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Novel Approaches to Suicide Prevention: Protective Factors and Clinical Interventions

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: closed (1 October 2020) | Viewed by 26881

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Special Issue Editors

Dr. Robert J. Cramer

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Guest Editor

Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
Interests: suicide prevention; hate crimes; sexual and gender minority health; scale development; program evaluation

Dr. Raymond P. Tucker

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Guest Editor

Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
Interests: theoretical models of suicide; suicide risk assessment; suicide risk and resilience factors in marginalized communities

Special Issue Information

Dear Colleagues,

World Health Organization data show that approximately 800,000 persons die by suicide each year. Moreover, suicide trends remain stable or are increasing across many nations. In light of the global concern posed by suicide, decades of research have been devoted to theoretical development and risk factor identification. Despite these efforts, a recent meta-analysis showed that most risk factors do little better than chance in predicting suicide risk. Suicide resilience factors were not better predictors of suicide either; however, they have been dramatically understudied according to this synthesis of the literature. Despite this issue, research demonstrates some progress in the articulation of several evidence-based, suicide-specific interventions, such as Dialectical Behaviour Therapy (DBT), Collaborative Assessment and Management of Suicide (CAMS), and Lethal Means Counselling.

This Special Issue is devoted to pushing forward both the basic and applied science of suicide prevention by targeting novel studies that investigate suicide protective factors and resilience. We are also interested in work that tests new interventions, or furthers the empirical evaluation of some of the current leading therapeutic interventions. Studies of interest may utilize quantitative, qualitative, or mixed-method approaches; moreover, they may be drawn from a number of disciplines. However, studies must either address (1) the identification of novel protective factors, and/or (2) testing an empirical intervention. Specific example topics include:

Examination of cognitive and affective individual differences mitigating suicidal thoughts and/or behaviours.
Examination of factors that offset the risk posed by common risk factors for suicide (i.e., moderators).
Exploration of cultural factors driving resilience in a number of vulnerable populations (e.g., immigrants, military, racial/ethnic minorities, sexual and gender minorities).
Design and psychometric testing of protective factor assessment instruments.
Pilot evaluation of a new or recently developed psychotherapeutic interventions.
Rigorously designed and executed meta-analyses or systematic reviews of suicide resilience factors.
Quantitative studies with null results that demonstrate failed replication of previously determined suicide resilience factors.
Adaptation of leading therapies to new patient populations, at-risk groups, or across national boundaries.

While this Special Issue is open to any type of article, priority will be given to rigorously designed empirical, over theoretical or review, articles.

Dr. Robert J. Cramer
Dr. Raymond P. Tucker
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Suicidal ideation
Suicide attempt
Risk assessment
Resilience
Therapy
Mental health
Cultural adaptation

Published Papers (6 papers)

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Editorial

Jump to: Research

3 pages, 245 KiB

Open AccessEditorial

Improving the Field’s Understanding of Suicide Protective Factors and Translational Suicide Prevention Initiatives

by Robert J. Cramer and Raymond Tucker

Int. J. Environ. Res. Public Health 2021, 18(3), 1027; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18031027 - 25 Jan 2021

Cited by 4 | Viewed by 2227

Abstract

World Health Organization data show that approximately 800,000 persons die by suicide each year [...] Full article

(This article belongs to the Special Issue Novel Approaches to Suicide Prevention: Protective Factors and Clinical Interventions)

Research

Jump to: Editorial

13 pages, 366 KiB

Open AccessArticle

The Common Factors of Grit, Hope, and Optimism Differentially Influence Suicide Resilience

by Déjà N. Clement, LaRicka R. Wingate, Ashley B. Cole, Victoria M. O’Keefe, David W. Hollingsworth, Collin L. Davidson and Jameson K. Hirsch

Int. J. Environ. Res. Public Health 2020, 17(24), 9588; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17249588 - 21 Dec 2020

