Evidence for an emotion–cognition interaction in the statistical prediction of suicide attempts
TL;DR: Testing the effect of an emotion-cognition interaction on suicide attempts among youth revealed a significant interaction, such that emotion reactivity was strongly associated with the probability of a suicide attempt among those with poor problem-solving skills.
About: This article is published in Behaviour Research and Therapy.The article was published on 2011-04-01. It has received 92 citations till now. The article focuses on the topics: Suicide attempt & Suicide prevention.
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TL;DR: Deficits in specific components of attention control, memory and working memory were associated with suicidal behavior in a sample where non-violent attempt predominated.
Abstract: BackgroundExecutive dysfunction, distinct from other cognitive deficits in depression, has been associated with suicidal behavior. However, this dysfunction is not found consistently across samples.MethodMedication-free subjects with DSM-IV major depressive episode (major depressive disorder and bipolar type I disorder) and a past history of suicidal behavior (n = 72) were compared to medication-free depressed subjects with no history of suicidal behavior (n = 80) and healthy volunteers (n = 56) on a battery of tests assessing neuropsychological functions typically affected by depression (motor and psychomotor speed, attention, memory) and executive functions reportedly impaired in suicide attempters (abstract/contingent learning, working memory, language fluency, impulse control).ResultsAll of the depressed subjects performed worse than healthy volunteers on motor, psychomotor and language fluency tasks. Past suicide attempters, in turn, performed worse than depressed non-attempters on attention and memory/working memory tasks [a computerized Stroop task, the Buschke Selective Reminding Task (SRT), the Benton Visual Retention Test (VRT) and an N-back task] but not on other executive function measures, including a task associated with ventral prefrontal function (Object Alternation). Deficits were not accounted for by current suicidal ideation or the lethality of past attempts. A small subsample of those using a violent method in their most lethal attempt showed a pattern of poor executive performance.ConclusionsDeficits in specific components of attention control, memory and working memory were associated with suicidal behavior in a sample where non-violent attempt predominated. Broader executive dysfunction in depression may be associated with specific forms of suicidal behavior, rather than suicidal behavior per se.
252 citations
Cites background from "Evidence for an emotion–cognition i..."
...The interaction of clinical risk factors with neurocognitive impairment (Dour et al. 2011), and also the relationships among the various neurocognitive measures that have been associated with suicide risk, warrant further study....
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TL;DR: Poor subjective sleep quality is associated with increased risk for death by suicide 10 years later, even after adjustment for depressive symptoms, and appears to confer considerable risk, independent of depressed mood, for the most severe suicidal behaviors.
Abstract: Importance Older adults have high rates of sleep disturbance, die by suicide at disproportionately higher rates compared with other age groups, and tend to visit their physician in the weeks preceding suicide death. To our knowledge, to date, no study has examined disturbed sleep as an independent risk factor for late-life suicide. Objective To examine the relative independent risk for suicide associated with poor subjective sleep quality in a population-based study of older adults during a 10-year observation period. Design, Setting, and Participants A longitudinal case-control cohort study of late-life suicide among a multisite, population-based community sample of older adults participating in the Established Populations for Epidemiologic Studies of the Elderly. Of 14 456 community older adults sampled, 400 control subjects were matched (on age, sex, and study site) to 20 suicide decedents. Main Outcomes and Measures Primary measures included the Sleep Quality Index, the Center for Epidemiologic Studies–Depression Scale, and vital statistics. Results Hierarchical logistic regressions revealed that poor sleep quality at baseline was significantly associated with increased risk for suicide (odds ratio [OR], 1.39; 95% CI, 1.14-1.69; P P P P Conclusions and Relevance Our results indicate that poor subjective sleep quality is associated with increased risk for death by suicide 10 years later, even after adjustment for depressive symptoms. Disturbed sleep appears to confer considerable risk, independent of depressed mood, for the most severe suicidal behaviors and may warrant inclusion in suicide risk assessment frameworks to enhance detection of risk and intervention opportunity in late life.
188 citations
TL;DR: Assessment of the rate and behavioral methods of nonsuicidal self-injury (NSSI) in a community sample of youth and effects of age and sex found ninth-grade girls seem most at risk, as they engage in NSSI at 3 times the rate of boys.
