite past literature showing a positive dose-response relationship, our results showed no clear evidence for a causal effect of smoking on suicidal ideation or attempts.ConclusionsThis was the first Mendelian randomisation study to explore the effect of smoking on suicidal ideation and attempts. Our results suggest that, despite observed associations, there is no clear evidence for a causal effect.
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Butter, Sarah, Mark Shevlin, and Jamie Murphy. "Negative self-evaluation and the genesis of internal threat: beyond a continuum of suicidal thought and behaviour." Psychological Medicine 49, no. 15 (December 3, 2018): 2591–99. http://dx.doi.org/10.1017/s0033291718003562.
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AbstractBackgroundDeath by suicide is often preceded by attempted suicide, suicidal ideation and non-suicidal self-injury. These extreme thoughts and behaviours have been considered in terms of a continuum of suicidality. Little known research, however, has considered a suicide continuum that extends beyond these extreme thoughts and behaviours and incorporates a much wider array of phenomena that may vary in severity and may constitute a broader negative self-evaluation (NSE) continuum.MethodHarvesting key indicators of NSE from a British epidemiological survey (N = 8580), the current study used exploratory factor analysis, confirmatory factor analysis and factor mixture modelling to (i) identify the dimensional structure of NSE in the general population and (ii) profile the distribution of the resultant NSE dimensions. Multinomial logistic regression was then used to differentiate between classes using an array of risk variables, psychopathology outcome variables and a suicide attempt indicator.ResultsA 4-factor model that reflected graded levels of NSE was identified; (F1) Low self-worth & subordination (F2) depression, (F3) suicidal thoughts, (F4) self-harm (SH). Seven classes suggested a clear pattern of NSE severity. Classes characterised by higher levels across the dimensions exhibited greater risk and poorer outcomes. The greatest risk for suicide attempt was associated with a class characterised by engagement in SH behaviour.ConclusionsLow self-worth, subordination and depression, while representative of distinct groups in the population are also highly prevalent in those who entertain suicidal thoughts and engage in SH behaviour. The findings promote further investigation into the genesis and evolution of suicidality and internal threat.
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Zortea, Tiago C., Seonaid Cleare, Ambrose J. Melson, Karen Wetherall, and Rory C. O’Connor. "Understanding and managing suicide risk." British Medical Bulletin 134, no. 1 (May 21, 2020): 73–84. http://dx.doi.org/10.1093/bmb/ldaa013.
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Abstract Background Suicidal behaviours and non-suicidal self-harm (NSSH) are global public health concerns that affect millions of lives. Sources of data This review is a narrative synthesis of systematic reviews, meta-analyses of randomized control trials (RCTs) and landmark studies published in scientific journals. Areas of agreement Restricting access to lethal means reduces the likelihood of future suicide deaths. Areas of controversy Our ability to predict future suicidal behaviour is no better than chance. No individual risk prediction instrument offers sufficient sensitivity and specificity to inform clinically useful decision-making. Growing points Different types of psychosocial interventions may be effective in preventing future suicide attempts; such interventions include clinical assessment, tailored crisis response and safety plans and follow-up contact. Areas timely for developing research Whilst some psychosocial interventions can be effective in reducing suicide risk, little is known about the mechanisms of recovery from suicidal thoughts and behaviours.
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Freeman, Jacinta, Penelope Strauss, Sharynne Hamilton, Charlotte Pugh, Katherine Browne, Suzanne Caren, Chris Harris, Lyn Millett, Warwick Smith, and Ashleigh Lin. "They Told Me “This Isn’t a Hotel”: Young People’s Experiences and Perceptions of Care When Presenting to the Emergency Department with Suicide-Related Behaviour." International Journal of Environmental Research and Public Health 19, no. 3 (January 26, 2022): 1377. http://dx.doi.org/10.3390/ijerph19031377.
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In Australia, the number of young people presenting to the emergency department with mental health concerns, in particular, suicidal behaviour (defined here as suicidal ideation, thoughts, intent and attempts) is increasing. Little is known about the experiences of Australian young people who present to hospital emergency departments with suicidal behaviour. In this qualitative study, we conducted a series of focus groups with 55 young people aged 16–25 years, with a view to developing a framework for youth suicide prevention for Western Australia. The data were analysed using a general inductive analysis approach. We explored the experiences and perceptions of the care and management of 35 young people presenting to Western Australian hospital emergency departments. Participants described a range of negative experiences relating to the emergency department environment, staff attitudes and their treatment by staff. We argue that adapting ED practices and approaches to young people presenting with suicidal thoughts and behaviours based on these findings will result in lower rates of repeated presentations and admissions to hospital and lower rates of suicide attempts and deaths by suicide.
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Pawłowska, Beata, and Jolanta Szymańska. "Suicidal ideation, plans, and attempts and the use of psychoactive substances by adolescents." Current Problems of Psychiatry 22, no. 3 (September 1, 2021): 217–24. http://dx.doi.org/10.2478/cpp-2021-0016.
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Abstract Introduction: Suicidal behavior and substance abuse constitute a serious public health problem. Aim: The study was to analyze the relationships between suicidal behaviors (ideation, plans, attempts) and substance abuse in adolescents. The authors also took into account the respondents’ motivation to attempt suicide and use psychoactive substances, as well as some demographic variables. Participants: The study involved 3493 secondary school students aged 16-17 years. The group included 69.41% girls and 30.59% boys. Methods: The participants were surveyed with a self-report questionnaire designed by one of the authors. Results: Statistically significant relationships were found between the respondents’ suicidal behaviors and the risky use of alcohol, cannabis, amphetamine, and designer drugs. Conclusions: 1. The use of psychoactive substances increases the risk of suicidal ideation and plans, as well as suicidal attempts in adolescents and young adults. 2. Significantly more respondents who report suicidal ideation, plans and attempts, in comparison to those who do not report such thoughts and behaviours, abuse alcohol and consumer cannabis, amphetamine and designer drugs to cope with problems and olster self-confidence. 3. In the group of respondents who report suicidal behaviour, psychoactive substances are consumed by significantly more men than women and by significantly more city inhabitants than people living in the country. 4. Young people, who report suicidal thoughts, plans, and attempts, are initiated into alcohol consumption at an earlier age than their non-suicidal peers.
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Rignanese, M., M. De Filippi, E. Salmè, F. Madeddu, and R. Calati. "Physical pain – suicidality association in adults: A meta-analysis." European Psychiatry 64, S1 (April 2021): S580—S581. http://dx.doi.org/10.1192/j.eurpsy.2021.1549.
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IntroductionMultiple epidemiologic and clinical studies have explored the relationship between physical pain and suicidal thoughts and behaviours.ObjectivesThe aim of this meta-analysis was to provide an update of the data already present in literature about this specific association in adults.MethodsStarting from a meta-analysis published by Calati and colleagues in 2015, 28 studies were included in this work. After searching on Pubmed (until March 2020), data were extracted from articles comparing the rates of current and lifetime suicidal thoughts and behaviours (death wish, suicidal ideation, suicidal planning, suicide attempt and suicide death: DW, SI, SP, SA, and SD) in adults with any type of physical pain and in individuals who did not report this condition. Data were analysed using Cochrane Collaboration Review Manager software (RevMan, version 5.4).ResultsAlthough high between-study heterogeneity was detected in most analyses, results suggested that adults with physical pain are more likely to report any form of suicidal outcome, except for death by suicide, compared to individuals not affected by pain. No evidence of publication bias was reported in the main analysis (lifetime SA).ConclusionsCollected data are therefore in line with previous literature on this topic, which considered physical pain an extremely relevant risk factor for suicidal thoughts and behaviours. Future studies should specifically focus on alternative types of physical pain (such as medically unexplained pain or psychogenic pain) or explore the different impact of acute versus chronic pain in terms of increased suicide risk.
