Skip to main content
SpringerLink
Log in

Stressful Life Events and Near-term Suicidal Risk in a Clinical Population

  • Original Paper
  • Published:
Psychiatric Quarterly Aims and scope Submit manuscript

Abstract

The present study examined 22 specific stressful life events (SLEs) in relation to recent and prospective suicidal thoughts and behaviors (STBs). The effect of assessment method (self-report vs. chart-based ratings) and inpatient/outpatient status was also investigated. Past 3-month STBs and SLEs were assessed for 1,058 psychiatric patients; 696 completed one-month follow-up assessments. SLEs were common, with 684 participants (64.7%) reporting at least one. Total number of SLEs correlated with recent and prospective STB. A higher incidence of SLE’s was found with self-report vs. chart-based measures (on 20 SLEs) and inpatients vs. outpatients (on 7 SLEs). SLEs of interpersonal rejection and loss, homelessness and academic failure offered elevated risk. In sum, SLEs are common and associated with STBs in psychiatric patients. SLEs of interpersonal rejection and loss, homelessness and academic failure may merit increased clinical attention.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Bertolote JM, Fleischmann A. Suicide and psychiatric diagnosis: a worldwide perspective. World Psychiatry: Official Journal of the World Psychiatric Association (WPA). 2002;1(3):181–5. http://www.ncbi.nlm.nih.gov/pubmed/16946849%0Ahttp://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC1489848.

    PubMed  Google Scholar 

  2. WHO. (n.d.). Suicide. Retrieved May 5., 2021, from https://www.who.int/news-room/fact-sheets/detail/suicide.

  3. Jean-Baptiste CO, Herring RP, Beeson WL, Santos D, H., Banta JE. Stressful life events and social capital during the early phase of COVID-19 in the U.S. Social Sci Humanit Open. 2020;2(1):100057. https://doi.org/10.1016/j.ssaho.2020.100057.

    Article  Google Scholar 

  4. Mousavi SAM, Hooshyari Z, Ahmadi A. The most stressful events during the COVID-19 epidemic. Iran J Psychiatry. 2020;15(3):220–7. https://doi.org/10.18502/ijps.v15i3.3814.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Rossi R, Socci V, Talevi D, Mensi S, Niolu C, Pacitti F, Di Marco A, Rossi A, Siracusano A, Di Lorenzo G. COVID-19 pandemic and lockdown measures impact on Mental Health among the General Population in Italy. Front Psychiatry. 2020;11(August):7–12. https://doi.org/10.3389/fpsyt.2020.00790.

    Article  Google Scholar 

  6. Brailovskaia J, Teismann T, Margraf J. Positive Mental Health, Stressful Life events, and suicide ideation: a 2-Year Follow-Up study. Crisis. 2020;41(5):383–8. https://doi.org/10.1027/0227-5910/a000652.

    Article  PubMed  Google Scholar 

  7. Howarth EJ, O’Connor DB, Panagioti M, Hodkinson A, Wilding S, Johnson J. Are stressful life events prospectively associated with increased suicidal ideation and behaviour? A systematic review and meta-analysis. J Affect Disord. 2020;266(January):731–42. https://doi.org/10.1016/j.jad.2020.01.171.

    Article  PubMed  Google Scholar 

  8. McFeeters D, Boyda D, O’Neill S. Patterns of Stressful Life events: distinguishing suicide ideators from suicide attempters. J Affect Disord. 2015;175:192–8. https://doi.org/10.1016/j.jad.2014.12.034.

    Article  PubMed  Google Scholar 

  9. Farahbakhsh M, Fakhari A, Davtalab Esmaeili E, Azizi H, Mizapour M, Rahimi A, V., Hashemi L. The role and comparison of Stressful Life events in suicide and suicide attempt: a Descriptive-Analytical Study. Iran J Psychiatry Behav Sci. 2020;14(2). https://doi.org/10.5812/ijpbs.96051.

  10. Pompili M, Innamorati M, Szanto K, Di Vittorio C, Conwell Y, Lester D, Tatarelli R, Girardi P, Amore M. Life events as precipitants of suicide attempts among first-time suicide attempters, repeaters, and non-attempters. Psychiatry Res. 2011;186(2–3):300–5. https://doi.org/10.1016/j.psychres.2010.09.003.

    Article  PubMed  Google Scholar 

  11. Buchman-Schmitt JM, Chu C, Michaels MS, Hames JL, Silva C, Hagan CR, Ribeiro JD, Selby EA, Joiner TE. The role of stressful life events preceding death by suicide: evidence from two samples of suicide decedents. Psychiatry Res. 2017;256(November 2016):345–52. https://doi.org/10.1016/j.psychres.2017.06.078.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Coope C, Donovan J, Wilson C, Barnes M, Metcalfe C, Hollingworth W, Kapur N, Hawton K, Gunnell D. Characteristics of people dying by suicide after job loss, financial difficulties and other economic stressors during a period of recession (2010–2011): a review of coroners’ records. J Affect Disord. 2015;183:98–105. https://doi.org/10.1016/j.jad.2015.04.045.

