Melanie A. Hom

Melanie A. Hom
Stanford University | SU

PhD

About

96
Publications
34,192
Reads
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3,336
Citations
Introduction
Skills and Expertise

Publications

Publications (96)
Article
Research has demonstrated that military service members are at elevated risk for a range of psychiatric problems, and mental health services use is a conduit to symptom reduction and remission. Nonetheless, there is a notable underutilization of mental health services in this population. This systematic review aimed to identify and critically exami...
Article
Objective: To identify demographic, diagnostic, and personality factors that predict treatment dropout in a sample of outpatients with clinically significant suicidal ideation. Method: A total of 287 adult outpatients at elevated risk for suicide completed self-report measures of demographics, suicidal and depression symptoms, and personality ch...
Article
Full-text available
Although a suicide attempt history is among the single best predictors of risk for eventual death by suicide, little is known about the extent to which reporting of suicide attempts may vary by assessment type. The current study aimed to investigate the correspondence between suicide attempt history information obtained via a single-item self-repor...
Article
Building upon the idea that humans may be a eusocial species (i.e., rely on multigenerational and cooperative care of young, utilize division of labor for successful survival), we conjecture that suicide among humans represents a derangement of the self-sacrificial aspect of eusociality. In this article, we outline the characteristics of eusocialit...
Article
Full-text available
Background Forecasts about the future can dictate actions and behaviors performed in the present moment. Given that periods of elevated acute suicide risk often consist of elevated negative affect and hopelessness, individuals during these periods may more bias-prone and make decisions (e.g., suicide attempts) based on inaccurate affective forecast...
Article
Despite the availability of well-established and efficacious treatments for social anxiety disorder, most socially anxious individuals do not seek treatment and those who do often suffer for years before seeking treatment. A more comprehensive understanding of the factors related to treatment seeking for social anxiety disorder is needed. This stud...
Article
Objective: Despite a proliferation of virtual partial hospital programs (PHP) during the COVID-19 pandemic, there is a dearth of research on such programs. In the current study, we compared treatment outcomes and patient satisfaction between an in-person and a virtual PHP. Further, we examined patients' qualitative feedback about the virtual PHP....
Article
Research is needed to better understand and characterize individuals who do not benefit from evidence-based psychiatric services or whose symptoms worsen following treatment. This study aimed to compare clinical severity at admission, treatment outcomes, treatment beliefs, and satisfaction with care among patients (N = 5,129) with perceived improve...
Article
The Depressive Symptom Index-Suicidality Subscale (DSI-SS) is a four-item self-report measure of suicidal ideation severity widely used across research and clinical contexts. However, the psychometric properties of the English-language version of the DSI-SS have not been extensively examined within a psychiatric sample, and important properties of...
Article
Objective To compare pre- and posttreatment psychological functioning and patient satisfaction among patients with and without recent suicidal ideation receiving care at a partial hospital program. Methods Patients (N = 1295) completed (1) self-report measures of clinical severity, treatment beliefs, and patient satisfaction and (2) a clinician-ad...
Chapter
Major depressive disorder is among the most common psychiatric disorders globally and is a leading cause of impaired functioning and psychiatric hospitalization. One setting to which individuals with major depressive disorder may present for treatment is a partial hospital program (PHP). PHPs represent a surprisingly feasible and effective environm...
Article
Aim Prior studies suggest that individuals may respond inconsistently to different assessments of suicide attempt (SA) history; yet, little is known regarding why inconsistent reporting of SA history may occur. The overarching goal of this study was to examine individuals’ self-reported reasons for inconsistently responding to different self-report...
Article
Objective The connection of individuals at elevated suicide risk to mental healthcare services represents a critical component of suicide prevention efforts. This article provides recommendations for enhancing the assessment of help‐seeking and mental health service use within the context of suicide prevention research. Method We discuss evidence‐...
Article
Background: Previous work suggests that reasons for living (RFL) are associated with suicide ideation; however, the relationship between RFL and suicide attempts among individuals with suicide ideation remains unclear. Such an examination is necessary to delineate whether RFL are associated with suicide attempts above and beyond their association w...
