Gun Owners At Risk for Suicide Less Likely to Be Detected by Screening

Researchers suggest psychiatric screening tools may be missing indicators of suicidal behavior in gun owners.

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In a new article published in JAMA Network Open, Craig Bryan and his colleagues explore suicidal ideation and behavior in gun owners and non-gun owners in the United States.

The present research examines Self-Injurious Thoughts and Behaviors Interview-Revised (SITBI-R) survey data from 9153 participants. The authors used latent class analysis to divide the responses into five subgroups. In the groups with lower probabilities of suicide risk (1-3), there is little difference between gun owners’ and non-gun owners’ responses to the SITBI-R. However, in the groups with the highest probability of attempting suicide (4-5), gun owners are less likely than non-gun owners to report suicidal ideation.

According to the authors, these findings mean gun owners with a high probability of suicidal behavior may not be detected by psychiatric screenings that attempt to assess suicidal ideation.

“In this study, in subgroups with lower probabilities of suicide attempt, gun owners and non–gun owners showed similar patterns of suicide risk item endorsement, but when the probability of a suicide attempt increased, gun owners were less likely than non–gun owners to endorse passive and active suicidal ideation,” the authors explain. “These findings suggest that assessing a broader range of suicide risk indicators may improve risk detection.”

Man holds handgun in gun shop. Gun owners are more likely than non-gun owners to die by suicide. This risk is so pronounced that some authors have called it an epidemic. The risk of suicide by firearm also appears to be linked to poverty rates in the United States.

Psychiatric treatment has largely failed in its attempts to prevent suicide. Antidepressant use and suicide rates have substantially increased in recent years in the United States. Even with bias and financial conflicts likely leading to an underestimate, antidepressants have been found to increase suicide risk at all ages. One study found that antidepressant use more than doubles the risk of suicide.

Benzodiazepines like Xanax have also been linked to increased suicide risk. Researchers have suggested this may be due to the drug’s effects on impulsivity and aggression, the devastating withdrawal symptoms, and toxicity associated with overdose.

Anti-manic drugs like Lithium are commonly prescribed to prevent suicide. However, one recent study found the drug was no better than a placebo in preventing suicide attempts. Similarly, research has found that electroconvulsive therapy does not affect suicide risk.

Involuntary psychiatric hospitalization increases the risk of suicide. One piece of research found that suicide risk is 100 times greater than average following discharge from a psychiatric hospital and remains elevated for years.

The authors explain that suicide rates in the United States have increased by 30% since 2000. Firearms are the most common method of suicide. Previous research has shown that gun ownership increases suicide risk. However, according to the authors, there has been little investigation into how suicidal ideation and behavior correlate to death by suicide. The current research attempts to fill this knowledge gap.

The researchers used online survey data (the SITBI-R) from 9153 participants. Each participant was at least 18 years old, lived in the United States, was able to speak and understand English, and answered either “yes” or “no” to a question about firearm ownership on the SITBI-R.

According to the authors, five subgroups of distinct response patterns to the SITBI-R emerged. Among gun owners, group 1 demonstrated an absence of active and passive suicidal ideation, suicidal behavior, suicidal planning, and non-suicidal self-injury (NSSI). Group 2 lacked suicidal behavior but often reported wanting to disappear, not exist, or go to sleep and never wake up. Group 3 demonstrated no patterns in their responses. Group 4 lacked the wish to go to sleep and never wake up but demonstrated thoughts about specific methods of suicide and preparatory behavior and a desire to disappear, active suicidal thoughts, and suicide attempts. Group 5 was characterized by active and passive suicidal thoughts, ambivalent thoughts of suicide, and thoughts about specific methods. Among gun owners, group 4 was the most likely to have recently attempted suicide.

Among non-gun owners, groups 1-3 demonstrated similar response patterns to gum owners. Group 4 showed active and passive suicidal ideation but lacked suicidal behavior overall. Group 5 again demonstrated similar response patterns to that of gun owners, with the addition of increased thoughts about a specific place to carry out suicide plans.

The authors conclude that gun owners and non-gun owners at similar risk of suicide do not endorse similar suicidal thought and behavior levels in psychiatric survey tools. Consistent with previous research, gun owners were generally more likely to have passive and active suicidal thoughts than non-gun owners. However, this was only true in the groups least likely to demonstrate suicidal behavior (1-3).

