MASCULINITY IDEOLOGY AS A MODERATOR ON THE EFFECTS OF LETHAL MEANS COUNSELING AND DISTRIBUTION OF CABLE LOCKS ON FIREARM STORAGE PRACTICES AMONG NATIONAL GUARD PERSONNEL

Safer firearm storage practices, which may reduce suicide risk, can be promoted by lethal means counseling (LMC). A recent trial found that providing a single LMC session or distributing cable locks can lead to sustained changes in firearm storage practices within a sample of firearm-owning National Guard personnel (Anestis et al., 2021). An important next step is to consider if the intervention effects may differ based on participant characteristics. One particularly relevant sociodemographic characteristic to consider is traditional masculine norms, which are evident in the military and firearm cultures and associated with several negative outcomes. The current study evaluated if overall adherence to masculinity ideology (1) is associated with firearm storages pre-intervention, (2) differentiates the effectiveness of receiving either intervention (LMC, cable locks) versus the control conditions, and (3) predicts storage changes over time among those who received the active interventions. For exploratory purposes, we examined three factors of masculinity ideology (Status, Toughness, Anti-Femininity) as predictors in our models. Results from our primary analyses did not support our hypotheses for Aims 1 and 3, suggesting that overall masculinity ideology is not associated with baseline firearm storage practices nor changes in firearm storage practices among those receiving LMC or cable locks. For Aim 2, all three-way interactions were probed regardless of statistical significance. Results suggest that neither intervention may be effective in changing rates of locking device use among those with high adherence to masculinity ideology, particularly in relation to the norms of Toughness and/or Anti-Femininity. This finding is particularly troubling given that high masculinity ideology is linked to several negative outcomes (e.g., reduced psychological help-seeking) related to suicide risk; therefore, the interventions may not be reaching those who are at higher risk for firearm suicide. While additional research is needed, these findings provide preliminary support that the interventions may need to be modified (e.g., content, who delivers the interventions) to expand their reach to individuals who strongly adhere to masculinity ideology

Willingness to Seek Professional Help for Suicidal Thoughts: The Role of Masculine Norms and Self-Stigma in Service Members

Given the high rate of suicide, it is important to understand what barriers are preventing service members from seeking professional help for suicidal thoughts. Self-stigma and conformity to masculine norms, which are evident in the military culture, have been demonstrated as barriers to care in civilians. This study sought to better understand how these two factors are related to willingness to seek professional help for suicidal thoughts and a personal-emotional problem among service members. Specifically, we (1) identified service members’ willingness to seek help from a variety of sources for suicidal thoughts and a personal-emotional problem, (2) examined how conformity to specific masculine norms differ among male and female service members and civilians, and (3) examined how self-stigma of seeking help and conformity to masculine norms are related to willingness to seek help from a behavioral health professional (i.e., BHP) for suicidal thoughts and a personal-emotional problem. Results partially supported hypotheses. Male service members reported higher conformity to masculine norms than female service members and civilian males. Female service members reported higher conformity to masculine norms than civilian females. In both models (i.e., personal-emotional problem, suicidal thoughts), conformity to masculine norms had a significant indirect effect on willingness to seek help from a BHP through self-stigma of seeking help. The direct effect of conformity to masculine norms on willingness to seek help from a BHP was non-significant in both models. Findings suggest help-seeking campaigns and interventions may need to be culturally adapted to address self-stigma of seeking help

The Association Between Beliefs About the Centrality of Mental Illness In Gun Violence and General Firearm Beliefs and Behaviors

Objective: The tendency to blame gun violence on mental illness may limit the implementation of evidence-based gun violence prevention efforts. We examined the extent to which the belief that gun violence is a mental health problem (vs. access to firearms) is associated with views about firearms and openness to means safety. Method: In 2 samples, U.S. firearm owners completed a survey on Amazon’s Mechanical Turk. In Sample 1 (n = 201, Mage = 36.79), participants endorsed that gun violence is either a mental health problem or a gun problem. In Sample 2 (n = 308, Mage = 38.47), participants endorsed a degree to which gun violence is a mental health problem or a gun problem. Results: In both samples, the belief that gun violence is a mental health problem was associated with less belief in an association between firearm ownership or storage and suicide risk, greater belief that individuals thwarted in an effort to use a specific method for suicide will find an alternative method (i.e., means substitution), and less openness to changing firearm storage practices to prevent suicide. Conclusions: Firearm owners who attribute gun violence purely or predominantly to mental illness may be more likely to endorse inaccurate beliefs and unsafe behaviors with respect to firearms. Targeting this misconception is a vital goal for the field to focus on to shift how Americans think about and promote gun violence prevention. (PsycInfo Database Record (c) 2021 APA, all rights reserved

