Changes in macroeconomic conditions are tied to population-level suicide risks for employed and unemployed persons. However, these associations vary depending on sex, employment status and occupational roles. In advance of future economic crises, it is important to develop prevention initiatives intended to reach the diverse populations potentially exposed to the adverse effects of sudden economic disruptions.

Disrupted social connectedness is associated with suicidal thoughts and behaviors among individuals with substance use disorders (SUDs). The current study sought to further characterize this relationship by examining several indices of social connectedness-1) living alone, 2) perceived social support, 3) interpersonal conflict, 4) belongingness. Participants (n = 814) were recruited from four residential substance-use treatment programs and completed self-report measures of social connectedness as well as whether they had ever thought about or attempted suicide. Multivariate results indicated that interpersonal conflict and belongingness were significant predictors of a history of suicidal ideation, and belongingness, perceived social support, and living alone were significant predictors of suicide attempt. These results indicate the most consistent support for the relationship between suicidality and thwarted belongingness, and also support the clinical utility of assessing whether individuals live alone. Keywordssuicide attempts; suicidal ideation; loneliness; thwarted belongingness; social support Substance dependence confers elevated risk for suicidal ideation (i.e., thoughts about killing oneself; Grant & Hasin, 1999) and suicide attempts (i.e., attempting suicide but surviving) (Kessler et al., 1999), as well as suicide (i.e., suicide attempts that result in death; Wilcox, Conner, & Caine, 2004). Reviews of the suicide literature have estimated that the risk for suicide among individuals with SUDs is five times or greater that of the general population (Wilcox, Conner, & Caine, 2004;Yoshimasu, Kiyohara, & Miyashita, 2008). The identification of psychological and social processes that elevate risk for suicidal thoughts and behaviors (i.e., ideation, attempts, or death) among individuals with substance use disorders (SUDs) represents one avenue for increased understanding of etiological mechanisms, as well as improved prevention efforts. (Shneidman, 1987) proposes that an unmet need for "affiliation" is one of several needs that contribute to suicide when unmet. The interpersonal theory of suicide (Joiner, 2005; Van Orden, Witte, Cukrowicz, Braithwaite, Selby, & Joiner Jr, in press) proposes that the need to belong to caring and supportive relationships (Baumeister & Leary, 1995) is so powerful that, when thwarted, contributes to a desire for suicide. Several studies specifically examining the relationship between belongingness-the degree to which individuals perceive that they are meaningfully connected to satisfying (and positive) relationships or social groups-and suicidal desire have supported the theory (Conner, Britton, Sworts, & Joiner, 2007;Joiner, Hollar, & Van Orden, 2006;Joiner, Van Orden, Witte, Selby, Ribeiro, Lewis, et al., 2009;Van Orden, Witte, Gordon, Bender, & Joiner, 2008;Van Orden, Witte, James, Castro, Gordon, Braithwaite, et al., 2008), although only one report used a substance dependent sample (Conner et al., 2007).Empirically, indices of social connectedness are related to ...

Background Stressful life events (SLEs) play a key role in suicidal behavior among adults with alcohol use disorders (AUD), yet there are meager data on the severity of SLEs preceding suicidal behavior or the timing of such events. Method Patients in residential substance use treatment who made a recent suicide attempt (cases, n=101) and non-suicidal controls matched for site (n=101) were recruited. SLEs that occurred within 30 days of the attempt and on the day of the attempt in cases were compared to SLEs that occurred in the corresponding periods in controls. SLEs were categorized by type (interpersonal, non-interpersonal) and severity (major, minor) and were dated to assess timing. Degree of planning of suicide attempts was also assessed. Results Major interpersonal SLEs conferred risk for a suicide attempt, odds ratio (95% CI) = 5.50 (1.73, 17.53), p=.005. Cases were also more likely to experience an SLE on the day of the attempt than on the corresponding day in controls, OR (95% CI) = 6.05 (1.31, 28.02), p=.021. However, cases that made an attempt on the day of a SLE did not make lower planned suicide attempts compared to other cases, suggesting that suicide attempts that are immediately preceded by SLEs cannot be assumed to be unplanned. Conclusions Results suggest the central importance of major interpersonal SLEs in risk among adults with AUD, a novel finding, and documents that SLEs may lead to suicide attempts within a short window of time (i.e., same day), a daunting challenge to prevention efforts.

Childhood physical abuse (CPA) has numerous short and long-term negative effects. One of the most serious consequences of CPA is an increased risk for suicide attempts. Clarifying the mechanisms by which CPA increases risk for suicidal behavior may enhance preventative interventions. One potential mechanism is a tendency toward aggression. In a sample of 266 criminal offenders, ages 18-62, we examined the relationships among CPA, lifetime aggression, and suicide attempts and tested lifetime history of aggression as a mediator of the relationship between CPA and suicide attempts. Results indicated that CPA and aggression were associated with suicide attempts. Consistent with our hypothesis, lifetime aggression mediated the CPAsuicide attempt relationship. Findings suggest that aggression may be an important mediator of the relationship between CPA and suicide attempts among criminal offenders, and are consistent with the possibility that treating aggression may reduce risk for suicide attempts.

Depressed women with sexual abuse histories have a heightened risk of suicidal ideation (SI), which may be only in part attributable to psychiatric symptoms of depression and posttraumatic stress disorder (PTSD). Emotions and SI were studied among 106 women with histories of childhood sexual abuse enrolled in treatment trials for major depression. Assessments were conducted at baseline, 10, 24, and 36 weeks. Sadness, guilt, and shame-proneness were associated with self-reported and observer-rated SI across time after adjusting for depressive and PTSD symptoms, suicide attempt history, and sociodemographic characteristics associated with SI. These findings highlight the need for clinical attention to self-directed negative emotions to potentially reduce suicide-related risk.