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Correlates of suicide ideation and behaviors among transgender people: A systematic review guided by ideation-to-action theory.

ABSTRACT: Transgender people are at high risk for suicide ideation, attempts, and deaths compared to the general population. Several correlates of suicide ideation and attempts have been identified empirically to understand this increased risk. However, few attempts have been made to systematically review this literature. Further, a theory to understand and identify targetable factors for intervention has rarely been applied to this population. In the first systematic review guided by ideation-to-action frameworks of suicide, we systematically reviewed the literature from January 1991 to July 2017 regarding correlates of suicide ideation, attempts, and deaths among transgender people. To be included in the review, articles must have been reported in English, reported on empirical data, included a sample or subsample of transgender people, and reported separately on correlates of suicide ideation, attempts, or deaths. Two independent reviewers searched three major databases, references of included articles, and unpublished literature, which produced 45 articles for review. The review suggested that ideation-to-action frameworks would be worth investigating within this population, with attention to sources of psychological pain, social connectedness, and capacity/capability for suicide unique to this population. Additionally, other aspects of cultural identity were often studied (e.g., race, religion), suggesting the need to understand intersectionality of identities among transgender people and their effects on suicide risk. Finally, the review highlighted important limitations of the literature, namely measurement of suicide ideation and attempts and sampling method, which future work should seek to improve.

SUBMITTER: Wolford-Clevenger C

PROVIDER: S-EPMC6813817 | biostudies-literature | 2018 Jul

REPOSITORIES: biostudies-literature

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Correlates of suicide ideation and behaviors among transgender people: A systematic review guided by ideation-to-action theory.

Wolford-Clevenger Caitlin C Frantell Keri K Smith Phillip N PN Flores Leticia Y LY Stuart Gregory L GL

Clinical psychology review 20180621

Transgender people are at high risk for suicide ideation, attempts, and deaths compared to the general population. Several correlates of suicide ideation and attempts have been identified empirically to understand this increased risk. However, few attempts have been made to systematically review this literature. Further, a theory to understand and identify targetable factors for intervention has rarely been applied to this population. In the first systematic review guided by ideation-to-action f ...[more]

PMID: 29960203

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Project description:IntroductionA core facilitator of the transition from suicidal thoughts to suicide attempt is the individual's capacity for suicide. Suicide capacity is a theoretically universal concept adaptable for specific groups that is hypothesised to comprise three contributing factors: acquired capability, for example, previous self-harm; dispositional, such as genetic influences and practical, knowledge of and access to lethal means. Given that suicide capacity as a concept is continuing to develop, a review and synthesis of the current literature is timely to ensure future research and development of suicide prevention strategies are based on evidential knowledge. The aim of this review is to map the available evidence to provide an overview of factors that contribute to an adult's capacity for suicide.Methods and analysisThis review will encompass five stages. Studies will be identified through broad search strings applied to 11 academic databases: Academic Search Ultimate, APA PsycArticles, APA PsycINFO, CINAHL, Psychology & Behavioural Sciences, & Sociology Source Ultimate via EBSCOHost Megafile Ultimate; PubMed; Science Direct; Wiley Online; Taylor & Francis and ProQuest dissertations and theses. Grey literature databases and key suicide organisations will also be searched for relevant literature. Two reviewers will independently screen titles and abstracts then review full texts to identify articles meeting inclusion criteria. Articles will be assessed for eligibility based on suicide attempt history, primary research study design, language and publication date. Data from eligible full texts will be extracted using a predesigned template for analysis. The synthesisation method will be textual narrative synthesis with an incorporated quality appraisal checklist tool.Ethics and disseminationEthics approval is not required for this scoping review as no human participants are involved. Study findings will be shared with key suicide organisations, through peer-reviewed publications, and conference presentations.

