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      Suicidal ideations among medical students: The role of anhedonia and type D personality

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      Journal: PLoS ONE
      Publisher: Public Library of Science

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          Abstract

          Background

          The relationships between hedonic deficits, type D personality and suicidal ideation were explored in a group of medical students.

          Methods

          In a cross-sectional study, 382 medical students filled out several questionnaires measuring suicide risk, depression (using the Beck Depression Inventory, i.e. BDI), type D personality (using the type D personality scale-14, i.e. DS-14) and anhedonia (using the anhedonia subscale of the BDI, the Snaith Hamilton Pleasure Scale, the Anticipatory and Consummatory subscales of the Physical Anhedonia Scale).

          Results

          State anhedonia and, in particular, recent change of state anhedonia and not trait anhedonia was significantly associated with suicidal ideation, specifically when depression was controlled for. Negative affectivity component of type D personality and anhedonia were independent predictors of suicidal ideation even when depression was controlled for. Loss of pleasure and not loss of interest was a significant predictor of suicidal ideation.

          Conclusions

          Change of state anhedonia and its component of loss of pleasure measuring dissatisfaction in life could be a risk factor of suicidal ideation in medical students. Dissatisfaction, particularly in the medical course, could be a strong predictor of suicidal ideation in medical students.

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          Most cited references27

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          DS14: standard assessment of negative affectivity, social inhibition, and Type D personality.

          Johan Denollet (2005)
          Type D personality-a joint tendency toward negative affectivity (NA) and social inhibition (SI)-is related to poor cardiac prognosis, but there is no standard for assessing Type D. This study reports on the Type D Scale-14 (DS14) as a standard measure of NA, SI, and Type D. The study included 3813 participants (2508 from the general population, 573 cardiac patients, 732 hypertension patients). They all filled out the DS14, containing 7-item NA and SI subscales; 275 subjects also completed the NEO-FFI, and 121 patients filled out the DS14 twice. Factor analysis of the DS14 yielded 2 dominant traits; all of the NA and SI items loaded between 0.62 to 0.82 on their corresponding factor (N = 3678). The NA scale covered dysphoria, worry, and irritability; the SI scale covered discomfort in social interactions, reticence, and lack of social poise. The NA and SI scales were internally consistent (alpha = 0.88/0.86; N = 3678), stable over a 3-month period (test-retest r = 0.72/0.82) and not dependent on mood and health status (N = 121). NA correlated positively with neuroticism (r = 0.68); SI correlated negatively with extraversion (r = -0.59/-0.65). Scale-level factor analysis confirmed the construct validity of the DS14 against the NEO-FFI. Using a cutoff of 10 (NA > or =10 and SI > or =10), 1027 subjects (28%) were classified as Type D, 21% in the general population versus 28% in coronary heart disease and 53% in hypertension (p < or = .001). Age, sex, and Type D (odds ratio, 3.98; 95% confidence interval, 3.2-4.6; p <.0001) were independently associated with cardiovascular morbidity. The DS14 is a brief, psychometrically sound measure of negative affectivity and social inhibition that could readily be incorporated in epidemiologic and clinical research.
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            Annual Research Review: Suicide among youth - epidemiology, (potential) etiology, and treatment

            Christine B Cha, Peter J. Franz, Eleonora M. Guzmán … (2018)
            Background Suicide is a leading cause of death and a complex clinical outcome. Here we summarize the current state of research pertaining to suicidal thoughts and behaviours in youth. We review their definitions/measurement and phenomenology, epidemiology, potential etiological mechanisms, and psychological treatment and prevention efforts. Results We identify key patterns and gaps in knowledge that should guide future work. Regarding epidemiology, the prevalence of suicidal thoughts and behaviours among youth varies across countries and sociodemographic populations. Despite this, studies are rarely conducted cross-nationally and do not uniformly account for high-risk populations. Regarding etiology, the majority of risk factors have been identified within the realm of environmental and psychological factors (notably negative affect-related processes), and most frequently using self-report measures. Little research has spanned across additional units of analyses including behaviour, physiology, molecules, cells, and genes. Finally, there has been growing evidence in support of select psychotherapeutic treatment and prevention strategies, and preliminary evidence for technology-based interventions. Conclusions There is much work to be done to better understand suicidal thoughts and behaviours among youth. We strongly encourage future research to: (1) continue improving the conceptualization and operationalization of suicidal thoughts and behaviours; (2) improve etiological understanding by focusing on individual (preferably malleable) mechanisms; (3) improve etiological understanding also by integrating findings across multiple units of analyses and developing short-term prediction models; (4) demonstrate greater developmental sensitivity overall; and (5) account for diverse high-risk populations via sampling and reporting of sample characteristics. These serve as initial steps to improve the scientific approach, knowledge base, and ultimately prevention of suicidal thoughts and behaviours among youth.
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              Time-related predictors of suicide in major affective disorder.

