Search Results (129)

Objectives: To analyze adolescent suicide rates during the COVID-19 pandemic, examine the relationship between bullying, cyberbullying, and suicidal behavior, and identify evidence-based prevention strategies. Methods: A systematic review of 26 peer-reviewed articles (published between 2020 and 2025) was conducted across five databases. Studies were appraised for quality using STROBE and SRQR guidelines. Results: The pandemic significantly impacted adolescent mental health, increasing depression, anxiety, and suicidal ideation, particularly among females and vulnerable populations. Notably, while traditional bullying decreased during school closures (78.2% reduction), cyberbullying reports saw a substantial increase (with a 264.4% spike documented in national helpline data). Key risk factors included social isolation, excessive social media use, pre-existing mental health conditions, and low socioeconomic status. Protective factors included family support and access to mental health services. Conclusions: COVID-19 created a significant adolescent mental health crisis. The shift to cyberbullying represents a critical emerging threat. Effective prevention requires a multitiered approach including universal screening, telehealth, and social–emotional learning programs while addressing the persistent shortage of mental health professionals. Full article

Black children and youth remain disproportionately represented within child welfare systems across Canada, yet limited research has examined how Black girls experience trauma within out-of-home placements and how these experiences shape mental health and suicidality. This qualitative study examines the experiences of Black young women who aged out of care in Ontario, Canada, and explores how cumulative and intersecting forms of trauma, affected their emotional well-being and mental health. Drawing on critical race theory, Black girlhood studies, and critical suicidology, the study conceptualizes trauma as relational, structural, and cumulative rather than as a singular event. Findings drawn from six out of 10 participants reveal five key themes: dysfunctional foster families and complex traumas; trauma of multiple placement; lack of mental health support for the initial and ongoing traumas they experienced while in care; and mental health impacts of out-of-home placements and exposure to traumas and suicide-related behaviours of other youth in care. The participants highlighted the links between their experiences in foster care and the increased risk of suicide-related thoughts and behaviours. The findings highlight the need for models of care that are racially affirming, trauma-informed, and culturally responsive for child welfare and mental health interventions for Black girls in out-of-home placements. The key limitation of the study is the small sample size. Full article

Adolescent suicide remains a critical public health concern, with rates continuing to rise globally. This study examined the role of strength development in mitigating suicide risk among youth receiving behavioral health services. Utilizing administrative data from a Midwestern state’s behavioral health authority, the study analyzed 391 adolescents aged 13–19 years (M = 16.34, SD = 1.51), including 244 girls (62.4%) and 147 boys (37.6%), who presented with recent suicidal ideation or behavior. Strength indicators included family strengths, interpersonal skills, optimism, educational support, vocational skills, talents and interests, spiritual or religious strengths, community involvement, relationship permanence, youth involvement in care, and natural supports. Latent Profile Transition Analyses identified two distinct strength groups: “usable strengths,” representing readily accessible protective factors, and “buildable strengths,” representing strengths requiring further development. Findings indicated that adolescents who transitioned from buildable to usable strengths experienced significantly lower suicide risk. Youth who maintained usable strengths across treatment also demonstrated substantially lower odds of suicide risk. Longer treatment duration was associated with lower suicide risk, whereas shorter treatment stays corresponded with elevated risk. Logistic regression analyses confirmed that maintaining or developing strengths related to social relationships, community connections, and supportive environments served as significant protective factors. These findings underscore the importance of integrating strength-based, relationship-centered, and community-informed approaches into behavioral health services to support resilience and reduce suicide risk among adolescents. Full article

Background: The psychological health of healthcare workers is a critical global public health concern. Identifying associated risk factors and their interrelationships is key to informing the development of effective interventions. This study aimed to construct a risk factor model for psychological health among healthcare workers and to examine the strength and patterns of associations between various factors and psychological health outcomes using structural equation modeling. Methods: A cross-sectional survey was conducted among 930 healthcare professionals. Structural equation modelling (SEM) was used to test the theoretical hypotheses, with bootstrapping used for path significance and multiple indicators multiple causes (MIMIC) models used for robustness validation. Results: The social environment and job demand risks were greater than the negative events and psychological adjustment risks. The final model explained 62.2% of the variance in psychological health. The social environment and organizational management functioned as distal risk factors, exerting indirect effects. Job demands, negative events, and job resource risks were associated with psychological health through psychological adjustment. Most of the hypothesized direct associations with the outcomes–burnout, anxiety, depression, suicidal ideation, and turnover intentions—were significant, except for the direct effects of job resource risk on anxiety and job demand/resource risk on suicidal ideation. MIMIC analysis confirmed the stability of the model. Conclusions: The proposed model clarifies how multilevel risk factors interact to affect healthcare workers’ psychological health. The findings support the development of comprehensive, prioritized interventions, including strengthened legal protections, dynamic staffing schemes in high-pressure departments, and routine psychological resilience training for staff. Full article

