Unsound sleep, wound-up mind: a longitudinal examination of acute suicidal affective disturbance features among an eating disorder sample

2021 ◽  
pp. 1-9
Author(s):  
Shruti S. Kinkel-Ram ◽  
William Grunewald ◽  
Lindsay P. Bodell ◽  
April R. Smith

Abstract Background Suicide is one of the most commonly reported causes of death in individuals with eating disorders. However, the mechanisms underlying the suicide and disordered eating link are largely unknown, and current assessments are still unable to accurately predict future suicidal thoughts and behaviors. The purpose of this study is to test the utility of two promising proximal risk factors, sleep quality and agitation, in predicting suicidal ideation in a sample of individuals with elevated suicidal thoughts and behaviors, namely those with eating disorders. Methods Women (N = 97) receiving treatment at an eating disorder treatment center completed weekly questionnaires assessing suicidal ideation, agitation, and sleep. General linear mixed models examined whether agitation and/or sleep quality were concurrently or prospectively associated with suicidal ideation across 12 weeks of treatment. Results There was a significant interaction between within-person agitation and sleep quality on suicidal ideation [B(s.e.) = −0.02(0.01), p < 0.05], such that on weeks when an individual experienced both higher than their average agitation and lower than their average sleep quality, they also experienced their highest levels of suicidal ideation. However, neither agitation nor sleep quality prospectively predicted suicidal ideation. Conclusions This study was the first to examine dynamic associations between interpersonal constructs and suicidal ideation in individuals with eating disorders. Results suggest that ongoing assessment for overarousal symptoms, such as agitation and poor sleep quality, in individuals with eating disorders may be warranted in order to manage suicidal ideation among this vulnerable population.

2019 ◽  
Vol 25 (2) ◽  
pp. 408-427 ◽  
Author(s):  
Lianne Schmaal ◽  
Anne-Laura van Harmelen ◽  
Vasiliki Chatzi ◽  
Elizabeth T. C. Lippard ◽  
Yara J. Toenders ◽  
...  

AbstractIdentifying brain alterations that contribute to suicidal thoughts and behaviors (STBs) are important to develop more targeted and effective strategies to prevent suicide. In the last decade, and especially in the last 5 years, there has been exponential growth in the number of neuroimaging studies reporting structural and functional brain circuitry correlates of STBs. Within this narrative review, we conducted a comprehensive review of neuroimaging studies of STBs published to date and summarize the progress achieved on elucidating neurobiological substrates of STBs, with a focus on converging findings across studies. We review neuroimaging evidence across differing mental disorders for structural, functional, and molecular alterations in association with STBs, which converges particularly in regions of brain systems that subserve emotion and impulse regulation including the ventral prefrontal cortex (VPFC) and dorsal PFC (DPFC), insula and their mesial temporal, striatal and posterior connection sites, as well as in the connections between these brain areas. The reviewed literature suggests that impairments in medial and lateral VPFC regions and their connections may be important in the excessive negative and blunted positive internal states that can stimulate suicidal ideation, and that impairments in a DPFC and inferior frontal gyrus (IFG) system may be important in suicide attempt behaviors. A combination of VPFC and DPFC system disturbances may lead to very high risk circumstances in which suicidal ideation is converted to lethal actions via decreased top-down inhibition of behavior and/or maladaptive, inflexible decision-making and planning. The dorsal anterior cingulate cortex and insula may play important roles in switching between these VPFC and DPFC systems, which may contribute to the transition from suicide thoughts to behaviors. Future neuroimaging research of larger sample sizes, including global efforts, longitudinal designs, and careful consideration of developmental stages, and sex and gender, will facilitate more effectively targeted preventions and interventions to reduce loss of life to suicide.


2018 ◽  
Vol 49 (1) ◽  
pp. 221-239 ◽  
Author(s):  
April R. Smith ◽  
Elizabeth A. Velkoff ◽  
Jessica D. Ribeiro ◽  
Joseph Franklin

2021 ◽  
Author(s):  
Khadija Karjouh ◽  
Fatima-Zahra Azzaoui ◽  
Riadh Ouerchefani ◽  
Wafae idrissi semlali ◽  
Khaoula Mammad ◽  
...  

