Changes in food cravings during low-calorie and very-low-calorie diets

Objective: This study examined food cravings during a primarily food‐based low‐calorie diet (LCD) and a supplement‐based very‐LCD (VLCD). Research Methods and Procedures: The Food Craving Inventory (FCI) was used to measure general cravings and cravings for specific types of foods (sweets, high fats, carbohydrates/starches, and fast food fats). The FCI was completed by participants in the LCD and VLCD programs at baseline and after 11 weeks of dieting. The VLCD group also completed the FCI at Week 6 and after 5 weeks of a refeeding phase, when their diet consisted primarily of solid food. Results: From baseline to Week 12, craving decreases were greater for the VLCD group than for the LCD group on all measures. All craving measures decreased significantly for the VLCD group. The LCD group experienced a marginally significant decrease in sweet cravings. Within the VLCD group, all craving measures decreased significantly by Week 6 and did not change thereafter, including after resumption of solid food intake, and craving scores during all dieting points were lower than baseline. Changes in cravings were not related to weight loss. Discussion: Cravings did not increase during either diet; all changes represented decreases. Compared with a primarily food‐based diet (LCD), a more restrictive supplement‐based diet (VLCD) resulted in significantly larger decreases in food cravings that occurred by the end of the 5th week of supplement use and did not rebound with resumption of solid food intake. The results of this study suggest that food cravings diminish with calorie restriction.     

Similarities in Food Cravings and Mood States Between Obese Women and Women Who Smoke Tobacco

The present study assessed food cravings in a cohort of 229 women who differed in smoking history (i.e., never smoker, former smoker, and current smoker) and body weight (i.e., normal weight, overweight, and obese). Each subject completed the Food Craving Inventory (FCI), which measures cravings for sweets, high fats, carbohydrates/starches, and fast‐food fats, and the Profile of Mood States (POMS), which measures psychological distress. Smoking and obesity were independently associated with specific food cravings and mood states. Current smokers craved high fats more frequently than former and never smokers. They also craved starches more frequently and felt more depressed and angry than never smokers, but not former smokers. Whereas cravings for starchy foods and some mood states may be characteristic of women who are likely to smoke, more frequent cravings for fat among smokers is related to smoking per se. Similarly, obese women craved high fats more frequently than nonobese women and depression symptoms were intensified with increasing body weights. We hypothesize that the overlapping neuroendocrine alterations associated with obesity and smoking and the remarkable similarities in food cravings and mood states between women who smoke and women who are obese suggest that common biological mechanisms modulate cravings for fat in these women.     

Psychometric properties of the Nurses Work Functioning Questionnaire (NWFQ)

Objectives

The Nurses Work Functioning Questionnaire (NWFQ) is a 50-item self-report questionnaire specifically developed for nurses and allied health professionals. Its seven subscales measure impairments in the work functioning due to common mental disorders. Aim of this study is to evaluate the psychometric properties of the NWFQ, by assessing reproducibility and construct validity.

Methods

The questionnaire was administered to 314 nurses and allied health professionals with a re-test in 112 subjects. Reproducibility was assessed by the intraclass correlations coefficients (ICC) and the standard error of measurement (SEM). For construct validity, correlations were calculated with a general work functioning scale, the Endicott Work Productivity Scale (EWPS) (convergent validity) and with a physical functioning scale (divergent validity). For discriminative validity, a Mann Whitney U test was performed testing for significant differences between subjects with mental health complaints and without.

Results

All subscales showed good reliability (ICC: 0.72–0.86), except for one (ICC = 0.16). Convergent validity was good in six subscales, correlations ranged from 0.38–0.62. However, in one subscale the correlation with the EWPS was too low (0.22). Divergent validity was good in all subscales based on correlations ranged from (−0.06)–(−0.23). Discriminative validity was good in all subscales, based on significant differences between subjects with and without mental health complaints (p<0.001–p = 0.003).

Conclusion

The NWFQ demonstrates good psychometric properties, for six of the seven subscales. Subscale “impaired decision making” needs improvement before further use.     

