Search Results (222)

Suicide is a substantial contributor to global mortality, with suicidal ideation (SI) a significant predictor of suicide. Research has demonstrated relationships between dispositional coping styles and SI. This study aimed to advance this research by examining the specific coping strategies people use when experiencing SI. Further, it assessed predicted use of coping strategies of people with a history of SI would differ from the actual coping strategies employed by people have experienced SI. Seventy-seven help-seeking adults (Mage = 31.6, SD = 10.4) with (n = 49) or without (n = 28) history of SI completed the Brief Coping Orientations to Problems Experienced (Brief COPE) adapted to SI-related coping and current emotional distress measured by the 21-item version of the Depression Anxiety Stress Scale (DASS-21). An ANCOVA, while controlling for current emotional distress levels, showed a greater predicted Problem-Focused coping use than actual use reported by participants with SI history. Facet-level ANCOVAs attributed this to differences in Active Coping, Use of Informational Support, and Planning strategies. There were no group differences in emotion-focused or avoidant coping. The preliminary findings suggest individuals without a history of SI may prognosticate more frequent use adaptive coping strategies, relative to how frequently people actually employ them during these times. Future research may examine the factors explaining these differences to help inform programs related to SI and coping. Full article

Objectives: To assess maternal readiness for newborn self-care and its associations with breastfeeding readiness and psychophysical condition in early postpartum rooming-in care. Methods: This cross-sectional study included 200 women at 48–72 h postpartum. Maternal readiness was assessed with three 0–10 self-report scales: daytime newborn care, nighttime newborn care, and breastfeeding readiness. Psychometric, pain, anxiety, obstetric, haemoglobin, and haematocrit data were analysed using stepwise ordinal regression with bootstrap sensitivity analyses. Results: Breastfeeding readiness was the strongest correlate of daytime and nighttime caregiving readiness, with a marked and partially non-linear gradient (OR ≈ 13 for linear trend, p < 0.001). Higher anxiety on day 2 was associated with lower readiness across all domains (daytime care: OR = 0.61; nighttime care: OR = 0.69; breastfeeding: OR = 0.73; all p < 0.001). Daytime readiness was associated with sleep disturbance (lower readiness; OR = 0.63, p = 0.006) and goal-directed behaviour despite low mood (higher readiness; OR = 1.47, p < 0.001). Nighttime readiness correlated with concentration under emotional strain (OR = 1.63, p < 0.001) and was reduced in women reporting suicidal ideation (OR = 0.24, p = 0.012). Breastfeeding readiness was associated with greater current engagement in breastfeeding (OR = 1.90, p < 0.001) and higher parity (OR = 2.46, p = 0.002), while sleep disturbance was associated with lower readiness (OR = 0.69, p = 0.013). Somatic factors and social support were not independent predictors, while psychological variables showed stronger associations with readiness. Conclusions: Maternal readiness for newborn self-care is related to breastfeeding readiness but remains a distinct, psychologically shaped construct. These findings question the assumption that breastfeeding readiness reflects readiness for continuous newborn care. Assessment of maternal readiness may help identify support needs and guide flexible postpartum care. Full article

Suicidal mental imagery are self-generated images of injury and death experienced across a range of mental health conditions, but also experienced in people who have no diagnosable mental health condition. For some, these images can be quite distressing and unwanted, but for others, these mental pictures serve to bring comfort and problem-solving capabilities. From a clinical and research perspective, they are not fully understood and are underexplored. Suicidal mental imagery is a known risk factor for attempted suicide due to imagery’s amplification and habituation effects, potentially moving a person from imagining suicide to acting on it. This paper presents a taxonomy of the different types of suicidal mental imagery from first-hand accounts extracted from phase one of a two-phase qualitative study called the suicidal mental imagery (SUMI) study. This taxonomy of imagery types is drawn from fifteen semi-structured interviews exploring imagery experiences in adults from Ireland. The characteristics of these images were analysed qualitatively using an Interpretive Description approach, with the resulting taxonomy developed through additional analytic processes informed by cognitive behavioural therapy (CBT) principles and a priori coding. The taxonomy, therefore, illustrates experiences from a rich dataset under distinct categories to improve our understanding of the key mechanisms underpinning suicidal mental imagery for practice, helping to assist open dialogue in imagery assessment to better inform suicide prevention interventions. Full article