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White, Tony. "Suicide contagion, the suicide pact and the effects of suicidal behaviour in therapeutic and family relationships." International Journal of Transactional Analysis Research & Practice 12, no. 1 (July 1, 2021): 18–24. http://dx.doi.org/10.29044/v12i1p18.
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This article is about suicide and relationships. How suicidal thoughts and behaviours can impact relationships for the suicidal person and those around them. This includes relationships between the suicidal person and other suicidal people as well as the suicidal person and others who are non-suicidal. How the suicidal can impact the other and how the other in turn then impacts the suicidal person back. What effects they have on each other in terms of how they think and feel and then how that effects their transactions with each other. More specifically it examines suicide clusters, suicide pacts, suicidality in the therapeutic relationship and suicidality in family relationships.
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Mwania, Jonathan, Walter Owino, and Josphert Kimatu. "Attachment Styles as Predictors of Suicidal Behavior in School Going Adolescents." International Journal of Psychology 8, no. 2 (July 30, 2023): 31–44. http://dx.doi.org/10.47604/ijp.2049.
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Purpose: Secondary school students face numerous challenges as they balance academic challenges, parental and peer pressures, emotional issues related to puberty changes and adolescence expectations. They also grapple about not knowing what the future holds in terms of career paths. As a result of these challenges, it is common for adolescents to have suicidal thoughts that may lead to suicide attempts.. Suicide is among the leading cause of death in young people and is prevalent worldwide. Suicidal behavior has been associated with attachment security in studies but few of these studies have been done in Kenyan adolescents. This study filled this gap by investigating whether attachment styles predicted suicidal behavior in students attending secondary schools in Nairobi, Kenya.
Methodology: The study was correlational in design and was based on the attachment theory. Three hundred and sixty seven randomly selected students completed self-report measures consisting of the Attachment Styles Questionnaire and a Suicidal Behavior Scale.
Findings: Results of multiple regression showed that that attachment styles significantly predicted suicidal behavior (F = 36.125, P < .000) and 30% of variance in suicidal behavior was attributed to the attachment styles (R2 = .300). Preoccupied (β = .487, P < .001) and dismissing (β = .122, P = .018) attachment styles predicted suicidal behaviors.
Unique Contribution to Theory, Practice and Policy: The contribution to knowledge of this paper is that it provides a theoretical and practical contribution on the importance of attachment styles in predicting suicidal behaviours. The results of the study show that attachment security plays an important role in adolescents’ suicide behavior as insecurely attached students have a higher risk of suicide.Basically, the study contributed to a theoretical enhancement of the current level of knowledge on the existing literature on attachment styles and suicidal behaviours, achieved by testing empirically the adolescent behaviour. Therefore, suicide prevention programs should take into account adolescents’ attachment styles.
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Madu, S. N., and M. P. Matla. "The Prevalence of Suicidal Behaviours among Secondary School Adolescents in the Limpopo Province, South Africa." South African Journal of Psychology 33, no. 2 (May 2003): 126–32. http://dx.doi.org/10.1177/008124630303300208.
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The aim of this study was to investigate the prevalence of suicidal behaviours among secondary school adolescents in the Limpopo Province. The participants in this study were 435 secondary school adolescents from Polokwane and surrounds. Two hundred and forty-three (56%) participants were female, and 192 (44%) were male. They were aged between 15 and 19 years, with a mean age of 17.25 years ( SD = 1.34). A questionnaire was used to record participants' demographic data and suicidal behaviours, including suicidal thoughts and threats, plans, and attempts to commit suicide). Thirty-seven percent of the secondary school adolescents surveyed indicated having thought of taking their own lives; 17% had made threats or informed others about their suicidal intentions; 16% had made plans to take their own lives but did not carry them through; 21% reported having attempted to take their own lives. These results indicate that a higher percentage of males than females had attempted suicide. The most frequent method used for attempting suicide was self-poisoning (44% of the attempters), followed by drug overdoses (25.3%), hanging (22%), self-stabbing (2.2%), and other methods, such as, jumping from heights, starvation, and drug abuse (6.6%).
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Grigienė, Dovilė, Greta Guogaitė, Said Dadašev, Jurgita Rimkevičienė, Paulius Skruibis, and Danutė Gailienė. "“What do you Mean by Masculinity?”: Comparison of Answers of Men with and without Suicidal Thoughts." Psichologija 66 (October 4, 2022): 47–63. http://dx.doi.org/10.15388/psichol.2022.51.
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Male suicides are often associated with masculinity norms that encourage certain behaviours that increase the risk of suicide. For example, research shows that restricted emotionality, avoidance of seeking help and self-reliance are associated with higher suicide risk. However, these pre-formulated aspects of masculinity do not necessarily reflect men’s subjective opinions of what masculinity is to them. Researchers argue that it is important to consider personal views about what masculinity is, not only stereotypes about masculinity. The aim of this study is to reveal and compare the subjective opinions about the masculinity of men with and without suicidal ideation. 281 men answered the open-ended question during the survey: “What does masculinity mean to you?”. The answers were analyzed using a content analysis method. We transformed qualitative data into quantitative and compared them statistically between two groups: men with and without suicidal ideation. It turned out that men with suicidal thoughts were more likely to mention that masculinity is the control of emotions, intelligence, and decision-making. Men without suicidal thoughts were more likely to mention family and caring for it as essential aspects of masculinity. The results showed that certain aspects of masculinity might be related to higher risk for suicide, but the study also revealed the masculinity that might be a source of coping.
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Zeppegno, P., and C. M. Gramaglia. "Homicide and Suicide in the Elderly." European Psychiatry 65, S1 (June 2022): S34—S35. http://dx.doi.org/10.1192/j.eurpsy.2022.122.
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Homicide and suicide are complex phenomena raising questions and interest which go far beyond the medical and psychiatric field, as they represent a challenge for an understanding which is, first of all, human. In older adults, homicide and suicide may present together in the homicide-suicide phenomenon. The most common motive underlying this behavior in intimate partner relationships is the so-called “mercy killing”, where the perpetrator kills the partner to eventually allow relief from declining health conditions, and then commits suicide. Actually, older adults account for a disproportionately high number of suicide deaths and approximately 55% of late-life suicides are associated with physical illness, notwithstanding psychiatric comorbidity. Physical illness is more likely to eventually lead to suicidal behaviour when it represents a threaten for the individual’s independence, autonomy, self-esteem and dignity, and when it impacts on quality of and pleasure with life, sense of meaning, usefulness and purpose in life. As the current historical period is one marked by opportunities which have allowed a rapid increase of life expectancy and longevity, it clearly emerges the need to balance benefits and harms of curative and palliative therapies, especially for painful, terminal illnesses. The expression of suicidal thoughts in older adults, as well as behaviours suggesting “silent” or indirect suicidal attitudes, should be carefully investigated and clinicians should try to decode the possible communicative role of suicidal behaviour while avoiding premature conclusions about the “rationality” of patients’ decision to die. Disclosure No significant relationships.
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Russell, Kirsten. "The importance of starting a conversation about suicide: Hints and tips for supporting postgraduate peers." PsyPag Quarterly 1, no. 107 (June 2018): 47–50. http://dx.doi.org/10.53841/bpspag.2018.1.107.47.