Abstract: OBJECTIVE: The goal was to assess the rate and behavioral methods of nonsuicidal self-injury (NSSI) in a community sample of youth and examine effects of age and sex. METHODS: Youth in the third, sixth, and ninth grades (ages 7–16) at schools in the community were invited to participate in a laboratory study. A total of 665 youth (of 1108 contacted; 60% participation rate) were interviewed about NSSI over their lifetime via the Self-Injurious Thoughts and Behaviors Interview. RESULTS: Overall, 53 (8.0%) of the 665 youth reported engaging in NSSI; 9.0% of girls and 6.7% of boys reported NSSI engagement; 7.6% of third-graders, 4.0% of sixth-graders, and 12.7% of ninth-graders reported NSSI engagement. There was a significant grade by gender interaction; girls in the ninth grade (19%) reported significantly greater rates of NSSI than ninth-grade boys (5%). Behavioral methods of NSSI differed by gender. Girls reported cutting and carving skin most often, whereas boys reported hitting themselves most often. Finally, 1.5% of youth met some criteria for the proposed fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnosis of NSSI. CONCLUSIONS: Children and adolescents engage in NSSI. Ninth-grade girls seem most at risk, as they engage in NSSI at 3 times the rate of boys. Behavioral methods of NSSI also vary by grade and gender. As possible inclusion of an NSSI diagnosis in the fifth edition of the DSM-5 draws near, it is essential to better understand NSSI engagement across development and gender.
181 citations
TL;DR: The distribution of STB in first-year students is widespread, and relatively independent of socio-demographic risk profile, as well as cross-nationally consistent and modest in effect size.
Abstract: Objective College entrance may be a strategically well-placed “point of capture” for detecting late adolescents with suicidal thoughts and behaviors (STB). However, a clear epidemiological picture of STB among incoming college students is lacking. We present the first cross-national data on prevalence as well as socio-demographic and college-related correlates for STB among first-year college students. Method Web-based self-report surveys were obtained from 13,984 first-year students (response rate 45.5%) across 19 colleges in 8 countries (Australia, Belgium, Germany, Mexico, Northern Ireland, South Africa, Spain, and the United States). Results Lifetime prevalence of suicidal ideation, plans, and attempts was 32.7%, 17.5%, and 4.3%, respectively. The 12-month prevalence was 17.2%, 8.8%, and 1.0%, respectively. About three-fourths of STB cases had onset before the age of 16 years (Q3 = 15.8), with persistence figures in the range of 41% to 53%. About one-half (53.4%) of lifetime ideators transitioned to a suicide plan; 22.1% of lifetime planners transitioned to an attempt. Attempts among lifetime ideators without plan were less frequent (3.1%). Significant correlates of lifetime STB were cross-nationally consistent and generally modest in effect size (median adjusted odds ratio [aOR] = 1.7). Nonheterosexual orientation (aOR range 3.3−7.9) and heterosexual orientation with some same-sex attraction (aOR range 1.9−2.3) were the strongest correlates of STB, and of transitioning from ideation to plans and/or attempts (aOR range 1.6−6.1). Conclusion The distribution of STB in first-year students is widespread, and relatively independent of socio-demographic risk profile. Multivariate risk algorithms based on a high number of risk factors are indicated to efficiently link high-risk status with effective preventive interventions.
162 citations
TL;DR: The association between emotion regulation difficulties and suicide attempts was modestly lower among students who perceived themselves as having higher levels of trusted adults in the family, consistent with a protective effect.
Abstract: To develop and refine interventions to prevent youth suicide, knowledge is needed about specific processes that reduce risk at a population level. Using a cross-sectional design, the present study tested hypotheses regarding associations between self-reported suicide attempts, emotion regulation difficulties, and positive youth–adult relationships among 7,978 high-school students (48.6 % male, 49.9 % female) in 30 high schools from predominantly rural, low-income communities. 683 students (8.6 %) reported a past-year suicide attempt. Emotion regulation difficulties and a lack of trusted adults at home and school were associated with increased risk for making a past-year suicide attempt, above and beyond the effects of depressive symptoms and demographic factors. The association between emotion regulation difficulties and suicide attempts was modestly lower among students who perceived themselves as having higher levels of trusted adults in the family, consistent with a protective effect. Having a trusted adult in the community (outside of school and family) was associated with fewer suicide attempts in models that controlled only for demographic covariates, but not when taking symptoms of depression into account. These findings point to adolescent emotion regulation and relationships with trusted adults as complementary targets for suicide prevention that merit further intervention studies. Reaching these targets in a broad population of adolescents will require new delivery systems and “option rich” (OR) intervention designs.
151 citations
References
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Book•
01 Jan 1991TL;DR: In this article, the effects of predictor scaling on the coefficients of regression equations are investigated. But, they focus mainly on the effect of predictors scaling on coefficients of regressions.
Abstract: Introduction Interactions between Continuous Predictors in Multiple Regression The Effects of Predictor Scaling on Coefficients of Regression Equations Testing and Probing Three-Way Interactions Structuring Regression Equations to Reflect Higher Order Relationships Model and Effect Testing with Higher Order Terms Interactions between Categorical and Continuous Variables Reliability and Statistical Power Conclusion Some Contrasts Between ANOVA and MR in Practice
27,897 citations
TL;DR: In this article, multiple regression is used to test and interpret multiple regression interactions in the context of multiple-agent networks. But it is not suitable for single-agent systems, as discussed in this paper.
