Background: Bereavement is associated with impaired mental health, increases in adverse health behaviors, and heightened risk of suicidal ideation, attempts, and death by suicide. The purpose of this literature review was to explore associations between cause of death and suicidal thoughts among bereaved individuals. Our aim was to compare incidence of suicidal ideation by cause of death and identify gaps in this literature to guide future research and clinical intervention. Methods: PRISMA-P guidelines were used to structure an electronic literature search in the PsycINFO, MEDLINE, and Web of Science databases. The search focused on English language studies that were published before February 2019 and sought to compare rates of suicidal ideation among bereaved people who lost a loved one to suicide, accidental overdose, cancer, dementia, cardiovascular disease, and HIV/AIDs. Results: Nine articles were identified with suicide as cause of death, zero articles for accidental overdose, zero articles for cardiovascular disease, seven articles for cancer, one article for dementia, and one article for HIV/AIDs. Given the limited number of articles generated by our search, a formal meta-analysis was not appropriate. However, a comparison of results did suggest that suicide bereavement was associated with the highest rates of suicide ideation (14.1% to 49%). Stigma, isolation, avoidance behaviors, and psychological distress were associated with suicidal thoughts among bereaved individuals, regardless of the deceased’s cause of death. Conclusions: Findings of this literature search revealed significant gaps in the literature, especially regarding thoughts of suicide in bereaved survivors of accidental overdose and cardiovascular disease. Results suggest that multiple causes of death are associated with suicidal ideation in bereavement, but that suicide bereavement may be the cause of death associated with the highest risk of suicidal ideation. More research is needed to understand the ways in which cause of death influences prevalence, risk, and protective factors associated with suicidal thoughts among bereaved individuals.

Nonfatal suicidal behavior is the most robust predictor of suicide death. However, only ∼10 % of those who survive an attempt go on to die by suicide. Moreover, ∼50 % of suicide deaths occur in the absence of prior known attempts, suggesting risks other than nonfatal suicide attempt need to be identified to help prevent suicide mortality. We studied data from 4,000 population-ascertained suicide deaths and 26,191 population controls to improve understanding of suicide deaths without prior nonfatal attempts. This study included 2,253 suicide deaths and 3,375 controls with evidence of nonfatal suicidal ideation or behaviors (SUI_SI/SB and CTL_SI/SB) from diagnostic codes and natural language processing of electronic health records notes. Characteristics of these groups were compared to 1,669 suicides with no prior nonfatal SI/SB (SUI_None) and 22,816 controls with no lifetime suicidality (CTL_None). The SUI_None and CTL_None groups had fewer overall diagnoses and were older than SUI_SI/SB and CTL_SI/SB. Mental health diagnoses were far less common in both the SUI_None and CTL_None groups; mental health problems were far less associated with suicide death than with presence of SI/SB. Physical health diagnoses were conversely more often associated with risk of suicide death than with presence of SI/SB. Pending replication, results indicate highly significant clinical differences among suicide deaths with versus without prior nonfatal SI/SB, and suggest that, for a substantial number of individuals at risk for suicide mortality, history of SI/SB does not serve as an effective clinical marker of risk.

Objective: Suicide is a leading cause of mortality among perinatal populations. Despite increasing rates, research on this topic remains limited. This paper examined (1) change in self‐injurious thoughts and behaviors (SITBs) from pregnancy to postpartum, (2) associations between risk factors and SITBs, and (3) whether risk factors moderated change in SITBs.Methods: Participants (N = 223) reported on SITBs, emotion dysregulation, and partner stress at the third trimester and 7 months postpartum, and childhood trauma at the third trimester. We tested study aims with generalized linear models.Result: While self‐injurious thoughts did not change from pregnancy to postpartum, the odds of self‐injurious behaviors were 3.56 times higher postpartum (OR = 3.56, p = 0.011), even while accounting for risk factors. Higher concurrent emotion dysregulation was associated with self‐injurious thoughts during pregnancy and postpartum (OR = 1.04, p < 0.001; OR = 1.05, p < 0.001) and with behaviors postpartum (OR = 1.05, p = 0.002). Childhood trauma was associated with self‐injurious thoughts during pregnancy (OR = 2.54, p = 0.004) and postpartum (OR = 2.05, p = 0.028) and with behaviors postpartum (OR = 3.25, p = 0.009). Partner relationship conflict was not associated with self‐injurious thoughts or behaviors at either time point. Higher rates of prenatal risk factors increased the odds of SITBs in the postpartum period.Conclusion: Findings support interventions addressing childhood trauma and emotion dysregulation for prevention of SITBs before postpartum, when risk is higher.

Prenatal maternal anxiety is considered a risk factor for the development of child internalizing problems. However, little is known about potential mechanisms that account for these associations. The current study examined whether prenatal maternal anxiety was indirectly associated with toddler internalizing problems via prenatal maternal physiology and infant negative affectivity. We examined these associations in a longitudinal study of 162 expectant mothers from their third trimester until 18 months postpartum. Path analyses showed that higher prenatal anxiety was associated with higher infant negative affectivity at 7 months, which in turn was associated with higher toddler internalizing problems at 18 months. Prenatal anxiety was not indirectly associated with child outcomes via baseline or task-evoked respiratory sinus arrhythmia (RSA) in response to an infant cry while pregnant. However, pregnant women with greater decreases in task-evoked RSA had toddlers with greater internalizing problems, which was mediated by infant negative affectivity at 7 months. Findings suggest that prenatal anxiety and RSA reactivity to an infant cry may be independent risk factors for the development of infant negative affectivity, which in turn increases risk for toddler internalizing problems. These findings contribute to a growing literature on mechanisms that underlie intergenerational transmission of internalizing problems.