Group treatments for individuals at risk for suicide: A PRISMA scoping review (ScR).

BACKGROUND: This PRISMA scoping review explored worldwide research of interventions for suicide prevention delivered within a group setting. Research on group treatments underscores the importance of peer connection in diminishing social isolation and increasing social support. Additional benefits of group treatment include cost efficiency and maximization of staff time. However, the clinical outcomes of group treatments with individuals at risk for suicide are less understood and under researched. AIM: This scoping review had two objectives: 1) To identify existing group treatments where suicidal thoughts and behaviors are openly discussed; 2) To examine the outcomes of these identified treatments, with special attention to treatment integrity. METHOD: To address these aims the authors searched Medline (Ovid), Embase (Ovid), and PsycINFO (Ovid), on November 25, 2020. At the Full Text stage, articles were included that were peer reviewed, described a suicide specific group intervention and reported suicide specific outcomes. An additional requirement was open dialogue of suicide in the group intervention. RESULTS: Only ten research reports of suicide-specific group treatments were identified in our PRISMA-ScR. In spite of many differences in setting, population, length, and frequency of sessions, all ten groups reported improvements in varying aspects of suicide symptoms. The only adverse impacts were reported by two studies wherein two (of 92) participants attempted suicide and a small number (7%) of adolescents reported feeling triggered with suicidal thinking during a session. Despite our focus on empirical data in this review, the methodological rigor of the studies evaluated was limited. CONCLUSION: Despite the paucity of group treatment research in which suicidal thoughts and behaviors are openly discussed, the outcomes of these treatments were promising in decreasing suicide risk. These results may be due to unfounded fears of contagion. Further implications of these findings are considered along with limitations that may have excluded clinical work from meeting inclusion criteria for this review. Nonetheless, this evidence suggests that, suicide-focused groups have great potential for prevention of suicidal symptoms and should be further expanded in the future.

Anomalous Amygdala Habituation to Unpleasant Stimuli Among Unmedicated Individuals With Borderline Personality Disorder and a History of Self-Harming Behavior.

Self-harming behavior (SB) is one of the diagnostic criteria for borderline personality disorder (BPD). However, it is not exhibited by all individuals with BPD. Furthermore, studies examining the neural correlates of SB in BPD are lacking. Given research showing that BPD patients have difficulty habituating to affective stimuli, this study investigated whether anomalous amygdala activation is specific to BPD patients with SB. The authors used fMRI to compare amygdala activation in BPD patients with SB (n = 15) to BPD patients without SB (n = 18) and healthy controls (n = 32) during a task involving pleasant, neutral, and unpleasant pictures, presented twice. BPD patients with SB demonstrated greater amygdala activity during the second presentation of unpleasant pictures. Results highlight neurobiological differences in BPD patients with and without SB and suggest that anomalous amygdala habituation to unpleasant stimuli may be related to SB.