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1.
J Interpers Violence ; : 8862605241257599, 2024 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-38872339

RESUMO

Sexual victimization is a serious public health crisis affecting college students, with high rates reported among both women and men. Sexual consent education is crucial as it defines sexual assault and is linked to reduced risk of victimization. Rape myths and stereotyped beliefs shifting blame to survivors are established risk factors for sexual violence. Comprehensive sexual education can mitigate these attitudes, fostering a supportive environment for survivors. However, most high school students in the United States receive abstinence-based or abstinence-plus education, which uses unstandardized protocols and often lacks information about sexual consent. The following study explores the influence of high school sexual education on past sexual victimization and rape myth acceptance in college students. Six hundred sixty-four undergraduate students participated in an online survey through a university participant pool. Results show that those who received comprehensive sexual education were more likely to understand sexual consent and were less likely to endorse past sexual victimization. In contrast, students without comprehensive sexual education reported lower satisfaction with their sexual education and greater acceptance of rape myths. Despite limitations in the study's sample and reliance on self-reporting, this research highlights the importance of implementing comprehensive sexual education, including consent education, in high schools. Policymakers and educators must recognize the influence of comprehensive sexual education in promoting healthy relationships and combating sexual assault. As a significant public health concern, incorporating standardized sexual consent education into high school curricula can equip students with the knowledge and skills to make informed decisions about their sexual health and relationships. Future research should explore diverse populations and the mediating role of related factors that may further influence these relationships. These efforts will contribute to fostering a safer environment within educational institutions and combating sexual assault.

2.
Arch Suicide Res ; : 1-17, 2024 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-38726680

RESUMO

Despite the far-reaching impact of suicide on our communities, suicide prevention has historically focused on distally related risk factors for suicidality, which gives us an incomplete picture of how someone comes to make a suicide attempt. Instead, our focus needs to extend to research that explains the maintenance and progression from an emotional state to a suicidal crisis. One such factor, rumination, may create or worsen suicidal thinking by amplifying the distress associated with negative thoughts. Ruminative thoughts are often described as difficult to control, and people may think about suicide as an escape from these uncontrollable thoughts. The current study examined the relationship between severity of lifetime suicidal thinking and certain forms of rumination (i.e., brooding, reflection, anger rumination, and suicidal rumination) in a sample of 145 undergraduate students with suicidal thoughts. For each form of rumination that was related to suicidal thinking, we then examined whether that relationship was accounted for by perceived uncontrollability of one's own thoughts. We found that all forms of rumination were related to severity of lifetime suicidal thinking, as well as heightened perceived inability to control one's own thoughts. This thought control inability helped account for the relationships between brooding, reflection, and anger rumination with severity of suicidal thinking, but did not play a role in the relationship between suicidal rumination and suicidal ideation severity. Clinicians should be aware of the impact ruminative thoughts may have on suicidal thinking. More research needs to be done to replicate and extend these effects.


Brooding, reflection, anger rumination, and suicidal rumination were examined.All subtypes of rumination were related to suicidal ideation and thought control.All but suicidal rumination were related to ideation through thought control.