Openness to Firearm Storage Safety as a Suicide Prevention Tool Among Those Exposed to Suicide: The Role of Perceived Closeness to the Suicide Decedent

Background Exposure to suicide and closeness to a suicide decedent may be relevant to means safety, especially in firearm owners. This study examines how such factors are associated with firearm owners’ current firearm storage methods and openness to changing storage methods. Method 300 firearm owners completed a survey on Amazon\u27s Mechanical Turk program; 176 participants reported being exposed to suicide. Perceived closeness was rated as Not at all close, Close, or Extremely Close. Results Those exposed to suicide were more open to secure storage and temporarily storing the firearm with a trusted individual to prevent someone else\u27s suicide. Those close to the suicide decedent were more likely to use secure storage practices, more open to using secure storage methods to prevent their own and someone else\u27s suicide, and had a higher degree of storage methods in place compared to those not close to the decedent. Limitations The sample may not be representative of all American firearm owners exposed to suicide. Conclusions Being close to a suicide decedent may influence firearm owners’ current storage practices and openness to changing storage methods. Such individuals may better relate to the suicide decedent and realize the significance of using secure storage methods to prevent suicide

Firearm Ownership, Means Safety, and Suicidality

Objective Means safety interventions are effective at reducing suicide rates. This study examined beliefs about firearm ownership or storage and suicide risk, lifetime suicidal thoughts, and openness to means safety. Method A community sample of 107 American adult firearm owners (51.4% male; 82.2% White; mage = 37.46) completed a series of self‐report questionnaires via Amazon\u27s Mechanical Turk. Results Hierarchical linear regressions indicated that beliefs regarding firearm ownership or storage were associated with openness to means safety measures to prevent a suicide attempt by someone else, but not to prevent one\u27s own suicide attempt. Additionally, results from analyses of covariance indicated that firearm owners with lifetime ideation had stronger beliefs regarding the association between firearm ownership or storage and suicide risk. Conclusions Findings indicate firearm owners’ willingness to engage in means safety may be influenced by the degree to which they believe firearm storage is associated with suicide. Furthermore, firearm owners with prior suicide ideation are more open to the idea that firearm ownership and storage are related to suicide risk. Viewing suicide as salient to one\u27s own life may serve as a focal point in efforts to increase openness to means safety among firearm owners

The Role of Reason for Firearm Ownership In Beliefs About Firearms and Suicide, Openness to Means Safety, and Current Firearm Storage

Objective: Firearm means safety strategies, such as safe storage, are effective in reducing suicide rates but are not widely implemented in the United States. This study examined the association between reason for firearm ownership, beliefs about firearm ownership and storage and suicide risk, willingness to engage in means safety, and current firearm storage practices. Method: A sample of 300 American firearm owners (53.0% male; 82.3% White; Mage = 36.11, age range = 20–69) completed an online survey via Amazon’s Mechanical Turk (mTurk) program. Results: Firearm owners who own a firearm for protection, compared to owning a firearm for other reasons, (1) endorsed decreased belief in the relationship between firearm ownership and storage and suicide risk, (2) were less willing to engage in the means safety measures of storing firearms safely and allowing a trusted individual to temporarily remove firearms from the home, and (3) were more likely to store their firearms loaded. Conclusions: Reason for firearm ownership influences views regarding firearms and suicide, willingness to engage in firearm means safety, and firearm storage practices. It is essential to understand how differences in reason for firearm ownership impact these outcomes so appropriate, efficacious messaging can be developed and implemented

Firearm Storage and Shooting Experience: Factors Relevant to the Practical Capability for Suicide

The capability for suicide is posited to facilitate the relatively rare transition from suicidal ideation to suicidal behavior, although the operational definition of the construct continues to evolve. The Three Step Theory proposes that capability is multifaceted and includes practical capability for suicide, defined as comfort with and access to lethal means. Empirical examinations of this construct are thus far limited. Two previous studies have examined the association between firearm storage and shooting experience and common measures of capability for suicide. This study expands the generalizability of previous findings by investigating the relationship between capability for suicide, firearm storage practices, and experience shooting a firearm in a sample of 300 American firearm owners. We found that individuals who store their firearms unsafely (loaded, in a non-secure location, or without a locking device) and who have greater experience shooting firearms have significantly higher capability for suicide. These findings extend the evidence for the construct of practical capability as it relates to firearms and highlight the need for firearm-specific means safety measures to prevent suicide

