Suicide

Question 1

Suicide

Answer 1

intentional ending of one’s own life

Question 2

“Attempted suicide”

Answer 2

when a person attempts to end their own life

vast majority of attempts do not result in death, for one reason or another.

Question 3

“Suicide survivors”

Answer 3

may refer to a person who attempts but does not die by suicide, or to those bereaved by suicide.

Question 4

“Sub-intentional deaths”

Answer 4

when people play an indirect, partial, or unconscious role in their own death.

• ie. the death is not consciously, deliberately willed, but still occurs as a predictable outcome of the person’s behavior.
• ex. “deaths of despair”: rise in overdose and alcohol-related deaths amongst low SES Americans.
• “Death darers”: people who do extremely risky things, where death is possible but not guaranteed.

Question 5

Self-harm/ self-injury

Answer 5

behavior which causes harm/injury to oneself.

• may be intentional, or a predictable consequence of behaviors performed for other reasons.
• death is not intended, but may occur unintentionally.

Question 6

IN Canada, the following groups have higher rates or risk for suicide

Answer 6

• men and boys
• people serving federal sentences
• survivors or suicide loss and survivors of a suicide attempt
• some First Nation and Metis communities, especially among youth
• people who live in Inuit regions in Canada

Women have higher rates of self-harm. Self-harm can be a risk factor for suicide.

Thoughts of suicide and suicide-related behaviors are more frequent among 2SLGBTQI+ youth in comparison to their non-LGBTQ peers.

Question 7

Retrospective analysis

Answer 7

A psychological autopsy in which clinicians piece together information about a person’s suicide from the person’s past.

Question 8

Four kinds of people who intentionally end their lives

Answer 8

• death seeker
• death initiator
• death ignorer
• death darer

Question 9

Two major strategies used in the study of suicide

Answer 9

• retrospective analysis
• study of people who survive suicide attempts

Question 10

hopelessness

Answer 10

a pessimistic belief that their present circumstances , problems, or mood will never change.

Some clinicians believe that a feeling of hopelessness is the single most likely indicator of suicidal intent, and they take special care to look for signs of hopelessness when they assess the risk of suicide.

Question 11

dichotomous thinking

Answer 11

viewing problems and solutions in rigid either/or terms

many people who attempt suicide fall victim to dichotomous thinking.

Question 12

social contagion effect

Answer 12

researches find increases in the risk of suicide among the relatives and friends of people who recently killed themselves.

Question 13

postvention

Answer 13

postsuicide programs

ex: today, a number of schools, for individuals of all ages, put into action programs of this kind after a student dies by suicide.

Question 14

Emile Durkheim’s categories of suicide

Answer 14

1. Egoistic suicides- carried out by people over whom society has little or no control. These people are not concerned with the norms or rules of society, nor are they integrated into the social fabric.
2. Altruistic suicides- undertaken by people who are so well integrated into the social structure that they intentionally sacrifice their lives for its well-being.
3. Anomic suicides- pursued by people whose social environment fails to provide stable structures, such as family and religion, to support and give meaning to life.

Question 15

Interpersonal theory of suicide

Answer 15

A theory that asserts that people with perceived burdensomeness, thwarted belongingness, and a psychological capability to carry out suicide are the most likely to attempt suicide.

Also called interpersonal-psychological theory

Question 16

Suicide prevention program

Answer 16

A program that tries to identify people who are at risk of killing themselves and to offer them crisis intervention.

Question 17

Crisis intervention

Answer 17

a treatment approach that tries to help people in a psychological crisis to view their situation more accurately, make better decisions, act more constructively, and overcome the crisis.

Question 18

Causes of Suicide (Individual)

Answer 18

• Suicide is frequently preceded by warning signs, and is usually precipitated by severe stress (acute or chronic)
• Immediate stressors: loss of a loved one, end of a relationship, job loss, financial loss, natural disasters
• chronic stressors: social isolation/loneliness, serious injury/illness, trauma, occupational stress
• in either case, the person feels like the situation is irrecoverable/permanent, and there is nothing they can do to make things better.