    Article  PubMed  Google Scholar 

  13. Fjeldsted R, Teasdale TW, Jensen M, Erlangsen A. Suicide in relation to the experience of Stressful Life events: a Population-Based study. Archives of Suicide Research. 2017;21(4):544–55. https://doi.org/10.1080/13811118.2016.1259596.

    Article  PubMed  Google Scholar 

  14. Overholser JC, Braden A, Dieter L. Understanding suicide risk: identification of high-risk groups during high-risk times. J Clin Psychol. 2012;68(3):349–61. https://doi.org/10.1002/jclp.20859.

    Article  PubMed  Google Scholar 

  15. Bagge CL, Glenn CR, Lee H-J. (2012, October 22). Quantifying the Impact of Recent Negative Life Events on Suicide Attempts. Journal of Abnormal Psychology. Advance online publication. https://doi.org/10.1037/a0030371.

  16. Qin P, Nordentoft M. Suicide risk in relation to Psychiatric hospitalization: evidence based on longitudinal registers. Arch Gen Psychiatry. 2005;62(4):427–32. https://doi.org/10.1001/archpsyc.62.4.427.

    Article  PubMed  Google Scholar 

  17. Liu BP, Zhang J, Chu J, Qiu HM, Jia CX, Hennessy DA. Negative life events as triggers on suicide attempt in rural China: a case-crossover study. Psychiatry Res. 2019;276:100–6. https://doi.org/10.1016/j.psychres.2019.04.008.

    Article  CAS  PubMed  Google Scholar 

  18. Currier D, Spittal MJ, Patton G, Pirkis J. Life stress and suicidal ideation in australian men - cross-sectional analysis of the australian longitudinal study on male health baseline data. BMC Public Health. 2016;16(3):43–9. https://doi.org/10.1186/s12889-016-3702-9.

    Article  PubMed Central  Google Scholar 

  19. Hawes M, Yaseen Z, Briggs J, Galynker I. The Modular Assessment of risk for imminent suicide (MARIS): a proof of concept for a multi-informant tool for evaluation of short-term suicide risk. Compr Psychiatr. 2017;72:88–96. https://doi.org/10.1016/j.comppsych.2016.10.002.

    Article  Google Scholar 

  20. Cohen LJ, Mokhtar R, Richards J, Hernandez M, Bloch-Elkouby S, Galynker I. The Narrative‐Crisis Model of suicide and its prediction of near‐term suicide risk. Suicide and Life‐Threatening Behavior. 2022;52(2):231–43. https://doi.org/10.1111/sltb.12816.

    Article  PubMed  Google Scholar 

  21. Rogers, M. L., Richards, J. A., Cao, E., Krumerman, M., Barzilay, S., Blum, Y., …Galynker, I. (2023). Associations between long-term and near-term stressful life events, suicide crisis syndrome, and suicidal ideation. International Journal of Stress Management. https://doi.org/10.1037/str0000272.

  22. Holmes TH, Rahe RH. The social readjustment rating scale. J Psychosom Res. 1967;11(2):213–8. https://doi.org/10.1016/0022-3999(67)90010-4.

    Article  CAS  PubMed  Google Scholar 

  23. Goodman LA, Corcoran C, Turner K, Yuan N, Green BL. Assessing traumatic event exposure: general issues and preliminary findings for the stressful life events screening questionnaire. J Trauma Stress. 1998;11(3):521–42. https://doi.org/10.1023/A:1024456713321.

    Article  CAS  PubMed  Google Scholar 

  24. Bebbington P, Hurry J. The list of threatening experiences: a subset of 12 life event categories with considerable long-term contextual threat. Psychol Med. 1985;15(1):189–94. https://doi.org/10.1017/S003329170002105X.

    Article  PubMed  Google Scholar 

  25. Spurgeon A, Jackson CA, Beach JR. The life events inventory: re-scaling based on an occupational sample. Occup Med. 2001;51(4):287–93. https://doi.org/10.1093/occmed/51.4.287.

    Article  CAS  Google Scholar 

  26. Posner K, Brown GK, Stanley B, Brent DA, Yershova KV, Oquendo MA, Currier GW, Melvin GA, Greenhill L, Shen S, Mann JJ. The Columbia-suicide severity rating scale: initial validity and internal consistency findings from three multisite studies with adolescents and adults. Am J Psychiatry. 2011;168(12):1266–77. https://doi.org/10.1176/appi.ajp.2011.10111704.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Cohen LJ, Ardalan F, Yaseen Z, Galynker I. Suicide Crisis Syndrome mediates the relationship between long-term risk factors and lifetime suicidal phenomena. Suicide Life-Threat Behav. 2018;48(5):613–23. https://doi.org/10.1111/sltb.12387.