Non-suicidal self-injury (NSSI) is a significant public health concern among university students. Accumulating evidence suggests that deficits in executive function (EF) are associated with NSSI; however, little is known about how specific EF components relate to the specific psychological functions that motivate self-injury. This study aimed to investigate the fine-grained associations between EF dimensions and NSSI functions in university students with past-year NSSI using network analysis. Altogether, 1078 Chinese university students (82.6% female; Mage = 19.07, SD = 1.03) who had engaged in at least one NSSI behavior in the past year were enrolled. Executive function was assessed using the Adolescent Executive Function Scale, which measures three dimensions: inhibitory control, cognitive flexibility, and working memory. NSSI functions were assessed using the 19-item function subscale of the Adolescent Non-Suicidal Self-Injury Assessment Questionnaire. A Gaussian graphical model was used to estimate the network. Expected influence (EI) and bridge expected influence (BEI) were computed to identify core nodes and bridge nodes, respectively. Of the 231 possible edges, 117 (50.65%) were non-zero, with the strongest within-community edge linking “coping with sadness and disappointment” (F3) and “expressing despair and hopelessness” (F4). Across communities, the most prominent edge was between “inhibitory control” and “having a desire to harm myself and cannot stop”. The three highest EI values were observed for “having a desire to harm myself and cannot stop,” “letting others make changes,” and “self-punishment”. “Inhibitory control” showed the highest BEI in the EF community, while “having a desire to harm myself and cannot stop” showed the highest BEI in the NSSI function community. Both EI and BEI demonstrated excellent stability (CS coefficients = 0.75). In university students with past-year NSSI, inhibitory control and the uncontrollable urge to self-injure function as critical bridge nodes linking executive dysfunction to NSSI functions, while self-punishment and interpersonal influence motives emerge as central drivers in the network. These findings highlight inhibitory control, the uncontrollable urge to self-injure, self-punishment, and interpersonal influence as promising targets for precision interventions aimed at disrupting the maladaptive cycle maintaining NSSI in this population. Full article

Negative emotion has been identified as a critical risk factor for suicidal ideation, yet the interpersonal psychological mechanisms underlying this association remain poorly understood among Chinese migrant workers, a population characterized by social marginalization and heightened vulnerability. Guided by the interpersonal theory of suicide, the present study examined the relationship between negative emotion and suicidal ideation and further investigated whether meaning in life and social connectedness functioned as sequential mediators in this relationship. A total of 739 migrant workers from Beijing and Shanxi Province completed self-report questionnaires assessing negative emotion, meaning in life, social connectedness, and suicidal ideation. The results indicated that negative emotion was positively associated with suicidal ideation, whereas higher levels of meaning in life and social connectedness were associated with lower suicidal ideation. Mediation analyses demonstrated that meaning in life and social connectedness partially mediated the link between negative emotion and suicidal ideation, both individually and sequentially. These findings elucidate an interpersonal psychological pathway through which negative emotion may be associated with heightened suicidal ideation by eroding intrapersonal meaning and interpersonal connectedness. Interventions aimed at enhancing meaning in life and strengthening social connectedness may hold promise for mitigating suicide risk among this vulnerable population. Full article

Prospection bias (PB) plays a crucial role in the development and maintenance of depression. However, the symptom-level mechanisms linking specific depressive symptoms to distinct PB components remain unclear, limiting the precision of targeted interventions. This study employed a network analysis approach to elucidate the intricate symptom-level relationships between depression and PB in a large sample of 1162 university students (453 males and 709 females; mean age = 19.47 years, SD = 1.45). Participants completed self-report assessments of depressive symptoms and prospection bias. The network demonstrated high stability. Central symptoms within the depression–PB framework were identified as “suicidal ideation”, “blurry future imagery”, “lack of energy”, and “catastrophic negative future thinking”. Critically, “suicidal ideation”, “future imaginations of self-harm/suicide”, and “guilt” served as the pivotal bridge symptoms connecting depression and PB. The Network Comparison Test revealed no significant gender differences in network structure. These findings highlight that current suicidal ideation and future-oriented suicidal imagery may serve as key nodes in the network of depressive symptoms and prospection bias. The results may help inform early identification and targeted intervention among at-risk university students. Full article