Two Measures of Health-Related Quality of Life in Morbid Obesity

Objective: To compare health-related quality of life (HRQOL) measures in obese presurgery patients with and without binge-eating disorder (BED) and to investigate the relationship between a generic [short form-36 (SF-36)] and a disease-specific HRQOL measure [Impact of Weight on Quality of Life Questionnaire (IWQOL)] and measures of eating-related and general psychopathology. Research Methods and Procedures: One hundred ten patients ages 19 to 62 years with a mean body mass index of 48.4 ± 8.3 kg/m² who were evaluated for gastric bypass surgery were asked to fill out questionnaires assessing eating-related and general psychopathology (depression, self-esteem), as well as the two HRQOL questionnaires. BED was assessed by self-report. Results: Nineteen (17.3%) patients met criteria for BED. Significant differences between patients with and without BED were found for four of the eight subscales of the SF-36—with effect sizes ranging from 0.44 to 0.75—and for the total score and three of the five subscales of the IWQOL-Lite—with effect sizes from 0.57 to 0.74. The mental composite score of the SF-36 as well as the IWQOL total score correlated significantly with the measures of psychopathology. Discussion: This is the first study comparing the results of HRQOL measures in morbidly obese presurgery patients with and without BED. The results indicate that BED has a profound negative impact on HRQOL that exceeds the influence of obesity. Both HRQOL measures were able to reliably discriminate between patients with and without BED. Depression and self-esteem influenced HRQOL in a similar way as binge eating.     

Emergency Room Validation of the Revised Suicide Trigger Scale (STS-3): A Measure of a Hypothesized Suicide Trigger State

Background

The Suicide Trigger Scale (STS) was designed to measure the construct of an affective ‘suicide trigger state.’ This study aims to extend the inpatient setting validation study of the original Suicide Trigger Scale version 2 to the revised Suicide Trigger Scale version 3 (STS-3) in an acute psychiatric emergency room setting.

Methods

The 42-item STS-3 and a brief psychological test battery were administered to 183 adult psychiatric patients with suicidal ideation or attempt in the psychiatric emergency room, and re-administered to subjects at 1 year follow up. Factor analysis, linear and logistic regressions were used to examine construct structure, divergent and convergent validity, and construct validity, respectively.

Results

The STS-3 demonstrated strong internal consistency (Cronbach’s alpha 0.94). Factor analysis yielded a three-factor solution, which explained 43.4% of the variance. Principal axis factor analysis was used to identify three reliable subscales: Frantic Hopelessness, Ruminative Flooding, and Near-Psychotic Somatization (Cronbach’s alphas 0.90, 0.80, and 0.76, respectively). Significant positive associations were observed between Frantic Hopelessness and BSI depression and anxiety subscales, between Ruminative Flooding and BSI anxiety and paranoia subscales, and Near Psychotic Somatization and BSI somatization subscales. Suicidal subjects with suicide attempt history had mean scores 7 points higher than those without history of suicide attempts. Frantic hopelessness was a significant predictor of current suicide attempt when only attempts requiring at least some medical attention were considered.

Conclusion

The STS-3 measures a distinct clinical entity, provisionally termed the ‘suicide trigger state.’ Scores on the STS-3 or select subscales appear to relate to degree of suicidality in terms of severity of ideation, history of attempt, and presence of substantive current attempts. Further study is required to confirm the factor structure and better understand the nature of these relations.     

The Associations between Self-Consciousness,Depressive State and Craving to Drink among Alcohol Dependent Patients Undergoing Protracted Withdrawal

Context

In order to understand how certain personality traits influence the relation between depression symptoms and craving for alcohol, trait self-consciousness (trait SC) was examined during a withdrawal and detoxification program.

Methods

Craving (Obsessive and Compulsive Drinking Scale), depressive state (Beck Depression Inventory) and trait SC (Revised Self-Consciousness Scale) were assessed in alcohol-dependent inpatients (DSM-IV, N = 30) both at the beginning (T1: day 1 or 2) and at the end (T2: day 14 to18) of protracted withdrawal during rehabilitation.

Results

A significant decrease in craving and depressive symptoms was observed from T1 to T2, while SC scores remained stable. At both times, strong positive correlations were observed between craving and depression. Moreover, regression analyses indicated that trait SC significantly moderated the impact of depression on cravings for alcohol.

Limitations

This study was performed on a relatively small sample size. Administration of medications during detoxification treatment can also be a confounding factor. Finally, craving could have been evaluated through other types of measurements.

Conclusions

During protracted withdrawal, alcohol craving decreased with the same magnitude as depressive mood. Depressive symptoms were related to alcohol craving but only among patients with high trait SC scores. Our results suggest that metacognitive approaches targeting SC could decrease craving and, in turn, prevent future relapses.     

