SI & NSSI (329 E1) Flashcards
suicidal ideation
thinking about death, including the wish to be dead, considering methods of accomplishing death, and formulating plans to carry the act out
suicidal behavior
acts associated w/ suicidal intent
suicidal attempt
engaging in potentially injurious behavior w/ the intention of death
interrupted self directed: by other
a person takes steps to injure self but stopped by another person prior to fatal injury occurring, at any point during the behavior or thought of suicide
interrupted self directed: by self
a person takes steps to injure self but stops prior to fatal injury
suicide/death by suicide
death caused by self directed injurious behavior w/ the intent to die as a result of the behavior
suicide survivors
the circle of survivors of a person who has died by suicide
postvention
providing mental healthcare and support to survivors or if a patient dies by suicide. Family, friends and healthcare workers are in need postvention, including support, understanding and possibly including referrals for psychiatric treatment
risk factor of suicide
-condition or circumstances that may elevate an individual’s risk for suicide
-may encompass biological, psychological or social factors in the individual, family and environment
-may be modifiable or non modifiable
warning signs of suicide definition
an individual or group of behavioral or emotional clues or changes that may indicate a person is contemplating suicide or at immediate risk for suicide
protective factors for suicide
factors that may reduce the risk for suicidal ideation, suicide attempt or death by suicide
cluster suicides
clusters occur close together in time and space than would normally be expected in a given community; sometimes referred to as contagion suicides or copycat suicides
research indicates an increase in suicides by when
-stories about suicides increase
-a story is reported at length
-story placed on front page or beginning of broadcast
-person broadly known and story/news of suicide spreads
-headline is particularly dramatic
unacceptable terms related to suicide
-completed suicide/committed suicide
-successful suicide
-failed suicide attempt
-non fatal suicide attempt
-suicidal gesture
-suicidality
suicide behavior disorder criteria (DSM-5)
-attempt within last 24 months
-it could not be better identified as NSSI
-attempt was not initiated in altered mental state such as delirium or confusion
-attempt was not undertaken for a religious or political objective
what can be done to prevent suicide
-know the risks and warning signs
-screen individuals for suicide risk & ask directly if they are thinking about it
-ID protective factors, develop safety plan & reduce lethal means
-provide individuals w/ resources for suicide prevention
-create community based systems to respond to suicide risk
warning signs of suicide
-expressing hopelessness / worthlessness
-talking about being a burden
-preoccupation w/ death/lack of cocern about personal safety
-talking about feeling trapped or in unbearable pain
-inc substance use
-anger, irritability, resentment
-being isolated / withdrawing
-giving away prized possessions or pets
-looking for lethal means
does screening prevent suicide
not without action
overt statement examples
“i can’t take it anymore”
“life isn’t worth living”
“i wish i was dead”
if a patient screens positive on the C-SSRS
they need to be re screened at continuous intervals (at least every 8 hrs)
covert statements examples
“it is okay now, soon everything will be fine”
“i wont be a problem much longer”
“nothing feels good to me again and probably never will”
based on screening, if a patient has a plan they are automatically considered
high risk of suicide
what is NSSI
deliberate and direct attempts to inflect painful injuries to the surface of the body without intending to die (commonly to the frontal area of thighs & dorsal side of forearm)
ex: cutting, burning, scraping, biting, hitting
diagnostic features of NSSI
-a desire to feel relief from negative thoughts or feelings such as anxiety, anger and distress
-negative self thoughts is common
-most often done w/ intent to either alleviate psychic pain or numbness
-may injure to achieve short but intense state of euphoria during or after the injury act
-may have impaired interpersonal relationships as the impetus for self injury
-to be considered significant, typically last at least a year & happen repeatedly
-majority do not seek help
epidemiology of NSSI
-lifetime prevalence is difficult to accurately determine
-female to male ratio is 3-4:1
-estimated that 13-23% of adolescents engage in NSSI
-global problem that peaks between 20-29 yrs of age
comorbidity of NSSI
-depression
-anxiety
-eating disorders
-substance use disorders
-borderline personality disorder
NSSI risk factors: biological
investigating the neurobiological mechanisms behind this disorder. Although inconclusive, the neurotransmitter, serotonin, dopamine & norepi may play a role in the mediation of NSSI
NSSI risk factors: cognitive
NSSI may be a form of self punishment as a way to make up for acts that possibly caused harm or distress to other
NSSI risk factors: environmental
researchers are investigating cultural differences
NSSI risk factors: societal
NSSI may be considered a social phenomenon, people often learn about NSSI from peers engaging in this behavior
how to take action if pt has NSSI
-establish therapeutic relationship
-caring for wounds/injuries
-psychotherapeutic interventions include learning healthy coping mechanisms
-CBT
-DBT
-group therapy
-psychopharmacology