3.
Front Cell Neurosci ; 18: 1396387, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38774486

RESUMO

Presbycusis is one of the most prevalent disabilities in aged populations of industrialized countries. As we age less excitation reaches the central auditory system from the periphery. To compensate, the central auditory system [e.g., the inferior colliculus (IC)], downregulates GABAergic inhibition to maintain homeostatic balance. However, the continued downregulation of GABA in the IC causes a disruption in temporal precision related to presbycusis. Many studies of age-related changes to neurotransmission in the IC have therefore focused on GABAergic systems. However, we have discovered that dense core vesicles (DCVs) are significantly upregulated with age in the IC. DCVs can carry neuropeptides, co-transmitters, neurotrophic factors, and proteins destined for the presynaptic zone to participate in synaptogenesis. We used immuno transmission electron microscopy across four age groups (3-month; 19-month; 24-month; and 28-month) of Fisher Brown Norway rats to examine the ultrastructure of DCVs in the IC. Tissue was stained post-embedding for GABA immunoreactivity. DCVs were characterized by diameter and by the neurochemical profile (GABAergic/non-GABAergic) of their location (bouton, axon, soma, and dendrite). Our data was collected across the dorsolateral to ventromedial axis of the central IC. After quantification, we had three primary findings. First, the age-related increase of DCVs occurred most robustly in non-GABAergic dendrites in the middle and low frequency regions of the central IC during middle age. Second, the likelihood of a bouton having more than one DCV increased with age. Lastly, although there was an age-related loss of terminals throughout the IC, the proportion of terminals that contained at least one DCV did not decline. We interpret this finding to mean that terminals carrying proteins packaged in DCVs are spared with age. Several recent studies have demonstrated a role for neuropeptides in the IC in defining cell types and regulating inhibitory and excitatory neurotransmission. Given the age-related increase of DCVs in the IC, it will be critical that future studies determine whether (1) specific neuropeptides are altered with age in the IC and (2) if these neuropeptides contribute to the loss of inhibition and/or increase of excitability that occurs during presbycusis and tinnitus.

4.
Cogn Behav Ther ; 53(2): 171-189, 2024 03.
Artigo em Inglês | MEDLINE | ID: mdl-37960947

RESUMO

Firefighters are frequently exposed to trauma and may experience a unique symptom presentation of post-traumatic stress. Prior research has identified stronger associations between certain post-traumatic stress symptoms (e.g. detachment, intrusions, physiological reactivity) using network analysis. However, little is known about the effects of symptom severity and emergency work-related trauma on symptom networks. The present study probed the network structure of post-traumatic stress symptoms in trauma-exposed firefighters (N = 871) to model the dynamic interactions of psychological symptoms. We developed a network of post-traumatic stress symptoms and a network of post-traumatic stress with clinical covariates and used moderated network modelling to assess the effects of having PTSD and experiencing work-related trauma on the networks. We identified high edge correlations between several nodes (e.g. startle/hypervigilance, internal/external cue avoidance, detachment/lack of interest) and high centrality of detachment, external cue avoidance, and flashbacks. Additionally, having PTSD moderated positive network associations between risk-taking and suicidality and between distorted blame and post-traumatic cognitions. Work-related trauma moderated negative associations between appetite gain and loss and appetite loss and suicidality. Findings suggest that targeting specific symptoms of detachment, external cue avoidance, and flashbacks could allow for the development of effective trauma-informed interventions for these populations.


Assuntos
Bombeiros , Transtornos de Estresse Pós-Traumáticos , Humanos , Transtornos de Estresse Pós-Traumáticos/psicologia , Bombeiros/psicologia , Ansiedade , Ideação Suicida
5.
Int Psychogeriatr ; : 1-14, 2023 Aug 29.
Artigo em Inglês | MEDLINE | ID: mdl-37642013

RESUMO

OBJECTIVES: To examine the relationship between childhood traumatic experiences and early and late-onset suicidal behavior among depressed older adults. DESIGN: Cross-sectional study. SETTING: Inpatient and outpatient psychiatric services in Pennsylvania. PARTICIPANTS: Our sample included 224 adults aged 50+ (M ± SD = 62.5 ± 7.4) recruited into three depressed groups: (1) 84 suicide attempters, (2) 44 suicide ideators, and (3) 58 non-suicidal comparisons, and a non-psychiatric healthy comparison group (N = 38). MEASUREMENTS: The Childhood Trauma Questionnaire measured experiences of childhood trauma such as emotional abuse, physical abuse, emotional neglect, physical neglect, and sexual abuse. RESULTS: Attempters were separated into early- and late-onset based on age of first attempt using a statistical algorithm that identified a cutoff age of 30 years old. Overall, we found group differences in emotional and physical abuse and neglect in both genders and sexual abuse in females, but not in males. Early-onset attempters experienced more childhood emotional abuse and neglect than late-onset attempters and were more likely to have experienced multiple forms of abuse. They also experienced more emotional abuse and neglect than all comparison groups. Consistently, early-onset attempters more often met criteria for current or lifetime PTSD relative to late-onset attempters and most comparison groups. Late-onset attempters had similar levels of childhood trauma as other depressed groups. CONCLUSIONS: Our study reaffirms that there are distinct pathways to suicidal behavior in older adults based on their age of first suicide attempt and that trauma experienced in childhood has long-lasting emotional and behavioral consequences, even into late life.