Suicide is commonly approached through clinical and psychological frameworks centred on the individual, alongside social explanations emphasising collective conditions. These perspectives offer complementary leverage for understanding and preventing suicidal behaviour. Between these levels, a clinically decisive segment can be specified with greater precision for psychiatric practice, namely the processes through which suffering becomes speakable, socially legitimate and clinically actionable, or is displaced into self-censorship, isolation and delayed help-seeking. This paper advances a service-facing biosemiotic model of suicide risk that formalises this segment as a communicative infrastructure and links it to the public circulation of suicide narratives across media and digital environments. The model comprises two coupled modules. The first, the communicative-classification module, characterises labelling and delegitimation operations that allocate epistemic credibility to crisis talk, foster self-stigma and increase the social cost of disclosing suffering. The second, the public-feedback module, specifies how media representation and repetition regulate the symbolic availability of narrative scripts, with closure- and openness-oriented configurations positioned along the Werther–Papageno continuum. Coupling the modules yields testable propositions concerning mediation via anticipated sanction and moderation by stigma and speakability and identifies conditions under which protective content may show limited translation into help-seeking behaviour. Implications are outlined for how the model may inform therapeutic risk assessment, continuity of care, and prevention. These implications are framed as hypotheses and implementation-relevant considerations derived from the model, with emphasis on (i) operationalising speakability as a clinically evaluable dimension, (ii) identifying institutional conditions that may reduce the communicative cost of help-seeking, and (iii) aligning public communication strategies with international reporting standards. The model is intended to support future empirical testing rather than to establish effectiveness at this stage. Full article

Indigenous peoples in Amazonia face major mental health inequities, including high rates of suicidal behaviour among adolescents and young adults in some settings. We conducted a scoping review of the peer-reviewed literature on community health workers (CHWs) and equivalent cadres involved in Indigenous and remote contexts, with a focus on their roles in relation to mental health, psychosocial support, and suicide prevention among Indigenous populations in Amazonia and the Guiana Shield. We reported this review in line with PRISMA-ScR. Searches (September–November 2025) were conducted in PubMed/MEDLINE, Scopus, Web of Science and SciELO, complemented by targeted searches in major publisher platforms and JSTOR. We included English, French, Spanish and Portuguese publications that (i) described CHWs or functionally equivalent cadres in Indigenous/remote contexts and/or (ii) reported CHW-related roles, models, or experiences relevant to mental health, psychosocial support or suicide prevention in Amazonian settings. Global documentation of CHW designations used in Indigenous/remote contexts was compiled; we compiled evidence from Amazonia and the Guiana Shield on CHW roles, programme models, implementation conditions and reported outcomes. Data were charted into a structured template (cadre designation, setting, population, study type, functions, programme features and reported mental health/suicide-related outcomes) and synthesised descriptively and thematically. CHWs commonly function as cultural and linguistic brokers between Indigenous communities and biomedical systems, supporting early detection of distress, psychosocial accompaniment, referral navigation and dialogue with local healing practices. Reported programme models differ markedly: Brazil’s institutionalised Indigenous Health Agents (AIS) offer stability and formal recognition, whereas French Guiana relies more heavily on project-based mediation with innovative practices but greater funding fragility. The available literature remains heterogeneous and uneven across countries, with limited evaluative designs and substantial reliance on descriptive reports. Future work should prioritise stronger implementation and impact evaluation, alongside Indigenous-led governance and sustainable support for CHW cadres. Full article

Background/Objectives: Psychological pain—also termed psychache or mental pain—has been suggested to constitute a relevant factor in the emergence of suicidal behaviour. Despite conceptual advances, empirical research on interventions specifically designed to alleviate psychological pain in individuals who have attempted suicide remains scarce. The present scoping review maps existing psychological and pharmacological interventions targeting psychological pain, identifies their core components, delineates gaps for future research, and proposes a therapeutic intervention protocol. Methods: Literature was searched through PubMed, PsycInfo, and ClinicalTrials.gov (until October 2025) using combinations of the terms suicide, psychache, psychological pain, intervention, treatment, therapy, pharmacological treatment, and psychotherapy. Both randomised controlled trials, non-randomised controlled trials, and literature reviews were included. Results: Evidence indicates that few interventions explicitly target psychological pain. Most suicide-specific therapies indirectly address components of psychological pain—such as unbearable affect, loss of meaning, and social disconnection. Narrative-based, emotion regulation, and acceptance-based therapies appear promising. Emerging pharmacological approaches may relieve psychological pain; however, further evidence is required. Conclusions: Integrating psychological pain as a therapeutic focus—through narrative, tolerance-building, and relational strategies—may enhance post-attempt interventions. Future trials should systematically measure psychological pain and test its role as a mediator of suicidal outcomes. Full article

