Latent Profiles of Childhood Adversity, Adolescent Mental Health, and Neural Network Connectivity

JAMA Network Open, Год журнала: 2024, Номер 7(8), С. e2430711 - e2430711

Опубликована: Авг. 28, 2024

Adverse childhood experiences are pervasive and heterogeneous, with potential lifelong consequences for psychiatric morbidity brain health. Existing research does not capture the complex interplay of multiple adversities, resulting in a lack precision understanding their associations neural function mental

Язык: Английский

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Understanding an overdose: intention, motivation, and risk

Clinical Toxicology, Год журнала: 2025, Номер unknown, С. 1 - 8

Опубликована: Янв. 27, 2025

Overdose is frequently categorized dichotomously: an inadvertent therapeutic or recreational misadventure versus a deliberate overdose for self-injurious suicidal purposes. Categorizing overdoses based on this dichotomy of intention fraught with methodological problems and may result in potentially inappropriate and/or divergent care pathways. Suicidality can rapidly shift magnitude frequency at different points time. A patient's reflect varying degrees desire to die, ambivalence about living, disregard risk, pleasure-seeking. Careful assessment overdose-related cognitions warranted all patients. There irreducibly subjective character such that collaborative understanding episode only be discovered by spending time dialogue the patient. At same time, objective risk factors circumstances need integrated experience comprehensive prevention approach. Some might wholly simply impulsive. However, if there some degree intent present, then patient who overdosed has attempted communicate something means overdose, message include other than die. Overdose-related motivation targeted treatment plans reduce elevated states. patient-specific are modifiable, as managing mental health psychosocial issues, reducing access lethal means, promoting safe prescribing medication administration practices. Other either unmodifiable (e.g., personal history overdose) involve public systems. Overdose-whether involving medications, illicit substances, hazardous chemicals, otherwise-can conceptualized single behavioral variable intentionality, motivations, factors. Clinical/medical toxicologists uniquely positioned contribute personalized reduction post-overdose.

Язык: Английский

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Absence of nonfatal suicidal behavior preceding suicide death reveals differences in clinical risks

Psychiatry Research, Год журнала: 2025, Номер 347, С. 116391 - 116391

Опубликована: Фев. 24, 2025

Язык: Английский

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Unveiling the silent battle: suicide rates among law enforcement personnel

Police Practice and Research, Год журнала: 2025, Номер unknown, С. 1 - 10

Опубликована: Янв. 21, 2025

Accurately calculating suicide rates among law enforcement officers has been a longstanding challenge. Since 2016, the nonprofit organization First H.E.L.P. implemented standardized and rigorous methodology to collect data on public safety personnel suicides. This study utilizes H.E.L.P.'s examine sworn from 2016 2022, disaggregated by year, sex, geographic region division. Findings reveal an average rate of 21.4 per 100,000 over seven-year period, with male showing significantly higher (22.7) than their female counterparts (12.7). Regionally, Midwest (27.5) Northeast (24.0) had South (19.4) West (19.7), although variation was noted across divisions within these regions. The paper concludes exploring potential reasons for discrepancies highlighting benefits systematic collection in improving our understanding officer

Язык: Английский

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Suicidality in Autistic Adolescents and Adults: Sleep the Unexplored Connection?

Autism Research, Год журнала: 2025, Номер unknown

Опубликована: Фев. 3, 2025

Despite substantial evidence linking insomnia with increased suicidality in non-autistic populations, its role autism remains under-explored. Poor sleep, most commonly symptoms (hereafter insomnia), is a significant issue autism, affecting up to 80% of autistic children and adults, compared 30%-50% about 45% adults the general population. Sleep, along quality life, anxiety, depression, social well-being, top mental health research priority for adults. These factors are all significantly associated both individuals. Current findings highlight association between psychosocial factors, Key people include traits, loneliness, lack support, experiences such as camouflaging burnout. What under-explored sleep autism. Effective psychological interventions individuals lacking, there limited understanding whether treating can reduce suicidality. Only two pilot studies have investigated treatments In this commentary, we argue that, given high rate potential insomnia, it crucial investigate contributes if addressing through prevention strategies, supports, improves outcomes. Collaboration community essential knowledge gap developing effective interventions.