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Suicide is a common cause of preventable death worldwide and the student population represents a particularly high-risk group for the development of suicidal thoughts and behaviours. When an individual feels suicidal they often have the impression of being trapped with no option for escape. As a result, they feel that they cannot talk about these thoughts and often struggle to ask for help. Therefore, it is important that others start the conversation and offer support to these individuals. This article highlights the issue of suicide in university students and provides advice for those who may be worried about someone and unsure of how to start a conversation about suicide.
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Kosidou, K., C. Dalman, P. Fredlund, B. K. Lee, R. Galanti, G. Isacsson, and C. Magnusson. "School performance and the risk of suicide attempts in young adults: a longitudinal population-based study." Psychological Medicine 44, no. 6 (July 24, 2013): 1235–43. http://dx.doi.org/10.1017/s0033291713001852.
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BackgroundPoor school performance is strongly associated with attempted suicide, but the mechanisms underlying this association are uncertain. We examined this relationship and the extent to which it is explained by (i) adult health behaviours and (ii) social conditions. Furthermore, we examined the potential modifying role of previous suicidal thoughts in the relationship.MethodWe conducted a longitudinal cohort study of 6146 individuals aged 18–33 years, recruited in 2002 and 2006 in Stockholm and resurveyed in 2007 and 2010 respectively. We estimated the risk of reported lifetime suicide attempts at follow-up among individuals without a history of suicide attempts at baseline and in relation to compulsory school-leaving grades, controlling for possible confounders and mediators.ResultsThere were 91 cases of self-reported suicide attempts during the follow-up (5-year incidence of 1.5%). ORs ranged from 3.35 [95% confidence interval (CI) 1.88–5.96] for those in the lowest grade quartile to 2.60 (95% CI 1.48–4.57) and 1.76 (95% CI 0.99–3.13) for those in the second and third quartiles respectively. The relationship between school performance and risk of suicide attempts did not differ by sex. Adult health behaviours and social conditions marginally attenuated, but did not explain, the relationship. The gradient varied with baseline history of suicidal thoughts, and was found only among individuals without such a history.ConclusionsPoor school performance was found to predict suicide attempts among young adults without a history of suicidal thoughts. Adult health behaviours and social conditions did not explain this relationship. Instead, other factors linked with poor school performance, such as poor coping ability, may increase the risk of suicide attempts.
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Igumnov, Sergey, Sergey Davidovsky, Robert Iskandarov, and Olga Iskandarova. "CURRENT CONCEPTS AND CHARACTERISTICS OF SELF-HARMING BEHAVIOUR." Health Sciences 31, no. 5 (August 1, 2021): 116–24. http://dx.doi.org/10.35988/sm-hs.2021.182.
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Several biological risk factors for suicidal and self-harming behaviour have now been identified. The differences relate to changes in key neurotransmitter systems (serotonergic, polyamine stress response, glutamatergic and GABAergic systems), inflammatory response, astroglial dysfunction, neuronal plasticity factor, confirming the need to differentiate between those motivated to commit suicide and those prone to non-suicidal self-harming behaviour from total suicide attempts. Non-suicidal self-injurious behaviour (self-injurious thoughts and behaviours or non-suicidal self-injury (NSSI)) is defined as repeated, deliberate, direct damage to the body without suicidal intent, which is not socially acceptable. An integrated theoretical model of NSSI development and support suggests that this type of behaviour functions as a method of regulating emotional experience and social interaction when a stressful event occurs. NSSI is currently included in Section 3 of the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) and is listed as a condition recommended for further study. The American Diagnostic and Statistical Manual of Mental Disorders, 4th Revision (DSM-IV-TR) and the International Classification of Diseases, 10th Revision (ICD-10) code NSSI as a symptom of borderline personality disorder. Recent studies have shown that 59.6% of individuals with NSSI show signs of substance abuse. There are concerns that rates of suicide and suicidal behaviour may increase during and after the COVID-19 pandemic.
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Littlewood, Donna. "American Association of Suicidology 50th Annual Conference." PsyPag Quarterly 1, no. 105 (December 2017): 50–52. http://dx.doi.org/10.53841/bpspag.2017.1.105.50.
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The 50th Annual Conference of the American Association of Suicidology drew a diverse range of attendees, who share an interest in suicide prevention. This provided a unique opportunity to disseminate findings of two studies from my PhD research to fellow researchers and psychologists, as well as other healthcare professionals, crisis centre staff and volunteers. Delegates also included people who have lost a loved one to suicide or had lived experience of suicidal thoughts and behaviours. By bringing together the different stakeholders in suicide prevention, this conference provided a mixed and thought–provoking programme.
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Williams, Kerry, Georgia Lada, Nick J. Reynolds, Kathleen Mcelhone, Ian Evans, Shernaz Walton, Olivia Hughes, Anthony Bewley, Kayleigh Mason, and C. Elise Kleyn. "PS04 Suicide risk in patients with psoriasis: results from the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR)." British Journal of Dermatology 191, Supplement_1 (June 28, 2024): i177. http://dx.doi.org/10.1093/bjd/ljae090.375.
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Abstract Psoriasis is associated with poor mental health, high prevalence of depression and reduced quality of life. However, suicide risk in this group is unclear. Previous meta-analyses have provided conflicting results regarding risk of suicidality outcomes, including suicidal thoughts and attempts and suicide. Existing literature has not investigated patients with clinically confirmed moderate-to-severe disease. Our aims were to investigate (i) the risk of suicide among patients with moderate-to-severe psoriasis compared with the general population and (ii) whether psychiatric comorbidity or history of suicidality increases suicidality risk in patients with psoriasis. We further estimated the incidence of suicidal and self-injurious behaviours in patients. We analysed suicidality outcomes from the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR). For controls, we used mortality and suicide data from the general population [Office for National Statistics (ONS)]. Data were collected before the COVID-19 lockdowns. The BADBIR cutoff was February 2020 and ONS data were 2019 entries. There were nine suicides in BADBIR. The incidence rate of suicide was 12.5 per 100 000 person-years [95% confidence interval (CI) 6.53–24.1] in BADBIR vs. 11.0 per 100 000 person-years (95% CI 10.7–11.3) in the general population in England and Wales. The incidence rate for the combined event of suicidal or self-injurious behaviour was 186 per 100 000 person-years for all patients with moderate-to-severe psoriasis (95% CI 157–221). History of psychiatric comorbidity or past suicidality significantly increased the risk for all suicidality outcomes apart from suicide, including suicide attempts and suicidal ideation, as well as self-harm behaviours. Suicide incidence was higher in patients with past psychiatric history than in those without; however, the difference was not statistically significant (23.0 per 100 000 person-years, 95% CI 8.62–61.2; vs. 9.20 per 100 000 person-years, 95% CI 3.83–22.1). In BADBIR, we could not find an increased suicide risk among patients with moderate-to-severe psoriasis compared with the general population. Further research is needed to replicate this result. Our findings highlight an increased overall suicidal and self-harm burden in patients with psychiatric comorbidities. Also, given the high prevalence of depression and anxiety in people with psoriasis, there is a need for mental health monitoring in these patients. Clinicians should ask patients openly about past and present suicidal thoughts or behaviour to ensure early intervention. BADBRL is a registered company within the BAD and funds the BADBIR study. BADBIR is coordinated by the University of Manchester as research sponsor. BADBRL receives income from AbbVie, Almirall, Bristol Myers Squibb, Boehringer Ingelheim, Eli Lilly, Janssen Cilag, LEO Pharma, Novartis, Samsung Bioepis and UCB for providing pharmacovigilance services. All decisions concerning analysis, interpretation and publication are made independently of any industry contribution.