Cited by 15 | Viewed by 3621

Abstract

No study to date has simultaneously examined the commonalities and unique aspects of positive psychological factors and whether these factors uniquely account for a reduction in suicide risk. Using a factor analytic approach, the current study examined the relationships between grit, hope, optimism, and their unique and overlapping relationships in predicting suicide ideation. Results of principle axis factor analysis demonstrated close relationships between these variables at both the construct and item level. Item-level analyses supported a five-factor solution (Stick-to-Itiveness, Poor Future, Consistency of Interest, Positive Future, and Poor Pathways). Four of the five factors (excluding Stick-to-Itiveness) were associated with suicide ideation. Additionally, results of a multiple regression analysis indicated that two of the five factors (Consistency of Interest and Positive Future) negatively predicted suicide ideation while Poor Future positively predicted suicide ideation. Implications regarding the interrelationships between grit, hope, and optimism with suicide ideation are discussed. Full article

(This article belongs to the Special Issue Novel Approaches to Suicide Prevention: Protective Factors and Clinical Interventions)

17 pages, 961 KiB

Open AccessArticle

A Feasibility Study Using a Machine Learning Suicide Risk Prediction Model Based on Open-Ended Interview Language in Adolescent Therapy Sessions

by Joshua Cohen, Jennifer Wright-Berryman, Lesley Rohlfs, Donald Wright, Marci Campbell, Debbie Gingrich, Daniel Santel and John Pestian

Int. J. Environ. Res. Public Health 2020, 17(21), 8187; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17218187 - 05 Nov 2020

Cited by 20 | Viewed by 6708

Abstract

Background: As adolescent suicide rates continue to rise, innovation in risk identification is warranted. Machine learning can identify suicidal individuals based on their language samples. This feasibility pilot was conducted to explore this technology’s use in adolescent therapy sessions and assess machine learning model performance. Method: Natural language processing machine learning models to identify level of suicide risk using a smartphone app were tested in outpatient therapy sessions. Data collection included language samples, depression and suicidality standardized scale scores, and therapist impression of the client’s mental state. Previously developed models were used to predict suicidal risk. Results: 267 interviews were collected from 60 students in eight schools by ten therapists, with 29 students indicating suicide or self-harm risk. During external validation, models were trained on suicidal speech samples collected from two separate studies. We found that support vector machines (AUC: 0.75; 95% CI: 0.69–0.81) and logistic regression (AUC: 0.76; 95% CI: 0.70–0.82) lead to good discriminative ability, with an extreme gradient boosting model performing the best (AUC: 0.78; 95% CI: 0.72–0.84). Conclusion: Voice collection technology and associated procedures can be integrated into mental health therapists’ workflow. Collected language samples could be classified with good discrimination using machine learning methods. Full article

(This article belongs to the Special Issue Novel Approaches to Suicide Prevention: Protective Factors and Clinical Interventions)

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18 pages, 2718 KiB

Open AccessArticle

Does Mental Well-Being Protect against Self-Harm Thoughts and Behaviors during Adolescence? A Six-Month Prospective Investigation

by Kirsten Russell, Susan Rasmussen and Simon C. Hunter

Int. J. Environ. Res. Public Health 2020, 17(18), 6771; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17186771 - 17 Sep 2020

Cited by 5 | Viewed by 3539

Abstract

Mental well-being protects against the emergence of suicidal thoughts. However, it is not clear whether these findings extend to self-harm thoughts and behaviors irrespective of intent during adolescence—or why this relationship exists. The current study aimed to test predictions—informed by the integrated motivational–volitional (IMV) model of suicide—concerning the role of perceived defeat and entrapment within the link between mental well-being and self-harm risk. Young people (n = 573) from secondary schools across Scotland completed an anonymous self-report survey at two time points, six months apart, that assessed mental well-being, self-harm thoughts and behaviors, depressive symptomology and feelings of defeat and entrapment. Mental well-being was associated with reduced defeat and entrapment (internal and external) and a decrease in the likelihood that a young person would engage in self-harm thoughts and behaviors. The relationship between mental well-being and thoughts of self-harm was mediated by perceptions of defeat and entrapment (internal and external). Mental well-being was indirectly related to self-harm behaviors via decreased feelings of defeat and internal (but not external) entrapment. Taken together, these findings provide novel insights into the psychological processes linking mental well-being and self-harm risk and highlight the importance of incorporating the promotion of mental well-being within future prevention and early intervention efforts. Full article

