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Research Trends

Participant Reactions to Suicide-Focused Research

Implications of Studying Suicide on an Inpatient Psychiatry Unit

Published Online:https://doi.org/10.1027/0227-5910/a000650

Abstract.Background: Concerns exist regarding the perceived risks of conducting suicide-focused research among an acutely distressed population. Aims: The current study assessed changes in participant distress before and after participation in a suicide-focused research study conducted on a psychiatric inpatient unit. Method: Participants included 37 veterans who were receiving treatment on a psychiatric inpatient unit and completed a survey-based research study focused on suicide-related behaviors and experiences. Results: Participants reported no significant changes in self-reported distress. The majority of participants reported unchanged or decreased distress. Reviews of electronic medical records revealed no behavioral dysregulation and minimal use of as-needed medications or changes in mood following participation. Limitations: The study's small sample size and veteran population may limit generalizability. Conclusion: Findings add to research conducted across a variety of settings (i.e., outpatient, online, laboratory), indicating that participating in suicide-focused research is not significantly associated with increased distress or suicide risk.

References

  • Ammerman, B. A., Sorgi, K. M., Berman, M. E., Coccaro, E. F., & McCloskey, M. S. (2018). Potential mood variation following a behavioral analogue of self-injurious behavior. Archives of Suicide Research. online publication. 10/1080/13811118.2018.1527267 First citation in articleCrossrefGoogle Scholar

  • Bagge, C. L., Littlefield, A. K., Connor, K. R., Schumacher, J. A., & Lee, H. J. (2014). Near-term predictors of the intensity of suicidal ideation: An examination of the 24h prior to a recent suicide attempt. Journal of Affective Disorders, 165, 53–58. 10.1016/j.jad2014.04.010 First citation in articleCrossref MedlineGoogle Scholar

  • Bajaj, P., Borreani, E., Ghosh, P., Methuen, C., Patel, M., & Crawford, M. J. (2008). Screening for suicidal thoughts in primary care: The views of patients and general practitioners. Mental Health in Family Medicine, 5, 229–235. First citation in articleMedlineGoogle Scholar

  • Becker-Blease, K. A., & Freyd, J. J. (2006). Research participants telling the truth about their lives: The ethics of asking and not asking about abuse. American Psychologist, 61, 218–226. 10.1037/0003-066X.61.3.218 First citation in articleCrossref MedlineGoogle Scholar

  • Berman, A. L., & Silverman, M. M. (2017). How to ask about suicide? A question in need of an empirical answer. Crisis, 38, 213–216. 10.1027/0227-5910/a000501 First citation in articleLinkGoogle Scholar

  • Blades, C. A., Stritzke, W. G. K., Page, A. C., & Brown, J. D. (2018). The benefits and risks of asking research participants about suicide: A meta-analysis of the impact of exposure to suicide-related content. Clinical Psychology Review, 64, 1–12. 10.1016/j.cpr.2018.07.001 First citation in articleCrossref MedlineGoogle Scholar

  • Centers for Disease Control and Prevention. (2016). Web-based injury statistics query and reporting system. Retrieved from http://www.cdc.gov/injury/wisqars/ First citation in articleCrossrefGoogle Scholar

  • Cha, C. B., Glenn, J. J., Deming, C. A., D'Angelo, E. J., Hooley, J. M., Teachman, B. A., & Nock, M. K. (2016). Examining potential iatrogenic effects of viewing suicide and self-injury stimuli. Psychological Assessment, 28, 1510–1515. 10.1037/pas0000280 First citation in articleCrossref MedlineGoogle Scholar

  • Chung, D. T., Ryan, C. J., Hadzi-Pavlovic, D., Singh, S. P., Stanton, C., & Large, M. M. (2017). Suicide rates after discharge from psychiatric facilities: a systematic review and meta-analysis. JAMA Psychiatry, 74, 694–702. 10.1001/jamapsychiatry.2017.1044 First citation in articleCrossref MedlineGoogle Scholar

  • Crawford, M. J., Thana, L., Methuen, C., Ghosh, P., Stanley, S. V., Ross, J., … Bajaj, P. (2011). Impact of screening for risk of suicide: Randomised controlled trial. British Journal of Psychiatry, 198, 379–384. 10.1192/bjp.bp.110.083592 First citation in articleCrossref MedlineGoogle Scholar

  • Curtin, S. C., Warner, M., & Hedegaard, H. (2016). Increase in suicide in the United States, 1999-2014 (NCHS data brief, no. 241). Hyattsville, MD: National Center for Health Statistics. First citation in articleGoogle Scholar

  • Dazzi, T., Gribble, R., Wessely, S., & Fear, N. T. (2014). Does asking about suicide and related behaviours induce suicidal ideation? What is the evidence? Psychological Medicine, 44, 3361–3363. 10.1017/S0033291714001299 First citation in articleCrossref MedlineGoogle Scholar

  • DeCou, C. R., & Schumann, M. E. (2018). On the iatrogenic risk of assessing suicidality: A meta-analysis. Suicide and Life-Threatening Behavior, 48, 531–543. 10.1111/sltb.12368 First citation in articleCrossref MedlineGoogle Scholar

  • Eynan, R., Bergmans, Y., Antony, J., Cutcliffe, J. R., Harder, H. G., Ambreen, M., … Links, P. S. (2014). The effects of suicide ideation assessments on urges to self-harm and suicide. Crisis, 35, 123–131. 10.1027/0227-5910/a000233 First citation in articleLinkGoogle Scholar

  • Gearing, R. E., Mian, I. A., Barber, J., & Ickowicz, A. (2006). A methodology for conducting retrospective chart review research in child and adolescent psychiatry. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 15, 126–134. First citation in articleMedlineGoogle Scholar

