Background: Along with other suicide risk factors, masculinity has been analyzed as an important subject for suicidal behavior in men. This study examines masculinity as a gender self-confidence which is the intensity of an individual's belief that he meets his standards for masculinity. We use Hoffman and her colleague's concept, which provides two theoretical constructs as elements of gender self-confidence: gender self-definition and gender self-acceptance. Gender self-definition relates to how salient masculinity is in one's identity; gender self-acceptance relates to how positively one views his masculinity.Methods: The quantitative research approach was applied in the study. The survey with a nonprobability quota sampling design was implemented to collect the data. The sample consisted of 562 Lithuanian men from various age groups and regions. The age of participants varied from 18 to 92 years (M = 42.99, SD = 17.18); 40.9% of men were from cities, 28.1% from towns, and 30.8% from rural locations. We used the Hoffman Gender Scale to measure gender self-definition and gender self-acceptance. Suicide risk was estimated with the Suicide Behavior Questionnaire—Revised. Patient Health Questionnaire-2 was used to measure depression symptoms as a controlled variable. Statistical analysis of regression and moderation was used to test the hypothesis.Results: Higher gender self-definition and higher gender self-acceptance were associated with lower suicide risk. The moderation analysis showed that in men with relatively low gender self-definition, the effect of gender self-acceptance on suicidality was larger than in men with high or moderate gender self-definition.Discussion: We conclude that a stronger gender self-confidence is an important protective factor in male suicide risk. Both, a smaller part of masculinity in one's identity and a negative view of one's masculinity have a cumulative effect on increased suicide risk. The findings have been discussed in accordance with the theories that explain suicidal behavior through the lenses of self-concept.

The Suicidal Ideation Attributes Scale (SIDAS) and the Suicidal Behaviors Questionnaire-Revised (SBQ-R) are widely used psychological instruments for assessing people‘s suicidal ideation and suicidal behavior. The aim of this study was to examine the psychometric characteristics of the Lithuanian versions of the SIDAS and SBQ-R. We analysed data collected from four samples: a Lithuanian general population quota sample based on age, gender and place of residence (N = 697, 52.9% women, aged 18–79 years); a sample of students (N = 2013, 72 % women, aged 18–29 years); a clinical sample of suicidal patients (N = 35, 77.1% women, aged 18–59 years); and a test-retest sample of students who completed the instruments twice within a two-week period (N = 54, 70.4% women, aged 18–47 years). The participants answered questions on gender, and age and completed the SIDAS and SBQ-R. The data analysis revealed that the Lithuanian versions of the SIDAS and SBQ-R have good internal consistency, temporal stability, construct, convergent, and criterion validity. The Lithuanian versions of the SIDAS and SBQ-R can be used to measure suicidality in research settings, as well as in clinical work as auxiliary tools.

Accessible and effective mental health services for people at risk of suicide are one of the cornerstones of suicide prevention. However, some people suicide while receiving such help, and it is important to understand the reasons for this. In the absence of a direct way to reveal the experiences of people who have received services and subsequently suicided, the professionals providing mental health services are an important source of information on this process. The main aim of this study was to describe the main difficulties experienced by professionals supporting people who later suicided. The sample included 15 mental health professionals (7 psychiatrists, 6 medical psychologists, and 2 social workers) who experienced patient suicide. The data were collected using semi-structured interviews, which were then analysed using thematic analysis. The following themes were identified in the stories of the participants: lack of collaboration from the patient, specific topics that were challenging to work with, treatment limitations, difficulties in assessing suicide risk, reactions experienced when working with the suicidal patient, and the role of the patient’s relatives. Therefore, the results of this study speak about the challenge of being with a patient in a suicidal crisis, who is not inclined to accept help, while bearing the limitations of the system and oneself as a specialist. This causes intense experiences of helplessness and anger.

The aim of this study was to investigate the relationship between suicide risk, alcohol consumption, and attitudes towards professional psychological help among Lithuanian general population men, conscripts, and regular active duty (AD) soldiers. In total, 1195 Lithuanian adult males participated in the study: 445 men from the general population, 490 conscripts, and 260 regular AD soldiers from the Lithuanian Armed Forces. The study’s measures included: general suicide risk, alcohol consumption levels, frequency of using alcohol as a means to suppress difficult thoughts and feelings, and attitudes toward psychological help. Both military samples showed significantly lower suicide risk than men from the general population. Alcohol use as a means to suppress difficult thoughts and feelings was the most significant predictor of suicide risk and a significant mediator between alcohol consumption and suicide risk in all study groups. Another significant suicide risk predictor and mediator between alcohol consumption and suicide risk—i.e., the value of seeking psychological treatment—was found only in the conscript sample. Results of the current study suggest that there is an opportunity for intervention aimed at the attitudes toward seeking professional psychological help for conscripts. However, that might not be the case for regular AD soldiers, nor the general population of Lithuanian men.

Male suicides are often associated with masculinity norms that encourage certain behaviours that increase the risk of suicide. For example, research shows that restricted emotionality, avoidance of seeking help and self-reliance are associated with higher suicide risk. However, these pre-formulated aspects of masculinity do not necessarily reflect men’s subjective opinions of what masculinity is to them. Researchers argue that it is important to consider personal views about what masculinity is, not only stereotypes about masculinity. The aim of this study is to reveal and compare the subjective opinions about the masculinity of men with and without suicidal ideation. 281 men answered the open-ended question during the survey: “What does masculinity mean to you?”. The answers were analyzed using a content analysis method. We transformed qualitative data into quantitative and compared them statistically between two groups: men with and without suicidal ideation. It turned out that men with suicidal thoughts were more likely to mention that masculinity is the control of emotions, intelligence, and decision-making. Men without suicidal thoughts were more likely to mention family and caring for it as essential aspects of masculinity. The results showed that certain aspects of masculinity might be related to higher risk for suicide, but the study also revealed the masculinity that might be a source of coping.

Association between suicidality and masculinity