Associations between experiences of disrupted attachments and suicidal thoughts and behaviours: an interpretative phenomenological analysis

Suicide is a major public health concern and itsaetiology is complex. Evidence suggests that experiences of early disrupted attachment relationships with parents and family members are associated with later experiences of suicidal thoughts and behaviours (STB). However, no study has investigated this relationship from an inductive, interpretative and idiographic perspective. Objective: This paper explores the role of interpersonal relationships in STB among nine individuals who have attempted suicide. Method: Semi-structured face-to-face interviews were analysed using an interpretative phenomenological analysis approach. Results and conclusion: Two inter-related master themes were identified: 1) ‘challenging relationships as catalysts for STB’; and 2) ‘positive relationships as buffers against STB’. Findings indicate that experiences of early disrupted parent-child attachments may contribute to vulnerability for STB by shaping participants' perceptions of intimate others and themselves (internal working models). These working models, along with other environmental factors and life events, may increase the risk of STB through perceptions of defeat, entrapment, perceived burdensomeness and thwarted belongingness. Results also suggest that being exposed to respectful, caring, unconditionally accepting, reciprocal, trusting, and non-judgemental intimate adult relationships increase resilience and is associated with recovery from past STB and a reduction of current suicide risk. The theoretical and clinical implications are discussed

The relationship between adult attachment and suicidal thoughts and behaviors: a systematic review

We aimed to (1) determine the extent of the relationship between attachment and suicidal thoughts and behaviors (STB), (2) investigate whether any gender differences exist, and (3) conduct a theoretical synthesis of the included studies. A systematic search of the databases Web of Science; EBSCO Host Medical and Psychology-related resources, which includes CINAHL, Health Source: Nursing/Academic Edition, Psychology and Behavioral Sciences Collection, and PsycINFO; and EMBASE was conducted, with 52 studies meeting the inclusion criteria. While secure attachment acts as protective factor, insecure attachment orientations appear to be vulnerability factors compromising an individual’s capacity to cope with relationship issues, increasing suicide risk. There is insufficient evidence about gender differences. The theoretical synthesis suggests that attachment, interacting with other psychological traits in response to negative life events, acts as a vulnerability or protective factor for STB. Implications for treatment are also discussed

Adult attachment: investigating the factor structure of the Relationship Scales Questionnaire

Objective: In this study, we aimed to conduct an in‐depth psychometric investigation of the Relationships Scales Questionnaire (RSQ). Method: About 717 UK‐based participants responded to an online questionnaire (F = 540, M = 177; age range 18–66 years, M = 25, SD = 8.46). We conducted (a) a series of confirmatory factor analyses (CFA) to test previously published factor models of the RSQ, (b) traditional (exploratory factor analysis and confirmatory factor analysis) and contemporary (exploratory graph analysis) exploratory techniques, followed by (c) validity and reliability analyses. Results: Although the RSQ was developed to assess four categories of adult attachment (typological approach – i.e., secure, preoccupied, dismissing, and fearful), our findings do not support the hypothesis that the RSQ delivers a psychometrically consistent measure of adult attachment styles. Conclusion: The results of the present study suggest that a two‐dimensional approach (i.e., anxiety and avoidance) to assessing adult attachment is optimal

The Impact of Infectious Disease-Related Public Health Emergencies on Suicide, Suicidal Behavior, and Suicidal Thoughts:A Systematic Review

Background: Infectious disease-related public health emergencies (epidemics) may increase suicide risk, and high-quality evidence is needed to guide an international response. Aims: We investigated the potential impacts of epidemics on suicide-related outcomes. Method: We searched MEDLINE, EMBASE, PsycInfo, CINAHL, Scopus, Web of Science, PsyArXiv, medRxiv, and bioRxiv from inception to May 13–16, 2020. Inclusion criteria: primary studies, reviews, and meta-analyses; reporting the impact of epidemics; with a primary outcome of suicide, suicidal behavior, suicidal ideation, and/or self-harm. Exclusion criteria: not concerned with suicide-related outcomes; not suitable for data extraction. PROSPERO registration: #CRD42020187013. Results: Eight primary papers were included, examining the effects of five epidemics on suicide-related outcomes. There was evidence of increased suicide rates among older adults during SARS and in the year following the epidemic (possibly motivated by social disconnectedness, fears of virus infection, and concern about burdening others) and associations between SARS/Ebola exposure and increased suicide attempts. A preprint study reported associations between COVID-19 distress and past-month suicidal ideation. Limitations: Few studies have investigated the topic; these are of relatively low methodological quality. Conclusion: Findings support an association between previous epidemics and increased risk of suicide-related outcomes. Research is needed to investigate the impact of COVID-19 on suicide outcomes

Establishing research priorities for investigating male suicide risk and recovery: A modified Delphi study with lived-experience experts.

