TY - JOUR
T1 - How do distal and proximal risk factors combine to predict suicidal ideation and behaviors? A prospective study of the narrative crisis model of suicide
AU - Bloch-Elkouby, Sarah
AU - Gorman, Bernard
AU - Lloveras, Lauren
AU - Wilkerson, Timothy
AU - Schuck, Allison
AU - Barzilay, Shira
AU - Calati, Raffaella
AU - Schnur, David
AU - Galynker, Igor
N1 - Publisher Copyright:
© 2020
PY - 2020/12/1
Y1 - 2020/12/1
N2 - Aim: : The Narrative Crisis Model of suicide posits that when individuals with trait vulnerabilities for suicide face stressful life events, they may develop distorted perceptions of themselves and society that culminate in a sense of no future. Referred to as the suicide narrative, these perceptions makes them more likely to experience the Suicidal Crisis Syndrome, an acute affective condition that increases the risk of engaging in suicidal ideation behaviors. The goal of this study was to assess the stage components of this model. Methods: : The stage components of the NCM were assessed among adult psychiatric inpatients (N = 223; listwise N = 85) aged 18–65 years old and admitted for suicidal ideation or attempts. Suicidal outcomes were assessed at one month follow-up. Structural equation modeling (SEM) was used to assess the model and its prediction of prospective suicidal outcomes. Results: : The model was supported by the SEM and proved to be a good fit for the data. Each temporal stage was significantly predicted by the precedent stage in the model and 13% of the variance in suicidal ideation and behaviors (when assessed conjointly) were explained by the model. When suicidal ideation and attempts were assessed separately, the amount of variance explained was 10.8% for suicidal ideation and 40.7% for suicidal attempts. Discussion: : The progression from trait vulnerabilities to suicidal outcomes proposed by the NCM was supported by our findings. These findings have clinical implications in the assessment and treatment of suicide risk and will need replication with larger samples.
AB - Aim: : The Narrative Crisis Model of suicide posits that when individuals with trait vulnerabilities for suicide face stressful life events, they may develop distorted perceptions of themselves and society that culminate in a sense of no future. Referred to as the suicide narrative, these perceptions makes them more likely to experience the Suicidal Crisis Syndrome, an acute affective condition that increases the risk of engaging in suicidal ideation behaviors. The goal of this study was to assess the stage components of this model. Methods: : The stage components of the NCM were assessed among adult psychiatric inpatients (N = 223; listwise N = 85) aged 18–65 years old and admitted for suicidal ideation or attempts. Suicidal outcomes were assessed at one month follow-up. Structural equation modeling (SEM) was used to assess the model and its prediction of prospective suicidal outcomes. Results: : The model was supported by the SEM and proved to be a good fit for the data. Each temporal stage was significantly predicted by the precedent stage in the model and 13% of the variance in suicidal ideation and behaviors (when assessed conjointly) were explained by the model. When suicidal ideation and attempts were assessed separately, the amount of variance explained was 10.8% for suicidal ideation and 40.7% for suicidal attempts. Discussion: : The progression from trait vulnerabilities to suicidal outcomes proposed by the NCM was supported by our findings. These findings have clinical implications in the assessment and treatment of suicide risk and will need replication with larger samples.
UR - http://www.scopus.com/inward/record.url?scp=85090562619&partnerID=8YFLogxK
U2 - 10.1016/j.jad.2020.08.088
DO - 10.1016/j.jad.2020.08.088
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C2 - 33065834
AN - SCOPUS:85090562619
SN - 0165-0327
VL - 277
SP - 914
EP - 926
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
ER -