Early detection of suicidal ideation and depressive risk remains a critical challenge, particularly when individuals express distress implicitly through metaphorical or obfuscated language. Existing approaches primarily rely on explicit linguistic signals, limiting their effectiveness in real-world settings. This paper proposes a unified multi-aspect transformer-based framework that integrates multi-source learning, multi-task optimization, affective feature fusion, and adversarial training to detect implicit psychological risk indicators in textual data. The model jointly learns suicidal ideation detection, depression severity classification, and perceived threat detection, while incorporating emotional representations derived from valence, arousal, and polarity signals. To improve robustness, an adversarial training strategy is employed to simulate obfuscated expressions, enhancing robustness and generalization under linguistic perturbations. Interpretability is ensured through a hybrid explainable AI approach combining attention mechanisms and SHAP-based feature attribution. Extensive experiments conducted on four benchmark datasets demonstrate that the proposed approach achieves state-of-the-art performance (F1-score = 0.91), with statistically significant improvements over strong baselines. Additional analyses, including ablation studies, adversarial evaluation, and calibration assessment, confirm the effectiveness, robustness, and reliability of the proposed framework. These results highlight the potential of the model for deployment in high-stakes applications such as clinical triage and online risk monitoring, where early and interpretable detection of concealed psychological distress is essential. Full article

Background/Objectives: Adolescent psychiatric inpatient units play a critical role in the management of severe psychiatric disorders and suicide risk. However, limited evidence exists regarding the clinical and familial factors that simultaneously influence suicidal ideation and treatment outcomes in hospitalized adolescents. This study aimed to identify demographic, diagnostic, and clinical predictors of suicidal ideation and clinical improvement among adolescents hospitalized in a tertiary child and adolescent psychiatry inpatient unit. Methods: This retrospective observational study included 75 adolescents aged 12–18 years who were hospitalized in a tertiary child and adolescent psychiatry inpatient unit between November 2023 and June 2025. Sociodemographic and clinical characteristics were obtained from medical records. Clinical improvement was evaluated using the Clinical Global Impression–Improvement (CGI-I) scale. Group comparisons were conducted using chi-square or Fisher’s exact tests for categorical variables and the Mann–Whitney U test for continuous variables. Multivariate logistic regression analyses were performed to determine independent predictors of suicidal ideation and clinical improvement. Results: Clinical improvement was evaluated in the full sample of adolescents (n = 75), and longer length of stay was independently associated with clinical improvement during hospitalization. Among adolescents admitted with suicidal ideation (n = 45), major depressive disorder, previous suicide attempt, irritability at admission, and fewer siblings were identified as independent predictors of suicidal ideation. In addition, female adolescents had higher rates of suicide attempts and non-suicidal self-injury, whereas psychotic disorders were more common among male adolescents. Conclusions: Suicidal ideation in hospitalized adolescents is strongly associated with affective pathology and prior suicidal behavior. Longer inpatient treatment duration appears to facilitate clinical improvement. These findings highlight the importance of early suicide risk stratification and adequate treatment duration in adolescent psychiatric inpatient care. Full article

Introduction: Increasing rates of youth suicide are a growing concern worldwide. The single highest risk factor for suicide is a prior suicide attempt; however, knowledge around the broader factors that may increase the likelihood of the initial suicide attempt is limited. Understanding these risk factors is critical for clinicians to inform the development of early intervention strategies. This study examines the characteristics of a specific cohort of young people attending a tertiary mental health service in Melbourne, Victoria, following a suicide attempt or with persistent suicidal ideation. Method: A file audit of all young people attending the service was conducted from the commencement of the new service in 2022 through to the end of 2024. One hundred and seventy-one files were examined for specific data, including items such as age, gender, gender diversity, socio-economic factors and neurodivergence. Results: One-sample z proportion tests showed significantly higher proportions of young people who were LGBTIQIA+, transgender, gender diverse or non-binary (TGDNB), neurodivergent, not engaged in employment, education or training (NEET), and international students in the clinical cohort compared with the Australian population. Almost one-fifth of the cohort reported a history of trauma. Discussion: The study provides insight into characteristics observed among a cohort of suicidal young people. Findings highlight that young people from several marginalised groups were more frequently observed in this clinical cohort. The findings have implications for youth mental health services, supporting earlier identification of potential factors associated with suicidality so that prevention strategies can be implemented in a timely manner. Full article