Suicide Attempt Trends Leading Up To and Following Gun Lock Changes in the 2013 National Defense Authorization Act

Purpose Firearms account for the majority of suicide deaths in the US military and general population. The percentage of suicides resulting from firearms is higher in the military, however, and as such, the ratio of non-lethal to lethal suicide attempts is lower in the military than in the general population. In 2013, Congress passed the National Defense Authorization Act, which facilitated a Department of Defense (DoD) shift toward allowing commanding officers and clinicians to inquire about personal firearms with service members perceived as being at risk and also began giving free cable locks to firearm-owning military personnel. The purpose of this paper is to provide a preliminary understanding of the effectiveness of this change, the authors examined trends in firearm suicide attempts within the US military and general population from 2010 to 2015. Design/methodology/approach Data on non-lethal and lethal suicide attempts overall and within specific methods were extracted from the Department of Defense Suicide Event Report and the Centers for Disease Control and Prevention’s Web-based Injury Statistics Query and Reporting System (2011–2015). Findings Contrary to expectations, firearms were not utilized in a smaller proportion of suicide attempts within the military post-law change. Consistent with expectations, however, the ratio of non-lethal to lethal suicide attempts increased, particularly after the change in law, with the ratio in the military converging somewhat with that of the general population. Originality/value Overall, results were mixed, with only limited and tangential evidence that the change in law has proven effective. More precise data collection will be required in order to fully evaluate such laws

Predicting Suicide Attempt History In a Psychiatric Inpatient Sample: A Replication and Extension

Stanley et al. (Psychological Assessment, 2018, 20, 1249) examined Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, Minnesota Multiphasic Personality Inventory-2 Restructured Form: Manual for administration, scoring, and interpretation, 2008/2011, University of Minnesota Press) profile configurations to predict which individuals engage in suicidal behavior using an outpatient psychiatric sample. Their results revealed that an interaction of overarousal [Hypomanic Activation (RC9) or Activation (ACT)] and shutdown [Demoralization (RCd)] indicators predicted increased history of suicide attempts. The purpose of the present study was to replicate and extend these results to a psychiatric inpatient sample in order to determine their generalizability to a clinically severe, at-risk population. The present study examined 581 valid MMPI-2-RF protocols of adult psychiatric inpatients who endorsed any level of suicide ideation on the Columbia-Suicide Severity Rating Scale (C-SSRS; Posner et al., The American Journal of Psychiatry, 2011, 168, 1266) in the 2 weeks prior to admission. Results revealed that in four of the six models tested, shutdown (Low Positive Emotions [RC2], Helplessness/Hopelessness [HLP]) but not overactivation (RC9, ACT) indicators provided an additional prediction of suicide attempt history beyond Suicidal/Death Ideation (SUI) and the covariates. The two models containing RCd did not provide additional predictive value above Suicidal/Death Ideation (SUI) with main effects or interaction terms. Overall, our results do not replicate those of Stanley et al. (Psychological Assessment, 2018, 20, 1249). Furthermore, while SUI was the best predictor of a history of suicide attempts, results indicate the main effects of RC2 and HLP were negative predictors of prior suicide attempts. Limitations of the study and clinical implications of the results are discussed

Exploring the Scope and Structure of Suicide Capability

© 2020 The American Association of Suicidology Objective: Recent theories of suicide suggest that a construct called “capability for suicide” facilitates the progression from suicidal thoughts to attempts. Various measures of capability have been developed to assess different parts of the construct, but studies report inconsistent findings regarding reliability, validity, and structure. The present study pooled items from multiple measures to identify distinct, reliable, and valid domains of suicide capability. Method: We administered items from several suicide capability measures to an online sample of US adults (n = 387), and utilized exploratory factor analysis to identify distinct domains of capability. We then examined the internal consistencies of and intercorrelations among these domains, as well as their associations with suicide attempts. Results: Findings identified three domains of suicide capability: fearlessness about death, practical capability, and pain tolerance. These domains were internally consistent (αs = 0.80–0.92), and relatively independent from one another (intercorrelations = 0.15–0.35). Finally, each of these domains was moderately elevated among attempters compared to ideators (although only fearlessness about death and practical capability offered unique information about attempter status). Conclusions: Findings suggest that fearlessness about death, practical capability, and pain tolerance can be measured reliably, and may be relevant for understanding which ideators make attempts