objective 4 Flashcards
associated with thwarted or unfulfilled
needs, feelings of hopelessness and helplessness,
ambivalent conflicts between survival and
unbearable stress, a narrowing of perceived
options, and a need to escape
suicide
suicide may be?
The culmination of self-destructive urges that have
resulted from the client’s internalizing his or her anger
* A desperate act by which to escape a perceived
intolerable psychological state or life situation
* The client may be asking for help by attempting
suicide, seeking attention, or attempting to
manipulate someone with suicidal behavior
Various theories have been proposed to explain possible factors that
influence suicidal behavior
etiology
what are the genetic and biologic theories?
Genetic Markers
2. Endocrine Basis
3. Relationship of Neurochemical Binding Sites
4. Protein Kinase C Abnormality
5. Familial Suicidal Behavior
6. Twin and Adoption Studies
what are psychological theories?
Theory of Self
2. Theory of Parasuicidal Behavior
3. Other Psychological Factors
DNA analysis
* Serotonin receptors did not normalize after depression was
treated
* Findings suggest biologic predisposition to suicide thoughts
(receptor gene associated with major depression)
genetic markers
Hyperarousal of the hypothalamic-pituitary-adrenal axis - affects
the ability for the brain to modulate stress states
* Disturbances in the regulation of anxiety and aggression due to
increased levels of cortisol placed the participants at an
increased risk for suicide
endocrine basis
Relationship between:
* Serotonin and Postsynaptic frontal cortices binding sites
* Increase binding sites decreases the availability of serotonin for
regulation of aggression
relationship of neurochemical binding sites
Enzyme present in body
* Postmortem studies of brains of teenagers who have committed
suicide show decrease in levels of Protein Kinase C
protein kinase C abnormality
Suicide is familial – studies show, however risk factors are unclear
from parent to child
familial suicide behaviour
Suicide among identical twins higher (11.3%) than suicide in
fraternal twins (1.8%)
* Adoptees that attempt suicide have more biological relatives
who had committed suicide than members of a control group
twin and adoption studies
identified society as an influencing factor in suicide rates
sociologic theory
what are the 4 categories based on the degree of an individuals socialization?
Egoistic Suicide
* Altruistic Suicide
* Anomic Suicide (alienated from society)
* Fatalistic Suicide
Internal view of personal existence is called “the self”
* Basic motivation for behaviour
* Healthy individuals have assimilation/incorporate new ideas and
expulsion/throw out old ideas
theory of seld
Individuals who engage in self-inflicted injury or mutilation but
usually do not wish to die
* Known as self inflicted behaviour (SIB)
theory of parasuicidal behaviour
Believed suicide was a result of anger turned inward
psychological theories
A reunion wish or fantasy
* A way to end one’s feelings of hopelessness and helplessness
* A cry for help
* An attempt to “save face” or seek a release to a better life
other psychological factors
what are the risk factors of suicide?
Psychiatric disorders
Alcohol or substance use
Suicidal ideation with intent; a plan; hx of previous attempts
Family hx of suicide
Hx of maltreatment
Recent stressful life event
Hopelessness/helplessness
Lack of social support
Low serotonin levels are related to depressed mood
Low cerebrospinal fluid 5-hydroxyindoleacetic acid is a
promising biological predictor of suicidal behavior
biological factors
aggression turned inward
Freud
wish to kill (wish to be killed or wish to die)
Menninger
central emotional factor is hopelessness
Aaron Beck
combination of suicidal fantasies and significant loss
recent theories
what are psychosocial factors?
Freud
Menninger
Aaron Beck
Recent theories
Cultural safety
“Pain is pain . . . in any cultural group” (Leong & Leach, 2008)
Cultural contexts and conditions
cultural factors
what are the factors influencing suicide rates?
religious beliefs
family values
attitude toward deaht
what are the verbal suicidal cues?
talking about death
making comments that significant others would be
better off without them
asking questions about lethal dosages of drugs
what are the behavioural suicidal cues?
writing forlorn love notes
directing angry messages at others
giving away personal items
taking out a large life insurance policy
what are the situational suicidal cues?
escribe events or situations that present themselves
either around or within the person
unexpected death of a loved one, divorce, job loss
what is the nursing process?
assessment
nursing diagnoses
outcome identification
planning interventions
implementation
evaluation
Suicide is considered more preventable than any other
cause of death.