Article
In this meta-analysis, we aimed to evaluate the cross-sectional and longitudinal relationships between various forms of sleep problems and loneliness. A total of 84 articles (110 samples, N = 227,112) were identified for inclusion. Random effects models revealed a significant medium association between overall sleep problems and loneliness ( r = .3...
Article
Research is needed to examine factors that contribute to psychological well-being among military service members. This study examined associations between various indices of psychological well-being, resilience, and help-seeking stigma among New Zealand Defence Force (NZDF) personnel (N = 2,805). Participants completed self-report measures of psych...
Article
Research suggests that individuals may benefit from participation in a partial hospital program (PHP) following discharge from inpatient psychiatric hospitalization. Indeed, PHPs are designed to facilitate further stabilization and skill-building before discharge to the community. As a result, our hospital-located in a large metropolitan area in th...
Article
Most suicides in the United States are enacted with firearms, and firearm ownership/access and unsafe storage are associated with elevated suicide risk. Exaggerated perceptions of threat, which are characteristic of post‐traumatic stress disorder (PTSD), might lead to the acquisition and/or unsafe storage of firearms, thereby increasing suicide ris...
Article
By virtue of their occupational responsibilities, protective service workers are often exposed to stressors and hazards that may increase their risk for various mental health problems. Efforts are thus needed to enhance connection to psychological services across protective service worker groups and to tailor the delivery of these services based on...
Article
Research indicates that connection to mental health care services and treatment engagement remain challenges among suicide attempt survivors. One way to improve suicide attempt survivors' experiences with mental health care services is to elicit suggestions directly from attempt survivors regarding how to do so. This study aimed to identify and syn...
Article
Objective: Firearms are the most common method of suicide in the United States. The provision of firearm-specific lethal means safety interventions is a best practice for the prevention and management of suicide risk. However, few data exist to inform firearm-specific lethal means safety interventions. This study tested four different lethal means...
Article
Nonalcohol substance use is a robust correlate of suicide risk. However, few data exist regarding the degree to which nonalcohol substance use, as measured by objective indicators (e.g., urinalysis toxicology screen), is related to suicide risk. This study examined the associations of a multimodal assessment of nonalcohol substance use and multiple...
Article
Objectives: Suicide attempts (SAs), by definition, represent a risk for serious injury or death; thus, one's SA may contribute to the development of posttraumatic stress disorder (PTSD). Yet, empirical data on this topic are lacking. This study aimed to characterize the phenomenology, rate, and associated features of PTSD following one's SA. Meth...
Article
Firefighters represent a group at elevated suicide risk. Identifying segments of the fire service at increased risk may facilitate the targeted provision of suicide prevention initiatives. Among the general population, American Indian/Alaska Native (AI/AN) individuals report higher rates of suicide attempts. This study sought to examine suicide att...
Article
Purpose: Youth suicide is a public health emergency, and its prevention is a national imperative. Pediatric providers are critical to risk assessment, triage, and intervention, yet little is known about the content, quality, and perceived adequacy of suicide prevention pediatric residency training. We thus sought to (1) characterize suicide risk a...
Article
Objective Utilizing a sample of military service members at risk of suicide, this study aimed to: (a) identify patterns of suicide attempt (SA) history reporting across five measures and (b) evaluate whether consistent SA reporters (i.e., individuals who consistently report an SA history across measures) differ from inconsistent SA reporters on oth...
Article
Background A growing body of literature supports the potential existence of a new clinical entity, Acute suicidal affective disturbance (ASAD), which is characterized by rapid-onset, acute suicidality. This study aimed to evaluate whether current ASAD symptoms (i.e., suicidal intent, thwarted belongingness, perceived burdensomeness, disgust with ot...
Article
Study objectives: Prior cross-sectional studies indicate that psychological factors (eg, perceived burdensomeness, thwarted belongingness) may explain the relationship between insomnia and suicidal ideation. Longitudinal studies are needed, however, to examine how these variables may relate to one another over time. Using data collected at three t...