Social media platforms contain rich but noisy narratives of psychological distress, creating opportunities for early mental health risk detection. However, existing datasets capture heterogeneous constructs such as suicide risk severity, depression diagnosis, and DSM-5 symptom presence, and most prior models are trained and evaluated on a single corpus, limiting their clinical alignment and cross-dataset generalizability. In this study, we fine-tune a domain-specific long-document transformer, AIMH/Mental-Longformer-base-4096, for binary mental health risk detection (risk vs. no risk) using two clinically aligned Reddit datasets: the C-SSRS Reddit corpus and the eRisk 2025 depression dataset. To handle long user histories, we introduce an LLM-based summarization pipeline that compresses posts exceeding 2000 tokens while preserving mental health-relevant information. We also conduct a seven-configuration ablation study across combinations of three corpora (C-SSRS, eRisk, and ReDSM5) to examine how dataset semantics influence model performance. On a held-out C-SSRS + eRisk test set (n = 279), the proposed model achieves a mean balanced accuracy of 0.89 ± 0.01 across five random seeds, with a best run of 0.90 and a 5.74 percentage point improvement over the strongest baseline (TF-IDF + Random Forest). The model also shows strong cross-platform generalization, achieving BA = 0.78 on the depression-reddit-cleaned dataset (n = 7731) and BA = 0.85 (ROC-AUC = 0.92) on a Twitter suicidal-intention dataset (n = 9119) without additional fine-tuning. The ablation analysis shows that although a three-dataset configuration (C-SSRS + eRisk + ReDSM5) maximizes aggregate performance, the ReDSM5 labels encode symptom presence rather than clinical risk, creating a semantic mismatch. This finding highlights the importance of label compatibility when combining heterogeneous mental health corpora. Explainability analysis using Integrated Gradients and attention visualization shows that the model focuses on clinically meaningful expressions such as therapy references, diagnosis, and hopelessness rather than isolated keywords. These results demonstrate that clinically aligned long-context transformers can provide accurate and interpretable mental health risk detection from social media while emphasizing the critical role of dataset semantics in multi-corpus training. Full article

Background: Emotion regulation and attachment styles are interrelated and are critical factors in psychopathology and treatment outcomes, particularly in youths with suicidal behavior receiving psychiatric inpatient care. This study examined the influence of emotion regulation and attachment style on psychiatric hospitalization duration among adolescents admitted due to suicidal ideation or behavior. Methods: Participants included 79 Israeli adolescents (mean age 15.35 years, 87.3% female) admitted to a tertiary psychiatric inpatient unit following a suicidal crisis. Data was collected using the Difficulties in Emotion Regulation Scale (DERS), the Experience in Close Relationships Scale (ECR), the Screen for Child Anxiety-Related Emotional Disorders (SCARED), the Patient Health Questionnaire (PHQ-9), and the Columbia-Suicide Severity Rating Scale (C-SSRS). Data were analyzed using correlation and multiple regression analyses. Results: Analysis revealed that greater emotion regulation difficulties predicted longer hospitalization duration (β = 0.41, p < 0.001), while avoidant attachment style was associated with shorter hospitalization duration (β = −0.35, p < 0.001). Notably, the level of suicidality as well as psychopathology symptoms (depression and anxiety) did not predict hospitalization duration. Conclusions: These findings underscore the important role of emotion regulation and attachment style in determining treatment duration in suicidal adolescents, beyond the severity of psychopathology and suicidality, suggesting their unique contribution to treatment planning. Clinical interventions targeting emotion regulation and attachment styles could enhance inpatient care effectiveness, offer a more personalized treatment approach and potentially reducing hospitalization duration. Full article