Abstract: (1994). Multiple Regression: Testing and Interpreting Interactions. Journal of the Operational Research Society: Vol. 45, No. 1, pp. 119-120.
13,068 citations
TL;DR: Results suggest the K-SADS-PL generates reliable and valid child psychiatric diagnoses.
Abstract: Objective To describe the psychometric properties of the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version (K-SADS-PL) interview, which surveys additional disorders not assessed in prior K-SADS, contains improved probes and anchor points, includes diagnosis-specific impairment ratings, generates DSM-III-R and DSM-IV diagnoses, and divides symptoms surveyed into a screening interview and five diagnostic supplements. Method Subjects were 55 psychiatric outpatients and 11 normal controls (aged 7 through 17 years). Both parents and children were used as informants. Concurrent validity of the screen criteria and the K-SADS-PL diagnoses was assessed against standard self-report scales. Interrater ( n = 15) and test-retest ( n = 20) reliability data were also collected (mean retest interval: 18 days; range: 2 to 38 days). Results Rating scale data support the concurrent validity of screens and K-SADS-PL diagnoses. Interrater agreement in scoring screens and diagnoses was high (range: 93% to 100%). Test-retest reliability κ coefficients were in the excellent range for present and/or lifetime diagnoses of major depression, any bipolar, generalized anxiety, conduct, and oppositional defiant disorder (.77 to 1.00) and in the good range for present diagnoses of posttraumatic stress disorder and attention-deficit hyperactivity disorder (.63 to .67). Conclusion Results suggest the K-SADS-PL generates reliable and valid child psychiatric diagnoses. J. Am. Acad. Child Adolesc. Psychiatry , 1997, 36(7): 980–988.
8,742 citations
"Evidence for an emotion–cognition i..." refers methods in this paper
...In the current study, answers to the following items were dichotomized to determine past-year presence of violent behavior: “Have you ever done something to purposefully hurt someone else without wanting to kill him/her?” and “How many times have you done this in the past year?” The presence of a current diagnosis of substance- or alcohol-use disorders was assessed with the KiddieSchedule for Affective Disorders and Schizophrenia e Present and Lifetime Version (K-SADS-PL; Kaufman et al., 1997)....
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...The presence of a current diagnosis of substance- or alcohol-use disorders was assessed with the KiddieSchedule for Affective Disorders and Schizophrenia e Present and Lifetime Version (K-SADS-PL; Kaufman et al., 1997)....
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Book•
01 Jan 1993TL;DR: The treatment of Borderline personality disorder (BPD) has been studied extensively in the literature as discussed by the authors, with a focus on the treatment of the behavioral patterns of patients with BPD.
Abstract: Part I: Theory and Concepts Borderline Personality Disorder: Concepts, Controversies, and Definitions Dialectical and Biosocial Underpinnings of Treatment Behavioral Patterns: Dialectical Dilemmas in the Treatment of Borderline Patients Part II: Treatment Overview and Goals Overview of Treatment: Targets, Strategies, and Assumptions in a Nutshell Behavioral Targets in Treatment: Behaviors to Increase and Decrease Structuring Treatment around Target Behaviors: Who Treats What and When Part III: Basic Treatment Strategies Dialectical Treatment Strategies Core Strategies: Validation Core Strategies: Problem Solving Change Procedures: Contingency Procedures of Managing Contingencies and Observing Limits Change Procedures: Skills Training, Exposure, Cognitive Modification Stylistic Strategies: Balancing Communication Case Management Strategies: Interacting with the Community Part IV: Strategies for Specific Tasks Structural Strategies Special Treatment Strategies Appendix: Suggesting Reading References Index
6,378 citations
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TL;DR: Evidence is provided that there is a heightened responsiveness to incentives and socioemotional contexts during this time, when impulse control is still relatively immature, which suggests differential development of bottom‐up limbic systems to top‐down control systems during adolescence as compared to childhood and adulthood.
Abstract: Adolescence is a developmental period characterized by suboptimal decisions and actions that are associated with an increased incidence of unintentional injuries, violence, substance abuse, unintended pregnancy, and sexually transmitted diseases. Traditional neurobiological and cognitive explanations for adolescent behavior have failed to account for the nonlinear changes in behavior observed during adolescence, relative to both childhood and adulthood. This review provides a biologically plausible model of the neural mechanisms underlying these nonlinear changes in behavior. We provide evidence from recent human brain imaging and animal studies that there is a heightened responsiveness to incentives and socioemotional contexts during this time, when impulse control is still relatively immature. These findings suggest differential development of bottom-up limbic systems, implicated in incentive and emotional processing, to top-down control systems during adolescence as compared to childhood and adulthood. This developmental pattern may be exacerbated in those adolescents prone to emotional reactivity, increasing the likelihood of poor outcomes.
2,660 citations