Assessment of hyperphagia in Prader-Willi syndrome

Objective: Prader‐Willi syndrome (PWS), the leading known genetic cause of obesity, is characterized by intellectual disabilities, maladaptive and compulsive behaviors, and hyperphagia. Although complications of obesity resulting from hyperphagia are the leading cause of death in PWS, quantifying this drive for food has long been an unmet research need. This study provides factor‐analytic and within‐syndrome analyses of a new measure of hyperphagia in PWS. Research Methods and Procedure: A 13‐item informant measure, the Hyperphagia Questionnaire, was developed and administered to the parents of 153 persons with PWS, 4 to 51 years of age. The intelligence quotients, genetic subtypes of PWS, and BMIs of offspring were obtained, as were measures of their non‐food problem behaviors. Results: Factor analyses with varimax rotation produced three statistically and conceptually robust factors that accounted for 59% of the variance: Hyperphagic Behaviors, Drive, and Severity. Hyperphagic Behavior increased with age, whereas Drive remained stable, and Severity dipped in older adults. Hyperphagic Drive and Severity were positively correlated with non‐food behavior problems, and Hyperphagic Drive differentiated the 36% of participants with extreme obesity from those who had overweight/obese (48%) or healthy (16%) BMI classifications. Discussion: The Hyperphagia Questionnaire is a robust tool for relating breakthroughs in the neurobiology of hyperphagia to in vivo food‐seeking behavior and for examining the psychological and developmental correlates of hyperphagia in PWS. The Hyperphagia Questionnaire also offers a nuanced, real‐life outcome measure for future clinical trials aimed at curbing the life‐threatening drive for food in PWS.     

Inherited Taste Sensitivity to 6‐n‐Propylthiouracil in Diet and Body Weight in Children

Objective: Negative associations between the inherited ability to taste the bitter compound 6‐n‐propylthiouracil (PROP) and preference for fat and body weight have been observed in adults. This study tested the relationships among the ability to taste PROP, reported food intake, and body weight in young children. Research Methods and Procedures: Fifty‐three 4‐ to 5‐year‐old children were classified as tasters (N = 35) or nontasters (N = 18) of PROP using a standard screening solution. Anthropometric measures were taken in the laboratory. Mothers completed questionnaires to assess their child's food intake and their own dieting behaviors. Results: Nontaster boys had higher weight‐for‐height percentiles than taster boys (77th vs. 56th percentile, respectively), but the relationship was opposite for girls (p ≤ 0.05). Nontasters reportedly consumed a higher percentage of their daily energy from protein (p ≤ 0.01), mainly as high‐fat meat products. Tasters reportedly consumed a higher percentage of their daily energy from sugars (p ≤ 0.05), mainly in the form of brownies, doughnuts, cookies, soft drinks, and juice drinks. There were no differences between tasters and nontasters for reported intake of grains, fruits, vegetables, dairy products, or discretionary fats. Discussion: This study is the first, to our knowledge, to report weight differences in children as a function of their PROP status. Genetic taste factors seem to play a role in the development of dietary patterns and weight differences in young children, but the nature of these relationships may vary with gender.     

Influence of environmental and colony factors on the initial commodity choice of foragers of the stingless bee Plebeia tobagoensis (Hymenoptera, Meliponini)

Novice foragers of social bees have to decide what food commodity to collect when they start foraging for the first time. In this decision making process two types of factors are involved: internal factors (the response threshold) and external factors (environmental and colony conditions). In this study we will focus on the importance of two external factors, pollen storage level and information from experienced foragers about food availability in the field, on the initial commodity choice of foragers of the stingless bee species Plebeia tobagoensis. We also studied the effect of the initial choice of individuals on their subsequent foraging career. This study was performed in a closed greenhouse compartment, where food availability and colony condition could be controlled. Information on food availability in the field from experienced foragers and pollen storage level both greatly influenced the initial commodity choice of individuals, with more choices for the commodity communicated by experienced foragers or lacking in storage. The initial choice of foragers is of importance for their future foraging career, although a substantial proportion of foragers did switch between food commodities. Because of the ability of novice foragers to become flexibly distributed over foraging tasks, social bees are able to react to changes in their environment without directly having to decrease foraging effort devoted to other foraging tasks. This, in combination with individual flexibility during foraging careers makes it possible for colonies of P. tobagoensis to forage efficiently in an ever-changing environment. Received 7 November 2005; revised 12 January 2006; accepted 16 February 2006.     