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Milligan, Meg, Hoon Peow See, Hall P. Beck, Sherrionda Crawford, and Kanessa Miller Doss. "SUICIDALITY: COLLEGE STUDENTS’ ATTITUDES AND BEHAVIOURS IN MALAYSIA." International Journal of Asia Pacific Studies 18, no. 1 (January 25, 2022): 151–67. http://dx.doi.org/10.21315/ijaps2022.18.1.7.
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The World Health Organization (WHO) identifies suicidality, the experience of suicidal thoughts or behaviour including attempts, as an ongoing global public health concern. The WHO estimated that more than 79% of suicides in 2016 occurred in low to middle income nations, with 60% of these occurring in Asia. Suicides are often underreported and misclassified as death by other causes. As a result, obtaining accurate information is difficult. This problem is exacerbated in developing countries facing limited budgets, legislative barriers, and social stigma. These realities place greater responsibility on researchers to collect and interpret data. This study addressed this issue in a sample of 176 college students in Malaysia. The Suicide Behaviours Questionnaire-Revised (SBQ-R), which examines individual attitudes and behaviour concerning suicide, was administered and demographic information was collected on gender, age, ethnicity, and religion. Data were analysed using Statistical Package for the Social Sciences (SPSS, version 25). Results showed no significant gender effects, but there were significant differences across religions. This is discussed in terms of buffering effects and minority-majority status. This study increases knowledge about suicidality among college students in Malaysia, a high-risk group. Recommendations for prevention and intervention and future research are included.
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STATHAM, D. J., A. C. HEATH, P. A. F. MADDEN, K. K. BUCHOLZ, L. BIERUT, S. H. DINWIDDIE, W. S. SLUTSKE, M. P. DUNNE, and N. G. MARTIN. "Suicidal behaviour: an epidemiological and genetic study." Psychological Medicine 28, no. 4 (July 1998): 839–55. http://dx.doi.org/10.1017/s0033291798006916.
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Background. Psychiatric history, familial history of suicide attempts, and certain traumatic life events are important predictors of suicidal thoughts and behaviour. We examined the epidemiology and genetics of suicidality (i.e. reporting persistent suicidal thoughts or a plan or suicide attempt) in a large community-based sample of MZ and DZ twin pairs.Method. Diagnostic telephone interviews were conducted in 1992–3 with twins from an Australian twin panel first surveyed in 1980–82 (N=5995 respondents). Data were analysed using logistic regression models, taking into account twin pair zygosity and the history of suicidality in the respondent's co-twin.Results. Lifetime prevalence of suicidal thoughts and attempts was remarkably constant across birth cohorts 1930–1964, and across gender. Major psychiatric correlates were history of major depression, panic disorder, social phobia in women, alcohol dependence and childhood conduct problems. Traumatic events involving assault (childhood sexual abuse, rape or physical assault) or status-loss (job loss, loss of property or home, divorce), and the personality trait neuroticism, were also significantly associated with suicide measures. Prevalence of serious suicide attempts varied as a function of religious affiliation. After controlling for these variables, however, history of suicide attempts or persistent thoughts in the respondent's co-twin remained a powerful predictor in MZ pairs (odds ratio=3·9), but was not consistently predictive in DZ pairs. Overall, genetic factors accounted for approximately 45% of the variance in suicidal thoughts and behaviour (95% confidence interval 33–51%).Conclusions. Risk of persistent suicidal thoughts and suicide attempts is determined by a complex interplay of psychiatric history, neuroticism, traumatic life experiences, genetic vulnerability specific for suicidal behaviour and sociocultural risk or protective factors.
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Alhaj, Hamid, Amal Ali, Hagar Abdulrahman, Mariam Rawashdeh, Omar Hamrawi, Tarek Zaki, and Yazan Katroon. "Identifying the Knowledge and Attitudes Towards Suicidal Warning Signs Among University Students in the UAE." BJPsych Open 9, S1 (July 2023): S43—S44. http://dx.doi.org/10.1192/bjo.2023.175.
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AimsOne of the top causes of death and injury among adolescents and young adults is suicidal behaviour. Indeed, suicide is the second leading cause of death among individuals aged between 15 and 24 years worldwide. Studies on the prevalence of suicide among university students in the UAE are scarce. Importantly, the extent of awareness and experience of suicidality among this group is still unknown. We aimed to ascertain the knowledge and attitudes towards suicidal warning signs and symptoms amongst university students in the UAE.MethodsAn online self-administered questionnaire platform was used to collect data from UAE university students in a quantitative cross-sectional study. In addition to demographics, experience regarding suicidal thoughts and behaviours, efficacy expectations, and outcome expectations and values were evaluated. Data were analysed using SPSS, setting a p-value of <0.05 as statistically significant.ResultsA total of 392 participants completed the questionnaire, 233 (59.4%) were males and 159 (40.6%) were females. Based on the knowledge scale, only 35.3% of total participants were identified as knowledgeable of the warning signs of suicide. Expectedly, out of the knowledgeable group, a vast majoring of 83.3% were medical students. When they were asked about what they would do if a friend told them that they are thinking about ending their life, many of the students chose to talk to their friends without getting anyone else's help. There was no statistically significant correlation between being educated regarding suicide and being knowledgeable of suicidal signs and symptoms (P = 0.1). Surprisingly, the degree course students enrolled in was not found to play a significant role in their level of confidence regarding suicidal signs and symptoms.ConclusionTo our knowledge this is the first study to investigate awareness and attitudes about suicidal thoughts and behaviours among university students in the UAE. Knowledge regarding suicidal signs and symptoms among university students in the UAE is notably low. According to the results, self-reported education did not play a major role in appropriately managing suicidal signs and symptoms. The nature of the education provided to students needs to be further investigated to explore the gaps in the knowledge provided.
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Adekoya, Toluwalase Samson, Pedepo Mark Emmanuel, and Taofeeq Aisha Damilola. "Investigating Psychosocial Predictors of Self-Harming Thoughts among Lagos State University Undergraduates During the Covid-19 Pandemic." East African Journal of Arts and Social Sciences 5, no. 2 (November 1, 2022): 118–25. http://dx.doi.org/10.37284/eajass.5.2.921.
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Pre-COVID-19 pandemic, suicide, and suicidal behaviour were serious public health concerns that had a global influence on youth. However, there are concerns about the possible Pandemic-related factors contributing to self-harming thoughts and behaviours. At the same time, the antecedents of self-harm thought have been examined previously; this study aimed at exploring suicidal ideation –the preoccupation to kill oneself — among young adults who are prone to be affected by pandemic-related conditions. This Cross-sectional study investigated the role of sex, psychological distress, and social media addiction in predicting Self-harm thoughts during the COVID-19 pandemic. Three hundred forty undergraduates cutting across the various faculties were conveniently selected from LASU to respond to the standardised questionnaire. It was hypothesised that male undergraduate students would be more susceptible to self-harm thoughts than female undergraduate students, and psychological distress and social media will have an independent and joint influence on Self-harm thoughts. The result revealed that there was a significant influence of sex on self-harm thoughts (t= 2.17; df (340); P <.05). Furthermore, male undergraduate students were more likely to have thoughts of self-harm than female undergraduate students. It was also revealed that psychological distress and social media addiction jointly (R2 = 0.89, F (2,339) = 16.56, p < .05) and independently predicted Self-harm thoughts. The findings suggested that Clinicians and counsellors, when assessing students with thoughts of self-harm, should consider finding out the extent of usage of social media and its addiction as it should be one of the important aspects to look out for during assessment. Additionally, University management should work on novel and practical approaches to detect early symptoms of psychological distress and advance suicide prevention efforts to secure the precious lives of Students
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Ammerman, Brooke A., Martha K. Fahlgren, Kristen M. Sorgi, and Michael S. McCloskey. "Differences in Suicidal Thoughts and Behaviors Among Three Racial Groups." Crisis 41, no. 3 (May 2020): 172–78. http://dx.doi.org/10.1027/0227-5910/a000621.
