Suicidality Flashcards
Fowler (2012)
Pragmatic guidelines on Suicide Risk Assssesment
High risk factors of suicide
Past suicide - STRONGEST predictor Previous self harm hopelessness reasons for living childhood sexual abuse LGBT Accessibility to firearms Family psych history life stress social support comorbid psychiatric diagnoses single diagnosis severity of mental illness
Self harm vs. Suicide
Self harm is more impulsive and less planned
Prevalence
Low …less than 1%
Suicidal ideation and attempts is much higher 5-10%or higher
self harm - 15%
Primary methods
- fire arms
- suffocation
- poisoning/overdose
self harm methods
- cutting
- burning, hitting, cratching
use to cope, relieve stress and tension, stop suicidal ideation.
Concurrence
Psychiatric disrders
- depressive disorders
- GAD
- substance use
- disruptive behavior disorders
Purposes of assessment of self harm behavior and risk
Assess imminent risk
Predict future self-harm behaviors
Treatment planning
Treatment Monitoring
Should school psychologists ask about suicide?
YES… it does not increase the probability of a child committing suicide…more harm not asking
Clinical strategies
- using follow-up questions
- ask concrete examples of suicidal behavior
Normalize topic. Reduce shame or embarrassment.
-Gentle assumption and amplicfication assumption
(when was the last time you thought about killing yourself?)
-amplified assumption - How many days have you cut yourself at least 5 times.
5 specific tasks for assessing imminent suicidality and be prepared to explain?
- 5 positive statements about self
- 0 to 1000 rate how you feel
- Plans for coping?
- Identify 3 support individuals
- Agreement not to kill self
Goldston & Compton (2006)
chapter in book
