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Article ; Online: Challenges and Promises of Brief Interventions to Decrease the Risk of Suicide After Psychiatric Hospitalization.

Brown, Gregory K / Stanley, Barbara

Joint Commission journal on quality and patient safety

2022 Volume 48, Issue 10, Page(s) 497–499

MeSH term(s)	Crisis Intervention ; Hospitalization ; Humans ; Mental Disorders/therapy ; Risk Factors ; Suicide/prevention & control ; Suicide, Attempted/psychology
Language	English
Publishing date	2022-07-31
Publishing country	Netherlands
Document type	Editorial ; Comment
ZDB-ID	1189890-2
ISSN	1938-131X ; 1549-425X ; 1553-7250 ; 1070-3241 ; 1549-3741
ISSN (online)	1938-131X ; 1549-425X
ISSN	1553-7250 ; 1070-3241 ; 1549-3741
DOI	10.1016/j.jcjq.2022.07.004
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Article ; Online: Health System-Based Low-Intensity Interventions to Prevent Self-harm Among Patients With Suicidal Ideation: Disentangling the Effects of Implementation Strategies and Interventions.

Stanley, Barbara / Dixon, Lisa

JAMA

2022 Volume 327, Issue 7, Page(s) 626–628

MeSH term(s)	Humans ; Self-Injurious Behavior/prevention & control ; Suicidal Ideation ; Suicide, Attempted
Language	English
Publishing date	2022-02-01
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	2958-0
ISSN	1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
ISSN (online)	1538-3598
ISSN	0254-9077 ; 0002-9955 ; 0098-7484
DOI	10.1001/jama.2022.0770
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Article: Brief and Ultra-Brief Suicide-Specific Interventions.

Stanley, Barbara / Brodsky, Beth / Monahan, Maureen

Focus (American Psychiatric Publishing)

2023 Volume 21, Issue 2, Page(s) 129–136

Abstract: The rising rates of suicide warrant effective treatments that can quickly help stabilize suicidal individuals and prevent future suicidal crises from occurring. Across the past few decades, there has been a rise in the development of ultra-brief (1-4 ... ...

Abstract	The rising rates of suicide warrant effective treatments that can quickly help stabilize suicidal individuals and prevent future suicidal crises from occurring. Across the past few decades, there has been a rise in the development of ultra-brief (1-4 sessions) and brief suicide-specific interventions (6-12 sessions) to meet this need. This article reviews several prominent ultra-brief and brief interventions, including the Teachable Moment Brief Intervention, Attempted Suicide Short Intervention Program, Safety Planning Intervention, Crisis Response Planning, Cognitive Therapy for Suicide Prevention, Brief Cognitive-Behavioral Therapy for Suicide Prevention, Collaborative Assessment and Management of Suicidality, and the Coping Long-Term With Active Suicide Program. A brief review of each interventions' evidence base is also provided. Current challenges and directions for future research in testing the efficacy and effectiveness of suicide prevention initiatives are discussed.
Language	English
Publishing date	2023-04-14
Publishing country	United States
Document type	Journal Article ; Review
ISSN	1541-4094
ISSN	1541-4094
DOI	10.1176/appi.focus.20220083
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Article ; Online: Classifying coping strategies from suicide prevention safety plans.

Daglas, Zoe / Lu, Sinh / Gresham, Daniel / Tatnell, Ruth / Stanley, Barbara H / Melvin, Glenn A

Suicide & life-threatening behavior

2024 Volume 54, Issue 2, Page(s) 275–285

Abstract: Introduction: Understanding the specific strategies individuals use to cope with their suicidal thoughts may have implications for suicide prevention. This study developed a classification system of coping strategies and applied this system to ... ...

Abstract	Introduction: Understanding the specific strategies individuals use to cope with their suicidal thoughts may have implications for suicide prevention. This study developed a classification system of coping strategies and applied this system to individual coping behaviors documented in a safety planning intervention smartphone application called Beyond Now. Method: 725 Beyond Now safety planning app users, aged 16 to over 55 years, entered coping strategies that were used to develop a classification system through content analysis. Entries were either user generated or selected from a list of suggested coping strategies, and 2960 entries were classified using the system. Results: Our classification system featured 11 distinct descriptive categories, with media consumption being the most popular coping strategy among Beyond Now users, followed by relaxation and self-care activities, exercise and creative activities. More than half (57%) of the entries were suggested coping strategies with the remainder being user-generated entries (43%). Conclusion: A wide range of coping strategies were entered into safety plans, with activities that aim to either distract or provide reductions in emotional arousal common. Future research is needed to evaluate the efficacy of the coping strategies listed in safety plans.
MeSH term(s)	Humans ; Suicidal Ideation ; Suicide Prevention ; Coping Skills ; Emotions ; Mobile Applications ; Adaptation, Psychological ; Suicide/psychology
Language	English
Publishing date	2024-02-01
Publishing country	England
Document type	Journal Article
ZDB-ID	750058-0
ISSN	1943-278X ; 0047-4592 ; 0363-0234
ISSN (online)	1943-278X
ISSN	0047-4592 ; 0363-0234
DOI	10.1111/sltb.13039
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Article ; Online: Association of Psychiatric Services Referral and Attendance Following Treatment for Deliberate Self-harm With Prospective Mortality in Norwegian Patients.