In the groups most likely to demonstrate suicidal behavior (4-5), self-disclosure of suicidal thoughts was more likely to be linked to suicide attempts in non-gun owners. For gun owners, preparatory behavior and thinking of specific methods of suicide were most commonly related to suicidal behavior. In other words, self-reported suicidal ideation may not be a good predictive factor for suicide in gun owners. The authors conclude:

“The findings suggest that supplementing passive and active suicidal ideation items with items assessing thoughts about specific ways or methods of attempting suicide and/or taking steps to prepare for a suicide attempt may improve detection of subgroups at high risk of a suicide attempt. “

 

 

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Bryan, C. J., Bryan, A. O., Wastler, H. M., Khazem, L. R., Ammendola, E., Baker, J. C., Szeto, E., Tabares, J., & Bauder, C. R. (2022). Assessment of Latent Subgroups With Suicidal Ideation and Suicidal Behavior Among Gun Owners and Non–Gun Owners in the US. JAMA Network Open, 5(5), e2211510. https://doi.org/10.1001/jamanetworkopen.2022.11510 (Link)

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Richard Sears
Richard Sears teaches psychology at West Georgia Technical College and is studying to receive a PhD in consciousness and society from the University of West Georgia. He has previously worked in crisis stabilization units as an intake assessor and crisis line operator. His current research interests include the delineation between institutions and the individuals that make them up, dehumanization and its relationship to exaltation, and natural substitutes for potentially harmful psychopharmacological interventions.

4 COMMENTS

  1. Whilst I am leery of the bullying that can from any “we” I am mulling over articles like this. Is this article blaming atrocities on all the aunts and uncles and daughters and sons and moms and dads and best friends and unimaginative colleagues and doctor prescribers and psychologists and priests and immams and rabbis and college leaders and teenage pals and chemists and tourist shop owners and bakers and baristas and psychiatric peers and long covid nurses and psychiatrists fresh out of studies and sailors and drug dealers and celebrities in a court room and a billion other helpless well meaning people who suggest that the suicidal might like to try a short course of antidepressants? Are all these naive and blameless people responsible for killing the world? Are the people who offer other dangerous substances such as wine and beer and spirits to billions of miserable friends guilty of pressing a gun in their hand?

    No!

    This wonderful article is getting to the bottom of the barrel in revealling that it is the human capacity to BLAME that is killing billions.

    Logic is the critical fault finder. It acts as a blamer virus.

    The gun is a hopeless person’s answer to being repeatedly blamed.

    The gun is also the accoutrement of the menacing blamer, welded to the fist of that imposter leader.

    The gun is a moulded steel manifestation of the words….

    “YOU DID THIS TO ME”.

    It is what everyone wants to scream at callous logic with it tyrannical rules rules rules.

    But the gun is cruelty itself. It has no place in a just and compassionate and sophisticated human civilization. A civilization that does not centre blame but centres love.

    That caring civilization can ONLY be found ONE WAY in the world.

    *WOMEN*
    __________

  2. https://youtu.be/JH40VvlejEI

    Richard, I have long said here that reality itself is…

    “a mirage”.

    It was the angels who told me this, around the time they told me a massive global flood is going to roll in. Yesterday in my mid afternoon drowse I chanced to come across this youtube video by an eminent professor of science. I was not looking for him. These videos often find me by happenstance. After my Divinity degree I flounced off into studying the paranormal. I attended a parapsychology school for a decade. I recall being taken aback when one of the first people I met there told me that Spiritualism was not a religion but a science. He himself was a scientist so I did not bother arguing with him. I then learned that it can be both a science and a faith, depending on individual preference. I always found that so healthy that congregants could be either or both.
    I find the idea of the nature of reality being made of “a mirage” both unfathomable and a relief. If reality is like a dream in which our nested consciousness cannot see that we are dreaming then it is hardly surprising we take it all so seriously. But one of the most liberating qualities in dreams is a sense that “anything goes”. Dreams, if you hadn’t noticed, have no orderly passage of clock time in them and they do not get bogged down in tight scruples and rules and criticisms. A figure may not like you in a dream but that is about all you get to know, which is really quite wonderful. The figure does not tell you are too uneductated or unpopular or remind you of a song you sang to them way back when you were twenty one. They just do not like you. That is it. The reason everyone is so simplified in dreams is because in that state the dreamer returns to being a human animal. Thinking stops. It takes a rest. Feelings pick up from where stressful daily thinking left off. Sleep edits out thinking. If it did not humans would go crazy with analysing too much. Returning to the animal core is what refreshes us when we stir awake to greet the new day, or mentally dread it.
    Being a dreamer who is more animal means to be more accepting of the “isness” of ever changing props in the dreams that we believe are “reality” while fast asleep. This acceptingness that is so very tiger and sheep and goldfish of us is really quite beautiful. Spiritual. The acceptance is almost a form of enlightenment. And yet it comes from being a humble unthinking oaf of an animal. So how come when we are at our most oafish are we at our most gentle? And how come when we are at our most intellectual are we at our most ruthless and even cruel? I have often said that cruelty comes from having a non acceptance of feelings. Children are very compassionate when in their pre school years. They may be bumptious and yell alot but they are not cruel enough to build a death camp. Children live in the dream. The dreaminess of feeling a lot about a lot of stuff a lot of the day. Which is why children are so unracist and unbigoted and very accepting of other people’s preferrencs. They see those as coming from intense feelings and not “logic”. And since feelings cannot be right or wrong but simply are what they are, children are like animals in how they accept each other’s differences of “free choice”.
    Children “get it”. Children get the “mirage” of reality. That is how they can play with it so unendingly. Adults take reality too seriously to play with it which is why they look so stressed and then try to think their way out of the stress that thinking all day causes to them.