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Abstract. Background: Despite being a major public health concern, it is unclear how suicidal thoughts and behaviors differentially impact separate racial groups. Aims: The aim of the current study was to examine the occurrence of nonlethal suicide events, in addition to suicide attempt characteristics and factors contributing to suicide attempts. Method: A final sample of 7,094 undergraduates from a large northeastern university, identifying as members of three racial groups (White [67.30%], Black [17.30%], and Asian [15.40%]), completed online questionnaires. Results: White participants reported increased likelihood of endorsing lifetime suicidal ideation and plan, whereas Black participants reported decreased likelihood of these events; no differences were found in rates of lifetime suicide attempts. Black participants' suicidal behavior may involve greater ambivalence of intent. A higher proportion of Asian participants endorsed interpersonal factors as contributing to their suicide attempts, whereas a greater percentage of White participants reported internal contributing factors. Limitations: Findings are limited by the sample size and assessment of lifetime suicidal thoughts and behaviors. Conclusion: The findings present a more nuanced look at attitudes and actions related to suicidal thoughts and behaviors that may inform future research and risk assessment procedures.
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Dazzi, T., R. Gribble, S. Wessely, and N. T. Fear. "Does asking about suicide and related behaviours induce suicidal ideation? What is the evidence?" Psychological Medicine 44, no. 16 (July 7, 2014): 3361–63. http://dx.doi.org/10.1017/s0033291714001299.
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There is a commonly held perception in psychology that enquiring about suicidality, either in research or clinical settings, can increase suicidal tendencies. While the potential vulnerability of participants involved in psychological research must be addressed, apprehensions about conducting studies of suicidality create a Catch-22 situation for researchers. Ethics committees require evidence that proposed studies will not cause distress or suicidal ideation, yet a lack of published research can mean allaying these fears is difficult. Concerns also exist in psychiatric settings where risk assessments are important for ensuring patient safety. But are these concerns based on evidence? We conducted a review of the published literature examining whether enquiring about suicide induces suicidal ideation in adults and adolescents, and general and at-risk populations. None found a statistically significant increase in suicidal ideation among participants asked about suicidal thoughts. Our findings suggest acknowledging and talking about suicide may in fact reduce, rather than increase suicidal ideation, and may lead to improvements in mental health in treatment-seeking populations. Recurring ethical concerns about asking about suicidality could be relaxed to encourage and improve research into suicidal ideation and related behaviours without negatively affecting the well-being of participants.
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RAMBERG, INGA-LILL, and DANUTA WASSERMAN. "Prevalence of reported suicidal behaviour in the general population and mental health-care staff." Psychological Medicine 30, no. 5 (September 2000): 1189–96. http://dx.doi.org/10.1017/s003329179900238x.
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Background. Higher rates of suicidal behaviour have been reported among staff in mental health care than in the general population. However, no studies of these two groups have been carried out simultaneously, using the same methods. This study aims to investigate whether they differ in terms of age- and sex-standardized prevalence of suicidal behaviour.Methods. Identical questions about suicidal behaviour were addressed in the same year to a random sample of the general population and to mental health-care staff in Stockholm. Life weariness among the latter was also investigated.Results. Age- and sex-standardized past year prevalences of suicidal thoughts and suicide attempts were found to be similar among mental health-care staff and the general population. Lifetime prevalence of both suicidal thoughts and suicide attempts was significantly higher among mental health-care staff than among the general population. Psychologists/social workers have a higher probability of: lifetime thoughts of life is not worth living; death wishes; and, suicidal thoughts, than nurses/assistant nurses.Conclusions. Reports on lifetime prevalence of suicidal behaviour may be biased in populations that are not reminded of these problems in everyday life. Data on past year prevalence of suicidal behaviour show clearly the similarity between the general population and the mental health-care staff.
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DUNBAR, G. C., S. MEWETT, and M. STOKER. "SUICIDAL THOUGHTS AND BEHAVIOUR (SUICIDALLY) WITH PAROXETINE." Behavioural Pharmacology 3, Supplement (April 1992): 55. http://dx.doi.org/10.1097/00008877-199204001-00170.
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Saini, Pooja, Anna Balmer, Laura Sambrook, Hana Roks, Jason McIntyre, Antony Martin, Jackie Tait, Peter Ashley-Mudie, Amrith Shetty, and Rajan Nathan. "The Provision of Mental Health Care for Service Users With Complex Needs Who Are at Risk of Suicide." BJPsych Open 8, S1 (June 2022): S70. http://dx.doi.org/10.1192/bjo.2022.241.
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AimsIndividuals presenting with complex behavioural and mental health needs may not receive the provision of care needed. Those presenting with a more complex clinical presentation may have a history of self-harm and suicide attempts. A common risk factor for preceding suicide is previous self-harm, suicide attempts or discharge from inpatient units. Understanding the descriptive symptom domains for inpatients and those treated in the community and the relationship between them could inform suicide prevention. The aim of this study was to explore the extent of self-harm and suicidal behaviours in individuals with complex mental health needs across inpatient and community settings.MethodsA cohort study design of in-depth written medical notes (n = 80) for people who were known to have complex mental health needs across inpatient and community settings. Data were extracted from medical records onto a coproduced questionnaire. As well as demographic data, information was collated about previous self-harm, suicide planning, suicide attempts, and support seeking regarding suicidal thoughts. The study will include a quantitative in-depth description and inferential analysis of the demographic clinical characteristics of the patient group.ResultsMedical case notes were reviewed for 80 service users with complex mental health needs. Across both groups, approximately three-quarters of participants had previously self-harmed (76%), or planned suicide (n = 73%), and/or attempted suicide (63%). Self-harm (83% vs. 70%) and suicide attempts (72% vs. 65%) were more prevalent in the inpatient group compared to the community group. Social support was received more by community patients than inpatients (70% vs. 50%), even though inpatients were more likely to sough help when experiencing suicidal thoughts compared to people cared for in the community (38% vs. 30%). In both groups, there were often multiple suicide plans and attempts made over their timeline of contact with services.ConclusionSelf-harm, suicide planning, and suicide attempts were prevalent for people treated across both inpatient and community settings. Self-harm and suicide planning was indicative of a later suicide attempt within both settings. In those experiencing suicidal thoughts, few had sought help, suggesting the importance in staff training to enable then to recognise and identify patterns of self-harming and suicidal behaviours in individuals with complex mental health needs. Social support needs for inpatients should be increased, particularly when they sought help for suicidal thoughts. This may help to reduce length of stays in hospital or future readmissions to hospital; thus, reducing the cost implications for the NHS mental health services.
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Castelnuovo, Alessandra, Samantha Mombelli, Daniela Bottoni, Antonella Somma, Andrea Fossati, Luigi Ferini-Strambi, and Sara Marelli. "696 Quality of sleep is the only predictor of suicide during Covid-19 lockdown in University students?" Sleep 44, Supplement_2 (May 1, 2021): A272. http://dx.doi.org/10.1093/sleep/zsab072.694.