Background: Migration and place of birth are increasingly recognised as social determinants of health among sexual minority populations. Among men who have sex with men (MSM), being born outside the country of residence may shape access to healthcare, community resources, and social capital networks. In Japan, however, little is known about how being born outside Japan is associated with social capital, health behaviours, and mental health among MSM. Methods: Data were drawn from a large cross-sectional online survey conducted in 2025 of 8150 MSM living in Japan, recruited via community-based in-person outreach and targeted geo-social networking application advertisements. Multivariable logistic regression analyses examined associations between country of birth and social, behavioural, and health-related outcomes. Results: Foreign-born MSM were younger and more concentrated in the Greater Tokyo metropolitan region. Being born outside Japan was associated with higher odds of HIV testing across all timeframes and higher levels of both gay and heterosexual social capital. Foreign-born MSM were also more likely to have disclosed their sexuality to friends and family. However, they were less likely to be aware of LGBT or HIV prevention organisations, despite higher participation once engaged. No differences were observed in suicidal ideation or unprotected anal intercourse with casual partners, although foreign-born MSM were more likely to report unmet need for mental health care. Conclusions: Foreign-born MSM in Japan demonstrate strong engagement in HIV prevention and higher social capital, alongside persistent barriers to community awareness and mental health service access. These findings highlight the importance of addressing structural and informational barriers and supporting community-based organisations to improve equitable health and wellbeing outcomes among MSM in Japan. Full article

Background/Objectives: This study examined gender-specific psychological and interpersonal correlates of suicidal behaviour using the framework of the Interpersonal Theory of Suicide (IPTS). Methods: The study included a total of 181 respondents from a clinical group (N = 93) and a control group (N = 88). Logistic regression analyses were conducted separately for women (N = 86) and men (N = 80) for cases that met leverage values (LEV) ≤ 0.2. Variables included personality traits, coping style, hopelessness, self-esteem, hope, perceived burdensomeness, thwarted belongingness, and acquired capacity for suicide. Interaction terms were also tested. Results: Among women, hopelessness (Exp(B) = 1.37; p = 0.038) and perceived burdensomeness (Exp(B) = 1.12; p = 0.033) were identified as significant correlates of suicidal behaviour. Among men, an avoidance-focused style (Exp(B) = 1.18; p = 0.009) and the interaction of general capacity for suicide x perceived burdensomeness x thwarted belongingness (Exp(B) = 5.29; p = 0.043) emerged as significant correlates. Further analysis indicated that thwarted belongingness became a significant factor in men only when perceived burdensomeness and capacity for suicide were high (Nagelkerke R² = 0.33; Exp(B) = 1.17; p = 0.042). Conclusions: Gendered expressions of suicidality appear to follow distinct pathways. Within the IPTS framework, women’s suicidality is more closely shaped by internalized cognitive and affective processes, including hopelessness and perceived burdensomeness, whereas men’s behaviour is influenced by maladaptive coping, social disconnection, and acquired capacity for suicide. These findings highlight the importance of gender-specific prevention and intervention strategies across clinical and community contexts. Early identification of these correlates may reduce suicidal intent, prevent rehospitalization, and improve mental health outcomes. Full article

The mental health of people living in farming communities has been identified as an important public health issue. Cumulative exposure to a range of situational factors contributes to heightened risk of poor mental health and suicide. Access to evidence-based psychological treatments is limited by the availability of skilled mental health professionals. The aim of this trial—co-designed by members of the farming community—is to establish the feasibility of conducting randomised controlled, trial-testing, peer-worker-delivered Behavioural Activation in the farming community. We will undertake a single-blind, parallel group, randomised controlled feasibility trial in rural Australia. People living in farming communities aged over 15 years and experiencing moderate to moderately severe depression symptoms will be included in the trial. Participants will be randomly allocated on a 1:1 ratio to 10 sessions of peer-worker-delivered behavioural activation (Back-on-Track) or a self-help workbook (Managing Stress on the Farm). Peer workers are members of the farming community that have completed training in behavioural activation and demonstrated competence. Feasibility outcomes include establishing recruitment rates, willingness to be randomised, dropout rate from trial, acceptability of peer delivered behavioural activation, and willingness to complete trial measures. The trial will contribute high quality evidence of the feasibility of undertaking a full-scale, randomised controlled trial of peer-delivered Behavioural Activation in farming communities in rural Australia. Full article

