Suicide Disclosure in Suicide Attempt Survivors: Does Family Reaction Moderate or Mediate Disclosure's Effect on Depression?

Abstract

Existing literature has found a link between disclosure of a stigmatized identity and improved mental health; however, research on the impact of suicide disclosure to family members is scarce. Suicide attempt survivors (n = 74) in the United States were examined to assess whether family reaction moderates or mediates the relationship between suicide disclosure and subsequent depression symptoms. Family reaction did not moderate but did mediate the relationship between disclosure and depression symptoms while controlling for time since most recent attempt. Higher rates of disclosure predicted more positive family reactions, which in turn predicted less severe depression symptoms. Findings indicate that family members can play an essential role in the recovery process after an attempt occurs, which has important implications for both researchers and clinicians who seek to decrease stigma for attempt survivors while simultaneously decreasing the likelihood of future attempts.

“Are You Having Thoughts of Suicide?” Examining Experiences With Disclosing and Denying Suicidal Ideation

“…Conversely, negatively valenced reactions were noticeably less common. These findings are encouraging in light of research indicating that (a) when suicidal individuals have negative experiences with a mental health provider, they are less likely to seek care in the future (Goldston et al., ; Moskos, Olson, Halbern, & Gray, ); and (b) when individuals with a suicide attempt history disclose this information to others and reactions are helpful, they are likely to disclose more information and experience reduced risk (Frey, Hans, & Cerel, ).…”

The Decision‐Making Process for Disclosing Suicidal Ideation and Behavior to Family and Friends

“…Although comprehensive disclosure decision-making models have been developed for other concealable stigmatized statuses-for example, the disclosure processes model conceptualizes HIV disclosure decision-making as a cyclical process in which disclosure goals motivate the disclosure event, which is linked to the quality of outcomes by several mechanisms (Chaudoir & Fisher, 2010)-researchers have not yet examined the disclosure decision process for attempt survivors. Similar to studies linking the disclosure of concealable stigmatized statuses, such as HIV status (Mayfield Arnold, Rice, Flannery, & Rotheram-Borus, 2008), to lower psychological distress (Quinn et al, 2014), previous research has linked higher rates of suicide-related disclosure to lower levels of depression symptomology (Frey, Hans, & Cerel, 2016a). This latter link was mediated by the quality of family reaction, with higher rates of suicide-related disclosure predicting more helpful family reactions, which in turn predicted less severe depression symptoms.…”

What Factors Influence the Decision to Share Suicidal Thoughts? A Multilevel Social Network Analysis of Disclosure Among Individuals with Serious Mental Illness

“…As an early warning sign for more serious suicidal behavior, suicidal ideation has been identified as a potential target for suicide prevention efforts (Fialko et al., ). However, these efforts require the detection of suicidal ideation, which almost exclusively relies on an individual's willingness to disclose suicidal thoughts (Frey, Hans, & Cerel, ). Nondisclosure of suicidal thoughts can have serious consequences, including undetected suicide risk, missed opportunities for the management/treatment of suicidal symptoms, and deaths by suicide (Cukrowicz, Duberstein, Vannoy, Lin, & Unützer, ).…”