    I like to put the notion of the “mirage” at the top of the tree of all the ways I can regard life. Every branch further down, like science or religion or atheism or philosophy are secondary to the initial tip of the top of the tree that sprung from the soil.

    If this reality we inhabit is ALL a wonderful riotous “mirage” or a dream that we cannot recognize is a dream then ALL ways of seeing that dream are open to the interpretation of

    YOUR FAVOURITE
    PERSONAL CHOICE.

    If from the top of the tree you gaze down at science and decide you love certain things science says but not other things then where is the harm in your choice to perceive science in your dream of reality in YOUR WAY?

    I believe I have a chemical imbalance boggling my brain enough to cause my suffering schizophrenia. It gives me comfort to regard my illness this way, in my dream. Try to think of me as an animal. What business is it of anyone else who has NEVER had one minute of schizophrenic hallucinations to tell me I cannot have my mirage or dream way of believing things about my OWN self? No one in an actual dream orders you to HAVE TO think you are a completely different person to who you feel you are in YOUR dream. How humanity will resolve problems of endemic bullying on all sides of ANY campaign will be when it wakes up to the realization there is NO need to oppress ANYONE with arrogant certainty born of thinking the campaign knows best. There are so many bickering ideologies. Do ANY of these make it into our nocturnal dreams, where we can be blissfully unfettered animals? Ideologies are the hellish nightmares of the wakeful.

    This video seems to say, and I did not watch it to the end, that the mind is science’s next baby step. Will scientists who snubbed my past interest in parapsychology apologize? Nae. Because I am too animal in my fervour and not adept at correct spelling. Someone put the spelling law in the mirage and a million dyslexics have found it turned their childhood accepting good dream into a bad dream. A billion other laws got typed into the mirage. Too many laws, too few examples.

    This professor is a diamond for jaded minds. He seems to moot that MIND may preceed MATTER. I feel he is echoing my angels. But maybe the cosmos is like a Mother and a foetus in the womb. Consciousness dreams up matter which is itself made of dream stuff. A baby in the womb is form and physical but the placenta nourishes it. Mind is maybe like a circulatory flow that permeates matter to the point they are inseperable.

    You know I shall finish MY mirage story my way don’t you? Which is that I will insist that my brain chemicals are affected by my mind being unwell and my mind’s unwellness affects my brain chemicals in turn, in that shared metaphysical circulation. However, mind is so ineffible that NOBODY should dare tell anyone what is going on in their mind or brain with ANY rash certainty. Especially if this is ALL a “mirage”.

    There is only one law that MUST be kept in our “reality” and that is the law against sexual abuse or bullying or cruelty.

    This means that a person who bullies you into HAVING TO think of yourself as ill when you are not is a person “behaving badly”. Likewise a person who bullies you into thinking of yourself as not unwell when you know that you are is a person “behaving badly”.

    People may wonder why I wax lyrical on these themes. It is because in the future a regime is coming. An Anti Christ. He is going to make it that humans being sweet dreamy animals in a mirage becomes like being forced to be collective puppets on a strings. Drones obeying a billion laws.

    When I go to bed tonight I won’t have a long list of what I have to believe in my dream, I am free to dream however I dream. In the future life will be given a long list of what to believe.

    If I have been banging a drum against being ordered as to what to believe it is only to test the drums timbre before leaving its fond echo.

  3. “In the groups with lower probabilities of suicide risk (1-3), there is little difference between gun owners’ and non-gun owners’ responses to the SITBI-R. However, in the groups with the highest probability of attempting suicide (4-5), gun owners are less likely than non-gun owners to report suicidal ideation.”

    Not terribly surprising. Maybe some who are very serious about ending their lives are more likely to choose guns because they’re statistically among the most lethal methods. Being so serious about ending their lives, they just might not divulge this to others who they feel would stop them by force. If any of these have ever been forcibly held in a psychiatric facility, the experience might have been so deeply traumatizing it discouraged them from ever reaching out to professionals again.

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