Simultaneous Longitudinal Examination of Hopelessness, Thwarted Belongingness, and Perceived Burdensomeness as Predictors of Suicide Ideation.

OBJECTIVE: Based on Beck's hopelessness model (Beck, Kovacs, & Weissman, Journal of the American Medical Association, 234, 1975, 1146) and Joiner's (Why people die by suicide, 2005, Harvard University Press, Boston, MA) interpersonal theory of suicide, this study simultaneously examined three cognitive risk factors (hopelessness, thwarted belongingness, and perceived burdensomeness) as predictors of suicide ideation. METHOD: The study focused on high school and college students (ns = 192 and 142, respectively), assessed twice 4 months apart. RESULTS: When hopelessness, perceived burdensomeness, and thwarted belongingness were examined separately, each cognitive risk factor predicted future suicide ideation in both groups. When the three cognitions were tested simultaneously, none emerged as uniquely predictive of suicide ideation. A longitudinal, latent variable model suggested that a common factor underlying all three types of cognition significantly predicted suicide ideation. Furthermore, thwarted belongingness predicted both hopelessness and perceived burdensomeness over time. CONCLUSIONS: Results suggest ways that aspects of Beck's and Joiner's theories complement each other and could be combined to yield a more comprehensive understanding of cognitive factors associated with suicide ideation.

Online Social Support for Young People: Does It Recapitulate In-person Social Support; Can It Help?

As social media websites have grown in popularity, public concern about online victimization has grown as well; however, much less attention has focused on the possible beneficial effects of online social networks. If theory and research about in-person social networks pertain, then online social relationships may represent an important modern source of or vehicle for support. In a study of 231 undergraduates, three major findings emerged: (1) for people with weaker in-person social support, social media sites provide a source of social support that is less redundant of the social support they receive in person; (2) in ways that were not redundant of each other, both online and in-person social support were associated with lower levels of depression-related thoughts and feelings, and (3) the beneficial effects of online social support (like in-person social support) offset some of the adverse effects of peer victimization. The study suggests that augmenting social relations via strategic use of social media can enhance young people's social support systems in beneficial ways.

Longitudinal and Incremental Relation of Cybervictimization to Negative Self-Cognitions and Depressive Symptoms in Young Adolescents.

Adolescents are among the most frequent users of social media websites, raising concern about the dangers of cyber bullying or cybervictimization (CV). A 12-month longitudinal study examined the unique, prospective relation of CV to the development of negative self-cognitions and depressive symptoms in a community sample of 827 children and young adolescents (ages 8-13; 55.1 % female) from the southeastern United States. Over and above conventional types of peer victimization, CV significantly predicted changes in self-referential negative cognitions, victimization-related cognitive reactions, and depressive symptoms, even after controlling for baseline levels of the dependent variables. Results also showed that CV was significantly less stable than other forms of victimization and tended to increase slightly with time. The study highlights the unique effects of CV and has implications for research and practice.

Sensitive periods for the effect of peer victimization on self-cognition: moderation by age and gender.

The link between the experience of peer victimization (PV) and future psychological maladjustment has been consistently documented; however, little is known about intermediary cognitive processes that underlie this relation or how these processes vary across childhood. The present study examined the prospective relations between physical and relational PV and the development of negative and positive automatic thoughts and self-cognitions. Self-reports of cognitions and peer nomination measures of victimization were obtained from 1,242 children and young adolescents (Grades 3 through 6) in a two-wave longitudinal study. The results revealed that PV predicted significant increases in negative views of the self, world, and future and decreases in self-perceived competence for girls under 11 years of age, with the effect being stronger for younger girls. PV was not significantly associated with changes in positive or negative self-cognitions for older girls or for boys of any age. These findings support the hypothesis that PV may be linked to future psychopathology through its influence on self-cognitions, but only for girls.

Peer victimization (and harsh parenting) as developmental correlates of cognitive reactivity, a diathesis for depression.

Prior research has shown cognitive reactivity to be a diathesis for depression. Seeking evidence for the developmental origins of such diatheses, the current study examined peer victimization and harsh parenting as developmental correlates of cognitive reactivity in 571 children and adolescents (ages 8-13 years). Four major findings emerged. First, a new method for assessing cognitive reactivity in children and adolescents showed significant reliability and demonstrated construct validity vis-à-vis its relation to depression. Second, history of more severe peer victimization was significantly related to cognitive reactivity, with verbal victimization being more strongly tied to cognitive reactivity than other subtypes of peer victimization. Third, harsh parenting was also significantly related to cognitive reactivity. Fourth, both peer victimization and harsh parenting made unique statistical contributions to cognitive reactivity, after controlling for the effects of the other. Taken together, these findings provide preliminary support for a developmental model pertaining to origins of cognitive reactivity in children and adolescents.

Does supportive parenting mitigate the longitudinal effects of peer victimization on depressive thoughts and symptoms in children?