              Theodore R. Gibbons, Steven E. Clark, W Scheftner … (1990)
              The authors studied 954 psychiatric patients with major affective disorders and found that nine clinical features were associated with suicide. Six of these--panic attacks, severe psychic anxiety, diminished concentration, global insomnia, moderate alcohol abuse, and severe loss of interest or pleasure (anhedonia)--were associated with suicide within 1 year, and three others--severe hopelessness, suicidal ideation, and history of previous suicide attempts--were associated with suicide occurring after 1 year. These findings draw attention to the importance of 1) standardized prospective data for studies of suicide, 2) assessment of short-term suicide risk factors, and 3) anxiety symptoms as modifiable suicide risk factors within a clinically relevant period.
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                Author and article information

                Contributors
                Gwenolé Loas:
                ORCID: http://orcid.org/0000-0003-1719-916X
                Role: ConceptualizationRole: SupervisionRole: Writing – original draft
                Alice Solibieda: Role: Data curation
                Marianne Rotsaert: Role: Writing – original draft
                Yvon Englert: Role: Conceptualization
                Vincenzo De Luca: Role: Editor
                Journal
                Journal ID (nlm-ta): PLoS One
                Journal ID (iso-abbrev): PLoS ONE
                Journal ID (publisher-id): plos
                Journal ID (pmc): plosone
                Title: PLoS ONE
                Publisher: Public Library of Science (San Francisco, CA USA )
                ISSN (Electronic): 1932-6203
                Publication date (Electronic): 21 June 2019
                Publication date Collection: 2019
                Volume: 14
                Issue: 6
                Electronic Location Identifier: e0217841
                Affiliations
                [001]Department of Psychiatry & Laboratory of Psychiatric Research (ULB 266), Cliniques universitaires de Bruxelles, Université Libre de Bruxelles (ULB), Bruxelles, Belgium
                University of Toronto, CANADA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                http://orcid.org/0000-0003-1719-916X
                Article
                Publisher ID: PONE-D-18-30921
                DOI: 10.1371/journal.pone.0217841
                PMC ID: 6588207
                PubMed ID: 31226120
                SO-VID: f97a0255-f1b6-4caa-ba93-33ef80c08376
                Copyright © © 2019 Loas et al
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date received : 26 October 2018
                Date accepted : 20 May 2019
                Page count
                Figures: 0, Tables: 2, Pages: 12
                Funding
                The authors received no specific funding for this work.
                Categories
                Subject: Research Article
                Subject: Medicine and Health Sciences
                Subject: Mental Health and Psychiatry
                Subject: Suicide
                Subject: Medicine and Health Sciences
                Subject: Mental Health and Psychiatry
                Subject: Mood Disorders
                Subject: Depression
                Subject: Biology and Life Sciences
                Subject: Psychology
                Subject: Personality
                Subject: Social Sciences
                Subject: Psychology
                Subject: Personality
                Subject: People and Places
                Subject: Population Groupings
                Subject: Professions
                Subject: Medical Personnel
                Subject: Medical Doctors
                Subject: Physicians
                Subject: Medicine and Health Sciences
                Subject: Health Care
                Subject: Health Care Providers
                Subject: Medical Doctors
                Subject: Physicians
                Subject: Biology and Life Sciences
                Subject: Psychology
                Subject: Psychometrics
                Subject: Social Sciences
                Subject: Psychology
                Subject: Psychometrics
                Subject: Medicine and Health Sciences
                Subject: Mental Health and Psychiatry
                Subject: Psychological Stress
                Subject: Biology and Life Sciences
                Subject: Psychology
                Subject: Psychological Stress
                Subject: Social Sciences
                Subject: Psychology
                Subject: Psychological Stress
                Subject: Research and Analysis Methods
                Subject: Mathematical and Statistical Techniques
                Subject: Statistical Methods
                Subject: Metaanalysis
                Subject: Physical Sciences
                Subject: Mathematics
                Subject: Statistics
                Subject: Statistical Methods
                Subject: Metaanalysis
                Subject: Research and Analysis Methods
                Subject: Mathematical and Statistical Techniques
                Subject: Statistical Methods
                Subject: Multivariate Analysis
                Subject: Bivariate Analysis
                Subject: Physical Sciences
                Subject: Mathematics
                Subject: Statistics
                Subject: Statistical Methods
                Subject: Multivariate Analysis
                Subject: Bivariate Analysis
                Custom metadata
                Data Availability All files are available from the OPEN 2.0 ICPSR data base (accession number 109 904).

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