Executive Functions in Tobacco Dependence: Importance of Inhibitory Capacities

Background

Executive functions are linked to tobacco dependence and craving. In this cross-sectional study, we assessed the impact of three executive functions: updating, inhibition and shifting processes on tobacco craving and dependence.

Method

134 tobacco consumers were included in this study: 81 moderately (Fagerström score <7) and 53 heavily dependent (Fagerström score >7). Dependence was assessed with the Fagerström test and craving with the tobacco craving questionnaire (TCQ 12). We used the Stroop test and the Hayling test to measure inhibition, the Trail Making Test to measure shifting processes and the n-back test to measure updating processes. A multivariate logistic model was used to assess which variables explained best the level of nicotine dependence.

Results

Inhibition (p = 0.002) and updating (p = 0.014) processes, but not shifting processes, were associated with higher tobacco dependence. Inhibition capacity had a significant effect on the nicotine dependence level independently of age, education, time since last cigarette, intellectual quotient, craving, updating and shifting process.

Conclusions

Nicotine dependence level seems better explained by inhibition capacities than by craving and updating effects. The capacity to inhibit our behaviours is a good predictor of the severity of tobacco dependence. Our results suggest a prefrontal cortex dysfunction affecting the inhibitory capacities of heavy tobacco dependent smokers. Further studies are needed to investigate the application of these findings in the treatment of tobacco dependence.     

Aspects of eating behaviors "disinhibition" and "restraint" are related to weight gain and BMI in women

Objective: The causes of adult weight gain leading to obesity are uncertain. We examined the association of adult weight gain and obesity with subscales of eating behavior characteristics in older women. Methods and Procedures: Current height and weight, eating behavior subscales (disinhibition subscales—habitual, situational, and emotional; restraint subscales—flexible and rigid; hunger subscales—internal and external) as assessed using the Eating Inventory (EI), and self‐reported body weight at six prior age intervals were reported by 535 women aged 55–65 years. Multiple regression analysis was used to examine the relationships between EI subscale scores and weight change from the age interval of 30–39 to 55–60 years and current BMI. Results: The strongest correlate of weight gain over 20 years was susceptibility to overeating in response to everyday cues within the environment (habitual disinhibition; partial correlation coefficient (r) = 0.25, P < 0.001); susceptibility to overeating in response to emotional states such as depression (emotional disinhibition) was a quantitatively weaker but significant correlate (partial r = 0.17, P < 0.001), and susceptibility to overeating in response to specific situations such as social occasions (situational disinhibition) was not associated with weight gain. Flexible control of dietary restraint attenuated the influence of habitual disinhibition in particular on weight gain and BMI, and was less effective in attenuating associations of emotional or situational disinhibition. Discussion: Lifestyle modification programs for prevention and treatment of adult‐onset obesity currently focus on reducing situational and emotional overeating; the results of this study suggest that a stronger emphasis on strategies that target habitual overeating may be warranted.     

Re-Validation of the Van Rie HIV/AIDS-Related Stigma Scale for Use with People Living with HIV in the United States

There is little consensus about which of the many validated human immunodeficiency virus (HIV) stigma scales should be regularly used, with few being re-validated in different contexts or evaluated for how they compare to other, existing HIV stigma scales. The purpose of this exploratory study was to re-validate the Van Rie HIV/AIDS-Related Stigma Scale, originally validated in Thailand and using a third-person wording structure, for use with people living with HIV in the United States. Adult HIV clinic patients completed a survey including the Berger and Van Rie scales, and measures of social support and depression. Eighty-five of 211 (40%) eligible participants provided data for both stigma scales. Exploratory factor analyses identified three factors to the Van Rie scale: Loss of Social Relationships (new subscale), Managing HIV Concealment (new subscale), and Perceived Community Stigma (original subscale). These subscales were moderately inter-related (r = 0.51 to 0.58) with acceptable to excellent reliability (Cronbach’s alpha = 0.69 to 0.90). The Van Rie subscales were also moderately inter-correlated with the Berger subscales (r = 0.44 to 0.76), had similar construct validity, and tended to have higher mean stigma scores when compared with Berger subscales that were conceptually most similar. The revised Van Rie HIV-related Stigma Scale demonstrates good validity and internal consistency, offering a valid measure of HIV stigma with a three-factor structure. The third-person wording may be particularly suitable for measuring stigmatizing attitudes during an individual’s transition from at-risk and undergoing HIV testing to newly diagnosed, a time when experiences of discrimination and processing issues of disclosure have not yet occurred. The stigma mechanisms for individuals making this transition have not been well explored. These scenarios, combined with the observed non-response to the Berger Enacted Stigma subscale items (a surprise finding), highlight gaps in our understanding of HIV stigma and how best to measure it.     

