Changes in Daily Behaviors and Cognitions During the COVID-19 Pandemic: Associations With Suicide Crisis Syndrome and Suicidal Ideation

The COVID-19 pandemic resulted in drastic disruptions to lives and possible pernicious impacts on mental health, including suicidality. Understanding these relations, as well as impacts on at-risk populations, is essential. The present study examined changes in daily behaviors and cognitions after the implementation of physical/social distancing mandates in individuals with symptoms of suicide crisis syndrome (SCS) and/or suicidal ideation. Adults (N = 5,528) across 10 countries completed online self-report measures. There were significant main effects of time and various configurations of interactions between time, SCS, and suicidal ideation in predicting behaviors (outdoor and social engagements) and cognitions (thoughts about health, finances, and living situation). Cross-culturally, individuals with more severe SCS symptoms generally had the largest changes in behaviors and cognitions, though this effect was not replicated across all countries. Overall, these findings highlight the implications of the potentially mutually exacerbating influences of routine disruptions and suicide risk and the importance of examining associations cross-culturally.

Cross-national presence and sociodemographic correlates of the suicide crisis syndrome.

BACKGROUND: The Suicide Crisis Syndrome (SCS) has been proposed as an acute, pre-suicidal mental state that precedes imminent suicidal behavior; however, its cross-national applicability and sociodemographic correlates have not yet been determined. The present study assessed the presence and severity of the SCS in ten countries and examined several potential sociodemographic correlates (i.e., age, gender, marital status, race/ethnicity) of the SCS. METHODS: 5528 community-based adults across 10 participating countries provided information on their SCS symptoms and sociodemographic characteristics in an anonymous online survey obtained via convenience sampling during the first year of the COVID-19 pandemic. RESULTS: The SCS occurred cross-nationally, with rates ranging from 3.6% (Israel) to 16.2% (Poland). Those in the United States, South Korea, Poland, and Turkey had the highest severity of symptoms. Participants who were older, identified as cisgender men, and married tended to have lower rates of the SCS than their respective counterparts. There were minimal differences in the SCS by race/ethnicity. LIMITATIONS: These data were both cross-sectional and collected via convenience sampling, limiting generalizability of findings and information about the SCS's predictive utility. CONCLUSIONS: These findings support the cross-national presence of the SCS during the COVID-19 pandemic. Sociodemographic correlates aligned with those of suicidal behavior more generally, providing additional evidence for the concurrent/predictive validity of the SCS.

Associations between long-term and near-term stressful life events, suicide crisis syndrome, and suicidal ideation

The suicide crisis syndrome (SCS) and suicidal ideation (SI) are differentially linked to short-term suicide risk. Since both are theoretically and empirically linked to stressful life events, which have increased during the COVID-19 pandemic, a clear understanding of these processes may be essential for suicide prevention. Thus, the present study examined (a) associations between SCS, SI, and total number of stressful life events and (b) relations between specific types of stressful life events, SCS, and SI. Participants (N = 5,528) across 10 participating countries completed an anonymous online battery of self-report measures assessing stressful life events, SCS symptoms, and SI during the COVID-19 pandemic. In a negative binomial regression, the association between SCS and the total number of stressful life events was approximately two to three times stronger than that of the relation between SI and the number of stressful life events. Relationship-related and role/identity-related stressors were most consistently related to SCS and SI cross-nationally. Remaining vigilant of the link between stressful life events, SI, and SCS is imperative in preventing suicide. During the COVID-19 pandemic, SCS has a stronger relationship to stressful life events than SI in a way that appears relatively invariant to cross-cultural differences. SCS and SI may identify two divergent pathways to suicidal behavior. (PsycInfo Database Record (c) 2023 APA, all rights reserved)