Social Risk Factors Social processes interact with many of the environmental risk factors mentioned earlier. This overlap makes it easier to investigate the contributing social and environmental risks associated with the prevalence of suicide in a region. One of the most studied social processes in this regard is interpersonal connectedness. Described simply as “loneliness” in many pieces of literature, there is much research evidence implicating loneliness as a direct and proximal risk factor for the subsequent development of suicidal ideation and its transition to a suicide attempt in youth. Study models on the effect of loneliness on suicidal intent have been established in different literature. Bivariate study models demonstrate a significant correlation between loneliness and suicide intent over time. On the other hand, multivariate prospective models show a complex relationship, suggesting that the correlation between loneliness and suicide intent during adolescence may be dependent on psychopathology (Cooper et al., 2021). There are also cases where loneliness takes a more vital role as a social risk factor in predicting the likelihood of suicide attempts in adolescent life. In these cases, it reportedly mediates the relationship between social anxiety and subsequent suicidal intent, creating an assessment module for the prediction of suicide attempts in later life stages. Affective Risk Factors In the context of affective processes as they relate to suicide studies, worthlessness and self-esteem are perhaps the most common risk factors studied in over the past decade. Evidence that supports affect-related processes in suicide ranges from strong to moderate depending on the aspect of effect, whether negative or positive. In this regard, convincing evidence indicates low self-esteem and worthlessness are risk factors for suicide intent and attempts (Madhavan et al., 2021). Preliminary studies investigating these two effects have found that self-reported worthlessness, low self-esteem, and other measures of negative thinking related to the concept of self can help predict the likelihood of suicidal ideation and attempts in adolescents. However, this is also largely dependent on other factors, including sex, environment, life stage happenings, and mental health. Hopelessness is another aspect of negative affect shown to play a key role in self-perception and in investigating the future risk of suicide in adulthood, although hopelessness is considered a more distal factor and does not exactly predict the future risk of suicidal ideation. In positive affect-related processes, anhedonia presents a persuasive case. Anhedonia is defined as the inability to experience pleasure, and studies on anhedonia have shown that at greater levels, the risk of suicide intent and behavior in adult life is significantly increased (Auerbach et al., 2022). In controlling for other risk factors, there seems to be a defined Previous Suicide Attempt Commonly grouped under psychological risk factors in suicide studies, previous suicide attempts seem to have a strong influence on suicidality scores in adult life. In some cases, prediction models consider time since the last attempt, age, and the method at the last attempt to be other factors that can predict the severity of suicide intent and behavior across all age groups. According to available evidence, about 25%–33% of all cases of suicide attempts and deaths are linked to an earlier attempt. This phenomenon, when examined across sex distributions, appears to be more prevalent in adolescent males. Subjects in this group have reportedly shown a 30-fold increase in suicide risk compared to adolescent males with no previous history of suicide. In adolescent girls with a previous history of suicide attempts have a threefold increase in suicidality score compared to those without a history of suicide attempts.
Another important concept studied as it relates to the social process and suicide intent, is the interpersonal theory of suicide, which is explained in detail in the 2005 Harvard University Press publication Why People Die by Suicide. As with loneliness, this theory focuses on how perceived burdensomeness and thwarted belongingness predict suicidal intent and behavior (SIB) in the youth population. Thwarted belongingness specifically interacts with the acquired capability to understand the associated risks and predict suicide attempt in adolescent females. Perceived burdensomeness does the same thing in adolescent males, interacting with the acquired capability to predict suicide attempts (Guzman et al., 2019). Recently, there has been interesting evidence exploring the use of machine learning for analyzing distinct patterns of vocalizations and voice quality– related features in social communications studies. Early research in this domain demonstrated that distinct patterns of prosodic and voice quality–related features are linked with adolescent suicide attempters. These features are less pronounced in non-attempters. An atypical cortisol response to social stress in suicide attempters is a commonly studied overlap between social processes and biological processes as a psychological risk factor of suicide. Non-attempters never show these pronounced atypical patterns (Genis-Mendoza et al., 2022). pattern in the transition from ideation to attempt in people with anhedonia. At first, subjects try different measures to solve their problems by leveraging drug therapy and confiding in people - a form of community connectedness. Transitioning to attempts occurs more often in subjects who ignore these protective factors or who cannot access therapy. Other aspects of positive affect thought to have a bearing on SIB include blunted reward responsivity and reward learning deficits. Suicide behavioral studies also find individuals who have the ability to change their emotions. Youth with limited emotion- controlling strategies have a greater tendency to be at risk of suicide intent and behavior compared to those with a healthy emotional regulation strategy (Zafar et al., 2021). There are special study cases related to specific approaches to emotion regulation in individuals with limited regulation strategy and those without. For instance, maladaptive cognitive emotion regulation strategies such as suppression of negative thoughts and feelings and numerations have been linked to an increased risk of suicidality in adult life. Longitudinal studies combining all the evidence available on the affective process are currently investigating whether suppression and expression strategies of both negative and positive thoughts and feelings have different or the same effect on suicidality. Data collation in this regard shows interesting insight into suicidality scores concerning the previous history of attempts. About 1%–6% of people attempting suicide reported dying by suicide within the first year. There seems to be a uniform pattern of transition from ideation to attempt or death in these individuals. The protective factors and primary risk factors identified have also been similar in many cases. Also, the risk of suicide in this group was found to be less about the severity of suicidal ideation and more dependent on the self-inflicting act. Future studies in this regard will aim to understand the controlling factors related to a previous suicide attempt in an effort to better understand management strategies in this population.
Page 95
Book Code: PYMA2024
EliteLearning.com/Psychology
Powered by FlippingBook