Article
Background: Relatively little is known regarding the relationship between attitudes toward suicide, suicide attempt (SA) history, and future suicidal behaviors. Aims: Utilizing a sample of firefighters, this study compared attitudes toward suicide between individuals with/without a career SA history and evaluated whether certain attitudes toward...
Article
A core component of suicide risk assessment and management is determining one's physical proximity to specific suicide means and counseling individuals to minimize their physical access to these means. However, this approach ignores other potentially relevant parameters, such as perceptions of how psychologically close/distant one feels to a partic...
Article
Background Research is needed to identify the factors that explain the link between prior and future suicidality. This study evaluated possible mediators of the relationship between: (1) the severity of prior suicidality and (2) suicidal ideation severity at 3-month follow-up among a sample of high-risk military personnel. Methods US military serv...
Article
Objective: Suicide is a global public health concern. To inform the prevention and treatment of suicidality, it is crucial to identify transdiagnostic vulnerability factors for suicide and suicide-related conditions. One candidate factor is anxiety sensitivity (AS)-the fear of anxiety-related sensations-which has been implicated in the pathogenesi...
Article
Recent standardized nomenclature has suggested distinctions among aborted, interrupted, and actual suicide attempts. This study examined differences in self-reported symptoms among individuals with a history of aborted, interrupted, and actual suicide attempts. 167 young adults with a history of suicidality completed self-report measures of suicide...
Article
Background: Research suggests that insomnia is associated with elevated perceptions of loneliness and social disconnection; however, few quasi-experimental studies have tested the relationship between these constructs. This study examined whether insomnia symptom severity predicts changes in perceptions of interpersonal connectedness and desire fo...
Article
Suicide attempt survivors represent a high-risk group for death by suicide; however, few empirically supported, tailored interventions exist for this population. One intervention format that may be useful in reducing suicide risk among suicide attempt survivors is support groups co-led by a clinician and peer survivor. This study aimed to evaluate...
Article
Research indicates that women firefighters may experience elevated rates of suicidal thoughts and behaviors; however, little is known about how at-risk women firefighters interface with mental health services and other support sources. This study aimed to identify rates of mental health service use and help-seeking, correlates of service use, and p...
Article
Sleep problems are robust suicide risk correlates. According to the interpersonal theory of suicide, thwarted belongingness (TB) and perceived burdensomeness (PB) may explain the link between sleep problems and suicide risk. This study examined these relationships among 331 community-dwelling adults identifying as sexual and/or gender minorities. S...
Article
1 Objective To examine experiences with suicide exposure and bereavement among women firefighters. 2 Methods Women firefighters (N = 266, Mage = 37.64y) completed self‐report measures assessing their experiences with suicide exposure, history of suicidality, current psychiatric symptoms, and suicide risk. 3 Results Three‐fourths (74.4%) of partic...
Article
This study examined whether atypical/severe nonsuicidal self-injury (NSSI; e.g., foreign body ingestion, cutting necessitating sutures) serves as a marker of severe psychopathology among 467 adult community mental health clients (n = 33 with an atypical/severe NSSI history). Information regarding psychiatric risk indicators was extracted from parti...
Preprint
Background: Firefighters are at increased risk for both problematic alcohol use and suicidality. Research has found that problematic alcohol use is related to suicidality among this population; however, limited data exist regarding what might account for this association. The present two-study investigation (1) examined the association between suic...
Article
Background: Firefighters are at increased risk for both problematic alcohol use and suicidality. Research has found that problematic alcohol use is related to suicidality among this population; however, limited data exist regarding what might account for this association. The present two-study investigation (1) examined the association between sui...
Article
Firefighters experience high rates of posttraumatic stress disorder (PTSD). It is imperative to identify malleable factors that protect against the development of PTSD symptoms among this population. We examined whether perceptions of belongingness broadly (Study 1) and social support from supervisors, coworkers, and family/friends specifically (St...
Article
Recent research has indicated that firefighters are at elevated suicide risk. Fire service organizations have called for research to examine fire service subgroups that might be at relatively increased suicide risk. Although anecdotal reports suggest that wildland firefighters represent one such group, to our knowledge, no study has empirically exa...
