Suicide is a leading cause of death among youth worldwide. The purpose of the current review was to examine recent cross‐national trends in suicide mortality rates among 10‐ to 19‐year‐olds. This study extracted suicide mortality data from the World Health Organization's (WHO) Mortality Database for the most recent year (since 2010) from any country with available high‐quality data (as defined by the WHO's guidelines). Data on access to lethal means (firearms, railways) and measures of economic quality (World Bank Income Group) and inequality (Gini coefficients) were obtained from publicly available data sources. Cross‐national suicide mortality rates in youth were heterogeneous. The pooled estimate across all ages, sexes, and countries was 3.77/100,000 people. The highest suicide rates were found in Estonia, New Zealand, and Uzbekistan. Suicide rates were higher among older compared with younger adolescents and higher among males than females. The most common suicide methods were hanging/suffocation and jumping/lying in front of a moving object or jumping from a height. Firearm and railway access were related to suicide deaths by firearms and jumping/lying, respectively. Economic quality and inequality were not related to overall suicide mortality rates. However, economic inequality was correlated with a higher ratio of male:female suicides. This study provides a recent update of cross‐national suicide trends in adolescents. Findings replicate prior patterns related to age, sex, geographic region, and common suicide methods. New to this review are findings relating suicide method accessibility to suicide mortality rates and the significant association between income inequality and the ratio of male:female suicide. Future research directions include expanding the worldwide coverage to more low‐ and middle‐income countries, examining demographic groupings beyond binary sex and to race/ethnicity within countries, and clarifying factors that account for cross‐national differences in suicide trends.

Background College students’ mental health may be disproportionally affected by the COVID-19 pandemic because of the abrupt shift off campus and subsequent loss of a social network and potential long-term impact on job prospects. Objective We sought to assess the nature of COVID-19’s mental health impact among a sample of undergraduates who were experiencing the pandemic as it occurred in real time. Methods In total, 140 college students completed smartphone-based ecological momentary assessments of anxiety and optimism related to COVID-19 and other generic mental health variables 6 times daily. Results Participants completed >23,750 surveys. Overall, >75% of these surveys indicated at least some level of anxiety about COVID-19. On average, the proportion of responses each day at the highest levels of anxiety about COVID-19 was 7 times greater than the proportion of responses at the highest levels of non–COVID-19–specific anxiety. Structural change analyses indicated a significant downward trend in COVID-19 anxiety after the first week of June, but even at the lowest point, >15% of the participants in the sample still reported high levels of COVID-19 anxiety each day. Participants felt more anxious about COVID-19 on days when the number of new cases and deaths due to COVID-19 were higher. When participants felt anxious about COVID-19, they also felt sad, anxious (in general), and had a greater desire to drink and use drugs. Participants felt more optimistic about COVID-19 when they received more support from others and from their university. Conclusions This study demonstrated the widespread mental health impact that COVID-19 has had on college students.

Compared to heterosexual individuals, sexual minorities exhibit elevated risk for depression and borderline personality disorder (BPD). One psychosocial factor relevant to sexual minority mental health is outness, or the degree to which an individual discloses or conceals their sexual orientation. Previous findings are mixed regarding whether outness is associated with better or worse mental health, likely because outness can have positive consequences (e.g., social support) and negative consequences (e.g., discrimination). Support exists for both mechanisms, but previous studies have not simultaneously considered how outness may be related to mental health outcomes in different ways through social support versus discrimination. The present study examined: (a) the association between outness and depressive symptoms, (b) the association between outness and BPD symptoms, and (c) the indirect effects of outness on depressive/BPD symptoms through social support and discrimination. A total of 256 sexual minority participants completed an online or in-person survey. Greater outness was associated with lower depressive symptoms and BPD symptoms. There was an indirect effect of outness on depressive symptoms through social support, with greater outness being associated with greater social support and, in turn, lower depressive symptoms. Outness had an indirect effect on BPD symptoms through both social support and discrimination. Greater outness was associated with both greater social support and discrimination, with greater social support being associated with lower BPD symptoms, and greater discrimination with greater BPD symptoms. Outness may from the National Institute on Drug Abuse (K08DA045575; PI: Brian A. Feinstein). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies.

