Improving Suicide Risk Screening to Identify the Highest Risk Patients: Results From the PRImary Care Screening Methods (PRISM) Study

Bryan, Craig J.; Allen, Michael; Thomsen, Cynthia J.; May, Alexis M.; Baker, Justin C.; Bryan, AnnaBelle O.; Harris, John F.; Cunningham, Craig A.; Taylor, Kara B.; Wine, Michelle D.; Young, Johnnie; Williams, Sean; White, Kirsi; Smith, Logan M.; Lawson, Wendy; Hope, Timothy; Russell, William Howard; Hinkson, Kent D.; Arne, Kimberly

doi:10.1370/afm.2729

Cited by 16 publications

(9 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For example, some individuals might not experience traditionally defined “passive” and “active” suicidal thoughts, but may instead experiencing other types of negative thoughts that signal increased vulnerability to suicidal behavior, such as unbearability (e.g., I can not imagine anyone being able to withstand this kind of pain ) and self‐hatred (e.g., I am completely unworthy of love ). Such thoughts have been shown to prospectively predict suicidal behaviors even when accounting for suicidal ideation (Bryan et al, 2014, Bryan, May, et al, 2020; Bryan, Rozek, et al, 2020; Bryan, Allen, et al, in press). This suggestion is consistent with our broader finding that suicide risk does not always involve a linear progression of worsening suicidal thoughts.…”

Section: Discussionmentioning

confidence: 99%

Suicide attempts among adults denying active suicidal ideation: An examination of the relationship between suicidal thought content and suicidal behavior

Wastler

Bryan

2021

J Clin Psychol

Self Cite

View full text Add to dashboard Cite

Objectives The purpose of the current study was to examine the possibility that there are multiple pathways to suicidal behavior by conducting a fine‐grained investigation of the relationship between suicidal thought content and suicidal behavior. Methods Six thousand two hundred US adults completed self‐report measures of suicidal thoughts and behaviors. Descriptive statistics and logistic regression were used to examine the relationship between suicidal thoughts and behaviors. Results About 36.0% of participants with a lifetime suicide attempt denied ever experiencing any active suicidal thoughts and 11.0% denied ever experiencing any suicidal thoughts; 53.8% of recent attempters denied recent active suicidal thoughts and 22.6% denied any recent suicidal thoughts. Additionally, the sole presence of passive suicidal ideation was associated with increased odds of lifetime and past‐month suicide attempts. Conclusions These findings suggest that there are likely multiple pathways to suicide, some of which do not involve progressively worsening suicidal thoughts.

show abstract

Section: Discussionmentioning

confidence: 99%

Suicide attempts among adults denying active suicidal ideation: An examination of the relationship between suicidal thought content and suicidal behavior

Wastler

Bryan

2021

J Clin Psychol

Self Cite

View full text Add to dashboard Cite

show abstract

“…Of clinical importance, our results suggest that suicide risk screening and assessment methods that focus on self-disclosure of thoughts about death and suicide may be well suited for identifying high risk states among non–gun owners but that these screening items are less likely to be endorsed by gun owners with the highest probability of suicide attempt. Evidence has shown that suicidal ideation has only modest sensitivity as an indicator of suicidal behavior, even when someone is screened within a few weeks of their suicide attempt . The present study’s results suggest that the modest sensitivity of suicidal ideation as an indicator of suicidal behavior may be explained in part by heterogeneous associations among various indicators of suicide risk.…”

Section: Discussionmentioning

confidence: 43%

“…Evidence has shown that suicidal ideation has only modest sensitivity as an indicator of suicidal behavior, even when someone is screened within a few weeks of their suicide attempt. 3,4,[34][35][36] The present study's results suggest that the modest sensitivity of suicidal ideation as an indicator of suicidal behavior may be explained in part by heterogeneous associations among various indicators of suicide risk. The findings suggest that supplementing passive and active suicidal ideation items with items assessing thoughts about specific ways or methods of attempting suicide and/or taking steps to prepare for a suicide attempt may improve detection of subgroups at high risk of suicide attempt.…”

Section: Jama Network Open | Psychiatrymentioning

confidence: 99%

Assessment of Latent Subgroups With Suicidal Ideation and Suicidal Behavior Among Gun Owners and Non–Gun Owners in the US

