SM_116b: Suicide

Question 1

____ is self-inflicted death with evidence that the person intended to die

Answer 1

Suicide is self-inflicted death with evidence that the person intended to die

(biologic, social, psychologic factors)

Question 2

____ is non-fatal self-injurious behavior undertaken with at least some intent to die

Answer 2

Suicide attempt is non-fatal self-injurious behavior undertaken with at least some intent to die

Question 3

____ is intentional self-inflicted damage to the surface of the body with expectation that it will cause only mild-moderate physical harm

Answer 3

Nonsuicidal self-injury is intentional self-inflicted damage to the surface of the body with expectation that it will cause only mild-moderate physical harm

Question 4

Biologic risk factors for suicide include ____ and ____

Answer 4

Biologic risk factors for suicide include low serotonin and genetic predisposition

Question 5

Psychologic factors in suicide include ____, ____, and ____

Answer 5

Psychologic factors in suicide include wish to kill, wish to be killed, and wish to die

Question 6

Suicide causes ____ death than homicide

Answer 6

Suicide causes more death than homicide

(major contributor to premature mortality, 10th leading cause of death for all ages in the US)

Question 7

____ are 3x more likely to attempt suicide, but ____ are 4x more likely to die by suicide

Answer 7

Women are 3x more likely to attempt suicide, but men are 4x more likely to die by suicide

(men are more likely to use firearms)

Question 8

Describe the epidemiology of suicide

Answer 8

Epidemiology of suicide

• LGBTQ youth have increased risk
• Among women, rate highest for age 45-64
• Among men, rate highest for age ≥ 75
• American Indian and white men at highest risk
• Suicide rates higher in rural counties than urban counties
  *

Question 9

Describe unmodifiable factors contributing to suicide

Answer 9

Unmodifiable factors contributing to suicide

• Prior attempt
• FHx of suicide
• FHx of child maltreatment
• Hx of aggression or impulsivity
• Recent interpersonal loss
• Cultural / religious beliefs

Question 10

Describe modifiable risk factors for suicide

Answer 10

Modifiable risk factors for suicide

• Mental illness, particularly depression and addiction
• Physical illness
• Feelings of personal isolation
• Feelings of hopelessness
• Barriers to mental health treatment
• Access to lethal means
• Local suicide epidemics

Question 11

Patient takes small number of aspirin and immediately tells a friend. This is ____ for suicide

Answer 11

Patient takes small number of aspirin and immediately tells a friend. This is low risk / high rescue for suicide

Question 12

Patient attempts to slash wrist with a piece of glass while home alone. This is ____ for suicide

Answer 12

Patient attempts to slash wrist with a piece of glass while home alone. This is low risk / low rescue for suicide

Question 13

During an argument on the 10th floor, patient shouts that they will jump and lunges for the balcony. This is ____ for suicide

Answer 13

During an argument on the 10th floor, patient shouts that they will jump and lunges for the balcony. This is high risk / high rescue for suicide

Question 14

Patient buys a gun and rents a hotel room under a false name. This is ____ for suicide

Answer 14

Patient buys a gun and rents a hotel room under a false name. This is high risk / low rescue for suicide

Question 15

Risk factors for suicide include ____, ____, and ____

Answer 15

Risk factors for suicide include suicidal ideation, planning, and previous suicide attempts

Question 16

Parasuicidal behavior is ____

Answer 16

Parasuicidal behavior is suicidal behavior with less risk of death

• Manipulative gesture
• Often an effort to solve interpersonal crises or communicate dysphoric effect
• More likely to eventually commit suicide

Question 17

____ and ____ are diagnosable mental illnesses in most completed suicides

Answer 17

Depression and alcohol use disorder are diagnosable mental illnesses in most completed suicides

Question 18

Describe risk factors for suicide

Answer 18

Suicide risk factors

• Suicidal ideation, especially if plan, intent, and preparatory behavior
• Depressive symptoms: agitated / dysphoric depression with excruciating quality
• High anxiety
• Command auditory hallucinations and delusions
• Akathisia: severe motor restlessness
• Insomnia
• Hopelessness
• Alcohol use disorder
• Acute alcohol intoxication
• Acute stressors: breakup, financial / job loss, legal problem, medical illness
• Chronic stress: social isolation, traumatic family background, poor health, poverty
• Contagion effect

Question 19

Contagion effect causes ____

Answer 19

Contagion effect causes suicide epidemics

Question 20

Describe protective factors against suicide

Answer 20

Protective factors against suicide

• Social support
• Access to treatment and engagement in treatment
• Personal sense of family responsibility
• Religious or cultural sanctions against suicide
• Good insight
• Skills in problem-solving and dispute resolution

Question 21

Assess risk for suicide via ____

Answer 21

Assess risk for suicide via direct questions

Question 22

Assess if individual is at low or increased ____ risk of suicide based on ____ of all dynamic (modifiable) and static (unmodifiable) risk and protective factors

Answer 22

Assess if individual is at low or increased acute risk of suicide based on current status of all dynamic (modifiable) and static (unmodifiable) risk and protective factors

Question 23

In people at high risk of suicide, it is especially important to identify and address ____ risk factors

Answer 23

In people at high risk of suicide, it is especially important to identify and address dynamic risk factors