Firefighters experience high rates of posttraumatic stress disorder (PTSD). It is imperative to identify malleable factors that protect against the development of PTSD symptoms among this population. We examined whether perceptions of belongingness broadly (Study 1) and social support from supervisors, coworkers, and family/friends specifically (Study 2) are associated with lower PTSD symptom severity among firefighters. Study 1 included 840 U.S. firefighters (91.1% male); participants completed the Interpersonal Needs Questionnaire and PTSD Checklist-Civilian Version. Study 2 included 200 U.S. women firefighters exposed to a Criterion A traumatic event; participants completed the Generic Job Stress Questionnaire, Life Events Checklist for Diagnostic and Statistical Manual of Mental Disorders-5, and PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-5. Linear regression analyses were conducted, adjusting for the number of years participants served as firefighters. Greater belongingness broadly (Study 1; b = -0.740, p < .001) as well as social support specifically (Study 2) from supervisors (b = -4.615, p < .001), coworkers (b = -4.465, p = .001), and family/friends (b = -3.206, p = .021) were associated with less severe PTSD symptoms. When all sources of social support were entered into a single model, only support from supervisors was significantly associated with lower overall PTSD symptom severity (b = -4.222, p = .004). Belongingness and social support may protect against the development of PTSD among firefighters. Supervisor social support may be particularly salubrious, suggesting that top-down mental wellness promotion within the fire service may be indicated to protect firefighters against PTSD. (PsycINFO Database Record

Theoretically-driven models of suicide have long guided suicidology; however, an approach employing machine learning models has recently emerged in the field. Some have suggested that machine learning models yield improved prediction as compared to theoretical approaches, but to date, this has not been investigated in a systematic manner. The present work directly compares widely researched theories of suicide (i.e., BioSocial, Biological, Ideation-to-Action, and Hopelessness Theories) to machine learning models, comparing the accuracy between the two differing approaches. We conducted literature searches using PubMed, PsycINFO, and Google Scholar, gathering effect sizes from theoretically-relevant constructs and machine learning models. Eligible studies were longitudinal research articles that predicted suicide ideation, attempts, or death published prior to May 1, 2020. 124 studies met inclusion criteria, corresponding to 330 effect sizes. Theoretically-driven models demonstrated suboptimal prediction of ideation (wOR = 2.87; 95% CI, 2.65–3.09; k = 87), attempts (wOR = 1.43; 95% CI, 1.34–1.51; k = 98), and death (wOR = 1.08; 95% CI, 1.01–1.15; k = 78). Generally, Ideation-to-Action (wOR = 2.41, 95% CI = 2.21–2.64, k = 60) outperformed Hopelessness (wOR = 1.83, 95% CI 1.71–1.96, k = 98), Biological (wOR = 1.04; 95% CI .97–1.11, k = 100), and BioSocial (wOR = 1.32, 95% CI 1.11–1.58, k = 6) theories. Machine learning provided superior prediction of ideation (wOR = 13.84; 95% CI, 11.95–16.03; k = 33), attempts (wOR = 99.01; 95% CI, 68.10–142.54; k = 27), and death (wOR = 17.29; 95% CI, 12.85–23.27; k = 7). Findings from our study indicated that across all theoretically-driven models, prediction of suicide-related outcomes was suboptimal. Notably, among theories of suicide, theories within the Ideation-to-Action framework provided the most accurate prediction of suicide-related outcomes. When compared to theoretically-driven models, machine learning models provided superior prediction of suicide ideation, attempts, and death.

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Objective: Firearms are the most common method of suicide in the United States. The provision of firearm-specific lethal means safety interventions is a best practice for the prevention and management of suicide risk. However, few data exist to inform firearm-specific lethal means safety interventions. This study tested four different lethal means safety interventions that varied on two dimensions salient to health behavior change (i.e., fear appeals and emphasis on temporariness). Method: Overall, 96 college-enrolled young adults with a history of suicidal ideation and current firearm familiarity (i.e., firearm ownership, access, and/or a desire/intention to obtain a firearm) were randomized to one of four different firearm-specific lethal means safety interventions occurring in the context of the Safety Planning Intervention. Assessments occurred at preintervention, postintervention, and 1-month follow-up. Results: Participants who received the firearmspecific lethal means safety intervention that deemphasized fear and emphasized temporariness reported significantly greater intentions to adhere to clinician recommendations to limit their access to firearms for safety purposes compared to individuals randomized to the other groups (Intervention ϫ Time), F(6, 184) ϭ 2.300, p ϭ .036, corresponding to a medium effect size ( p 2 ϭ .070). Across groups, 35.4% of participants reported an increase in engagement in firearm safety thoughts/behaviors from preintervention to 1-month follow-up; there were no significant group differences. All four intervention approaches were rated as similarly highly acceptable. Conclusions: Findings underscore the potential importance of deemphasizing fear and emphasizing temporariness in firearm-specific lethal means safety interventions. Future studies leveraging these pilot data are needed to replicate and extend findings. What is the public health significance of this article?Over half of the suicide fatalities in the United States are enacted with firearms. Study findings suggest that firearm-specific lethal means safety psychoeducation that occurs within the context of the Safety Planning Intervention might increase buy-in from individuals at elevated suicide risk if it, with due caution, (a) focuses on normalizing firearm ownership and (b) emphasizes the temporariness of limiting access to firearms during at-risk periods.

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It is well known that most people who think about suicide do not attempt or die by suicide. Capability for suicide, a construct proposed by Joiner (2005) within the interpersonal theory of suicide, was relatively novel in that it explained a potential mechanism by which individuals move from thinking about suicide to engaging in suicidal behavior. In this paper, we examine Joiner’s (2005) original conceptualization of the nature of capability for suicide, and review the evidence for and against this conceptualization. We examine the evidence for specific constructs that comprise capability for suicide, how capability for suicide develops, whether it can change, and possibilities regarding the functional neural correlates of capability for suicide. We then end our review proposing future directions in the study of capability for suicide, which include research across disciplines and countries.