Social acceleration and recurrent structural shocks increase habitus–field mismatch, yet similar exposure does not produce uniform trajectories of daily well-being or suicidal distress. This paper asks how comparable structural strain can generate divergent, path-dependent outcomes and why suicidal vulnerability may persist after objective conditions improve. We develop a theory-building, concept-driven framework that integrates Bourdieu’s practice theory with social and behavioural scholarship on stress, anomie, and despair, and conceptualises these dynamics as social hysteresis. The regime-based model specifies two ideal-typical response orientations through which mismatch can stabilise: an anomic regime marked by shame, withdrawal, and inwardly directed harm, and a radicalising regime marked by grievance framing, moral indignation, and organised participation, without implying violent extremism. Represented through hysteresis loops, the framework implies multistability, asymmetric switching thresholds, and scarring, providing a mechanism for persistence and non-linearity in distress trajectories. The model derives testable expectations for longitudinal panel and experience-sampling designs and suggests that prevention and intervention design should combine reductions in mismatch with relational and institutional infrastructures that facilitate regime shifts and reopen the space of possibles. Full article

Animals may offer vital psychosocial support, particularly for neurodiverse individuals. However, evidence surrounding the effects of pet ownership remains equivocal, especially in relation to cat–human dynamics. This study explored the relationship between cat–human-related factors (CHRFs) and psychological well-being in a sample of 127 adults, including individuals formally diagnosed with autism (30), ADHD (15), and/or co-occurring autism and ADHD (AuADHD; 22). Participants completed measures assessing neurodiverse traits, CHRF engagement, and symptoms of anxiety, depression, and suicidality. Spearman’s correlations analysed the relationships between CHRFs, neurodiverse traits, and well-being. Kruskal–Wallis tests established group differences in well-being and engagement in CHRFs between individuals with and without neurodevelopmental differences. The findings confirmed that autistic and ADHD traits were positively associated with greater anxiety, depression, and suicidality. Autistic individuals reported significantly elevated anxiety and depression; co-occurring diagnoses (AuADHD) were associated with heightened anxiety. Neurodiverse and neurotypical individuals demonstrated similar patterns of CHRF engagement. Several CHRFs, such as anxious cat behaviour, inability to provide for the cat, poor cat health, and close proximity, were linked to negative well-being outcomes. These findings highlight the nuanced, bi-directional nature of cat–human interactions, underscoring the importance of mitigating negative relational factors to support mental health in neurodiverse populations. Full article

Background and objectives: Suicide attempts and self-harm are critical issues in adolescence, often leading to serious and irreversible consequences. These behaviours frequently co-occur and share common biopsychosocial risk factors. Identifying these factors enables a more comprehensive assessment of suicide and self-harm risk, helping specialists recognize high-risk individuals and implement effective preventive measures. This study aimed to examine the association between suicide attempts, self-harm and psychosocial factors among hospitalized adolescents. Materials and methods: A retrospective data analysis was performed using the database of the University Department of Children and Adolescents of the Republican Vilnius Psychiatric Hospital. The study covered patients’ records from December 2022 to February 2025. Information on gender, age, suicide attempts, self-harm, adverse events (bullying, psychological abuse, physical violence within the family, and sexual abuse) and unhealthy habits (smoking, harmful alcohol consumption, and psychoactive substance use), was selected and analyzed in this study. A Chi-square test was used to assess the difference between groups. Results were considered statistically significant when p < 0.05. Results: The study included 599 hospitalized adolescents (26.9% boys; mean age 15.1 ± 1.4 years), of whom 70.8% reported at least one episode of self-harm and 37.8% at least one suicide attempt. Rates of self-harm and suicide attempts were significantly higher in girls than in boys (self-harm: 81.3% vs. 42.2%, $\varphi =0.381$, $p<0.001$; suicide attempts: 45.5% vs. 16.5%, $\varphi =0.304$, $p<0.001$), and adolescents with self-harm had a significantly higher prevalence of suicide attempts than those without self-harm (46.7% vs. 15.8%, $\varphi =0.308$, $p<0.001$). Adverse childhood experiences and unhealthy behaviours were significantly more frequent in adolescents with self-harm and suicide attempts, although effect sizes were small to moderate ($\varphi$ range 0.086–0.230, all $p<0.05$). In multivariable models, female gender ($\beta =0.355$, $p<0.001$) and smoking ($\beta =0.330$, $p<0.001$) were the strongest predictors of self-harm, whereas alcohol use ($\beta =0.337$, $p<0.001$) and self-harm ($\beta =0.232$, $p<0.001$). Conclusions: Exposure to adverse childhood experiences and engagement in unhealthy habits were associated with higher rates of both self-harm and suicide attempts. A comprehensive assessment and early detection of self-harm behaviours and adverse psychosocial circumstances are crucial elements of effective suicide prevention strategies and prompt intervention among high-risk adolescents. Full article