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Abstract Introduction COVID-19 epidemic led to great psychological and social stress, related to anxiety, depression, sleep disorders, suicidal risk and behavior, and changes in daily routine. The aim of this study was to assess the psychological impact of COVID-19 lockdown in Italian students. We focused on perceived sleep quality, anxiety and depression symptoms, and mostly on risk of suicide. Methods A total of 307 students (mean age 22.84±2.68) completed Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Beck Anxiety Inventory (BAI), and Beck Depression Inventory-II (BDI-II). In our study, we focused on item 9 of BDI-II, that is related to suicide. We divided our sample on presence or absence of suicidal ideation based on this item. Results We found that 30.1% showed depressive, while 38.2% anxious symptoms. Concerning item 9 of BDI-II (suicidal thoughts or wishes), 84.7% answered that they do not have any thoughts of killing themselves, while 15.3% answered that they have some suicidal ideation. Concerning sleep variables, we found that 58% of our sample showed a PSQI total score higher than 5 (poor quality of sleep), and a global worsening in sleep quality and increase of insomnia both in student with and without suicidal ideation. Conclusion Our results on risk of suicide are in line with literature. Recent reviews focused on suicidal ideation in medical students found that depressive symptoms and suicidal ideation are common among medical students, finding a prevalence of suicidal ideation of 11%. Several studies suggest that sleep disorders are a risk factor for suicidal thoughts and behaviours. Our findings show that sleep cannot considered a predictive factor of risk of suicide during health emergency, because the risk is polyfactorial. Support (if any) None
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Michel, Konrad. "Suicidal thoughts and actions: We need a new model." Open Access Government 45, no. 1 (January 13, 2025): 160–61. https://doi.org/10.56367/oag-045-11785.
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Suicidal thoughts and actions: We need a new model Konrad Michel, MD, Psychiatrist from the University of Bern, Switzerland, discusses the clinical approach to suicidal patients, providing a new look at a human phenomenon. Suicide rates are declining in many European countries; in others, they are rising. Suicide is one of the leading causes of death for adolescents and young adults worldwide. Many countries have National Suicide Prevention Programmes, but it is difficult to show that they affect suicide rates. There is evidence that reducing the availability of suicide methods, and promoting responsible media reporting on suicide can reduce suicidal behaviour.
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Amin, PhD, Samia, Ummay Salma Rahman, MPH, and Ashish Joshi, PhD. "Suicidal Behaviour among E-cigarette Users: A Systematic Review of Recent Evidence." Research in Health Science 7, no. 2 (May 16, 2022): p14. http://dx.doi.org/10.22158/rhs.v7n2p14.
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Objectives: Prior evidence reported inconsistently that there is an association between e-cigarette use and suicidal behaviours. The aim of this study was to systematically review the recent literature that explored the association between e-cigarette use and suicidal behaviour such as ideation, planning and attempts. Methods: PubMed and Web of Science databases were searched to include studies between 2017 to 2021. Two reviewers screened all studies and narrative data synthesis was conducted. Results: This review analysed eight cross-sectional studies, which involved a total of 6,84,478 participants where only 4.9% were e-cigarette users (33,714 of 6,84,478). The suicidal ideation/thoughts, planning and attempts were measured among e-cigarette users based on diverse variables such as smoking status, gender, asthmatic, and depressive conditions. Suicidal ideation/thoughts, planning and attempts were higher among male, smoker, asthmatic, and depressive e-cigarette users than lifetime and never e-cigarette users. Conclusions: Public health researchers and policymaker should consider these variables as crucial factors to design any intervention or helpline services to prevent suicidal behaviour among e-cigarette users.
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Macneil, Sasha, Lorelie Roderbourg, Massimiliano Orri, Marie-Claude Geoffroy, Jennifer J. Mcgrath, Johanne Renaud, and Jean-Philippe Gouin. "Attachment Styles and Suicidal Thoughts and Behaviors: A Meta-Analysis." Journal of Social and Clinical Psychology 42, no. 4 (August 2023): 323–64. http://dx.doi.org/10.1521/jscp.2023.42.4.323.
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Introduction: This meta-analysis examined the association between dimensional and categorical conceptualizations of attachment styles and suicidal thoughts and behaviors (STBs). Methods: Random-effects meta-analysis was conducted to examine the associations between categorical secure attachment, categorical insecure attachment, and insecure attachment dimensions and STBs. Methodological moderators were also explored. This protocol was registered in PROSPERO (CRD42020152604). Results: Systematic search for articles published by December 2020 returned 58 eligible studies and 159 cross-sectional effects. Secure attachment was inversely associated with suicidal thoughts and not associated with suicide attempts. All categorical insecure attachment styles were positively associated with suicidal thoughts. Only fearful and preoccupied attachment were associated with risk for suicide attempts. Dimensional attachment anxiety was more strongly associated with suicidal thoughts and attempts than dimensional attachment avoidance. Discussion: Overall, attachment styles characterized by high attachment anxiety were associated with greatest vulnerability to STBs. Longitudinal studies are needed to better understand the association between attachment insecurity and STBs.
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Høilo Granheim, Ida Pauline, Siv Kvernmo, Anne Silviken, and Christina Viskum Lytken Larsen. "The association between suicidal behaviour and violence, sexual abuse, and parental substance abuse among Sami and Greenlandic adolescents: the WBYG study and the NAAHS." Scandinavian Journal of Child and Adolescent Psychiatry and Psychology 11, no. 1 (January 1, 2023): 10–26. http://dx.doi.org/10.2478/sjcapp-2023-0002.
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Abstract Background For young Indigenous people, suicide is one of the leading causes of death, and high rates in Arctic areas indicate serious health and societal concerns. More knowledge is needed, as suicidal behaviour predicts later death by suicide. The aim of this study was to investigate associations between suicidal thoughts and suicide attempts and negative life events, including violence, sexual abuse, and parental substance abuse, in Sami and Greenlandic adolescents, within and between groups and gender. Method Working samples included 442 Sami and 399 Greenlandic Inuit (15–16-year-olds), in The Norwegian Arctic Adolescent Health Study (NAAHS) and the Well-Being among Youth in Greenland (WBYG) study. Multivariable logistic regression explored associations between suicidal behaviour and violence, sexual abuse, and parental substance abuse. Results Across Indigenous groups, suicidal thoughts and attempts were significantly associated with violence and sexual abuse. The association between suicidal behaviour; especially suicidal thoughts, and sexual abuse was significant and strong among Sami females. Sami and Inuit adolescents with a history of childhood violence reported significantly more suicide attempts; the strongest association was found among Sami males. Conclusion To Sami and Greenlandic Inuit, the experiences of negative life events, such as violence or sexual abuse are significant risk factors for suicidal behaviour. Public health programmes and prevention strategies targeting youth mental health and suicide should be culturally sensitive and sensitive to gender differences in the association between negative life events and suicidal behaviour.
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Huen, Jenny Mei Yiu, Augustine Osman, Bob Lew, and Paul Siu Fai Yip. "Utility of Single Items within the Suicidal Behaviors Questionnaire-Revised (SBQ-R): A Bayesian Network Approach and Relative Importance Analysis." Behavioral Sciences 14, no. 5 (May 14, 2024): 410. http://dx.doi.org/10.3390/bs14050410.
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The Suicidal Behaviors Questionnaire-Revised (SBQ-R) comprises four content-specific items widely used to assess the history of suicide-related thoughts, plans or attempts, frequency of suicidal ideation, communication of intent to die by suicide and self-reported likelihood of a suicide attempt. Each item focuses on a specific parameter of the suicide-related thoughts and behaviors construct. Past research has primarily focused on the total score. This study used Bayesian network modeling and relative importance analyses on SBQ-R data from 1160 U.S. and 1141 Chinese undergraduate students. The Bayesian network analysis results showed that Item 1 is suitable for identifying other parameters of the suicide-related thoughts and behaviors construct. The results of the relative importance analysis further highlighted the relevancy of each SBQ-R item score when examining evidence for suicide-related thoughts and behaviors. These findings provided empirical support for using the SBQ-R item scores to understand the performances of different suicide-related behavior parameters. Further, they demonstrated the potential value of examining individual item-level responses to offer clinically meaningful insights. To conclude, the SBQ-R allows for the evaluation of each critical suicide-related thought and behavior parameter and the overall suicide risk.
