Understanding suicidal transitions in Australian adults: LifeTrack protocol

The LifeTrack study was established to increase knowledge about why some people who experience suicidal ideation make a suicide attempt while others don’t, with the goal of informing new treatments to reduce suicide attempts. More than 3,000 Australians die by suicide every year, with suicide being the leading cause of death for those aged 15-44 years. It is estimated that 3.3% of Australians experience suicidal ideation and 0.3% Australians report a suicide attempt each year. To create new approaches to reduce suicide attempts, we need a better understanding of factors that predict the transition from ideation to attempt.

The LifeTrack project recruited 923 Australian adults who experienced suicidal ideation in the past 30 days from the general population. We will follow participants for three years to identify key modifiable risk and protective factors that predict the transition from suicidal ideation to suicide attempt or remission of suicidal ideation. Participants will receive online surveys every 6 months. They will be asked about mental and physical health, psychological factors, service use, life events, and demographics. Each year, participants will also be asked to complete one week of short daily measures of suicidal ideation and related factors to capture short-term fluctuations. Outcomes of this study may inform new public health approaches to reduce suicide attempts in the community, with a focus on risk and protective factors.

Read the journal article (open access) here: https://doi.org/10.1186/s12888-023-05335-1

Baseline cohort characteristics and psychosocial factors associated with duration of suicidal ideation and prior suicide attempt

This paper reports on data from 923 participants who completed the baseline LifeTrack survey between July 2023 and October 2023. It aims to (a) describe the characteristics of the sample and (b) identify factors associated with duration of suicidal ideation and prior suicide attempt. The survey included questions on sociodemographic variables (age, gender, sexuality, relationship status, education, living alone), history of suicidal ideation and suicide attempt, physical and mental health conditions, psychological factors, and stressful and traumatic life events.

• Sample characteristics
  • 55% of participants reported first experiencing suicidal thoughts over 10 years ago. Only 17% of participants reported an onset in the past 2 years.
  • About 50% of participants reported a prior suicide attempt
  • 62% of participants reported having ever received a mental health diagnosis
  • 47% reported a physical health diagnosis and 20% reported a developmental condition.
• Predictors of long-term suicidal ideation and prior suicide attempt
• Minority gender and sexual identities were associated with both duration of suicidal ideation and history of suicide attempt, possibly due to discrimination and stigma:
  • Long term (>10 years) suicidal ideation was associated with female gender. However, women did not report higher rates of attempt than men, which is inconsistent with previous research.
  • Non-binary gender was associated with a higher rate of prior attempt.
  • Bisexuality was associated with greater duration of suicidal ideation and higher rate of prior attempt, consistent with previous research.
• Other sociodemographic factors associated with both long-term ideation and prior attempt include lower levels of education and higher levels of financial worry.
• Psychological and physical health were also important. Symptoms of depression and post-traumatic stress disorder were associated with longer duration of suicidal ideation and higher rates of prior attempt, as was any mental health diagnosis. Greater pain interference was associated with longer duration of ideation.

Read the journal article (open access) here: https://doi.org/10.1016/j.psycom.2025.100210

Longitudinal causal dynamics between perceived burdensomeness and suicidal ideation

Thomas Joiner’s Interpersonal-Psychological Theory of Suicide suggests that suicidal ideation is caused by thwarted belongingness (lack of connectedness to others) and perceived burdensomeness (sense that others would be ‘better off without me’), combined with a sense of hopelessness that these feelings will improve. However, the evidence for this theory is mixed. This study investigated whether daily levels, or changes in, perceived burdensomeness predicted short-term changes in frequency of suicidal thoughts among a large cohort of Australian adults with suicidal ideation.

791 participants from the LifeTrack project completed between 2 and 7 daily measurements assessing suicidal thoughts, attempts, self-harm, mental health and a range of theory-informed modifiable risk and protective factors. The effect of perceived burdensomeness on suicidal ideation the next day was weak, especially compared to the relation between perceived burdensomeness and suicidal ideation on the same day. The effect of perceived burdensomeness on suicidal ideation frequency was stronger among middle-aged adults compared to younger adults and was stronger for those who lived with others compared to those who lived alone.

The findings partially support the Interpersonal-Psychological Theory of Suicide due to the strong cross-sectional relationship between perceived burdensomeness and frequency of suicidal ideation. However, the lack of predictive power suggests that perceived burdensomeness varied concurrently with suicidal ideation, instead of predicting later suicidal ideation, which is inconsistent with the theory. The findings suggest that the repeated measurement of perceived burdensomeness may not be helpful in suicide risk assessment or monitoring.

Read the journal article (open access) here: https://doi.org/10.1016/j.jpsychires.2025.06.022

Longitudinal role of sleep disturbance in mental health and functioning among adults with suicidal ideation

Despite sleep disturbances being among the most frequently reported symptoms experienced by individuals with psychological distress, there is limited research into the role poor sleep plays in the mental health of those experiencing suicidal distress. This paper examined whether there were long-term associations between baseline sleep disturbance symptoms and subsequent depression, psychological distress, suicidal ideation and functional impairment at 6 and 12 months later. Participants in LifeTrack, a 3-year study of Australian adults with suicidal ideation, were asked questions about age, gender, parenthood status, depression symptoms, psychological distress, suicidality, everyday functioning, sleep disturbance, financial concern, pain, and medical diagnoses.

Baseline sleep disturbance symptoms were closely linked with depression, psychological distress and functional impairment at 6 months, but not with severity of suicidal ideation. However, at 12 months, baseline sleep disturbance was closely linked to subsequent suicidal ideation as well as depression, psychological distress, and functional impairment. The relation between sleep disturbance and functional impairment was stronger for men, people with fewer physical health problems, people with less pain interference, and people with less financial worry.

This evidence suggests that sleep disturbance may have a delayed effect on suicidal ideation, possibly through its effects on psychological distress or other mediators (e.g. rumination, impulsivity, emotional regulation). Targeting sleep disturbance in the treatment of suicidal ideation is likely to reduce individuals’ psychological distress and depressive symptoms, potentially improving their daily functioning.

The journal article is available at http://doi.org/10.1111/bjc.70021 with open access coming soon here: https://openresearch-repository.anu.edu.au/home