Cohen and Wills (Cohen, S., & Wills, T. A., 1985, Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98, 310-357) described two broad models whereby social support could mitigate the deleterious effects of stress on health: a main effect model and stress-buffering model. A specific application of these models was tested in a three-wave, multimethod study of 1888 children to assess ways parental support (social support) mitigates the effects of peer victimization (stress) on children's depressive symptoms and depression-related cognitions (health-related outcomes). Results revealed that (a) both supportive parenting and peer victimization had main effects on depressive symptoms and cognitions; (b) supportive parenting and peer victimization did not interact in the prediction of depressive thoughts and symptoms; (c) these results generalized across age and gender; and (d) increases in depressive symptoms were related to later reduction of supportive parenting and later increase in peer victimization. Although supportive parenting did not moderate the adverse outcomes associated with peer victimization, results show that its main effect can counterbalance or offset these effects to some degree. Implications for practice and future research are discussed.

Patterns of treatment utilization before suicide among male veterans with substance use disorders.

OBJECTIVES: We sought to describe the extent and nature of contact with the health care system before suicide among veterans with substance use disorders (SUDs). METHODS: We examined all male Veterans Health Administration patients who died by suicide between October 1, 1999, and September 30, 2007, and who had a documented SUD diagnosis during the 2 years before death (n = 3132). RESULTS: Over half (55.5%; n = 1740) of the male patients were seen during the month before suicide, and 25.4% (n = 796) were seen during the week before suicide. In examining those with a medical visit in the year before suicide (n = 2964), most of the last visits before suicide (56.6%; n = 1679) were in a general medical setting, 32.8% (n = 973) were in a specialty mental health setting, and 10.5% (n = 312) were in SUD treatment. CONCLUSIONS: Men with SUDs who died from suicide were frequently seen in the month before their death. Most were last seen in general medical settings, although a substantial minority of those with SUDs was seen in specialty mental health settings.

Suicide attempts and overdoses among adults entering addictions treatment: comparing correlates in a U.S. National Study.

BACKGROUND: Suicide attempts and non-fatal overdoses are both associated with substance use. The aim of the present study was to examine correlates of suicide attempts and non-fatal overdoses simultaneously among individuals seeking addictions treatment. METHODS: A large U.S. national sample of individuals entering addictions treatment participated in a cross-sectional survey (n=5892). Multinomial logistic regression modeling tested the adjusted associations of violence, injection drug use, specific substances, and depressive symptoms with a four-category outcome variable based on prior histories of suicide attempt and non-fatal overdose (neither, suicide attempt only, overdose only, both), adjusting for demographic and treatment characteristics. RESULTS: Sexual and physical victimization was associated with suicide attempts with or without overdoses (ORs 1.25-2.84), while perpetrating violence was associated with having experienced either or both outcomes (ORs 1.25-1.56). Depressive symptoms had a stronger association with suicide attempts (OR=3.05) than overdoses (OR=1.29). Injection drug use was associated with overdoses with or without suicide attempts (ORs 2.65-3.22). Individuals seeking treatment for marijuana use were less likely have overdosed or attempted suicide (ORs 0.39-0.67), while individuals seeking treatment for heroin use were more likely to have overdosed (OR=1.46). Seeking treatment for use of more than one substance was associated with overdose and overdose and suicide attempt (ORs 1.58-2.51), but not suicide attempt alone. CONCLUSIONS: The present findings indicate that suicide and overdose are connected yet distinct problems. Individuals who have had a history of both may be a group with particularly poor psychological functioning as well as more severe drug-related problems.

Measuring pain medication expectancies in adults treated for substance use disorders.

BACKGROUND: The U.S. prevalence of misuse of prescription opioid analgesics has increased substantially over the past decade but research on the factors influencing misuse of these medications remains preliminary. In the literature on alcohol, marijuana and stimulants, substance-related expectancies have been found to predict level of substance use. A similar line of research is needed to better understand reasons for misusing pain medications. METHODS: This study utilized a sample of adults presenting to a large residential addictions treatment program (N=351). Participants were administered a new instrument, the Pain Medication Expectancy Questionnaire (PMEQ) as well as questions about current alcohol, illegal drug and pain medication misuse. Exploratory factor analysis was used to determine underlying factors of the PMEQ. RESULTS: Results of the factor analysis supported a three-factor solution focusing on pleasure/social enhancement, pain reduction and negative experience reduction. In general, greater perceived expectancy of the positive effects of Prescription Opiate Analgesics (POAs) in all three domains were correlated with greater frequency of substance use and poorer mental health functioning. Expectancies directly related to the pain-reducing properties of POAs were also related to greater pain and poorer physical functioning. CONCLUSIONS: This new measure of pain medication expectancies had sound psychometric properties and the resulting factors were associated with other clinically important aspects of patient functioning. The results highlight the need to assess for and address perceptions related to pain medication use in patients presenting to addictions treatment.