Background: Adolescence is a developmental phase characterised by profound biological, emotional and social changes and these changes make adolescents particularly vulnerable to the emergence of psychiatric disorders. In this context, gender differences in mental health disorders are of increasing clinical interest. Method: We conducted a scoping review of the literature regarding gender differences in psychiatric disorders during adolescence. Three databases, PubMed, Web of Science and EBSCO, were used to identify articles published in English from 2015 until 2025. Twenty-one studies fulfilled the inclusion criteria. Results: Ten studies deal with mood disorders, with a focus on gender differences in depression and anxiety during adolescence. Two articles analyse eating disorders, highlighting that girls show higher levels of food restriction and body dissatisfaction. Two studies focus on externalising and neurobehavioural disorders, showing a higher prevalence in boys than in girls. Four articles examine self-harm and suicidal behaviour, where girls report higher rates of suicidal ideation and self-harm. Finally, two studies address personality disorders in adolescence, noting a higher incidence of borderline traits and impulsive behaviour among girls. Conclusions: Research has revealed gender differences in the onset, frequency and factors associated with psychiatric disorders in adolescence. Understanding these differences is essential for developing prevention strategies, early diagnosis and specific interventions. Full article

Early detection of suicidal risk in adolescents requires valid tools adapted to the clinical and educational context. However, there are currently no observational scales developed specifically for use by significant people in the adolescent’s environment. Therefore, the aim of the present study was to design, validate and apply to a pilot sample an observational scale to identify behavioural and emotional signs of suicidal risk in adolescents, from the perspective of adolescents, parents and teachers. Validation study of an Observational Adolescent Suicide Risk Scale (EORSA) based on a theoretical review and expert consensus. Content validity was evaluated through expert judgement by professionals with recognised experience in mental health, psychometrics, and suicide prevention. The scale was subsequently applied to a sample of adolescents, parents and teachers, analysing the mean scores per item in each group. The final scale included 19 items with a high level of agreement among experts (content validity index > 0.80). When applied to the pilot sample, significant differences were observed in the items considered most frequent by each group. The EORSA is a valid and potentially useful tool for identifying signs of suicidal risk in adolescents from an observational perspective. Its design and application allow for a contextualised and multidimensional assessment, favouring preventive interventions adapted to each setting. Full article

Suicide in children and young adults is a leading cause of premature mortality, and there is a need to develop a more profound understanding of the factors that contribute to these deaths. This study is part of the nationwide Retrospective Investigation of Health Care Utilization in Individuals who died by Suicide in Sweden 2015, conducted at Lund University, Sweden. The aim was to examine symptoms and diagnoses in children and young adults who died by suicide, as documented in their medical records at their last visits for primary care, somatic specialist care, or psychiatric care 24 months prior to suicide, and to apply contemporary psychological research in youth suicidality to the findings to formulate clinical implications. The proportions of symptoms and diagnoses in children (0–17 years), young adults (18–24 years), males, and females are described. The main symptoms noted in the cohort were depressive symptoms (28%), anxiety symptoms (26%), and pain (25%). The diagnoses predominately covered mental and behavioural disorders, and the most frequent of the mental and behavioural diagnoses were neurotic, stress-related, and somatoform disorders (32%) and mood (affective) disorders (29%). The diagnoses and symptoms were not sufficient to uncover suicidality in children and young adults. The clinical implications for alternative assessments and preventive interventions are discussed. Full article