Язык: Английский

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Veterans at High Risk for Post–COVID-19 Suicide Attempts or Other Self-Directed Violence

JAMA Network Open, Год журнала: 2025, Номер 8(3), С. e250061 - e250061

Опубликована: Март 4, 2025

Importance US veterans have a higher risk of suicide than the general civilian population. Research suggests that COVID-19 infection is associated with increased attempts or other forms self-directed violence (SDV) among veterans. Objective To identify subgroups high post–COVID-19 SDV. Design, Setting, and Participants This retrospective cohort study conducted using data from Veteran Health Administration (VHA). included VHA enrollees first case between May 1, 2021, April 30, 2022, residing in 50 states Washington, DC. Exposure infection. Main Outcomes Measures The main outcome was attempt SDV 12 months after Latent class analysis used to subgroups. Outcome rates 95% CIs per 10 000 were calculated. Multinomial regressions model marginal ratios 99.5% compare across latent classes. Results 285 235 predominantly male (248 118 [87.0%]) younger 65 years (171 636 [60.2%]). Chronic pain (152 788 [53.6%]), depression (98 093 [34.4%]), posttraumatic stress disorder (79 462 [27.9%]) diagnoses common. 12-month rate 73.8 events (95% CI, 70.7-77.0 000). Two classes identified. high-risk subgroup (46 693 [16.4%]) older (34 472 [73.8%] aged ≥65 years) had prevalence physical conditions (43 329 [92.8%] hypertension, 36 824 [78.9%] chronic pain); 103.7 94.7-113.3 second (82 309 [28.9%]) generally (68 822 [83.6%] <65 lower but mental health (61 367 [74.6%] depression, 073 [60.8%] disorder); 162.9 154.5-171.8 000), compared lowest subgroup, 14 times this (risk ratio, 14.23; 10.22-19.80). Conclusions Relevance In COVID-19, 2 veteran distinct profiles SDV, suggesting different groups may require approaches prevention COVID-19.

Язык: Английский

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Study Preregistration: Typologies and Phenotypes of Youth Suicide Decedents

Journal of the American Academy of Child & Adolescent Psychiatry, Год журнала: 2025, Номер unknown

Опубликована: Март 1, 2025

Язык: Английский

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Absence of nonfatal suicidal behavior preceding suicide death reveals differences in clinical risks

medRxiv (Cold Spring Harbor Laboratory), Год журнала: 2024, Номер unknown

Опубликована: Июнь 5, 2024

ABSTRACT Nonfatal suicidality is the most robust predictor of suicide death. However, only ∼10% those who survive an attempt go on to die by suicide. Moreover, ∼50% deaths occur in absence prior known attempts, suggesting risks other than nonfatal need be identified. We studied data from 4,000 population-ascertained and 26,191 population controls improve understanding leading This study included 2,253 3,375 with evidence (SUI_SI/SB CTL_SI/SB) diagnostic codes natural language processing electronic health records notes. Characteristics these groups were compared 1,669 suicides no SI/SB (SUI_None) 22,816 lifetime (CTL_None). The SUI_None CTL_None had fewer diagnoses older SUI_SI/SB CTL_SI/SB. Mental far less common both groups; mental problems associated death presence SI/SB. Physical conversely more often risk Pending replication, results indicate highly significant clinical differences among versus without

Язык: Английский

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Barriers and Facilitators to Using an App-Based Tool for Suicide Safety Planning in a Psychiatric Emergency Department: A Qualitative Descriptive Study Using the Theoretical Domains Framework and COM-B Model

Research Square (Research Square), Год журнала: 2024, Номер unknown

Опубликована: Май 21, 2024

Background Emergency departments (ED) play a crucial role in suicide prevention, with evidenced-based safety planning interventions (SPI) playing an important role. Traditional plans, which are often paper based, come challenges (i.e., not easily accessible, or easy to misplace). Digital tools offer alternative mode of intervention delivery, but clinical implementation remains limited. Using behavioural change frameworks, we aim provide insights into the factors influencing app adoption. These will be used as knowledge base design behavior strategies promote SPI psychiatric ED. Methods We qualitative descriptive conduct semi-structured interviews clinicians ED Toronto, Canada. Participants encompassed all staff, irrespective their usage. The interview guide was developed using Theoretical Domains Framework (TDF) and capability (C), opportunity (O), motivation (M) (B) (COM-B) model. then directed content analysis, identifying findings within TDF COM-B domains barriers, facilitators, both. Findings: A total 29 were interviewed, including nurses, psychiatrists, social workers, program assistants, pharmacist. majority had app. observed strong among across disciplines use app, they considered high-priority care strategy closely linked professional identity responsibility. Anticipated barriers regarding new delivery routine practice included: documentation, communication, efficiency, patient access smartphones. Some attributable lack interoperability between electronic health record documentation infrastructure for Conclusion identified key behavioral found that tailored essential address while leveraging facilitators can sustain implementation. Additionally, ongoing monitoring adaptation necessary, may arise weaken over time, impacting sustained these inform next phase this work, involves co-designing targeted strategies.

Язык: Английский

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Associations between gun violence exposure and suicide mortality rates in US counties

Social Psychiatry and Psychiatric Epidemiology, Год журнала: 2024, Номер unknown

Опубликована: Сен. 28, 2024

Язык: Английский

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