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Porras-Segovia, Alejandro, Ana Pascual-Sanchez, Geva Greenfield, Hanna-Marie Creese, Sonia Saxena, Dougal Hargreaves, and Dasha Nicholls. "Early Risk Factors for Self-Injurious Thoughts and Behaviours: A UK Population-Based Study of 219,581 People." Behavioral Sciences 14, no. 1 (December 24, 2023): 16. http://dx.doi.org/10.3390/bs14010016.
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Mental disorders are a major problem among young people. To identify early risk factors of self-injurious thoughts and behaviours (SITB) among young adults with mental health problems, this case–control study drew data from the Clinical Practice Research Datalink (CPRD), a primary care database covering 8% of the UK population. We explored the role of early factors (presenting at 8–14 years old) for suicidal ideation, suicide attempts, and non-suicidal self-injury (NSSI) in young adulthood (age 18–25 years) by performing logistic regressions. Our sample consisted of 219,581 participants, of which 6.51% had at least one SITB in young adulthood. Early risk factors for SITB included early NSSI, suicidal ideation, sexual abuse, behavioural problems, and mood and psychotic symptoms. Frequency of GP visits had a protective effect. Lack of access to mortality data, ethnicity, and socioeconomic status was a limitation of the current study. In conclusion, early symptoms in late childhood/early adolescence can be the start of long-standing problems going into adult life. The training of primary care providers in suicide risk assessment and proper co-ordination with child and adolescent mental health services are crucial for suicide prevention.
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Bauder, C. Rosie, and Austin G. Starkey. "Examining Suicidal Thoughts and Behaviors Among Ohio Youth with Oppressed Identities Using the 2019 Ohio Youth Risk Behavior Survey." Ohio Journal of Public Health 5, no. 2 (January 23, 2023): 1–8. http://dx.doi.org/10.18061/ojph.v5i2.8878.
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Background: Suicide is the second leading cause of death among youth aged 10 to 14 years and third for those aged 15 to 24 years in the United States and in Ohio. Suicidal thoughts and behaviors disparately affect youth with oppressed identities, including those with oppressed racial, ethnic, gender, and sexual minority identities. The purpose of this study was to examine the relationship between self-reports of suicidal thoughts and behaviors among Ohio youth with oppressed identities. This research also contextualizes relationships between these indicators through the context of intersectionality. Methods: This cross-sectional descriptive study used responses from the 2019 Ohio Youth Risk Behavior Survey (YRBS; n = 1263) to examine the relationships between identity variables and suicidal thoughts and behaviors through a series of logistic regression models. Results: Female youth have higher odds of reporting persistent feelings of sadness and hopelessness and seriously considering suicide than male youth. Lesbian, gay, or bisexual (LGB) youth have higher odds of reporting all outcome measures of suicidal thoughts and behaviors (STBs), and youth with oppressed racial and ethnic identities were in general more likely to report higher odds of STBs when compared to White youth. Conclusion: Suicidal thoughts and behaviors disparately affect youth with these oppressed identities. Our findings suggest further examination of these youth nationally may influence public health suicide prevention strategies. Implica-tions also suggest that researchers, practitioners, and organizations across the spectrum of youth suicide prevention in Ohio should understand the increased risk that youth with multiple, intersectional oppressed identities face for suicide.
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Rignanese, M., E. Salmè, M. De Filippi, F. Madeddu, M. De Prisco, M. Fornaro, and R. Calati. "Physical pain-suicidality association in all ages: a complete and updated meta-analysis." European Psychiatry 65, S1 (June 2022): S326. http://dx.doi.org/10.1192/j.eurpsy.2022.829.
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Introduction This work represents the continuation of the studies presented in two e-posters during the EPA 2021 conference (De Filippi et al., 2021; Rignanese et al., 2021), which addressed the physical pain-suicidality association (k=44 studies). Objectives The aim of this meta-analysis is to provide an update of those studies, integrating data relating to adolescents, adults, and olders. Methods We started with the analysis of three papers, in particular a meta-analysis (Calati et al., 2015) and two systematic reviews (Hinze et al., 2019; Santos et al., 2019). After searching on Pubmed (until September 2020), data were extracted from articles comparing the rates of current and lifetime suicidal thoughts and behaviours (death wish, suicidal ideation, suicidal planning, suicide attempt and suicide death: DW, SI, SP, SA, and SD) in adolescents, adults, and olders with any type of physical pain and in individuals who did not report this condition. Data were analysed using Comprehensive Meta-Analysis Software (CMA) version 2. Results 67 studies were included, of which 16 on adolescents, 29 on adults, 16 on olders, and 6 on mixed ages. Although quite high between-study heterogeneity was detected in most analyses, results suggested that individuals with physical pain are more likely to report any form of suicidal outcome if compared to those not affected by pain. Conclusions Collected data are therefore in line with previous literature on this topic, which considered physical pain an extremely predictive risk factor for suicidal thoughts and behaviours. However, further research on this topic would be extremely useful. Disclosure No significant relationships.
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Briere, John, and Marsha Runtz. "Suicidal thoughts and behaviours in former sexual abuse victims." Canadian Journal of Behavioural Science/Revue canadienne des sciences du comportement 18, no. 4 (1986): 413–23. http://dx.doi.org/10.1037/h0079962.
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Batterham, Philip J., A. Kate Fairweather-Schmidt, Peter Butterworth, Alison L. Calear, Andrew J. Mackinnon, and Helen Christensen. "Temporal effects of separation on suicidal thoughts and behaviours." Social Science & Medicine 111 (June 2014): 58–63. http://dx.doi.org/10.1016/j.socscimed.2014.04.004.
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Mortier, P., K. Demyttenaere, R. P. Auerbach, P. Cuijpers, J. G. Green, G. Kiekens, R. C. Kessler, M. K. Nock, A. M. Zaslavsky, and R. Bruffaerts. "First onset of suicidal thoughts and behaviours in college." Journal of Affective Disorders 207 (January 2017): 291–99. http://dx.doi.org/10.1016/j.jad.2016.09.033.
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Bertelsen, Mette, Pia Jeppesen, Lone Petersen, Anne Thorup, Johan ⊘hlenschlæger, Phuong Le Quach, Torben Østergaard Christensen, Gertrud Krarup, Per J⊘rgensen, and Merete Nordentoft. "Suicidal behaviour and mortality in first-episode psychosis: the OPUS trial." British Journal of Psychiatry 191, S51 (December 2007): s140—s146. http://dx.doi.org/10.1192/bjp.191.51.s140.