Bryan

Wastler

et al. 2022

JAMA Netw Open

Self Cite

View full text Add to dashboard Cite

IMPORTANCEFirearm ownership is associated with increased risk for suicide. OBJECTIVE To examine patterns of associations among suicidal thoughts and behaviors among gun owners and non-gun owners in the US. DESIGN, SETTING, AND PARTICIPANTS In this survey study, cross-sectional online survey data were collected from March to April 2020 from US adults recruited via Qualtrics Panels. Quota sampling was used to approximate US census demographics. MAIN OUTCOMES AND MEASURESThe primary outcomes were past-year passive suicidal ideation, active suicidal ideation, suicidal planning, suicidal behaviors, and nonsuicidal self-injury as measured by items from the Self-Injurious Thoughts and Behaviors Interview-Revised (SITBI-R).Simple latent class analysis (LCA) was used to assign participants to separate classes based on posterior probabilities, and multigroup LCA was used to assess whether the same construct was measured in specified groups. RESULTSOf 65 079 adults invited to participate, 10 625 (16.3%) completed the survey; 9153 responded "yes" or "no" to the firearm ownership item and were included in the analysis. Of these 9153 respondents (4695 [51.3%] male; mean [SD] age, 46.7 [16.8] years), 2773 (30.3%) reported owning a gun and 6380 (69.7%) reported not owning a gun. Compared with non-gun owners, gun owners were more likely to be male (1779 [64.2%] vs 2916 [45.7%]; χ 2 1 , 263.3; P < .001) and White (2090 [75.4%] vs 3945 [61.8%]; χ 2 5 , 232.9; P < .001) and to have served in the military (772 [27.8%] vs 609 [9.5%]; χ 2 1 , 571.4; P < .001).Five distinct patterns of SITBI-R item endorsement were extracted using simple LCA. Multigroup LCA indicated that the probability of SITBI-R item endorsement differed between gun owners and non-gun owners across subgroups. Among gun owners, the probability of past-month nonfatal suicide attempts was highest in class 4 (ranging from 16.8% for reaching out for help to 27.2% for starting, then changing one's mind). Gun owners in class 4 were characterized by high probabilities of endorsing thoughts about specific ways or methods to attempt suicide (100%) and preparatory behavior (100%). Among non-gun owners, the probability of nonfatal suicide attempts was highest in class 5 (ranging from 14.9% for reaching out for help to 29.7% for starting, then changing one's mind). Non-gun owners in class 5 were characterized by high probabilities of endorsing passive suicidal ideation (84.0%-100%), active suicidal ideation (86.7%-95.0%), and thoughts about specific ways or methods to attempt suicide (97.4%) and a specific place (92.1%) to attempt suicide. CONCLUSIONS AND RELEVANCEIn this study, in subgroups with lower probabilities of suicide attempt, gun owners and non-gun owners showed similar patterns of suicide risk item endorsement, but when the probability of a suicide attempt increased, gun owners were less likely than non-gun (continued) Key Points Question Do survey item response patterns for suicidal ideation and behaviors differ between adult gun owners and non-gun owners in the US? ...

show abstract

“…The Suicide Cognitions Scale-Revised (SCS-R) ( 25 ) is a 16-item self-report scale designed to measure maladaptive suicidogenic beliefs and perceptions commonly reported by suicidal patients (e.g., “I can't stand this pain anymore” and “Nothing can help solve my problems”). Items are rated using a 5-point scale, with higher scores indicating greater identification with negative self-perceptions and worldviews.…”

Section: Methodsmentioning

confidence: 99%

Invariance-based causal prediction to identify the direct causes of suicidal behavior

Goddard

Yu²,

Bryan³

2022

Front. Psychiatry

Self Cite

View full text Add to dashboard Cite

Despite decades of research, the direct causes of suicide remain unknown. Some researchers have proposed that suicide is sufficiently complex that no single variable or set of variables can be determined causal. The invariance-based causal prediction (ICP) is a contemporary data analytic method developed to identify the direct causal relationships, but the method has not yet been applied to suicide. In this study, we used ICP to identify the variables that were most directly related to the emergence of suicidal behavior in a prospective sample of 2,744 primary care patients. Fifty-eight (2.1%) participants reported suicidal behavior during the following year. Of 18 predictors tested, shame was most likely to be directly causal only under the least restrictive conditions. No single variable or set of variables was identified. Results support the indeterminacy hypothesis that suicide is caused by many combinations of factors, none of which are necessary for suicide to occur.

show abstract

Improving Suicide Risk Screening to Identify the Highest Risk Patients: Results From the PRImary Care Screening Methods (PRISM) Study

Cited by 16 publications

References 27 publications

Suicide attempts among adults denying active suicidal ideation: An examination of the relationship between suicidal thought content and suicidal behavior

Suicide attempts among adults denying active suicidal ideation: An examination of the relationship between suicidal thought content and suicidal behavior

Assessment of Latent Subgroups With Suicidal Ideation and Suicidal Behavior Among Gun Owners and Non–Gun Owners in the US

Invariance-based causal prediction to identify the direct causes of suicidal behavior

Contact Info

Product

Resources

About