Qin, Ping / Stanley, Barbara / Melle, Ingrid / Mehlum, Lars

JAMA psychiatry

2022 Volume 79, Issue 7, Page(s) 651–658

Abstract: Importance: Psychiatric care following somatic treatment for deliberate self-harm (DSH) is pivotal in patients' lives both in the short and long term, but evidence to guide such care is limited.: Objective: To examine follow-up psychiatric care for ... ...

Abstract	Importance: Psychiatric care following somatic treatment for deliberate self-harm (DSH) is pivotal in patients' lives both in the short and long term, but evidence to guide such care is limited. Objective: To examine follow-up psychiatric care for patients treated for DSH (ie, intentional self-injury or self-poisoning, irrespective of motivation) at hospital emergency departments and to assess the association of psychiatric referral and treatment attendance with risk of subsequent mortality in these patients. Design, setting, and participants: Retrospective data from several Norwegian registries were interlinked to follow up a national cohort of all patients with hospital-treated DSH for up to 11 years from 2008 through 2018. Data were analyzed from March to October 2021. Exposures: Socioeconomic characteristics, psychiatric history, and clinical features of DSH. Main outcomes and measures: Referral to psychiatric services, attendance in psychiatric treatment, and prospective mortality were the 3-stage outcomes during follow-up. Logistic regression with odds ratios and cause-specific survival analysis with hazard ratios were used to examine associations between exposures and outcomes. Results: The study identified 43 153 patients (24 286 [56.3%] female; median [IQR] age at index DSH, 39.0 [23.0-56.0] years) involving 69 569 DSH episodes. Of these patients, 6762 (15.7%) were referred to psychiatric services after somatic treatment for DSH, and 22 008 patients (51.0%) attended psychiatric treatment within 3 months of discharge following somatic treatment for DSH. Prior psychiatric history and psychiatric disorders comorbid with DSH were associated with both referral to and attendance in psychiatric care. During follow-up, 7041 patients died by suicide (n = 911) or other causes (n = 6130). While suicide risk was associated with male sex, age 35 to 64 years, and particularly prior and coexisting psychopathologies, other-cause mortality was associated with age 65 years and older and socioeconomic disadvantage. Patients with psychiatric referrals generally had an increased risk of suicide, but the risk was particularly high among patients who received a referral but did not subsequently attend psychiatric treatment (adjusted hazard ratio, 3.07; 95% CI, 2.28-4.12). The observed association was more pronounced during the first years of follow-up and in patients aged 10 to 34 years or 35 to 64 years and those with a clear intent of self-harm. Conclusions and relevance: This national cohort study found an association between psychiatric care attendance following treatment for DSH and prospective mortality, highlighting the importance of patient engagement in psychiatric treatment.
MeSH term(s)	Cohort Studies ; Female ; Humans ; Male ; Mental Health Services ; Prospective Studies ; Referral and Consultation ; Retrospective Studies ; Risk Factors ; Self-Injurious Behavior/epidemiology ; Self-Injurious Behavior/psychology ; Self-Injurious Behavior/therapy
Language	English
Publishing date	2022-05-18
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2701203-7
ISSN	2168-6238 ; 2168-622X
ISSN (online)	2168-6238
ISSN	2168-622X
DOI	10.1001/jamapsychiatry.2022.1124
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Article ; Online: The Need for Innovation in Health Care Systems to Improve Suicide Prevention.

Stanley, Barbara / Mann, J John

JAMA psychiatry

2019 Volume 77, Issue 1, Page(s) 96–98

Abstract: Suicide rates have continued to rise in the United States. Speculations for this rise proliferate but the causes for the increase remain unknown. While research focuses on identifying causes, the health care system is an important site for identification ...

