Suicide Flashcards
suicide
intentional, direct, conscious taking of one’s own life
suicide ideation
- thoughts of death
- killing oneself
- funerals
- other morbid ideas
suicide attempts
severe self-destructive B with intent to kill oneself
death by suicide
suicide completion
suicide stats
- 10.7 million adults had serious thoughts of committing
- 3.3 million made plans and suicide attempted
- 1.4 million attempted suicide
- 0.2 million made no plans and attempted suicide
prevalence of suicide
- 10th leading cause of death for people aged 10-64
- 2nd leading cause of death in youth ages 15-34 in Canada
- 12% Canadian adults reported suicidal ideation in their lifetime
- 3.1% reported suicide attempt in their lifetime
- of people who contemplated suicide, around 90% have a mental illness (often undiagnosed)
rates of suicidal ideation among vulnerable populations
- Indigenous: 22-29%, especially Inuit
- LGBTQ: 24-50%
studying suicide: psychological autopsy
- systematically examining info after person’s death to understand B
psychological autopsy methods
- interviews with relatives and friends
- recollections of therapist
- information obtained from crisis phone calls
- social media postings
- messages left in suicide note
suicide among youth: factors
- barriers to identification and treatment
- copycat suicides
- (cyber) bullying
- decreased prescribing of antidepressants
- discrimination
- substance use
- social media use
suicide among college students
- increased rates (20%) of suicidal ideation, 9% attempted suicide
- Asian, multiracial, transgender students at higher risk
- high stress, mental health diagnosis
suicide among military members
- high rates of suicide among military members and veterans
- contributing factors
1. military culture may stigmatize emotional symptoms
2. barriers to mental health carein military
3. separated from families, loss of comrades
4. unrecognized or untreated mental disorders
suicide among elderly
- elderly men have highest suicide rate (except in cultures where elderly are revered + respected
- contributing factors
1. bereavement
2. physical ailments
3. social isolation
4. financial difficulties
5. prejudice, discrimination, abuse
etiology: biological
- neurotransmitters
- genetics
- sleep difficulties
neurotransmitters
- low serotonin levels
- differences in levels of neuropeptides
genetics
- relationship is unclear
- certain endophenotypes associated with suicide
- unique DNA alterations in the hippocampus
sleep difficulties
strong predictor of suicidal B
etiology: psychological
- desire to escape from psychological pain and psychache
- rumination increases risk of suicidal B
- history of mental illness
- substance use increases risk
psychache
- intolerable pain created from an obsence of joy
- acute state of shame, guilt, humiliation, loneliness, fear
- strongly associated with suicidal ideation
substance use
- around 70% of suicide attempts involve alcohol
- may lower inhibitions related to fear of death
- alcohol-induced myopia
etiology: social
- triggering events
- include intense interpersonal conflict and social withdrawal - disconnection from friends, family, religious institution, community
- increase susceptibility to suicide - stable marriage or relationship decreases risk
- Joiner’s Interpersonal-Psychological Theory of Suicide* (refer to notebook)
etiology: Emile Durkheims’s sociocultural theory
- suicide results from inability to integrate oneself into society
- lack of close ties deprives one of support systems necessary for adaptive functioning
- alienation + isolation experienced by many LGBTQ youth
etiology: sociocultural - race, ethnicity, culture
- suicide rates for men of colour are 3x higher than females
- highest rate of completed suicides in indigenous
- cultural + religious values play a role in risk
- environmental and economic hardship can have a significant impact on suicide
rates of suicide during economic recessions ____
increase, especially among the poor and unemployed
etiology: sociocultural - gender
- chances of death by suicide = 3x higher for men
- changes of attempt suicide = 3x higher for women
- higher rates of depression, childhood abuse, IPV among women
- cultural conditioning related to gender role (men avoid seeking help/confiding in others)
- difference in lethality of means
most common methods of suicide
- suffocation
men = 48%
women = 44% - firearms
men = 18%
women = 2% - poisoning
men = 18%
women = 40%
suicide prevention efforts
- understanding risk and protective factors and early detection
- paths to intervention
- 3-step process
suicide prevention efforts: paths to intervention
- self-referrals from concerned family or friends
- gatekeeper training
gatekeeper training
designated people within a system learn about risk factors and screening methods
suicide prevention efforts: 3-step process
- know which factors increase likelihood of suicide
- determine probability that person will act on suicide wish (high, moderate, low)
- implement appropriate actions
suicide risk factors
- previous suicide intent/plan or attempt
-substance use, chronic pain or physical illness, insomnia, certain m.d.
-hopelessness, shame, humiliation, despair - recent severe loss or significant trauma
- relational conflicts, loneliness, social isolation
- easy access to lethal methods
- family turmoil
- family member, peers, or favoured celebrities have died by suicide
suicide protective factors
- good emotional regulation, problem-solving and conflict resolution skills
- willingness to talk
- cultural and religious beliefs that discourage suicide
- open to seeking treatments for mental/physical/SUD
- family and community
- connection to/responsibility for children or beloved
- restricted access to lethal means of suicide
suicide hotlines
- crisis requiring immediate preventive assistance
- staffers trained in crisis intervention techniques
- evidence suggests that this helps immediate needs of callers
suicide crisis intervention
- focus on emotional pain, offer resources to cope, instill hope
- “no harm” agreement or “no suicide” contracts
- temporary hospitalization
- relatives and friends are often enlisted to help monitor the safety and well-being
psychotherapy
- CBT and DBT decrease risk by 50% (compared to other therapies)
- CBT focuses on vulnerabilities
- DBT focuses on helping clients accept current lives and emotional anguish
- safety planning
myths about suicide
- asking about suicide makes people suicidal
- people who discuss suicide will not commit to the act
- suicidal people clearly want to die
- suicidal B happens out of the blue, there is no warning sign
- suicidal B is a sign of weakness (“coward”)
- if people want to die by suicide, we cannot stop them
myths about suicide: “asking about suicide makes people suicidal”
Gould et al. (2005) experiemnt with 6th graders showed no differences with the class that received a suicide screener and the control
myths about suicide: “people who discuss suicide will not commit to the act”
- research has clearly disproved the tragic belief that those who threaten to take their lives seldom do so
- Pompili et al. (2016) found that 50% of deceased individuals by suicide communicated their intentions
myths about suicide: “suicidal people clearly want to die”
- most people with suicidal ideation are ambivalent
- most people do not really wish to die but instead want to escape their intense psychological pain
myths about suicide: “suicidal B happens out of the blue, there is no warning sign”
the more impulsive a suicide attempt is, the less medically serious the injuries tend to be
myths about suicide: “suicidal B is a sign of weakness (“coward”)”
Joiner: “Death by suicide requires staring the product of millions of years of evolution in the face
and not blinking; it is tragic, fearsome, agonizing, and awful, but it is not easy.”
myths about suicide: “if people want to die by suicide, we cannot stop them”
- restriction of means
- suicide rates decrease when cities/states restrict people’s access to guns and high infrastructures. etc.
helping out a suicidal person
- Be direct. Talk openly and matter-of-factly about suicide.
- Be willing to listen. Allow expressions of feelings.
- Be non-judgmental.
- Don’t act shocked.
- Don’t be sworn to secrecy. Seek support.
- Offer hope that alternatives are available.
- Take action. Remove means.
- Get help from those specializing in crisis intervention and suicide prevention.
- Hotlines, crisis lines, chat-talk suicide.
