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SY41: IASP SIG Postvention Symposium 1: Addressing crucial gaps in our understanding of suicide bereavement and postvention
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IASP SIG Postvention Symposium 1: Addressing crucial gaps in our understanding of suicide bereavement and postvention Over the decades, the research on suicide bereavement and postvention has been expanding. Nonetheless, there remain important gaps in our understanding of this type of bereavement. The recent studies presented in this symposium will address these major gaps, including a novel model for understanding suicide bereavement, the crucial role of peer influence as a risk factor in exposure to suicide, critical aspects of effective psychotherapy with suicide loss survivors, and lessons learned from a global bibliometric study on postvention. Implications for further research and practice will be highlighted. Chairs: Birgit Wagner, Karl Andriessen Presentations of the Symposium A model for suicide bereavement: Based on a meta-ethnography of adult’s experiences and postvention Background: Suicide rates are typically higher for males, but the literature is limited in exploring male perspectives on being suicide loss survivors (SLS). Aim: This study aimed to assess the overall qualitative literature on suicide bereavement, that included a substantial male contribution. Methods: Following the eMERGe and PRISMA guidelines, a meta-ethnography was carried out to assess historical research into suicide-loss survivorship. Seven data sources were searched, up to 30-Nov-2022, for peer-reviewed studies, written in English, that used identifiable and interpretative qualitative methods, had at least 50% male participation, and offered a valuable contribution to the synthesis. Overall, 1,645 records were screened, and 15 reports of included studies assessed. Results: Eight main themes were identified: changed forever, trauma, stigmatization, protector, lost futures, lost in plain sight, societal norms, and dualities. Via line of argument synthesis, and considering the broader literature, a model for suicide bereavement, applicable to all, is proposed that brings together the gamut of pertinent factors into an integrated framework. Conclusion: The model can be used in practice (clinical, therapy/counselling, education) to enable better understanding of the highly complex and interwoven components of suicide bereavement, thereby facilitating improved and extended services available to SLS that are more in-tune with their needs. A common perception, among SLS, is that those not bereaved by suicide can never understand their situation. While the model cannot confer full comprehension of suicide bereavement, it can go a long way to assist those looking to assist SLS by providing a platform for dialogue and empathy. The limited data, on male specific experiences, did not facilitate a clear differentiation on aspects of the model that are gender weighted, emphasising the need for further research. Association between sensitivity to peer influence and suicidal thoughts or behaviour among adolescents exposed to a relative or friend’s suicide or suicide attempt: longitudinal study of the Add Health cohort Introduction: Exposure to a relative or friend’s suicidal behavior is considered a risk factor for suicidality. Adolescents tend to be particularly susceptible to social modelling of others’ suicidal behaviour. It is unclear whether sensitivity to peer influence increases risk of suicidal behaviour in this vulnerable group. Methods: We analysed data from the US National Longitudinal Study of Adolescent to Adult Health (Add Health), including 6,042 adolescents who reported suicide or suicide attempt of a relative or friend at any of the first three waves of data collection. We investigated the longitudinal association between sensitivity to peer influence and i) suicidal ideation and ii) suicide attempts, adjusting for gender, age, and baseline depression. We conducted interaction tests to investigate the modifying effects of gender, kinship to the person who had enacted suicide or attempt (relative vs. friend vs. both), and nature of exposure (suicide vs suicide attempt vs. both). Results: We did not find evidence to support an association between sensitivity to peer influence and suicidal ideation or attempts (all ps > .05). Conducting interaction tests to explore stratum-specific patterns, we found no modifying effect of gender or nature of exposure for either outcome (all ps > .05). However, among participants exposed to suicide/attempt in both peers and relatives, those with the highest sensitivity to peer influence had significantly higher odds of suicide attempt than the lowest sensitivity group in the fully adjusted model (AOR = 7.00, 95% CI [1.20, 40.75], p = .031), acknowledging the limited power of interaction tests. Conclusions: Sensitivity to peer influence was not significantly associated with the risk of suicidal ideation or attempt in this adolescent suicide-bereaved sample. Whilst our interaction tests are suggestive of a dose-response effect this requires further investigation in larger samples. What are we missing in psychotherapy with suicide loss survivors? Implications for interventions Background: Despite the profound psychological impact of suicide bereavement, few psychotherapeutic interventions for suicide loss survivors show robust empirical support. The limited randomized controlled trials (RCTs) available are typically short-term, group-based interventions that yield minimal or no significant effects compared to control conditions. Moreover, most existing approaches fail to address the trauma-related and relational dimensions inherent in suicide loss. This presentation aims to identify critical gaps in psychotherapy for suicide loss survivors by integrating insights from trauma-focused research and emphasizing the importance of unresolved relational dynamics and disturbances in self-organization (DSO) symptoms. Aim: The aim of this presentation is to discuss implications for improving the development of interventions for suicide loss survivors. Methods: Two recent studies (Hofmann, Merkl, & Wagner, 2024; Hofmann & Wagner, 2024), each including a total of N = 167 suicide loss survivors, were analyzed with regard to improving care for suicide loss survivors. Results: Our recent studies highlight two key determinants of bereavement trajectories: (1) the quality and emotional entanglement of the relationship with the deceased, which predict prolonged grief, PTSD, and guilt; and (2) the high prevalence of complex PTSD-related disturbances, including affective dysregulation, negative self-concept, and interpersonal difficulties. These findings suggest that suicide bereavement encompasses not only grief but also profound disruptions in identity and relational functioning. Conclusion: Current psychotherapeutic approaches insufficiently address these trauma-related and self-structural dimensions. Future interventions should incorporate trauma-informed and individualized components—such as emotion regulation training, identity reconstruction, and relational repair—to more effectively meet the needs of suicide loss survivors. Recognizing and treating complex PTSD symptoms may represent a crucial next step in advancing clinical care for this underserved and often overlooked population. Research trends in suicide bereavement and postvention: A global bibliometric and content analysis Background: Suicide bereavement is one of the most devastating life events, often characterized by intense emotional distress and an increased risk of mental health problems and suicidal behaviour among the bereaved. Postvention aims to support suicide loss survivors cope with the bereavement and mitigate associated risks. As research in this field continues to expand globally, including Low- and Middle-Income Countries, there is a growing need to systematically map its development and identify key trends. Aim: The IASP SIG on Suicide Bereavement and Postvention decided to conduct a global bibliometric analysis of research on suicide bereavement and postvention. By exploring developments in the field over the past decades, it will identify publication trends, thematic clusters, and research gaps. Methods: Given the scale of the study, we established a global team of 35 co-investigators, and we preregistered the study protocol (OSF, August 15, 2025). Systematic searches in six databases (Embase, Emcare, Medline, PsycINFO, Scopus, and Web of Science) yielded 49,386 references. After removal of duplicates, and a two-step screening process conducted independently by pairs of two researchers, 1,106 articles published between 1953 and 2025 were included. Original research articles, scoping and systematic reviews, and opinion papers were included. The collaborating researchers could provide additional references not identified through the searches. As a next step, we will extract data from the studies, including publication details, characteristics of the sample, and type of study. Results: The analysis, currently ongoing, will provide a global overview of research designs and methodologies, the demographic (e.g., age groups, population types) and geographic distribution, the temporal development of research outputs, identify key research themes and topical clusters, and identify research gaps and underexplored areas to inform future research priorities. The findings will be presented at the conference. | ||