Developing and Communicating a Taxonomy of Ecological Indicators: A Case Study from the Mid-Atlantic

To ensure indicators of ecosystem health are integrated into environmental decision-making, it is imperative to provide a comprehensive framework for indicator selection and use. The same framework can also be used to evaluate the utility of any given indicator. The Atlantic Slope Consortium (ASC) has developed such a framework, based upon three primary elements: 1) The specific questions to be answered (the type of indicator), recognizing the following types of questions/indicators: Condition assessment: snapshot of the current state of the system; Stressor diagnosis: identification of causative factors of condition; Communication to the public: encouraging comprehension of condition in its most elementary or integrated form; Futures assessment: estimating the probable trajectory of condition, or assessing the vulnerability of any system to a stochastic event; Evaluation: a subset of condition indicators that evaluate the effectiveness of management actions. 2) The spatial and/or temporal scale of the issue being addressed (the spatial/temporal scale over which the indicator is valid). 3) The context of the question, using categories of surrounding land use as surrogates for social choices. A Fish Community Index (FCI) developed for the ASC will provide an example of utilizing the framework to select an indicator, as well as using the framework to judge the utility of the indicator.     

Redefining animal signaling: influence versus information in communication

Researchers typically define animal signaling as morphology or behavior specialized for transmitting encoded information from a signaler to a perceiver. Although intuitively appealing, this conception is inherently metaphorical and leaves concepts of both information and encoding undefined. To justify relying on the information construct, theorists often appeal to Shannon and Weaver’s quantitative definition. The two approaches are, however, fundamentally at odds. The predominant definition of animal signaling is thus untenable, which has a number of undesirable consequences for both theory and practice in the field. Theoretical problems include conceptual circularity and running afoul of fundamental evolutionary principles. Problems in empirical work include that research is often grounded in abstractions such as signal honesty and semanticity, and thereby distracted from more basic and concrete factors shaping communication. A revised definition is therefore proposed, making influence rather than transmission of encoded information the central function of animal signaling. This definition is conceptually sound, empirically testable, and inclusive, yet bounded. Implications are considered in both theoretical and empirical domains.     

A psychometric investigation of the sleep,circadian rhythms,and mood (SCRAM) questionnaire

The sleep, circadian rhythms, and mood (SCRAM) questionnaire (Byrne, Bullock et al., 2017) was designed to concurrently measure individual differences in three clinically important functions: diurnal preference, sleep quality, and mood. The 15-item questionnaire consists of three 5-item scales named Morningness, Good Sleep, and Depressed Mood. The overarching aim of the current project was to investigate the validity and reliability of the questionnaire. Here, we report on associations investigated in three data sets. Study 1 (N = 70, 80% females) was used to examine the test–retest reliability of the questionnaire, finding strong test–retest reliability of the three scales over a 2-week period (r’s ranging from 0.73 to 0.86). Study 2 (N = 183, 80% females) enabled us to examine the construct validity of the SCRAM scales against well-validated self-report measures of diurnal preference, sleep quality, and depression. Strong correlations were found between each SCRAM scale and their respective measure in bivariate analyses, and associations were robust after the inclusion of the remaining two SCRAM scales as predictors in regression analyses. Data from Study 3 (N = 42, 100% males) were used to measure the extent to which SCRAM scores correlated with objective measures of sleep–wake behavior using actigraphy. Morningness was found to be related to earlier sleep onset and offset times, and Good Sleep was related to higher sleep efficiency but to no other measures of sleep quality; Depressed Mood was not related to actigraphy measures. The findings provide provisional support for construct validity and reliability of the SCRAM questionnaire as a measure of diurnal preference, sleep quality, and depressed mood. Future research into the psychometrics of SCRAM should test the questionnaire’s discriminant and predictive validity in clinical samples.     