  • Gibson, S., Boden, Z. V., Benson, O., & Brand, S. (2014). The impact of participating in suicide research online. Suicide and Life-Threatening Behavior, 44, 372–383. 10.1111/sltb.12082 First citation in articleCrossref MedlineGoogle Scholar

  • Hallensleben, N., Glaesmer, H., Forkmann, T., Rath, D., Strauss, M., Kersting, A., & Spangenberg, L. (2019). Predicting suicidal ideation by interpersonal variables, hopelessness and depression in real-time. An ecological momentary assessment study in psychiatric inpatients with depression. European Psychiatry, 56, 43–50. 10.1016/j.eurpsy.2018.11.003 First citation in articleCrossref MedlineGoogle Scholar

  • Jorm, A. F., Kelly, C. M., & Morgan, A. J. (2007). Participant distress in psychiatric research: A systematic review. Psychological Medicine, 37, 917–926. 10.1017/S0033291706009779 First citation in articleCrossref MedlineGoogle Scholar

  • Kleiman, E. M., Turner, B. J., Fedor, S., Beale, E. E., Huffman, J. C., & Nock, M. K. (2017). Examination of real-time fluctuations in suicidal ideation and its risk factors: Results from two ecological momentary assessment studies. Journal of Abnormal Psychology, 126, 726–738. 10.1037/abn0000273 First citation in articleCrossref MedlineGoogle Scholar

  • Klonsky, E. D., & May, A. M. (2015). The three-step theory (3ST): A new theory of suicide rooted in the "ideation-to-action" framework. International Journal of Cognitive Therapy, 8, 114–129. 10.1521/ijct.2015.8.2.114 First citation in articleCrossrefGoogle Scholar

  • Lakeman, R., & FitzGerald, M. (2009). The ethics of suicide research: The views of ethics committee members. Crisis, 30, 13–19. 10.1027/0227-5910.30.1.13 First citation in articleLinkGoogle Scholar

  • Legerski, J. P., & Bunnell, S. L. (2010). The risks, benefits, and ethics of trauma-focused research participation. Ethics & Behavior, 20, 429–442. 10.1080/10508422.2010.521443 First citation in articleCrossrefGoogle Scholar

  • Linehan, M. M., Comtois, K. A., & Ward-Ciesielski, E. F. (2012). Assessing and managing risk with suicidal individuals. Cognitive and Behavioral Practice, 19, 218–232. 10.1016/j.cbpra.2010.11.008 First citation in articleCrossrefGoogle Scholar

  • Michaels, M. S., Chu, C., Silva, C., Schulman, B. E., & Joiner, T. (2014). Considerations regarding online methods for suicide-related research and suicide risk assessment. Suicide and Life-Threatening Behavior, 45, 10–17. 10.1111/sltb.12105 First citation in articleCrossref MedlineGoogle Scholar

  • National Institute for Mental Health. (n.d.). Conducting research with Participants at Elevated Risk for Suicide: Considerations for Researchers. Retrieved from https://www.nimh.nih.gov/funding/clinical-research/conducting-research-with-participants-at-elevated-risk-for-suicide-considerations-for-researchers.shtml First citation in articleGoogle Scholar

  • O'Connor, R. C., & Kirtley, O. J. (2018). The integrated motivational–volitional model of suicidal behaviour. Philosophical Transactions of the Royal Society B, 373, 20170268. 10.1098/rstb.2017.0268 First citation in articleCrossref MedlineGoogle Scholar

  • Omerov, P., Steineck, G., Dyregrov, K., Runeson, B., & Nyberg, U. (2014). The ethics of doing nothing. Suicide-bereavement and research: Ethical and methodological considerations. Psychological Medicine, 44, 3409–3420. 10.1017/S0033291713001670 First citation in articleCrossref MedlineGoogle Scholar

  • Poindexter, E. K., Nazem, S., Barnes, S. M., Hostetter, T. A., & Smith, P. N. (2019). Veteran participation in intensive suicide research protocols: No evidence of iatrogenic effects. Suicide and Life-Threatening Behavior, 49, 303–309. 10.1111/sltb.12444 First citation in articleCrossref MedlineGoogle Scholar

  • Rivlin, A., Marzano, L., Hawton, K., & Fazel, S. (2012). Impact on prisoners of participating in research interviewers related to near-lethal suicide attempts. Journal of Affective Disorders, 136, 54–62. 10.1016/j.jad.2011.09.009 First citation in articleCrossref MedlineGoogle Scholar

  • Reynolds, S. K., Lindenboim, N., Comtois, K. A., Murray, A., & Linehan, M. M. (2006). Risky assessments: Participant suicidality and distress associated with research assessments in a treatment study of suicidal behavior. Suicide & Life-Threatening Behavior, 36, 19–34. 10.1521/suli.2006.36.1.19 First citation in articleCrossref MedlineGoogle Scholar

  • Shepard, D. S., Gurewich, D., Lwin, A. K., Reed, G. A., & Silverman, M. M., (2016). Suicide and suicidal attempts in the United States: Costs and policy implications. Suicide and Life-Threatening Behavior, 46, 352–362. 10.1111/sltb.12225">https://doi.org/10.1111/sltb.12225 First citation in articleCrossref MedlineGoogle Scholar

  • Sisti, D. A., & Joffe, S. (2018). Implications of zero suicide for suicide prevention research. JAMA, 320, 1633–1634. 10.1001/jama.2018.13083 First citation in articleCrossref MedlineGoogle Scholar

  • Vassar, M., & Holzmann, M. (2013). The retrospective chart review: Important methodological considerations. Journal of Educational Evaluation for Health Professions, 10(12), 1–7. 10.3352/jeehp.2013.10.12 First citation in articleCrossref MedlineGoogle Scholar