Background: Suicide is among the top 10 leading causes of premature morality in the United States and its rates continue to increase. Thus, its prevention has become a salient public health responsibility. Risk factors of suicide transcend the individual and societal level as risk can increase based on climatic variables. The purpose of the present study is to evaluate the association between average temperature and suicide rates in the five most populous counties in California using mortality data from 1999 to 2019. Methods: Monthly counts of death by suicide for the five counties of interest were obtained from CDC WONDER. Monthly average, maximum, and minimum temperature were obtained from nCLIMDIV for the same time period. We modelled the association of each temperature variable with suicide rate using negative binomial generalized additive models accounting for the county-specific annual trend and monthly seasonality. Results: There were over 38,000 deaths by suicide in California’s five most populous counties between 1999 and 2019. An increase in average temperature of 1 °C corresponded to a 0.82% increase in suicide rate (IRR = 1.0082 per °C; 95% CI = 1.0025–1.0140). Estimated coefficients for maximum temperature (IRR = 1.0069 per °C; 95% CI = 1.0021–1.0117) and minimum temperature (IRR = 1.0088 per °C; 95% CI = 1.0023–1.0153) were similar. Conclusion: This study adds to a growing body of evidence supporting a causal effect of elevated temperature on suicide. Further investigation into environmental causes of suicide, as well as the biological and societal contexts mediating these relationships, is critical for the development and implementation of new public health interventions to reduce the incidence of suicide, particularly in the face increasing temperatures due to climate change.

Background: Traumatic stress symptoms are common, severe, and persistent in family caregivers of children with cancer, but the benefits of therapeutic interventions to relieve them are not well established.Aim: To review, describe, and appraise the available research on psychosocial interventions aimed at alleviating traumatic stress symptoms in family caregivers of children with cancer.Methods: Systematic searches of APA PsycInfo, CINAHL, MEDLINE, and Embase were conducted to identify randomized controlled trials (RCTs) and nonrandomized studies of psychosocial interventions (NRSIs) for families affected by pediatric cancer in which traumatic stress symptoms were reported as a primary or secondary outcome. Results were screened by independent reviewers in duplicate. 18 articles were included. All were evaluated for risk of bias and data on study design, intervention format, delivery, and impact, and were abstracted for narrative synthesis.Results: Study samples (8–430 participants) were primarily comprised of mothers of children with acute leukemia. Most interventions (1 day–15 weeks) involved an interventionist (n = 17; 94%) and used cognitive‐behavioral techniques (n = 14; 78%). Eight RCTs (n = 10; 80%) and seven NRSIs (n = 8; 87.5%) found a significant reduction in traumatic stress symptoms following intervention delivery, with small to large effect sizes (Cohen's d = 0.28–1.30). However, only three RCTs confirmed having adequate power to comment on effectiveness. Risk of bias ranged from low to moderate.Conclusions: The prevalence and problematic nature of traumatic stress symptoms in this population is well documented in the observational literature. However, the evidence remains unclear as to the effectiveness of psychosocial interventions to alleviate them due to methodological limitations in current interventional research. High quality RCTs that include a diverse group of family caregivers are needed to demonstrate their effectiveness and to inform clinical care practices aimed at improving family wellbeing.

A diagnosis of acute leukemia (AL) represents a sudden, life-threatening event that places family caregivers (FCs) at high risk for traumatic stress. While traumatic stress symptoms have been documented among FCs later in the cancer trajectory, little is known about how these responses unfold during the immediate peri-diagnostic period, when acute stress disorder (ASD) may emerge, and early intervention could be most impactful. We conducted a qualitative study using a constructivist grounded theory approach to examine early traumatic stress responses among FCs of adults and children with newly diagnosed AL. Semi-structured interviews were conducted with 18 caregivers within the first six months of diagnosis as part of two clinical trials at major cancer centres in Toronto, Canada, and were analyzed iteratively using constant comparative methods. Caregivers described a coherent trajectory of traumatic stress responses across three phases. The anticipatory phase was characterized by prolonged uncertainty, helplessness, and mounting fear during diagnostic investigations. The acute phase, beginning at diagnosis, involved an abrupt shift toward emotional numbing, deliberate avoidance of catastrophic thoughts, and a narrowed focus on immediate tasks, often described as operating on “autopilot.” In the post-acute phase, as patients stabilized and discharge approached, caregivers reported increased emotional access, including grief, anger, and recognition of their own trauma, alongside emerging concerns about long-term caregiving and life disruption. These findings suggest that FCs of individuals with newly diagnosed AL exhibit a phased pattern of traumatic stress responses, marked by an early, adaptive dissociative coping response followed by delayed emotional processing, underscoring the importance of phase-sensitive psychosocial care in oncology.