Background: Cyberbullying has emerged as a major public health concern with profound psychological repercussions on the adolescent population. The shift toward virtual communication has fundamentally altered interpersonal dynamics, removing the spatio-temporal barriers of aggression and creating new challenges for mental health. Methods: A systematic review was conducted following PRISMA 2020 guidelines, including a comprehensive update executed in February 2026. Searches were performed across PubMed, EBSCO, Web of Science, and Scopus. The review included observational and experimental studies involving adolescents (aged 10–19 years) reporting clinical mental health outcomes. Methodological quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools. Results: Forty-two high-quality articles were selected. Key findings include the following: Prevalence: A median cyber-victimization prevalence of 19.1% was identified, although significant methodological heterogeneity exists with ranges between 2.1% and 88.0%. Clinical Impact: Victims exhibited significantly elevated rates of depression (90%) and anxiety (87%) compared to uninvolved peers. Suicidality: Victimization is a critical risk factor, with suicide attempts reported in 19.0% of victims, compared to 3.0% in aggressors. Vulnerable Groups: Adolescents with autism spectrum disorder (ASD) demonstrated extreme vulnerability, with victimization rates between 64.1% and 68.9%. Additionally, females and LGBTQ+ youth showed a higher risk of symptom internalization and post-traumatic stress. The Role of the Bystander: Observers experienced fear, moral frustration, and helplessness, acting as either passive reinforcers or active upstanders depending on the school climate. Conclusions and Implications: Effective prevention requires a socio-ecological approach that transcends the classroom, integrating families, healthcare centers, and technological platforms. A transition toward modernized cyber-education is recommended, utilizing interactive tools and “serious games” to foster empathy. Full article

Background/Objectives: Suicidal ideation and non-suicidal self-injury (NSSI) among elementary school students represent critical public health concerns that require develop-mentally appropriate, evidence-informed school-based interventions. This study con-ducted a retrospective comparative analysis of two school-based approaches—Sandplay Therapy with Suicidal Ideation and Self-Injury-Focused Engagement (SPT-SAFE) and a School-based Dialectical Behavior Therapy-informed Brief Intervention (DBT-BI)—for elementary school students presenting with suicidal ideation and NSSI. The objective was to describe pre–post-changes in key outcomes within each intervention and to explore whether outcome trajectories differed between the two approaches in a non-randomized, real-world school-based setting. Methods: This retrospective study analyzed archival clinical records from 109 elementary school students (SPT-SAFE: N = 59; DBT-BI: N = 50) who received services at a school-based suicide prevention center in South Korea between 2022 and 2024. Seven validated outcome measures assessed suicidal ideation, NSSI frequency, depression, anxiety, aggression, impulsiveness, and self-concept at pre- and post-intervention. Pre–post-changes and exploratory between-group differences were examined using 2 × 2 mixed-design ANOVAs (Group × Time interaction), with baseline-adjusted ANCOVAs conducted as complementary analyses. Suicidal ideation was operationalized using the SIQ-JR total score, and NSSI was operationalized using the FASM summed frequency index. Results: Both interventions were associated with significant reductions in suicidal ideation (F = 29.98, p < 0.001, partial η² = 0.219) and NSSI frequency (F = 15.95, p < 0.001, partial η² = 0.130), with large within-group effect sizes and no significant Group × Time interactions. Accordingly, between-group differences were limited and should be interpreted as exploratory rather than comparative–effectiveness evidence. Modest between-group differences favoring DBT-BI were observed for self-concept outcomes (F = 4.14, p = 0.044, partial η² = 0.037; d = −0.39). Conclusions: These findings suggest that both interventions were associated with pre–post-improvements in suicidal ideation and NSSI frequency within a school-based clinical context. Full article

Background: Suicide remains a leading cause of death in the United States, with more than 49,000 fatalities in 2023. Rural counties consistently face higher suicide mortality rates than urban areas, reflecting deep-seated mental health inequities. Methods: This study analyzes 39 U.S. states with suicide mortality rates exceeding the national average, as defined by the Centers for Disease Control and Prevention (CDC) (>14.1 per 100,000), to examine rural–urban disparities and their intersectional demographic factors. Age-adjusted mortality data (2019–2023) from HDPulse were analyzed using IBM SPSS Statistics, version 31.0. Counties were classified by USDA Rural–Urban Continuum Codes and stratified by region, sex, age, and race. Subgroup differences were tested using a two-way ANOVA (p < 0.01). Results: Rural suicide rates were significantly higher than urban rates (28.69 vs. 20.20 per 100,000; p < 0.001). The West reported the highest mortality and widest rural–urban gap (38.23 vs. 24.83), while the Northeast had the lowest. Men had higher rates than women, particularly in rural settings (37.12 vs. 11.77). The largest rural–urban gap occurred among young adults (20–39 years). American Indian/Alaska Native populations experienced the highest rates (rural: 58.73; urban: 35.15). The literature review highlighted limited healthcare access, social stigma, substance use, and economic hardship as variables commonly associated with rural–urban differences in suicide mortality. Conclusions: Suicide mortality is markedly elevated in rural America across all subgroups, with the greatest risks among young adults, men, and American Indian/Alaska Native populations. Tailored prevention strategies and expanded mental health infrastructure are critical for high-burden states. Full article