Lecture 5.2 - Self Harm and Suicide Flashcards
What three categories of factors contribute to the etiology of suicide?
Biological factors
–> Genetic influence
–> Acathesia with SSRIs
Psychosocial Factors
–> Cognitive theories: hopelessness, rigid thinking, perfectionism
–> Cluster suicides are a stressor
Social Factors
–> MAID - minimizes suffering
——–> Persons with major mental disorders are currently excluded
What is the suicidal crisis process?
- Stressful situations leads to vulnerability
- Search for possible solutions
- Incapacity to find solutions results in intensifying helplessness
- Risk for suicide
Individuals with what mental illnesses have higher suicide rates?
–> Depression (or depressive phase of bipolar)
–> schizophrenia
–> Substance use
–> Antisocial and borderline PDs
What is the best way to prevent suicide?
An therapeutic relationship with the individual that promotes empathy, respect, humility, and openness.
What interventions should be used during a suicidal crisis?
Establish a therapeutic relationship and inform the rest of the care team.
Remain with the pt. Accept, listen and support them, and validate their feelings and foster hope.. Develop a safety care plan together, consider giving the patient a task to complete.
Milieu management: Increased observation, remove dangerous objects, open communication, ensure the patient swallows their medication.
What is a a postvention? What is the goal of it?
A postvention is tertiary intervention provided to a loved one’s after a an individual dies by suicide. May include referral to supportive sevices.
The goal is the reduce the traumatic effects felt by loved ones following the suicide.
What is the purpose of self harming behaviours? What disorders are they associated with?
Self-harm is often performed as self-punishment, to alleviate psychic pain, or to pierce numbness in dissociation.
Associated with other psychiatric disorders such as anxiety, depression, EDs, BPD.
How can we treat self-harming behaviours?
CBT, DBT, and treatment of underlying mental disorders.
What assessment should be performed on someone with Self-harming behaviours?
–> Historical information about the type and frequency of the behaviour
–> Identification of triggers
–> Physical assessment of wounds
How can akathesia with SSRIs pose a risk to suicide?
Because SSRIs treat the physical symptoms of depression before the psychological ones, there is a theory that initial treatment could provide an individual with the energy they need to follow through on a plan.
What kinds of patterns of thinking contribute to the etiology of suicidal behaviour?
Hopelessness, rigid thinking, perfectionsim
What are the clinically relevant association between neurotransmitters and suicide attempts?
There are none
What is the SAD PERSONS scale?
A scale that can be used to determine if someone is at high risk for suicide
Addresses sex, age, depression, previous attempts, ethanol use, rational thinking loss, social supports, the presence of an organized plan, if they have a spouse or sickness.