    Article  PubMed  Google Scholar 

  28. Bloch-Elkouby S, Gorman B, Lloveras L, Wilkerson T, Schuck A, Barzilay S, Calati R, Schnur D, Galynker I. How do distal and proximal risk factors combine to predict suicidal ideation and behaviors? A prospective study of the narrative crisis model of suicide. J Affect Disord. 2020;277:914–26. https://doi.org/10.1016/j.jad.2020.08.088.

    Article  PubMed  Google Scholar 

  29. Calati R, Cohen LJ, Schuck A, Levy D, Bloch-Elkouby S, Barzilay S, Rosenfield PJ, Galynker I. The Modular Assessment of risk for imminent suicide (MARIS): a validation study of a novel tool for suicide risk assessment. J Affect Disord. 2020;263:121–8. https://doi.org/10.1016/j.jad.2019.12.001.

    Article  PubMed  Google Scholar 

  30. Bernstein DP, Fink L. CTQ child trauma questionnaire: a retrospective self-report. San Antonio: The Psychological Corporation; 1998. (after Posner).

    Google Scholar 

  31. Barzilay S, Yaseen Z, Hawes M, Gorman B, Altman R, Foster A, Apter A, Rosenfield P, Galynker I. Emotional responses to suicidal patients: factor structure, construct, and predictive validity of the therapist response questionnaire – suicide form. Front Psychiatry. 2018;9:104. https://doi.org/10.3389/fpsyt.2018.00104.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Leavey G, Mallon S, Rondon-Sulbaran J, Galway K, Rosato M, Hughes L. The failure of suicide prevention in primary care: Family and GP perspectives - a qualitative study. BMC Psychiatry. 2017;17(1):1–10. https://doi.org/10.1186/s12888-017-1508-7.

    Article  Google Scholar 

  33. Campbell JC, Lewandowski LA. Mental and physical health effects of intimate partner violence on women and children. Psychiatr Clin North Am. 1997;20(2):353–74. https://doi.org/10.1016/S0193-953X(05)70317-8.

    Article  CAS  PubMed  Google Scholar 

  34. Mechanic MB, Weaver TL, Resick PA. Mental health consequences of intimate partner abuse: a multidimensional assessment of four different forms of abuse. Violence Against Women. 2008;14(6):634–54. https://doi.org/10.1177/1077801208319283.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Schreiter S, Bermpohl F, Krausz M, Leucht S, Rössler W, Schouler-Ocak M, Gutwinski S. The prevalence of mental illness in homeless people in Germany - A systematic review and meta-analysis. Deutsches Arzteblatt International. 2017;114(40):665–72. https://doi.org/10.3238/arztebl.2017.0665.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Nordentoft M. Prevention of suicide and attempted suicide in Denmark. Dan Med Bull. 2007;54(4):306–69.

    PubMed  Google Scholar 

  37. Nieto M, Romero D, Ros L, Zabala C, Martínez M, Ricarte JJ, Serrano JP, Latorre JM. Differences in coping strategies between Young and older adults: the role of executive functions. Int J Aging Hum Dev. 2020;90(1):28–49. https://doi.org/10.1177/0091415018822040.

    Article  PubMed  Google Scholar 

  38. Kitzrow MA. (2003). The Mental Health Needs of Today’s College Students: Challenges and Recommendations. In NASPA Journal (Vol. 41, Issue 1).

Download references

Acknowledgements

The authors would like to extend gratitude to all patients and clinicians who participated in the study and all research assistants who contributed to data collection and entry.

Funding

This study was supported by the American Foundation for Suicide Prevention (AFSP) focus grant #RFA-1-015-14.

Author information

Authors and Affiliations

  1. Icahn School of Medicine at Mount Sinai, New York, NY, United States of America

    Lisa J. Cohen, Sarah Bloch-Elkouby & Igor Galynker

  2. Department of Psychiatry, Mount Sinai Beth Israel, New York, NY, United States of America

    Lisa J. Cohen, Jenelle Richards, Sarah Bloch-Elkouby & Igor Galynker

  3. Taub Institute, Columbia University Medical Center, New York, NY, United States of America

    Michelle Hernandez

  4. Graduate School of Applied and Professional Psychology, Rutgers University, Piscataway, NJ, United States of America

    Radwa Mokhtar

  5. Department of Psychology, Texas State University, San Marcos, TX, United States of America

    Megan L. Rogers

Authors
  1. Lisa J. Cohen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michelle Hernandez
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Radwa Mokhtar
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jenelle Richards
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sarah Bloch-Elkouby
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Megan L. Rogers
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Igor Galynker
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lisa J. Cohen.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic Supplementary Material

Below is the link to the electronic supplementary material.

Supplementary Material 1

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cohen, L.J., Hernandez, M., Mokhtar, R. et al. Stressful Life Events and Near-term Suicidal Risk in a Clinical Population. Psychiatr Q 94, 467–482 (2023). https://doi.org/10.1007/s11126-023-10038-7

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11126-023-10038-7

Keywords

Search

Navigation