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BackgroundThose with first-episode psychosis are at high-risk of suicideAimsTo identify predictive factors for suicidal thoughts, plans and attempts, and to investigate the rate of suicides and other deaths during the 5 years after first diagnosis and initiation of treatmentMethodA longitudinal, prospective, 5-year follow-up study of 547 individuals with first-episode schizophrenia spectrum psychosis. Individuals presenting for their first treatment in mental health services in two circumscribed urban areas in Denmark were included in a randomised controlled trial of integrated v. standard treatment. All participants were followed in the Danish Cause of Death Register for 5 years. Suicidal behaviour and clinical and social status were assessed using validated interviews and rating scales at entry, and at 1- and 2-year follow-upsResultsSixteen participants died during the follow-up. We found a strong association between suicidal thoughts, plans and previous attempts, depressive and psychotic symptoms and young age, and with suicidal plans and attempts at 1- and 2-year follow-upConclusionsIn this first-episode cohort depressive and psychotic symptoms, especially hallucinations, predicted suicidal plans and attempts, and persistent suicidal behaviour and ideation were associated with high risk of attempted suicide
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Kyron, Michael J., Wavne Rikkers, Andrew C. Page, Patrice O’Brien, Jennifer Bartlett, Anthony LaMontagne, and David Lawrence. "Prevalence and predictors of suicidal thoughts and behaviours among Australian police and emergency services employees." Australian & New Zealand Journal of Psychiatry, July 2, 2020, 000486742093777. http://dx.doi.org/10.1177/0004867420937774.
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Objective: This study presents rates of suicide thoughts and behaviours of police and emergency services personnel around Australia. In addition, it examines personal (i.e. mental health, substance use) and working environment risk and protective factors. Method: A stratified random sample of personnel from 33 Australian emergency services organisations were invited to participate in a mental health and wellbeing survey. In total, 14,868 Australian ambulance, fire and rescue, police and state emergency services employees participated and self-reported any suicidal thoughts, plans and/or attempts in the 12 months prior to the survey or at any stage in their life. Logistic regressions assessed factors associated with suicidal thoughts and behaviours. Results: Employees reported notably higher rates of suicidal thoughts and plans than the general Australian adult population, but not attempts. Male, single/divorced, non-heterosexual or longer-serving employees reported higher rates of suicidal thoughts and behaviours across each sector. Perceptions of stigma regarding mental health conditions from others in the workplace, negative impact of work on one’s private life and low meaning of work were associated with suicidal thoughts, while bullying significantly differentiated who planned and attempted suicide from those who reported suicidal thoughts only. Higher resilience and social support were associated with lower suicidal thoughts, while intermittent explosive anger and illegal drug use were associated with higher rates of suicidal thoughts. Post-traumatic stress disorder symptoms significantly differentiated who planned suicide, while misuse of prescription drugs and psychological distress differentiated who attempted suicide from those who only reported suicidal thoughts. Conclusion: Amid inherently stressful occupations, it is important that workplaces function in a way that supports their personnel. Access to mental health services should be promoted and readily available to personnel.
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Teasdale-Dubé, Audrée, Charles Viau-Quesnel, and Sylvie Lapierre. "Suicidal Ideation in Canadian Family Caregivers for a Person with Dementia: A Portrait of the Situation." Canadian Journal on Aging / La Revue canadienne du vieillissement, February 6, 2024, 1–8. http://dx.doi.org/10.1017/s0714980824000011.
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Abstract This study aimed to explore the prevalence of suicidal thoughts and potential associations (i.e., strength and direction) with caregiver characteristics or factors. A targeted survey was distributed to dementia caregivers aged 55+ years. Questions concerning psychological distress, suicidal thoughts while caregiving and antecedents of suicidal behaviours were administered. A sample of 71 French-speaking Canadian caregivers completed the survey between May and October 2019. Among them, 52.1 per cent (n = 37) reported suicidal ideation while providing care to a relative or a friend living with dementia. Caregivers who presented suicidal ideation reported more abusive behaviour toward the care recipient. Caregivers who reported suicidal thoughts were significantly more distressed than caregivers without them on measures of burden, depression, and anxiety. Suicidal thoughts in caregivers are important evaluation targets, primarily for the prevention of suicide, but also because caregivers who report suicidal thoughts also present a heightened risk for abusing the care recipient.
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Balt, Elias, Saskia Mérelle, Jo Robinson, Arne Popma, Daan Creemers, Isa van den Brand, Diana van Bergen, Sanne Rasing, Wico Mulder, and Renske Gilissen. "Social media use of adolescents who died by suicide: lessons from a psychological autopsy study." Child and Adolescent Psychiatry and Mental Health 17, no. 1 (April 7, 2023). http://dx.doi.org/10.1186/s13034-023-00597-9.
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Abstract Background while there are many benefits for young people to use social media, adverse effects such as cyberbullying, online challenges, social comparison and imitation may provoke and aggravate suicidal thoughts and behaviors. The influence of social media on mental health and suicidal thoughts and behaviours has been amply studied, but there is little empirical evidence for its potential role in adolescent suicides. The current study aimed to inform digital suicide prevention strategies by examining the meaning of social media in the lives of young suicide victims and elucidating the harmful and supportive effects of social media use on their wellbeing and distress. Methods data were analyzed from a psychological autopsy study of 35 adolescents who died by suicide in the Netherlands (43% of all adolescents who died by suicide in that year). These were 18 girls and 17 boys. All were under the age of twenty years, with an average of seventeen years. Interpretative Phenomenological Analysis was performed of 55 semi structured interviews with peers and parents of the decedents. Results young people benefitted from peer support and recovery stories. However, various themes were discussed relating to the harmful effects of social media, including dependency, triggers and imitation, challenges, cybervictimization and psychological entrapment. The themes of dependency and triggers and imitation were more salient in young females. A group of girls cultivated an online identity around their suicidal thoughts and behaviours. Next-of-kin, particularly parents, faced various challenges to talk to the adolescents about social media use, including technological illiteracy, online anonymity, and the youths’ closedness. Conclusions based on the findings, we recommend education to stimulate the digital literacy of parents, health workers and educators, supporting conscientious social media use in young people, and extending the prevention of cyberbullying. We encourage future research to examine how virtual social networks may sustain suicidal thoughts and behaviour, and to further investigate the effectiveness of digital interventions, like moderated peer support and the use of positive role models.
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Sivertsen, Børge, Mari Hysing, Marit Knapstad, Allison G. Harvey, Anne Reneflot, Kari Jussie Lønning, and Rory C. O'Connor. "Suicide attempts and non-suicidal self-harm among university students: prevalence study." BJPsych Open 5, no. 2 (March 2019). http://dx.doi.org/10.1192/bjo.2019.4.
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BackgroundSuicide attempts and non-suicidal self-harm (NSSH) are major public health concerns that affect millions of young people worldwide. Consequently, there is a strong need for up-to-date epidemiological data in this population.AimsTo provide prevalence and trend estimates of suicidal thoughts and behaviours and NSSH thoughts and behaviour in university students.MethodData are from a 2018 national health survey for higher education in Norway. A total of 50 054 full-time students (69.1% women) aged 18–35 years participated (response rate 31%). Suicidal ideation, suicide attempts and NSSH were assessed with three items drawn from the Adult Psychiatric Morbidity Survey, and thoughts of NSSH were assessed with one item from the Child and Adolescent Self-Harm in Europe study.ResultsLifetime suicidal thoughts were reported by 21.0%, and 7.2% reported having such thoughts within the past year. In total, 4.2% reported a suicide attempt, of whom 0.4% reported attempting suicide within the past year. The prevalence of lifetime NSSH behaviour and thoughts was 19.6% and 22.6%, respectively. All four suicidal behaviour and NSSH variables were more common among students who were single, living alone and with a low annual income, as well as among immigrants. There was an increase in suicidal thoughts from 2010 (7.7%) to 2018 (11.4%), which was evident in both men and women.ConclusionsThe observed high and increasing prevalence of suicidal thoughts and NSSH among college and university students is alarming, underscoring the need for further research, preferably registry-linked studies, to confirm whether the reported prevalence is representative of the student population as a whole.Declaration of interestNone.