Suicide Flashcards
Risk Factors
- Marital status
> Single, never married, divorced, & widowed people may be at greater risk for suicide than married people - Gender
> More women may attempt suicide than men, but men often succeed more often - Age
> Adolescents; the elderly (for nurses, look in ALL age groups) - Religion
> Religious than non-religious
- Socioeconomic status
> Those of very high status & very low status as opposed to middle class - Ethnicity
> Whites followed by American Indians, Alaskan natives, Hispanic Americans, Asian Americans, & African Americans - Other
> 90% of people who kill themselves have a diagnosable mental disorder, most commonly a mood disorder or a substance abuse disorder
> Half of individuals who kill themselves have previously attempted suicide
> Inc risk of suicide following d/c from a psychiatric hospital
> Insomnia, alcohol, & barbiturate use; loss of a loved one through death or separation, lack of employment, or inc financial burden as well as bullying
Potentiating Risk Factors
- Also, arrest, which could be traumatizing or shaming
Theories of Suicide - Psychological Theories
- Anger Turned Inward
> Freud believed that suicide occurred as a result of an earlier repressed desire to kill someone else - Hopelessness & other sx’s of depression
> Hopelessness has been identified as a sx of depression & an underlying factor in the predisposition to suicide & the strength of the person’s intention to die has also been identified as a significant risk factor
- H/o aggression & violence
> H/o violent behavior or impulsive act(s) been assoc w/an inc risk for suicide - Shame & humiliation
> Suicide as a face-saving mechanism is a way to prevent public humiliation following a social defeat such as a loss of social income, status or arrest
> Individual becomes too embarrassed to seek help
Theories of Suicide - Sociological Theories
- Durkheim’s Theory
> Durkheim believed that there was a relationship b/t society & the individual, & the more that the individual felt connected to society, the less likely they were to commit suicide - Interpersonal Theory of Suicide
> This looked @ the same thing & had to do w/the lack of feeling of belonging & that would incr someone’s suicide risk
- The Three-Step Theory
> Looked @ the combination of psychological pain & hopelessness. It was believed that connectiveness would prevent suicide ideation from escalating & that would hopefully prevent the idea of suicide
Theories of Suicide - Biological Theories
- Genetics
> Studies conducted on genetic predisposition to suicidal behavior
- Neurochemical Factors
> It’s been revealed that a deficiency in serotonin can incr somebody’s risk for suicidal behavior
Protective Factors
Are personal or environmental characteristics that help protect the individual from suicide
Warning Signs
Assessment
! Should be patient-centered & collaborative
- determine seriousness of client’s suicidal intentions
- existence of a plan
- availability & lethality of the method
suicidal self-injury ⥢ non-suicidal self-injury
- Non-suicidal self-injury has been thought of as a method to release emotions, but it may be a way of communicating the severity of distress that a client is experiencing
Demographics
- Military history is relatively new data
Assessment cont’d
- Presenting sx’s & medical-psychiatric dx
- Suicidal ideas or acts
- Interpersonal support system
- Analysis of the suicidal crisis (precipitating stressor, relevant hx, life stage issues)
> The precipitating stressor could be an adverse life event, like the loss of a loved one, either by death or divorce; problems in major relationships; changes in social or occupational roles; serious physical illness, esp in combo w/depression
Relevant hx – has the person experienced numerous failures and rejections?
- Psychiatric, medical, & fhx
- Coping strategies
Presenting Symptoms
Is the path warm?
Diagnosis & Outcome Identification
> Risk for suicide
Hopelessness
Interventions
- A safety plan allows the client to identify internal coping skills; it encourages the client to engage family members & friends as avail support systems
- Stockpiling & hoarding is a concern as well as overdose
Psychological Interventions
✓ The Collaborative Assessment & Management of Suicidality (CAMS)
✓ Dialectical Behavior Therapy (DBT)
✓ Cognitive-Behavioral Therapy (CBT)
- serves to change distortions in cognition
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Is a type of psychotherapy developed specifically as a treatment for the chronic self-injurious & para-suicidal clients; these clients generally have a dx of borderline personality disorder
Dialectical Behavior Therapy
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Is an evidence-based approach that focuses on the importance of patient-centered, problem-focused interventions to build an alliance w/pt for collaboration in reducing the risk for suicidal behavior
The Collaborative Assessment & Management of Suicidality
Discharge or in an Outpatient Setting