Abstract Alexithymia is an emotion regulation problem that may be related to suicidality, especially in patients with SUD.The study aimed at estimating the prevalence of alexithymia in Moroccan psychoactive substances users, and to establish the links between alexithymia and suicidal ideation and behaviors, anxiety and depression in drug-dependent patients.We also aimed to elucidate if alexithymia predicts suicidal thoughts and behaviors in these consumers. The study included 451 consecutively admitted patients with substance use. Consumers were examined with the Toronto alexithymia scale (TAS-20), State and Trait Anxiety Inventory (STAI-Y), Beck Depression Inventory (BDI) and The Columbia-Suicide Severity Rating Scale (C-SSRS)Among substance-dependent individuals, 72.7% was identified as a group with alexithymia. Current age and age at first substance use were lower in the alexithymic group (p<0.01).The mean STAI-Y state and C-SSRS scores were higher in the group with alexithymia (p<0.01). There was a statistically significant difference between the groups in terms of mean scores for anxiety traits (p<0.05) and no significant difference in terms of mean scores for depression. All of the scores correlated significantly with.Addicted patients with alexithymia could be targeted at preventing the onset of suicidal thoughts and behaviorThe present study also evokes that whenever an emotional regulation disorder is observed, the possibility of anxio-depressive symptomatology and suicidality (ideation and behavior) needs to be assessed.


2020 ◽  
Author(s):  
Brooke A. Ammerman ◽  
Taylor A. Burke ◽  
Ross Jacobucci ◽  
Kenneth McClure

Evidence suggests that the negative consequences of COVID-19 may extend far beyond its considerable death toll, having a significant impact on psychological well-being. Prior work has highlighted that previous epidemics are linked to elevated suicide rates, however, there is no research to date on the relationship between the COVID-19 pandemic and suicidal thoughts and behaviors. Utilizing an online survey, the current study aimed to better understand the presence, and extent, of the association between COVID-19-related experiences and past-month suicidal thoughts and behaviors among adults in the United States. Results support an association between several COVID-19-related experiences (i.e., general distress, fear of physical harm, effects of social distancing policies) and past-month suicidal ideation and attempts. Further, we found that a significant proportion of those with recent suicidal ideation explicitly link their suicidal thoughts to COVID-19. Exploratory analyses highlight a potential additional link between COVID-19 and suicidal behavior, suggesting that a portion of individuals may be intentionally exposing themselves to the virus with intent to kill themselves. These findings underscore the need for increased suicide risk screening and access to mental health services. Particular attention should be paid to employing public health campaigns to disseminate information on such services in order to reduce the enormity of distress and emotional impairment associated with COVID-19 in the United States.


2021 ◽  
Vol 2 ◽  
Author(s):  
Jodie C. Stevenson ◽  
Kamila Irvine ◽  
Sarah Allen ◽  
Umair Akram

Abstract Evidence demonstrates increased vulnerability to thoughts and behaviors related to suicide (i.e., suicidal ideation) in students. This study examined the interaction between insomnia-symptoms and student-status (students vs. non-students) on reports of suicidal thoughts of behaviors. A total of 363 (N = 363) university students and 300 (N = 300) members of the general population provided complete data on measures of insomnia-symptoms and suicidal ideation. Students indicated greater reports of both total and lifetime ideation while also considering suicidal behavior within the past year. However, no differences were observed in reports of possible future attempt(s) and the disclosure of suicidal thoughts and behaviors to another person. Moreover, students presenting concurrent symptoms of insomnia reported significantly elevated levels of suicidal ideation relative to nonstudents. These outcomes highlight the possible role of insomnia symptoms in accentuating suicidal thoughts and behaviors in the student population.


Crisis ◽  
2020 ◽  
Vol 41 (3) ◽  
pp. 172-178
Author(s):  
Brooke A. Ammerman ◽  
Martha K. Fahlgren ◽  
Kristen M. Sorgi ◽  
Michael S. McCloskey

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.


Author(s):  
Robert J. Cramer ◽  
Andrea R. Kaniuka ◽  
Farida N. Yada ◽  
Franck Diaz-Garelli ◽  
Ryan M. Hill ◽  
...  

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