This study uses the Delphi expert consensus method to work with lived-experience experts and establish research priorities to advance our understanding of male suicide risk and recovery. Items for the Delphi were generated via findings from two recent quantitative and qualitative systematic reviews on male suicide, a comprehensive gray literature search, responses to a global survey on male suicide, and feedback from a panel of 10 international academic/clinical male suicide experts. A two-round Delphi study was conducted to gain consensus among 242 lived-experience experts representing 34 countries on 135 potential male suicide research questions. Panelists were asked to rate each item on a 5-point Likert scale from should not be included to essential. Consensus was defined as 80% of respondents scoring an item as “essential” or “important.” After two Delphi rounds, consensus was reached on 87 items. The final questions were then grouped by the author team and expert academic/clinical panel into thematic clusters to create a 22-point agenda of research priorities. Like all methodologies, there are weaknesses to the Delphi method, not least that the experts employed in a Delphi study do not represent all experts on a topic. We note that many items that did not make it to the top of the research agenda related to minority experiences. All the questions prioritized in this agenda can be applied to different demographics. However, minority populations may require tailored Delphi’s using expert panels drawn specifically from those groups. A final agenda of 22 research priorities was developed. Questions related to 10 thematic domains: (a) relationships with others, (b) relationship with self, (c) relationship with emotions, (d) mental health, (e) suicidal behaviors, (f) early-life experiences, (g) structural challenges, (h) cultural challenges, (i) at-risk groups, and (j) support and recovery. The three highest endorsed items related to loneliness and isolation (98%), feelings of failure (97%), and sources of stress and emotional pain (96%) for men who are suicidal. (PsycInfo Database Record (c) 2023 APA, all rights reserved

Mental health and well-being during the second wave of COVID-19: longitudinal analyses of the UK COVID-19 Mental Health and Wellbeing study (UK COVID-MH)

Background Waves 1 to 3 (March 2020 to May 2020) of the UK COVID-19 Mental Health and Wellbeing study suggested an improvement in some indicators of mental health across the first 6 weeks of the UK lockdown; however, suicidal ideation increased. Aims To report the prevalence of mental health and well-being of adults in the UK from March/April 2020 to February 2021. Method Quota sampling was employed at wave 1 (March/April 2020), and online surveys were conducted at seven time points. Primary analyses cover waves 4 (May/June 2020), 5 (July/August 2020), 6 (October 2020) and 7 (February 2021), including a period of increased restrictions in the UK. Mental health indicators were suicidal ideation, self-harm, suicide attempt, depression, anxiety, defeat, entrapment, loneliness and well-being. Results A total of 2691 (87.5% of wave 1) individuals participated in at least one survey between waves 4 and 7. Depressive symptoms and loneliness increased from October 2020 to February 2021. Defeat and entrapment increased from July/August 2020 to October 2020, and remained elevated in February 2021. Well-being decreased from July/August 2020 to October 2020. Anxiety symptoms and suicidal ideation did not change. Young adults, women, those who were socially disadvantaged and those with a pre-existing mental health condition reported worse mental health. Conclusions The mental health and well-being of the UK population deteriorated from July/August 2020 to October 2020 and February 2021, which coincided with the second wave of COVID-19. Suicidal thoughts did not decrease significantly, suggesting a need for continued vigilance as we recover from the pandemic

Perceptions of past parenting and adult attachment as vulnerability factors for suicidal ideation in the context of the integrated motivational-volitional model of suicidal behavior

Objective: We aimed to investigate whether perceptions of past parenting and current attachment orientations are associated with key components of the Integrated Motivational–Volitional (IMV) Model of Suicidal Behavior. We investigated the relationship between perceptions of past parenting, attachment, suicide ideation, defeat, entrapment, coping, and resilience. Method: A total of 730 adult participants responded to an online questionnaire comprised of psychological measures. An initial regression analysis indicated that memories of past parenting and attachment were associated with suicide ideation. Four mediation models were tested based on the IMV model, all controlling for depressive symptoms. Results: In the first model, attachment orientations mediated the relationships between perceptions of past parenting dimensions and defeat. In the second, defeat mediated the relationships between attachment orientations and entrapment. In the third, entrapment mediated the relationship between defeat and suicidal ideation, but coping did not moderate the defeat–entrapment relationship. In the final model, entrapment mediated the relationship between defeat and suicide ideation, with resilience moderating this relationship. Conclusions: The findings are novel and congruent with the core principles of the IMV model. Clinical implications suggest the protective effect of resilience and strengthening of self-compassion attitudes to reduce the effect of insecure attachment strategies