Project description:ImportanceChildren and young people's reports of experiences of adverse childhood events have increased in recent years, and this trend has been associated with an elevated risk for suicide behaviors. However, a systematic review and meta-analysis is needed to confirm the significance of this association in young people.ObjectiveTo quantify the association between core types of childhood maltreatment, including sexual, physical, and emotional abuse and/or neglect and suicide behaviors in children and young adults.Data sourcesMedline, PsychInfo, Embase, Web of Science, and CINAHL (Cumulative Index to Nursing and Allied Health) databases were searched from January 1, 1980, until December 31, 2019. The reference lists of all the included studies were also checked.Study selectionQuantitative studies that focused on the association between core types of childhood abuse and/or neglect and suicide ideation, plans, and attempts.Data extraction and synthesisData were extracted by 2 independent raters. Publication bias and risk of bias across studies were assessed. Meta-analyses using random-effect models were applied, and heterogeneity was quantified using the I2 statistic. Data were analyzed from January to May 2020 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and Meta-analysis of Observational Studies in Epidemiology (MOOSE) reporting guidelines.Main outcomes and measuresThe association between core types of childhood maltreatment and suicide behaviors.ResultsSeventy-nine studies with 337 185 young individuals (mean [SD] age, 15.67 [2.11] years; 63.19% female) were included. The findings demonstrated that sexual abuse (odds ratio [OR], 3.41; 95% CI, 2.90-4.00), physical abuse (OR, 2.18; 95% CI, 1.75-2.71), emotional abuse (OR, 2.21; 95% CI, 1.37-3.57), emotional neglect (OR, 1.93; 95% CI, 1.36-2.74), physical neglect (OR, 1.79; 95% CI, 1.27-2.53), and combined abuse (OR, 3.38; 95% CI, 2.09-5.47) were significantly associated with higher rates of suicide attempts. Core types of childhood maltreatment were also associated with as much as 2.5-fold greater odds for suicide ideation, and sexual abuse with a 4.0-fold increase for suicide plans. Studies based on community samples (β [SE] = -1.68 [0.79]; P = .04) or with lower methodological quality (β [SE] = -2.86 [1.30]; P = .03) were associated more strongly with suicide attempts in those reporting experiences of sexual abuse, whereas young age was associated with both suicide attempts (β [SE] = -0.59 [0.27]; P = .03) and ideation (β [SE] = -0.41 [0.18]; P = .03).Conclusions and relevanceThese findings suggest that policy actions should focus on raising public awareness and offering proactive suicide prevention therapies for children and young adults who have experienced abuse and/or neglect.

Project description:PurposeThe purpose of this study was to examine the prevalence and correlates of suicidal ideation (SI) in patients with stable moderate to very severe chronic obstructive pulmonary disease (COPD).Patients and methodsWe conducted an exploratory mixed methods analysis of data from participants in a longitudinal observational study of depression in COPD. We measured depression with the Patient Health Questionnaire-9 (PHQ-9), which includes an item on SI. We compared participants with and without SI in relation to sociodemographics, symptoms, anxiety, and healthcare resource use with independent t-tests and chi-square tests. Content analysis was performed on qualitative data gathered during a structured SI safety assessment.ResultsOf 202 participants, 121 (60%) had depressive symptoms (PHQ ≥6); 51 (25%) had a PHQ-9 ≥10, indicating a high likelihood of current major depression; and 22 (11%) reported SI. Compared to the 99 depressed participants without SI, those with SI were more likely to be female (59% vs 27%, P=0.004); had worse dyspnea (P=0.009), depression (P<0.001), and anxiety (P=0.003); and were also more likely to have received treatment for depression and/or anxiety (82% vs 40%, P<0.001) and more hospitalizations for COPD exacerbations (P=0.03) but had similar levels of airflow obstruction and functioning than participants without SI. Themes from the qualitative analysis among those with SI included current or prior adverse life situations, untreated or partially treated complex depression, loss of a key relationship, experience of illness and disability, and poor communication with providers.ConclusionOur findings suggest that current SI is common in COPD, may occur disproportionately in women, can persist despite mental health treatment, and has complex relationships with both health and life events. Adequate management of SI in COPD may therefore require tailored, comprehensive treatment approaches that integrate medical and mental health objectives.

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Correlates of suicide ideation and behaviors among transgender people: A systematic review guided by ideation-to-action theory.

Publications

Correlates of suicide ideation and behaviors among transgender people: A systematic review guided by ideation-to-action theory.

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