6.
J Adolesc ; 95(6): 1116-1126, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37118913

RESUMO

BACKGROUND: Concussions are associated with a variety of physical, cognitive, and mental health impairments. If sustained during adolescence, a time when the brain is undergoing development, the risk of long-term impairments becomes heightened. This is a notable subject for investigation as many concussions are sustained among adolescents during high school sports and other physical activities. METHODS: We used data from the 2019 United States Youth Risk Behavior Survey to investigate the association between concussions and suicidality (i.e., suicide ideation, planning, and attempts), suicide capability (i.e., physical fighting and weapon carrying), and hopelessness, a risk factor for suicide. We utilized a cross-sectional design and used multivariate regression models and t tests for analysis. RESULTS: Participants were 1754 adolescent students who sustained a concussion during the prior year (54.61% male; M age = 15.94) and 9795 adolescent students who did not sustain a concussion during the prior year (47.27% male; M age = 15.95). Females were less likely (13.23%) than males (17.12%) to report at least one concussion in the past 12 months. Both male and female students who had experienced a concussion were more likely to report physical fighting, weapon carrying, and hopelessness. Male students with a concussion history were also more likely to report suicide attempts than male students without a concussion history. CONCLUSION: Findings indicate that concussions are associated with an increased risk of suicide attempts, suicide capability, and hopelessness among male adolescents and suicide capability and hopelessness among female adolescents. They further suggest a need for additional mental health support and safety policies for student-athletes and other at-risk adolescents.


Assuntos
Traumatismos em Atletas , Concussão Encefálica , Suicídio , Humanos , Adolescente , Masculino , Feminino , Estados Unidos/epidemiologia , Estudos Transversais , Concussão Encefálica/epidemiologia , Exercício Físico , Atletas/psicologia
7.
J Clin Psychiatry ; 84(2)2023 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-36791367

RESUMO

Objective: In young and middle-aged adults, suicidal ideation is an important predictor of prospective suicide attempts, but its predictive power in late life remains unclear. In this study, we used Latent Profile Analysis (LPA) in a cohort of depressed older adults to identify distinct ideation profiles and their clinical correlates and test their association with risk of suicidal behavior longitudinally.Methods: A total of 337 depressed older adults (aged 50-93 years) were assessed for suicidal ideation and behavior for up to 14 years (median = 3 years), at least once per year (study period: 2002-2020). LPA was used, which derived 4 profiles of ideation scores based on subject-level aggregates. Groups were compared using analysis of variance (ANOVA) and χ2 tests at baseline and competing risk survival analysis during follow-up.Results: Ideation showed significant decline over time, on average (P < .001). LPA identified 4 suicidal ideation profiles. Risk of suicide attempt/death was higher for chronic severe ideators (age-adjusted hazard ratio [HR] = 5.75; 95% CI, 2.25-14.7; P < .001) and highly variable ideators (HR = 3.21; 95% CI, 1.03-10.1; P = .045) compared to fast-remitting ideators, despite comparable current ideation severity at baseline. Fast-remitting ideators had higher risk than low/non-ideators with no attempts or suicides (P < .001). Chronic severe ideators displayed the most severe dysfunction across personality, social characteristics, and impulsivity measures, whereas highly variable and fast-remitting ideators displayed specific deficits.Conclusions: Assessing suicidal ideation over months/years has clinical relevance, as it enabled the identification of distinct ideation patterns associated with substantive differences in clinical presentation and risk of future suicidal behavior despite similar ideation levels at baseline.