Abstract	Suicide rates have continued to rise in the United States. Speculations for this rise proliferate but the causes for the increase remain unknown. While research focuses on identifying causes, the health care system is an important site for identification of patients at risk. Forty percent of individuals who die by suicide were seen in primary care in the month prior to suicide. The Zero Suicide model describes a comprehensive approach for health care systems to aid in identification and intervention of suicidal patients. While this model promises to improve care of suicidal patients, the need for innovation in our approach to understanding and caring for suicidal patients is pressing. Use of technology to enhance moment-to-moment monitoring of at-risk individuals offers promise and the possibility of intervening close to escalation of acute suicidal states. Further, once identified, suicidal individuals are often difficult to engage in treatment. Novel approaches to engagement and treatment that are effective and acceptable to suicidal patients ought to be developed. Specifically, males are much more likely than females to die by suicide. At the same time, males are less likely to seek and remain in the treatments we have to offer. Innovation should seek to identify strategies that are acceptable to males. Additionally, while about half of psychiatric inpatient admissions are suicide related, there is a paucity of suicide-specific psychosocial interventions available for inpatient settings. Innovation in monitoring and treatment offer promise in helping to reduce suicidal behavior in the United States.
MeSH term(s)	Delivery of Health Care/organization & administration ; Delivery of Health Care/standards ; Humans ; Organizational Innovation ; Quality Improvement/organization & administration ; Suicide/prevention & control ; United States
Language	English
Publishing date	2019-10-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	2701203-7
ISSN	2168-6238 ; 2168-622X
ISSN (online)	2168-6238
ISSN	2168-622X
DOI	10.1001/jamapsychiatry.2019.2769
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Article ; Online: Identifying Neurobiological Underpinnings of Two Suicidal Subtypes.

Stanley, Barbara / Itzhaky, Liat / Oquendo, Maria A

Journal of psychiatry and brain science

2021 Volume 6, Issue 4

Abstract: Despite substantial suicide prevention efforts, US suicide rates continue to climb, currently reaching about 14 per 100,000 individuals. Suicidal behavior has been linked to neurobiological, neurocognitive and behavioral factors; however, integrative, ... ...

Abstract	Despite substantial suicide prevention efforts, US suicide rates continue to climb, currently reaching about 14 per 100,000 individuals. Suicidal behavior has been linked to neurobiological, neurocognitive and behavioral factors; however, integrative, multi-modal studies are rare. Furthermore, prospective studies, crucial to understanding future risk factors, have focused on a single predictor and a single outcome, implying that suicidal behavior is homogeneous. But recent research shows suicidal behavior is complex and heterogeneous, with the possible existence of subtypes. The present report describes a project testing a model that posits two putative subtypes, using a prospective, multi-model design. The subtypes differ in regard to the patterns of suicidal ideation and underlying mechanisms. One hundred subjects diagnosed with a Major Depressive episode, half of whom have attempted suicide in the past, are enrolled and followed for two years, notably the highest risk period for suicidal behavior. Baseline assessments include a clinical assessment, neurocognitive and behavioral tasks, Ecological Momentary Assessments (EMA), PET imaging, and a cognitive emotion regulation task in the MRI scanner. The follow-up assessment includes a clinical assessment and EMA. The study findings have the potential to pave the way for a clearer understanding of suicidal ideation and behaviors and to improve our ability to treat those at risk for suicide by developing tailored approaches that will allow for more accurate pharmacological and psychosocial interventions.
Language	English
Publishing date	2021-08-31
Publishing country	England
Document type	Journal Article
ISSN	2398-385X
ISSN (online)	2398-385X
DOI	10.20900/jpbs.20210016
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Article: Suicide Risk and Addiction: The Impact of Alcohol and Opioid Use Disorders.

Rizk, Mina M / Herzog, Sarah / Dugad, Sanjana / Stanley, Barbara

Current addiction reports

2021 Volume 8, Issue 2, Page(s) 194–207

Abstract: Purpose of review: Suicide is a major public health concern and a leading cause of death in the US. Alcohol and opioid use disorders (AUD/OUD) significantly increase risk for suicidal ideation, attempts, and death, and are the two most frequently ... ...

Abstract	Purpose of review: Suicide is a major public health concern and a leading cause of death in the US. Alcohol and opioid use disorders (AUD/OUD) significantly increase risk for suicidal ideation, attempts, and death, and are the two most frequently implicated substances in suicide risk. We provide a brief overview of shared risk factors and pathways in the pathogenesis of AUD/OUD and suicidal thoughts and behaviors. We also review clinical recommendations on inpatient care, pharmacotherapy, and psychotherapeutic interventions for people with AUD/OUD and co-occurring suicidal ideation and behavior. Recent findings: Among people with an underlying vulnerability to risk-taking and impulsive behaviors, chronic alcohol intoxication can increase maladaptive coping behaviors and hinder self-regulation, thereby increasing the risk of suicide. Additionally, chronic opioid use can result in neurobiological changes that lead to increases in negative affective states, jointly contributing to suicide risk and continued opioid use. Despite significantly elevated suicide risk in individuals with AUD/OUD, there is a dearth of research on pharmacological and psychosocial interventions for co-occurring AUD/OUD and suicidal ideation and behavior. Summary: Further research is needed to understand the effects of alcohol and opioid use on suicide risk, as well as address notable gaps in the literature on psychosocial and pharmacological interventions to lower risk for suicide among individuals with AUD/OUD.
Language	English
Publishing date	2021-03-14
Publishing country	Switzerland
Document type	Journal Article ; Review
ISSN	2196-2952
ISSN	2196-2952
DOI	10.1007/s40429-021-00361-z
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Article ; Online: Attentional control deficits and suicidal ideation variability: An ecological momentary assessment study in major depression.