Stress does not inevitably or commonly lead to suicide

The vast majority of people who experience stress adapt to and overcome the situation without ever considering or attempting suicide

Question 19

Two claims on the individual causes of suicide

Answer 19

• Claim 1: Suicide is associated with impulsivity, as a personality trait.
  Evidence suggest a small effect.
• Claim 2: Suicides are impulsive decisions, with little forethought or opportunity for intervention
  Evidence suggests that this is uncommon; most suicide attempts are planned, and planned attempts are more lethal
  Impulsive actors tend to have fewer risk factors for frequent suicide attempts (depression, family history, history of abuse, substance addiction)

Question 20

Causes of Suicide (Sociocultural)

Answer 20

Emile Durkheim argued that rates of suicide depend on two variables:

• Social integration: whether or not people have strong attachments to each other and to society as a whole
  -Too little integration leads to feelings of meaningless and loneliness
  -Paradoxically, suicides are also more likely in people/societies with extremely strong integration, as people will sacrifice themselves for causes.
• Social regulation: the degree to which society monitors and controls individual behavior.
  If we’re too regulated, we feel trapped; but if we’re less regulated, we feel loss of control.

Question 21

Causes of Suicide (Interpersonal)

Answer 21

Interpersonal theory: suicide occurs when people hold certain beliefs concerning their relationships with other people

Perceived burdensomeness: the belief that one is a burden to others; that people would be better off without them

Thwarted belongingness: when people want to have relationships with other people or belong to social groups, but feel incapable or rejected (whether this perception is accurate or not)

Perceived burdensomeness and thwarted belongingness lead to suicidal ideation/suicidal thoughts

To attempt suicide, the individual must hold those two beliefs, and then also have the “psychological capacity” for suicide
ex. high pain tolerance or low fear of death
this capability is acquired through various means, which may differ based on the individual

Question 22

Physician-assisted suicide

Answer 22

• mixed evidence on whether avoiding/ending pain is the primary motive
  Yu et al (2019): “The most salient intrinsic motivation towards suicide travel was to relieve or avoid pain in the dying process.”
• by contrast, Emanuel et al. (2016): “Pain is not the main motivation for PAS. Typically, less than 33% of patients experience inadequate pain control. The dominant motives are loss of autonomy and dignity and being less able to enjoy life’s activities.
  Self-determination theory: people derive life satisfaction from feelings of competency, autonomy, and relatedness
  Gaignard et al. (2023): PAS is due to existential suffering: “Almost all participants encountered difficulties when facing existential suffering, most of them related to a feeling of helplessness.”

Question 23

Treatment for Suicide

Answer 23

• Suicidal ideation and suicidal desires can be treated
• People who survive a suicide attempt can benefit from treatment to recover to a non-suicidal state, and reduce their risk of subsequent attempts

Question 24

CBT for Suicide

Answer 24

• Acceptance and Commitment Therapy (ACT):
  -clients are encouraged to acknowledge and accept negative emotions, rather than avoid or deny them.
  -goal is to increase resilience.
• Dialectical Behavior Therapy (DBT):
  -focuses on skills training to help people regulate emotions and communicate effectively with others.
  -incorporates a variety of techniques (individual and group/family therapy, phone coaching, medication management.

Question 25

Other Therapies for Suicide

Answer 25

• Art therapy:
  -at a prison in Australia, every day of attendance at an art program for Aboriginal prisoners was associated with 19% reduction in suicide/self-harm risk.
• Psychotherapy/Existentialism:
  -Victor Frankl’s “Logotherapy”: an appeal to meaning
  -The Hero’s Journey (Shumaker, 2017): every hero has to pass through the abyss/”dark night of the soul” where things seem hopeless.

Question 26

Suicide Prevention

Answer 26

• therapists of all kinds are often trained to recognize warning signs for suicide
• suicide prevention centers and hotlines exist for people to receive quick/immediate help during periods of crisis.
  Establish a positive relationship -> Understand/clarify the problem -> Assess suicide potential -> Assess and mobilize the caller’s resources -> Formulate a plan
• School inclusion policies:
  -GSA’s, anti-bullying policies, education days, etc. are associated with decreases in suicidal ideation and social exclusion, and increased belongingness amongst both LGB and heterosexual boys/girls.

Question 27

Warning signs that might suggest someone is at risk of suicide:

Answer 27

• thinking or talking about suicide
• having a plan for suicide

Question 28

Other signs and behaviors that might suggest that someone is at risk of suicide

Answer 28

• withdrawal from family, friends or activities
• feeling like you have no purpose in life or reason for living
• increasing substance use, like drugs, alcohol and inhalants
• feeling trapped or that there’s no other way out of a situation
• feeling hopeless about the future or feeling like life will never get better
• talking about being a burden to someone or about being in unbearable pain
• anxiety or significant mood changes, such as anger, sadness or helplessness.