Assuntos
Ideação Suicida , Tentativa de Suicídio , Pessoa de Meia-Idade , Humanos , Idoso , Depressão/complicações , Estudos Prospectivos , Personalidade , Fatores de Risco
8.
Am J Geriatr Psychiatry ; 31(6): 415-424, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-36682987

RESUMO

OBJECTIVE: Suicide is an outcome arising from a combination of risk and protective factors. Examining psychological resilience traits associated with successful aging may help to better understand late-life suicide and depression. We examined self-reported protective factors including mindfulness, life satisfaction and engagement, flourishing, and subjective and objective social support in a high suicide-risk sample of depressed older adults. METHODS: Participants were 297 individuals aged 55+ (mean age: 64.2): 92 depressed suicide attempters, 138 depressed individuals who never attempted suicide, and 67 non-psychiatric comparisons. Using linear and binomial logistic regression, we examined the effects of a combined Protective Factor value on presence and severity of depression and suicidal ideation, and history of suicide attempt. RESULTS: Relative to the non-psychiatric comparison group, all depressed participants had significantly lower Protective Factor values. Higher Protective Factor value was associated with lower likelihood of depression, depression severity, and likelihood of ideation, but was not associated with ideation severity or history of suicide attempt. Participants with one standard deviation higher Protective Factor had lower odds of ideation incidence by a factor of OR=0.68 (95%CI=0.48-0.96). CONCLUSION: Resiliency characteristics relevant to psychological wellbeing and successful aging may mitigate the emergence of depression and suicidal ideation, as well as the severity of depression in late-life. The Resilience Factor used in this study can help clinicians nuance their appraisal of depression and suicide risk.


Assuntos
Atenção Plena , Tentativa de Suicídio , Humanos , Idoso , Tentativa de Suicídio/prevenção & controle , Tentativa de Suicídio/psicologia , Ideação Suicida , Depressão/epidemiologia , Depressão/psicologia , Satisfação Pessoal , Fatores de Risco
9.
Drug Alcohol Depend ; 241: 109677, 2022 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-36334469

RESUMO

BACKGROUND AND AIMS: Firefighters are at heightened risk for developing alcohol use disorder (AUD), possibly due to chronic stress and exposure to potentially traumatic events. Daily trauma experiences and transdiagnostic risk factors (i.e., anxiety sensitivity and distress intolerance) are related to posttraumatic stress and depressive symptoms, as well as alcohol use severity and alcohol as a coping strategy. Although alcohol use has been identified as a key target for addressing mental health in firefighters, prior research has not fully integrated transdiagnostic vulnerabilities, internalizing symptoms, posttraumatic stress symptoms, alcohol coping, and overall alcohol use into a dynamic network model. METHODS: We assessed the symptom structure of overall alcohol use in firefighters with a likely AUD and transdiagnostic risk factors in all firefighters using network analysis. RESULTS: Failing to meet expectations (Expected Influence [EI]: 1.32), morning dependence (EI: 1.07), and guilt about drinking (EI: 1.10) were most central to the network model developed for firefighters with a likely AUD. In a transdiagnostic model of use in firefighters overall, anxiety sensitivity cognitive concerns (EI: 1.48) and negative alterations to cognitions and mood related to trauma (EI: 1.87) had the highest influence on the network. Notable correlations were also identified between trauma arousal and overall alcohol use, between depression and alcohol coping motives, and between trauma avoidance and alcohol coping motives. CONCLUSIONS: Alcohol use behaviors may follow a unique etiologic pathway in firefighters and intervention strategies should target factors found to be more central to symptom networks.