(This article belongs to the Special Issue Novel Approaches to Suicide Prevention: Protective Factors and Clinical Interventions)

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9 pages, 286 KiB

Open AccessArticle

Suicide Safety Planning: Clinician Training, Comfort, and Safety Plan Utilization

by Emma H. Moscardini, Ryan M. Hill, Cody G. Dodd, Calvin Do, Julie B. Kaplow and Raymond P. Tucker

Int. J. Environ. Res. Public Health 2020, 17(18), 6444; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17186444 - 04 Sep 2020

Cited by 14 | Viewed by 6208

Abstract

Extant literature has demonstrated that suicide safety planning is an efficacious intervention for reducing patient risk for suicide-related behaviors. However, little is known about factors that may impact the effectiveness of the intervention, such as provider training and comfort, use of specific safety plan elements, circumstances under which providers choose to use safety planning, and personal factors which influence a provider’s decision to use safety planning. Participants were (N = 119) safety plan providers who responded to an anonymous web-based survey. Results indicated that most providers had received training in safety planning and were comfortable with the intervention. Providers reported that skills such as identifying warning signs and means safety strategies were routinely used. Providers who reported exposure to suicide were more likely to complete safety plans with patients regardless of risk factors. In addition, almost 70% of providers indicated a need for further training. These data provide important considerations for safety plan implementation and training. Full article

(This article belongs to the Special Issue Novel Approaches to Suicide Prevention: Protective Factors and Clinical Interventions)

17 pages, 564 KiB

Open AccessArticle

Preferences in Information Processing, Marginalized Identity, and Non-Monogamy: Understanding Factors in Suicide-Related Behavior among Members of the Alternative Sexuality Community

by Robert J. Cramer, Jennifer Langhinrichsen-Rohling, Andrea R. Kaniuka, Corrine N. Wilsey, Annelise Mennicke, Susan Wright, Erika Montanaro, Jessamyn Bowling and Kristin E. Heron

Int. J. Environ. Res. Public Health 2020, 17(9), 3233; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17093233 - 06 May 2020

Cited by 10 | Viewed by 3559

Abstract

Suicide-related behavior (SRB) is a mental health disparity experienced by the alternative sexuality community. We assessed mental health, relationship orientation, marginalized identities (i.e., sexual orientation minority, gender minority, racial minority, ethnic minority, and lower education), and preferences in information processing (PIP) as factors differentiating lifetime SRB groups. An online cross-sectional survey study was conducted in 2018. Members of the National Coalition for Sexual Freedom (NCSF; n = 334) took part. Bivariate analyses identified the following SRB risk factors: female and transgender/gender non-binary identity, sexual orientation minority identity, lower education, suicide attempt/death exposure, Need for Affect (NFA) Avoidance, depression, and anxiety. Monogamous relationship orientation was a protective factor. Multi-nomial regression revealed the following: (1) monogamous relationship orientation was a protective factor for suicidal ideation and attempt; (2) lower education was a risk factor for suicide attempt; (3) anxiety was a risk factor for suicide attempt; and (4) depression was a risk factor for suicidal ideation. A two-way interaction showed that elevated NFA Approach buffered the negative impacts of depression. Relationship orientation, several marginalized identities (i.e., based on gender, sexual orientation, and educational level), and PIP all contributed uniquely to SRB. Further study is necessary to understand the role of relationship orientation with suicide. Health education and suicide prevention efforts with NCSF should be tailored to account for marginalized identity, mental health, and NFA factors. Full article

(This article belongs to the Special Issue Novel Approaches to Suicide Prevention: Protective Factors and Clinical Interventions)

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