Article
Help-seeking stigma is a potent barrier to the utilization of mental health services. This study aimed to determine if, compared to a psychoeducation condition, individuals randomized to a novel cognitive bias modification intervention for help-seeking stigma (CBM-HS) demonstrate greater reductions in help-seeking stigma, as well as increases in re...
Article
Background: Research suggests that screening for suicidality does not have iatrogenic effects; however, less is known regarding the impact of repeatedly screening for suicidal ideation among individuals with varying levels of exposure to these screenings. This staggered sequential study evaluated whether suicidal ideation severity increases with r...
Article
Objective: Research has identified non-suicidal self-injury (NSSI) as a robust correlate of suicidal thoughts and behaviors; however, little is known regarding why these constructs may be related. Consistent with the interpersonal theory of suicide, this study investigated thwarted belongingness (TB), perceived burdensomeness (PB), and capability...
Article
Objective: To evaluate the characteristics of suicide risk assessments completed using the Decision Tree framework both in and between psychotherapy sessions, clinical features of patients for whom between-session assessments are indicated, and data collected across assessments. Method: Data were collected from 1,358 suicide risk assessments con...
Article
Over the past decade, the interpersonal theory of suicide has contributed to substantial advances in the scientific and clinical understanding of suicide and related conditions. The interpersonal theory of suicide posits that suicidal desire emerges when individuals experience intractable feelings of perceived burdensomeness and thwarted belongingn...
Article
Research indicates that physical and sexual abuse are associated with increased suicide risk; however, these associations have not been investigated among firefighters-an occupational group that has been shown to be at elevated suicide risk. This study examined whether physical and sexual abuse histories are associated with (a) career suicide ideat...
Article
This cross-sectional study investigated the association between harassment, career suicidality, and psychiatric symptoms among women firefighters. Women firefighters (n = 290) completed self-report measures of experiences with harassment on the job, career suicidality, and various psychiatric symptoms. Logistic regression analyses and one-way analy...
Article
This study aimed to evaluate: (1) treatment progress utilizing the cognitive behavioral analysis system of psychotherapy (CBASP) in an outpatient community sample and (2) whether treatment gains might be accounted for by situational analysis performance. A total of 24 psychiatric outpatients receiving CBASP from psychology trainees participated in...
Article
Objective The present study aimed to validate a Korean version of the self-report Depressive Symptom Inventory-Suicidality Subscale (DSI-SS). Methods 553 South Korean undergraduate students (aged 18–34 years, 74.8% females) completed questionnaires. Participants completed Korean versions of the self-report Depressive Symptom Inventory-Suicidality...
Article
Objective: Posttraumatic stress disorder (PTSD) symptoms are associated with increased suicide risk. Anxiety sensitivity (AS)—the fear of anxiety-related sensations—is both a vulnerability factor for and consequence of PTSD symptoms. AS also predicts suicide risk. To our knowledge, no study has examined whether AS concerns account for the associati...
Article
Writing is a core feature of the training requirements and career demands of psychology faculty members and graduate students. Within academic psychology, specifically, writing is vital for the generation of scientific knowledge through manuscripts and grant applications. Although resources exist regarding how to improve one’s writing skills, few m...
Article
Objective: Young adults attempt suicide at disproportionately high rates relative to other groups and demonstrate high rates of sleep disturbance. No study has yet prospectively evaluated disturbed sleep as an acute indicator of risk using an objective index of sleep. We investigated objective and subjective parameters of disturbed sleep as a warn...
Article
Full-text available
Background: Women protective service workers die by suicide at a higher rate than women workers in other occupational groups. However, no study has examined rates and correlates of suicidal thoughts and behaviors among women firefighters, despite the potential for these data to inform suicide screening, prevention, and intervention initiatives. The...
Article
Full-text available
Objectives: To describe the relative utility of the terms "means safety" versus "means restriction" in counseling individuals to limit their access to firearms in the context of a mock suicide risk assessment. Method: Overall, 370 participants were randomized to read a vignette depicting a clinical scenario in which managing firearm ownership an...