Assuntos
Alcoolismo , Bombeiros , Transtornos de Estresse Pós-Traumáticos , Humanos , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Bombeiros/psicologia , Ansiedade/epidemiologia , Ansiedade/psicologia , Alcoolismo/epidemiologia , Alcoolismo/psicologia , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia
10.
J Psychiatr Res ; 154: 252-260, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35961181

RESUMO

Predictive models using traditional statistical methods have largely failed to describe suicide etiology. Network theory, which conceptualizes factors as mutually interacting, reinforcing elements of a complex outcome, can model relationships between transdiagnostic and neurocognitive vulnerability factors. The present study used a network approach to produce an atheoretical model of psychological factors and their interrelationships within a population of ideators and non-ideators. We developed two network models (i.e., suicidal ideators and psychiatric controls) describing the relationships between a diverse set of risk factors and symptom measures for a population of psychiatric outpatients. We compared networks using three measures of network structure (i.e., network structure invariance, global strength invariance, edge invariance) and described the differences. Network structures for ideators (N = 229) and non-ideators (N = 454) were stable and accurate. In non-ideators, cognitive-affective depression symptoms (Expected Influence [EI]: 2.06), trauma avoidance (EI: 1.08), and negative affect (EI: 0.81) were most influential to the psychological network. In ideators, cognitive-affective depression symptoms (EI: 1.77), intolerance of uncertainty-negative self-referent implications (EI: 1.29), and negative affect (EI: 1.19) were most influential. Invariance testing did not indicate significant differences in overall network structure between ideators and non-ideators (p = .111), but did indicate significant differences in node strength (p = .013). Significant differences in node EI were detected for intolerance of uncertainty-negative self-referent implications, anxiety sensitivity physical concerns, thwarted belongingness, worry, and negative affect. These findings indicated differences in network structures for suicidal psychiatric outpatients and provide crucial directions for future research on therapeutic targets for suicidal thoughts and behaviors.


Assuntos
Tentativa de Suicídio , Suicídio , Humanos , Pacientes Ambulatoriais , Fatores de Risco , Ideação Suicida , Suicídio/psicologia , Tentativa de Suicídio/psicologia
11.
J Affect Disord ; 295: 123-130, 2021 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-34425314

RESUMO

BACKGROUND: Studies of risk factors for suicidal behavior are typically restricted to narrow age ranges, making it difficult to determine if they have the same relevance or potency across the full adult lifespan. METHODS: This study examined selected clinical and neurocognitive risk factors for suicidal behavior - borderline personality traits, aggression, depressive rumination, memory performance, and language fluency- in a multi-site sample (N = 309, ages 16-80) of depressed patients with a recent (last 5 years) suicide attempt or no history of attempt, and demographically similar non-psychiatric controls. We examined cross-sectional age and attempter/non-attempter differences on these risk factors, and whether certain risk factors were more prominent discriminators of past suicide attempt earlier or later in the lifespan. Correlations with age were computed, and logistic regression was used to classify attempter status based on each risk factor and its interaction with age. RESULTS: Nearly all risk factors were negatively correlated with age. Borderline traits, aggression, memory, and category fluency each predicted attempter status (p < 0.05), but these effects were not different across ages. In contrast, the association between rumination and suicide attempt status differed across the lifespan, becoming a stronger discriminator of past suicidal behavior at older ages. LIMITATIONS: The cross-sectional design limits our developmental findings. CONCLUSIONS: Despite age-related changes in symptom severity or neurocognitive performance, key risk factors for suicidal behavior previously identified in studies with more restricted age-ranges are salient throughout the adult lifespan. In contrast, depressive rumination may be particularly salient in later life.


Assuntos
Depressão , Tentativa de Suicídio , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Depressão/epidemiologia , Humanos , Longevidade , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Fatores de Risco , Adulto Jovem
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