Associations Between PTSD Features and Firearm Ownership and Storage: Results From the PRImary Care Screening Methods (PRISM) Study.

INTRODUCTION: Veterans and active duty service members are significantly more likely to die by suicide using firearms compared to the general population. Not-secure firearm storage (e.g., keeping guns loaded/in an unlocked location) is associated with greater risk for suicide and a third of veteran firearm owners store at least 1 personal firearm unsecured. Veterans and active duty service members are also significantly more likely to be diagnosed with posttraumatic stress disorder (PTSD) than the general population. Symptoms of PTSD are divided into 4 criteria: reexperiencing, avoidance, negative affect, and hyperarousal. Research has suggested that endorsement of hyperarousal symptoms is positively associated with unsecure firearm storage and that avoidance symptoms might be negatively associated with unsecure storage practices. The present study examined the relationship between self-reported firearm ownership and storage practices among each item from the Primary Care PTSD Screening for DSM-IV-TR (PC-PTSD-IV) to explore associations between PTSD features and firearm ownership and storage. MATERIALS AND METHODS: Participants were recruited from primary care clinics across 5 military installations in the United States as part of a larger study (Mage = 45.4, SD = 16.9). Among participants (n = 2,685), most of our sample identified as male (51.3%) and white (67.3%) with 61.6% currently serving in the military, 16.8% retirees, and 21.6% family members. PTSD symptoms were assessed using the PC-PTSD-IV and a quarter met the clinical threshold for PTSD. Binomial and multinomial logistic regression analyses were used. RESULTS: Among completed responses, 989 (38.1%) people reported owning guns; among gun owners, 386 (39.0%) reported that they were loaded, and 352 (35.6%) reported they were loaded and unlocked. Endorsement of specific items on the PC-PTSD-IV, including those specific to hyperarousal and avoidance, was not significantly associated with storing firearms loaded and/or in nonsecure locations when controlling for military service. Non-responses to items around firearm storage practices were significantly associated with those individuals meeting the clinical threshold for PTSD according to the PC-PTSD-IV and participants currently serving had higher odds of storing at least 1 personal firearm loaded and both loaded and unlocked. CONCLUSIONS: Results from our study highlight similarities and departures from the previous literature on the connection between PTSD and non-secure firearm storage practices. Further research may examine (1) the relation between PTSD symptoms and firearm storage between active duty service members, retirees, and family members and (2) whether non-response to items regarding firearm ownership is systematic.

Firearm ownership factors and cognitive functioning: A preliminary study.

Recent studies have suggested that owning a firearm for the purpose of protection and intending to acquire a firearm within the next year are associated with disrupted cognitive-affective processes that may increase firearm suicide risk. Prior studies were limited by self-report measures and would benefit from the utilization of objective indicators of cognitive functioning to clarify associations between firearm ownership and cognitive-affective states. The present study examined objective cognitive performance in a sample of U.S. adults in relation to firearm ownership variables. Based on prior studies, we hypothesized that protective owners and individuals with the intention to acquire a firearm within the next year would demonstrate reduced performance on decision-making, mental flexibility, and emotional bias tasks. A total of 112 participants (61% female, 79% white) completed objective cognitive tasks following completion of a larger survey study through ResearchMatch. Results indicated that intention to purchase a firearm within the next year was not associated with cognitive functioning but was associated with an array of heightened psychiatric symptoms. Owning a firearm for the purpose of protection was associated with decreased mental flexibility relative to non-owners, but no differences were seen for decision-making or emotional bias. These findings represent the first attempt to examine underlying objective cognitive processes related to firearm ownership, and implications for future research are discussed.

Suicide-related cognitions and emotional bias performance in a community sample.

BACKGROUND: Suicide is theorized to be connected to social interactions and feelings of belongingness. Those with suicide-related cognitions (SRCs) demonstrate attentional bias toward negative or suicide-related words, which can lead to increased feelings of rejection or alienation. As social interactions employ both verbal and nonverbal cues, there exists a gap in understanding how perception of emotional expressions can contribute to the development or exacerbation of suicidal ideation. METHODS: The current sample (N = 114, 60.5 % female, 74.6 % white) completed the Suicide Cognitions Scale-Revised (SCS-R) and Patient Health Questionnaire (PHQ-9) to assess SRCs and depression severity. The Emotional Bias Task (EBT) was used to assess emotional response latency. RESULTS: Multiple regression analyses on EBT results showed that endorsement of SRCs and depression severity were not associated with any particular emotional response bias. However, presence of SRCs showed an association with longer latencies to identify ambiguous emotional expressions, even when controlling for depressive symptoms and age LIMITATIONS: Measures were self-completed online. Relative homogeneity of the sample and cross-sectional design limits interpretation of the results. CONCLUSIONS: Those with more severe SRCs take longer to recognize positive, nonverbal cues. Irregular processing of positive emotional stimuli combined with bias toward negative verbal cues could worsen feelings of rejection or alienation in social interactions, therefore increasing risk of developing SI. This suggests that interventions focusing on allocation of attentional resources to process positive social cues may be beneficial for those with SRCs to reduce severity and risk of suicide.

Associations among posttraumatic stress disorder symptoms, suicidal ideation, suicide attempts, and reward discounting.