Article
Full-text available
Anxiety and depression diagnoses are associated with suicidal thoughts and behaviours. However, a categorical understanding of these associations limits insight into identifying dimensional mechanisms of suicide risk. This study investigated anxious and depressive features through a lens of suicide risk, independent of diagnosis. Latent class analy...
Chapter
Full-text available
This chapter reviews issues related to the dissemination of cognitive behavioral therapy (CBT), including barriers and potential solutions. Survey of psychologists who treat eating disorders found that 39% endorsed CBT as their primary treatment approach, while a majority of the sample indicated that they used CBT techniques “always” or “often”. An...
Article
Loneliness has been repeatedly associated with sleep problems; however, there is a dearth of research examining the prospective relationship between insomnia and loneliness, as well as this association controlling for other psychiatric symptoms. This study evaluated the cross-sectional and prospective relationship between insomnia and loneliness us...
Article
Objective: To characterize individuals' prior experiences with being asked whether they are having thoughts of suicide and to understand factors that affected their response accuracy. Method: Undergraduates (N = 306) reporting a lifetime history of suicidal ideation completed a web-based survey about their experiences being probed about suicidal...
Article
Suicide has become an issue of great concern within the U.S. military in recent years, with recent reports indicating that suicide has surpassed combat related deaths as the leading cause of death. One concern regarding suicide risk in the military is that existing self-report measures allow service members to conceal or misrepresent current suicid...
Article
Firefighters are at increased risk for mental health problems. However, little is known about differences in psychiatric symptoms between volunteer and career firefighters. This study aimed to (1) describe differences in psychiatric symptoms and barriers to mental health care between U.S. firefighters in volunteer-only and career-only departments;...
Article
Background: Insomnia is a robust correlate of suicidal ideation and behavior. Preliminary research has identified thwarted belongingness (c.f. social disconnection) as an explanatory link between insomnia and suicidal ideation. Objectives: This study replicates and extends previous findings using both cross-sectional and longitudinal designs in...
Article
Research into the causes and prevention of suicide has been deemed a national priority, with a recent focus on sectors of the workforce, such as firefighters, who experience occupational hazards that may confer risk for suicide. Elevated levels of posttraumatic stress symptoms (PTSS), which show robust relationships with both suicidal ideation (SI)...
Article
There exists a stigmatizing belief that some individuals utilize psychotherapy merely because they are seeking attention or reassurance from others; however, this supposition has not been empirically scrutinized. This study aimed to determine the extent to which attention-seeking and/or reassurance-seeking tendencies are associated with psychothera...
Article
Sleep disturbances are robust correlates of suicidal ideation and behavior. However, less is known about the mechanisms underlying this association. Preliminary research has identified thwarted belongingness (c.f. loneliness) as an explanatory link between insomnia and suicidal ideation. This study aimed to replicate previous findings in three demo...
Article
Background: Research with human subjects represents a critical avenue for suicide prevention efforts; however, such research is not without its ethical and practical challenges. Specifically, given the nature of research with individuals at elevated risk for suicide (e.g., increased concerns regarding participant safety, adverse events, liability),...
Article
Objective: Although the interpersonal theory of suicide may explain the elevated suicide risk among military service members, past explorations have been equivocal. This study aimed to investigate the propositions of the interpersonal theory in a sample of U.S. Army recruiters. Method: Participants (N = 3,428) completed self-report measures asse...
Article
Objective: The interpersonal-psychological theory of suicide posits that perceived burdensomeness (PB; i.e., the belief that others would be better off if one were dead) and thwarted belongingness (TB; i.e., the belief that one lacks meaningful social connections) are both necessary risk factors for the development of suicidal ideation. To test th...
Article
With the increasing utilization of Web-based surveys for suicide and suicide-related research, it is critical to understand factors that affect participants' decision to request study compensation (and thus potentially reveal their identity) or remain anonymous. This study evaluated differences in demographics, suicidal symptoms, and suicide-relate...
Article
Given the high rates of suicide among military personnel and the need to characterize suicide risk factors associated with mental health service use, this study aimed to identify suicide-relevant factors that predict: (1) treatment engagement and treatment adherence, and (2) suicide attempts, suicidal ideation, and major depressive episodes in a mi...