The “suicide lexicon” is commonly used to describe the
range of suicide thoughts and behavior during assessment
Assessment of suicide risk is an ongoing process
Regard all behaviors and comments about suicide seriously
Review medical records
Demonstrate accepting attitude
assessment
what are the 10 major risk factors to assess suicidal potential>
Sex (male)
6. Rational thinking loss
2. Age 25 to 44
7. Social supports lacking
or 65+ years or recent loss
3. Depression
8. Organized plan
4. Previous attempt
9. No spouse
5. Ethanol use
10. Sickness
what is the application of the nursing process?
nursing diagnosis
outcomes identification
implementation
what are the levels of intervention?
primary
secondary
tertiary
activities that provide support, information, and
education to prevent suicide
primary
treatment of the actual suicidal crisis
secondary
interventions with a circle of survivors left by individuals
who completed suicide to reduce the traumatic
aftereffects
tertiary
what are the planning interventions?
Establish a safe environment
Assist the client in meeting basic needs
Administer and monitor prescribed medications
Assist with interactive therapies
Provide client and family education
Provide continuum of care
what are the advanced-practice interventions?
Psychotherapy
Psychobiological interventions
Clinical supervision
Consultation
of the client’s progress is an ongoing
process – mood may fluctuate quickly and
unpredictably.
Reassessment of information obtained from the
client, family, or significant others regarding
Client’s mood, affect, and behavior
Plan of care
Continuum of care
evaluation
Characterized by self-harming behaviour with no intent to
die
Also commonly known as self-injurious behaviour, self-
mutilation, parasuicide, deliberate self-harm, self-abuse,
and self-inflicted violence
Behaviour most commonly consists of cutting, burning,
scraping or scratching skin, biting, hitting, skin or hair
picking, and interfering with wound healing
non-suicidal self injury
Children, youth and young adults can text ‘TALK’ to 686868
to a trained volunteer Crisis Responder who will help with any issues – big or
small. The service is free, confidential, and available 24/7
crisis text line
if you feel like you are unable to cope, are
thinking about suicide or if you are unsure where to turn for help. The
Mental Health Crisis Line is a free, confidential service for individuals, family
and friends. The crisis line is province-wide, 24 hours a day. Phone (709)
737-4668 / 1-888-737-4668
mental health crisis line
offers free telephone and texting support to children and
youth, 24/7 in French and English. Youth can be anonymous and will
receive professional counselling, information and referrals. Call 1-800-668-
6868, visit KidsHelpPhone.ca for online resources or download the Always
There App
kids help phone
a peer support service run by and for 2SLGBTQIA+
people in Newfoundland and Labrador. If you need someone to talk to,
call us and we will do our best to support you and provide you resources
2SLGBTQIA+ warm line
an information and referral service that connects Newfoundlanders
and Labradoreans to critical human, social, community, and government
supports. The service is available in 170 different languages, 24/7, 365 days
a year and is 100% free and confidential service to all users
211
HealthLine is a free, confidential, 24 hour telephone line, staffed by
experienced registered nurses in our province who can offer health
advice, information and connect you to resources and local services.
811
a new way to connect with guidance and supports
for mental health and addictions in Newfoundland and Labrador. Easily
accessible, from a computer, tablet or a phone, one can instantly access
content that can provide advice, inspiration, assurance, or direction for
finding additional supports. Offers self-help resources, links to local
services, and allows the user to share their own personal stories
bridgethegapp.ca
comprised of mental
health and addictions clinicians and police officers who are trained to
respond together to mental health and addictions-related calls for
service. The purpose of these teams is to deliver crisis intervention services
directly to people in the community, thereby helping divert individuals
from emergency departments and the criminal justice system
mobile crisis response team
a mental health and addictions walk-in service. Counsellors
offer single-session therapy services. Some examples of what could be
discussed with a counsellor are: depression, anxiety, bullying, coping,
grief/loss, addictions, relationship issues and/or stress. Doorways is not an
emergency service
doorways