Posttraumatic stress disorder (PTSD) is associated with suicidal thoughts and behaviours. Decision-making processes and risk-taking are prominent for coping in both, but the implications for guaranteed and probabilistic reward discounting, important components in behavioural decision-making processes, are unclear. This study explored the relationships between PTSD and suicide risk with tendencies towards devaluing guaranteed rewards that are larger but delayed (i.e., delay discounting; DD) and devaluing larger but uncertain rewards (i.e., probability discounting; PD) for immediate but smaller rewards. The current study evaluated 498 participants (majority male [51.4%] and white [63.8%]; 33.3% screening positive for probable PTSD; 19.2% with lifetime suicide attempts; 30.8% with recent suicide ideation) on both delayed discounting and PD tasks. Provisional PTSD diagnosis, but not suicide attempts or ideation, was associated with increased PD (i.e., more devaluation of uncertain rewards). Conversely, PTSD interacted with both attempt history and ideation to predict increased delayed discounting (i.e., more devaluing of greater but delayed rewards). These results highlight how those with PTSD symptoms assign valuations to rewards, as well as how the addition of suicide risk interacts to impact these decision-making processes. While further research is needed, this suggests potential implications for treatment as they may benefit from structuring progress in smaller, more immediate goals.

Examining the roles of disability-related body esteem and perceived burdensomeness in suicidal ideation among adults with vision- and mobility-related disabilities.

PURPOSE/OBJECTIVE: People with disabilities (PWD) generally exhibit an increased risk of suicidal ideation (SI) and behaviors. Underlying cognitive states, namely perceived burdensomeness, have been identified as a contributor to the increased risk of suicidal thoughts and behaviors in PWD. However, the role of body esteem in the development of SI in this population remains unexamined, despite its salience in other populations. In this study, we examined whether the interaction of perceived burdensomeness and body esteem contributed to the perceived likelihood of future SI among PWD, and whether this relationship was further moderated by disability type. METHOD: Participants included 119 adults with self-reported vision- and mobility-related disabilities who participated in a larger study focused on disability and suicide involving interviews and self-report measures. We examined the interaction between perceived burdensomeness and disability-related body esteem on self-reported likelihood of future SI and whether this interaction was further moderated by disability type (i.e., vision- or mobility-related disability). RESULTS: Greater perceived burdensomeness was associated with a greater perceived likelihood of future SI only for participants with vision impairments and at low levels of body esteem. CONCLUSIONS/IMPLICATIONS: The combination of experiences of perceived burdensomeness and low body esteem may be particularly relevant to SI among people with vision-related versus mobility-related disabilities. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Differences in Guilt, Shame, Self-Anger, and Suicide Cognitions Based on Recent Suicide Ideation and Lifetime Suicide Attempt History.

ABSTRACT: Suicide risk factors such as hopelessness and psychiatric disorders can predict suicide ideation (SI) but cannot distinguish between those with SI and those who attempt suicide (SA). The fluid vulnerability theory of suicide posits that a person's activation of the suicidal mode is predicated on one's predisposition, triggers, and baseline/acute risks. This study compared guilt, shame, self-anger, and suicidal beliefs based on recent SI and lifetime SA. In a total of 2222 primary care patients in this cross-sectional, observational study reported no recent SI or lifetime SA (SI-SA-), 161 reported recent SI only (SI-SA+), 145 reported lifetime SA only (SI+SA-), and 56 reported both recent SI and lifetime SA (SI+SA+). Kruskal-Wallis test showed that the four risk factors were the highest for SI+SA+, followed by SI+SA-, then SI-SA+, and lastly SI-SA-. The study shows that risk factors may be worse in those with recent SI than those with SA history.

Content Analysis of Warning Signs Identified as Part of Crisis Response Planning in a Community Sample of Gun Owners and Non-owners.

Background: Assessing for and identifying those at imminent risk for suicide continues to present challenges, especially as many who die do not interact with specialty mental health treatment preceding suicide. Suicide-specific interventions in healthcare settings have been found to improve suicide-related outcomes, yet little is known about the confluence of behavioral, cognitive, emotional, and physiological indicators of emotional distress as they correspond to other key risk characteristics and high-risk groups like gun owners. Aim: The purpose of this content analysis was to examine self-identified warning signs of distress between gun owners and non-owners through crisis response planning (CRP). Methods: Participants completed a collaborative CRP. Warning signs were categorized as being either behavioral, cognitive, emotional, or physiological in nature. Bivariate logistic regression models were used to examine associations between firearm ownership and variables of interest. Participants were evenly split between men (n = 44) and women (n = 44) and were predominantly white (67.1%) with a mean age of 35.9 (SD = 13.6). Results: Emotional warning signs of distress (68.2%) were reported slightly more often than behavioral (65.9%) followed by physiological (52.3%), and cognitive (46.6%). Firearm owners were significantly more likely to be male (OR = 2.5, 95%CI [1.07-6.0]). All participants were about a fourth as likely to report both a behavioral and physiological warning sign concurrently (OR = 0.26, 95% CI [0.09-0.67]). Conclusion: Similarities and departures in warning signs of emotional distress may inform future research exploring both self-reported warning signs and related self-management strategies identified through suicide-specific interventions, particularly among high-risk groups such as gun owners.