Lecture 7 Suicidal behaviours

Question 1

What are the stats on suicide deaths?

Answer 1

• approx 1 million people died by suicide in 2000
• Every 40 seconds, or 17 minutes in US alone
• 11th leading cause of death
• 3rd cause of death in teens

Question 2

Are people who commit suicide mentally ill?

Answer 2

Most of them are, in fact 90% meet criteria for a psychiatric disorder

• 9% BPD
• 7% Depression, bipolar, substance abuse
• 5% eating disorders, schizophrenia, antisocial personality disorder

Question 3

Difference between men & women in suicide?

Answer 3

Females are more likely to attempt suicide, whereas men are more likely to complete suicide (kill themselves).

Question 4

What racial group (in Canada) is at greater risk for suicide?

Answer 4

First Nations people are 2.5 times more likely to commit suicide

Question 5

Two universal processes/mental states present in those who commit suicide?

Answer 5

1. Isolation: feeling isolated and cut-off

2. No hope: perception of the world is drastically narrowed. The world and the pain are one

Question 6

Protective Factors (attitudes)

Answer 6

1. The participant attitude

2. The challenging attitude

Question 7

The participant attitude

Answer 7

a protective factor and therapeutic technique in which the helper manifests an attitude that is fully empathetic to the suicide’s pain and plight

Question 8

The challenger attitude

Answer 8

a protective factor and therapeutic technique in which the helper attempts to deal with the suicides tunnel vision. Address the suicides momentary blindness (suffering of others, availability of other options, etc)

Question 9

What is borderline personality disorder?

Answer 9

A disorder of pervasive emotion dysregulation

• emotions: easily upset
• thinking: suspiciousness or paranoia
• behaviour: impulsive behaviour
• relationships: fear abandonment; idealization/devaluation

Question 10

Suicide rates among those diagnosed with BPD

Answer 10

• 8-10% die by suicide
• 75% have attempted suicide
• 69-80% self-harm

Question 11

Psychodynamic Approach to BPD (transference focused therapy/ TFP)

Answer 11

Insight oriented approach that involves the therapist helping the patient to understand and observe the origins and effects of his or her transference reactions

Question 12

Psychodynamic approach to BPD (mentalization based treatment)

Answer 12

-mentalization: based on theory of mind
-the ability to imagine/understand other people’s mental states
-may include: Partial hospitalization
program, incl. individual therapy, group therapy, expressive therapy, community meeting

Question 13

Medication for BPD

Answer 13

• best evidence of working is for SSRI’s, (serotonin reuptake inhibitors)(e.g., prozac)
• anti-psychotic meds may also be useful
• not recommended by itself

Question 14

Two components that make up Linehan’s Biosocial Theory of BPD

Answer 14

1) Emotional dysregularity: impulsive reactions, problems inhibiting behaviour, problems in regulating emotions, etc
2) Invalidating Environment: the tendency to negate, punish, or not validate experiences

Question 15

DBT: Stage 1- attaining basic capacities (4 components)

Answer 15

1. Decrease Life-threatening behaviours
2. Decrease therapy interfering behaviours
3. Decrease Quality of life interfering behaviours
4. Decrease skills deficits, increase skillful behaviour

Question 16

DBT: Stage 2- Escaping quiet desperation

Answer 16

• reduce extreme emotional pain

- increase the capacity for normative emotional experiencing

Question 17

DBT: Stage 3- Resolving problems in living and increasing respect for self

Answer 17

• the individual is functional in major domains of living
• the goal here is to reach an ordinary level of happiness/unhappiness +self respect
• the therapist pulls back and helps client be more self reliant

Question 18

DBT: Stage 4- Attaining the capacity for freedom and sustained contentment

Answer 18

-the goals are expanded to self awareness, spiritual fulfillment, and the movement into experiencing flow