Seminar 9 Flashcards
Suicide
Suicide is an action of killing oneself intentionally.
Prevalence
1.000.000 suicides/ year in the world
150.000 suicide/year in Europe
10-20 x more attempts
Main methods used by lethal suicides
Self-strangulation Self-poisoning Jumping from a high place Jumping or lying before moving object Handgun Sharp object Drowning
A, Primary, psychiatric risk factors
Psychiatric disorder (90%): major depression (45-87%) schizofrenia substance dependence and/or abuse personality disorder Anxiety disorders
B, Secondary, psychosocial risk factors:
Childhood trauma / losses Agression, impulsivity Isolation, Negative life events Smoking
C, Tertiary, demografic risk factors:
Male gender, homosexuality Adolesence, midlife and older age (65+) Vulnerable periods: Spring and early summer, Birthday, Perimenstrual period, Morning hours Mondays
Protective factors
Good family/social/medical support Children Pregnancy Religiosity Lack of lethal means Regular physical activity Hipersomnia
Crisis
Overhelming situation (can not be avoided)
Cry for help
Warning sign in almost all cases.
Communication of suicide intent
Indirect signs - risk taking behaviour
Presuicidal syndrome - Ringel
Inhibited aggression directed towards the self
Suicidal thoughts, intense phantasies about one’s death, funeral
Ambivalence!
active suicide
individual takes concrete actions
passive suicide
refuse those actions that would be necessary for living
suicide ambivalent
the intention of suicide is not obvious
Types of suicide attemtps
1, Deliberate self-harm – relaese psychological pain
2, Parasuicide pause/ temporary rest
3, Parasuicide gesture (manipulation)
4, Serious suicide attempt (intent to die)
Wherter effect
Striking increase in railway suicides after the suicide of German goalkeeper Robert Enke in 2009.
Youth suicide
15-24 and 25-34 leading cause of death in Hungary
Warning Signs for Youth Suicide
Sense of being a burden
Profound sense of loneliness, alienation and isolation
Sense of fearlessness
„To do list”
Supportive
Keep distance
Clarify
Refer to adequate therapy
Crisis intervention
Try to widen the patient’s view (problem –focused, fixed)
Intervention
Three basic steps:
1. Show you care 2. Ask about suicide 3. Get help
Myth vs. Fact
Myth: People who talk about suicide don’t die by suicide.
Fact: Many people who die by suicide have given definite warnings to family and friends of their intentions. Always take any comment about suicide seriously.
Myth: Suicide happens without warning. Fact: Most suicidal people give many clues and warning signs regarding their suicidal intention.
Ten Most Common Errors During A Suicide Intervention
#1: Superficial Reassurance #2: Avoidance of Strong Feelings #3: Professionalism #4: Inadequate Assessment of Suicidal Intent #5: Failure to Identify the Precipitating Event #6: Passivity #7: Insufficient Directness #8: Advice Giving #9: Stereotypic Response #10: Defensiveness