Herzog, Sarah / Keilp, John G / Galfalvy, Hanga / Mann, J John / Stanley, Barbara H

Journal of affective disorders

2022 Volume 323, Page(s) 819–825

Abstract: Suicidal behavior is associated with deficits in cognitive control; however, suicidal ideation (SI), a key precursor to suicidal behavior, has been less consistently linked to neuropsychological functioning. Additionally, no study to date has examined ... ...

Abstract	Suicidal behavior is associated with deficits in cognitive control; however, suicidal ideation (SI), a key precursor to suicidal behavior, has been less consistently linked to neuropsychological functioning. Additionally, no study to date has examined attentional control capacities in relation to variability in suicidal ideation, defined as fluctuation in SI intensity and duration across short periods of time. Prior research suggests that suicidal individuals with highly variable SI experience greater stress-responsive increases in SI and cortisol, potentially raising risk for suicidal behavior. Here, we examined attentional control capacities associated with SI variability and severity in ninety-five subjects with major depressive disorder. Variability and severity of SI and depressive affect were quantified using Ecological Momentary Assessment (EMA) over a 7-day period. Participants completed the Continuous Performance Task (CPT) and a computerized Stroop task for assessment of attentional control. EMA SI variability was associated with greater attentional interference on the Stroop task, and this was not accounted for by severity of SI, concurrently assessed depressive affect, or baseline depression. CPT performance was not related to SI variability or intensity. Findings highlight the utility of EMA methods in characterizing patterned experiences of SI and suggest that attentional control deficits may contribute to these characteristic patterns.
MeSH term(s)	Humans ; Attention/physiology ; Depressive Disorder, Major/psychology ; Ecological Momentary Assessment ; Suicidal Ideation
Language	English
Publishing date	2022-12-19
Publishing country	Netherlands
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	135449-8
ISSN	1573-2517 ; 0165-0327
ISSN (online)	1573-2517
ISSN	0165-0327
DOI	10.1016/j.jad.2022.12.053
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Article ; Online: Persons Who Engage in Self-Harm While in the Emergency Department: A Case-Control Analysis.

Lawrence, Ryan E / Krumheuer, Aaron / Loh, Ryan / Stanley, Barbara / Simpson, Scott A

The Journal of nervous and mental disease

2022 Volume 210, Issue 10, Page(s) 736–740

Abstract: Abstract: Some patients engage in self-harm behaviors while in the emergency department. Risk factors for self-harm have been described for inpatient and outpatient/community settings, but not among emergency department patients. Authors conducted case- ... ...

Abstract	Abstract: Some patients engage in self-harm behaviors while in the emergency department. Risk factors for self-harm have been described for inpatient and outpatient/community settings, but not among emergency department patients. Authors conducted case-control, retrospective reviews of medical records and incident reports for emergency department patients in two academic medical centers. Variables were analyzed using conditional logistic regression. There were 113 individuals who engaged in self-harm while in the emergency department and 226 individuals who did not. Four variables were significant in the final model: a history of nonsuicidal self-harm (odds ratio [OR], 4.28; 95% confidence interval [CI], 1.95-9.41), opioid use in the prior 2 weeks (OR, 2.89; CI, 1.19-7.02), current manic episode (OR, 3.59; CI, 1.33-9.70), and a history of seizures (OR, 4.19; CI, 1.16-15.14). Risk of self-harm while in the emergency department may be mitigated with interventions that support adaptive coping skills, promptly address pain and withdrawal symptoms, and treat mania.
MeSH term(s)	Analgesics, Opioid ; Emergency Service, Hospital ; Humans ; Odds Ratio ; Retrospective Studies ; Self-Injurious Behavior/diagnosis ; Self-Injurious Behavior/epidemiology
Chemical Substances	Analgesics, Opioid
Language	English
Publishing date	2022-04-05
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	3020-x
ISSN	1539-736X ; 0022-3018
ISSN (online)	1539-736X
ISSN	0022-3018
DOI	10.1097/NMD.0000000000001528
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