This randomized clinical trial aimed to determine feasibility, acceptability, and initial efficacy of brief Dialectical Behavior Therapy (DBT) skills videos in reducing psychological distress among college students during the COVID-19 pandemic. Over six weeks, 153 undergraduates at a large, public American university completed pre-assessment, intervention, and post-assessment periods. During the intervention, participants were randomized to receive animated DBT skills videos for 14 successive days ( n = 99) or continue assessment ( n = 54). All participants received 4x daily ecological momentary assessments on affect, self-efficacy of managing emotions, and unbearableness of emotions. The study was feasible and the intervention was acceptable, as demonstrated by moderate to high compliance rates and video ratings. There were significant pre-post video reductions in negative affect and increases in positive affect. There was a significant time × condition interaction on unbearableness of emotions; control participants rated their emotions as more unbearable in the last four vs. first two weeks, whereas the intervention participants did not rate their emotions as any more unbearable. Main effects of condition on negative affect and self-efficacy were not significant. DBT skills videos may help college students avoid worsening mental health. This brief, highly scalable intervention could extend the reach of mental health treatment.

Suicide among young people is an increasingly prevalent and devastating public health crisis around the world. To reduce the rate of suicide, it is important to identify factors that can help us better predict suicidal ideation and behaviors. Adolescent temperament (Effortful Control, Negative Emotionality, Positive Emotionality) may be a source of risk and resilience for the onset of suicidal ideation, plans, and attempts. The present study uses longitudinal data from a large, community sample of Mexican-origin youth (N=674), assessed annually from age 12 to 21, to examine how temperament is associated with the onset of suicidal ideation and behaviors during adolescence and young adulthood. Results indicate that higher levels of Effortful Control (Activation Control, Inhibitory Control, Attention) are associated with decreased probability of experiencing the onset of suicidal ideation, plans, and attempts, whereas higher levels of Negative Emotionality (particularly Aggression, Frustration, and Depressed Mood) are associated with increased probability of experiencing the onset of suicidal ideation and behaviors. Positive Emotionality (Surgency, Affiliation) was not associated with the onset of suicidal ideation and behaviors. Supplemental analyses showed conceptually similar findings for the Big Five, with Conscientiousness associated with decreased risk, Neuroticism associated with increased risk, and the other three dimensions showing largely null results. The findings did not vary significantly for boys and girls or for youth born in the U.S. versus Mexico. Overall, these findings suggest that adolescent temperament serves as both a protective factor (via Effortful Control/Conscientiousness) and a risk factor (via Negative Emotionality/Neuroticism) for suicidal ideation and behaviors in Mexican-origin youth.

UNSTRUCTURED Background: College students’ mental health may be disproportionally affected by the COVID-19 pandemic because of the abrupt shift off campus and subsequent loss of a social network and potential long-term impact on job prospects. We sought to assess the nature of COVID-19’s mental health impact of among a sample of undergraduates who were experiencing the pandemic, as it occurred in real-time. Methods: 140 college students completed 6x daily smartphone-based ecological momentary assessment (EMA) of anxiety and optimism related to COVID-19 as well as other generic mental health variables. Results: Participants completed >23,750 surveys, >75% of which indicated at least some level of anxiety about COVID-19. On average, the proportion of responses each day at the highest levels of anxiety about COVID-19 was 7 times greater than the proportion of responses at the highest levels of non-specific anxiety. Structural change analyses indicated a significant downward trend in COVID-19 anxiety after the first week of June, but even at the lowest point, >15% of the sample still endorsed high levels of COVID-19 anxiety each day. Participants felt more anxious about COVID-19 on days when the number of new cases and deaths due to COVID-19 were higher. When participants felt anxious about COVID-19, they also felt sad, anxious (in general), and had a greater desire to drink and use drugs. Participants felt more optimistic about COVID-19 when they received more support from others and from their university. Conclusion: This study demonstrated the wide-spread mental health impact that COVID-19 has on college students.

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Background Consumption of distressing news media, which substantially increased during the COVID-19 pandemic, has demonstrable negative effects on mental health. Objective This study examines the proximal impact of daily exposure to news about COVID-19 on mental health in the first year of the pandemic. Methods A sample of 546 college students completed daily ecological momentary assessments (EMAs) for 8 weeks, measuring exposure to news about COVID-19, worry and optimism specifically related to COVID-19, hopelessness, and general worry. Results Participants completed >80,000 surveys. Multilevel mediation models indicated that greater daily exposure to news about COVID-19 is associated with higher same-day and next-day worry about the pandemic. Elevations in worry specifically about COVID-19 were in turn associated with greater next-day hopelessness and general worry. Optimism about COVID-19 mediated the relationship between daily exposure to COVID-19 news and next-day general worry but was not related to hopelessness. Conclusions This study demonstrates the mental health impact of daily exposure to COVID-19 news and highlights how worry about the pandemic contributes over time to hopelessness and general worry.