Food cravings, mood, and the menstrual cycle

The primary objective of the present investigation was to document positive changes in food cravings, food consumption, and mood changes over the menstrual cycle and to explore the relation between these factors and dieting habits. A total of 32 female undergraduates completed daily self-reports of food cravings, foods eaten, and mood, for 5 or more weeks. Comparisons of these measures in the 10 days preceding (luteal phase) and 10 days following menstruation onset (follicular phase) revealed that both food cravings and amount eaten were greater in the luteal phase than in the follicular phase. Although women also experienced less positive affect in the luteal phase, there was no correlation between mood and either cravings or amount eaten. Women rated as chronic dieters craved less than those rated an nondieters. The findings on mood and eating confirm previous research, whereas those on cravings extend such research by suggesting that carbohydrate cravings may be augmented by the luteal phase in healthy women.     

Hospital staff education on severe sepsis/septic shock and hospital mortality: an original hypothesis

Background

The Functional Comorbidity Index (FCI) was recently developed to predict physical function in acute lung injury patients using comorbidity data. Our objectives were to determine: (1) the inter-rater reliability of the FCI collected using in-patient discharge summaries (primary objective); and (2) the accuracy and predictive validity of the FCI collected using hospital discharge summaries and admission records versus complete chart review (secondary objectives).

Methods

For reliability, we evaluated the FCI’s intraclass correlation coefficient (ICC) among trained research staff performing data collection for 421 acute lung injury patients enrolled in a prospective cohort study. For validity and accuracy, we compared the detection of FCI comorbidities across three types of inpatient medical records, and the association of the respective FCI scores obtained with patients’ SF-36 physical function subscale (PFS) scores at 1-year follow-up.

Results

Inter-rater reliability was near-perfect (ICC 0.91; 95% CI 0.89-0.94). Hospital admission records and discharge summaries (vs. complete chart review) significantly underestimated the total FCI score. However, using multivariable linear regression, FCI scores collected using each of the three types of inpatient medical records had similar associations with PFS, suggesting similar predictive value.

Conclusions

Data collection using in-patient discharge summaries represents a reliable and valid method for collecting FCI comorbidity information.     

Die revidierte Impact of Event-Skala (IES-R)

In response to an extremely stressful event such as a severe accident, rape or assault, human beings may develop posttraumatic stress disorder (PTSD). One of the most widely used and translated self-report measures for assessing the degree of a symptomatic response to a specific traumatic event is the Impact of Event Scale (IES) originally published in 1979. The IES comprises two subscales “Intrusion” and “Avoidance” and was revised in 1997 (IES-R). The IES-R has three subscales, i.e. “Intrusion”, “Avoidance”, and “Hyperarousal”. Psychometric properties of the IES-R are satisfactory. The IES-R is not intended to be used as a proxy for a diagnosis of PTSD but rather allows an estimation of symptom severity.     

Love and Suicide: The Structure of the Affective Intensity Rating Scale (AIRS) and Its Relation to Suicidal Behavior

Background

Suicide has been linked to intense negative affect. However, little is known about the range of affects experienced by suicidal persons, or the separate effects of affect valence and intensity. We examine a novel self-report scale, the 17-item Affective Intensity Rating Scale (AIRS), and its relation to suicidality in a high-risk sample.

Methodology/Principal Findings

Patients presenting with suicidality were recruited from the Emergency Department in a large urban hospital, and completed a battery of assessments there. Structure of the AIRS was assessed using Maximum Likelihood Factor Analysis with Oblimin rotation. Convergent and divergent validity were assessed by regressing AIRS subscales against Brief Symptom Inventory subscales. Relation to suicidality was assessed by regression of suicide attempt status against scale and subscale scores, and individual items and two-way item interactions, along with significant clinical and demographic factors. 176 subjects were included in analyses. Three reliable subscales were identified within the AIRS measure: positive feelings towards self, negative feelings towards self, and negative feelings towards other. Only individual AIRS items associated significantly with suicide attempt status; strong ‘feelings of love’ associated positively with actual suicide attempt, while ‘feelings of calm’ and ‘positive feelings towards self’ associated negatively. Interaction analyses suggest ‘calm’ moderates the association of ‘love’ with suicide attempt.

Conclusions/Significance

Factor analysis of the AIRS is consistent with a circumplex model of affect. Affective dimensions did not predict suicidal behavior, but intense feelings of love, particularly in the absence of protective feelings of calm or positive self-view associated with current attempt.