Suicide* Flashcards
themes
Statistics
> 10 suicides/day
Overall base rate: 11.9/100,000
* Over 2x higher in old age
Suicides(actually do it) < attempts (trying)< ideation(thinking about it)
* thinking is less then attempt and attempt is less then sucide
* For every completed suicide, 20 attempt
Gun control decrese suicide rates
Culture
Rates per 100,000:
* Overall = 11.9
* First Nations = 24
First Nations:
Protective factor:
* Cultural identity preserved & maintained
Risk factors:
* Overcrowding, poverty, single-parent
families, few elders in community
Youth Suicide
2nd leading cause of death
24% of deaths (15 – 24 yrs)
16% of deaths (25 – 44 yrs) - decreses as you get older
Rates increses
(15 – 24 yrs tripled from 1950s to 1980s)
50% of suicidal adolescents & young adults do not use mental health services
youth suicede
- ideation goes up by 12
- plan and attempt also increses but way lower then ideation,they also go together
Sex Differences
Men: 4x as likely to complete
Methods: Guns & hanging
Women: 3x as likely to attempt
(and survive)
Method: Overdose
Suicide Attempts
more likely to attemp with 18 –24 yrs
Comorbidity:
* Mood disorders
Suicide Completions
45-55
75+ (Caucasian men)
* loss precipitate these events
Comorbidity
* Bipolar disorder
* Conduct disorder
* PTSD
* Intermittent explosive disorder
* Substance abuse
(all have anxiety,agitation,ilpussivness)
Etiology: Psychosocial
- Impulsivity
- Aggression
- Pessimism
- Family psychopathology or instability
- Hopelessness
- Negative affectivity(general negative emotions
Most dangerous time?
- in the time of comming out of depression: because they still have maladaptive thinking but their energy are comming back enought to try sucide
Etiology: Risk Factors
- Caucasian
- First Nations
- Male
- Middle age (45-55)
- Elderly (esp 75+)
- Suicide of friend/family member
- Psychiatric disorder
- Substance use
- Sudden Loss
- Hopelessness
- Bereavement
- Divorced
- Physical illness
- Unemployment
- Access to gun
- decresed in 5-HT (seratonin)
Difficulties in Predicting Suicide
- Low base rates(is reletitively low)
- Hard to apply risk factors to individuals(we know population only)
- Short-term(anxiety) vs. long-term risk(hoplessness)
- Interactions between risk factors
Protective Factors
- Cognitive flexibility(see things from other perspectives
- Strong social support (e.g., church or school involvement)
- Hope
- Receiving treatment for psychiatric disorder
Myths about Suicide
People who talk about it won’t do it
People who are suicidal always want to die
Religious people will not attempt
suicide
Improved mood = less risk
Suicidal ideation is rare
Asking about suicide might give them the idea/push them over the edge
Why Suicide?
“Solution” to problem of intense suffering
Goal = stop the pain (by ceasing consciousness)
Solutions:
* Reduce suffering
* Help identify options
* Pull back even a little from suicidal act
Why Suicide? Joiner’s Theory
Suicidal thoughts when
* Perception of self as burden
* Perception of not belonging
Suicide attempt
* Suicidal thoughts + Capacity for suicide (acquired)
* e.g., different methods of pain,planing
Treating Suicidality
DBT(very effective)
* Acceptance
* Change
* Strong empirical support
CBT
* very effective in adolescents that attempt suicede
dbt is a form of cbt
Preventing Suicide
Treat underlying disorders
Pharmacology
* Antidepressants
* Mood stabilizers
Psychotherapy
* ** DBT
* CBT
* IPT**
Preventing Suicide: Crisis Intervention
Cope with immediate crisis
1. Validate emotional pain
2. Help clarify problems
* What needs to be solved?
3. Distress
* …can be tolerated in this moment
* …will end
Maintain supportive contact
Encourage person to seek professional help
* There are treatments that work!
Reach out to person’s family/friends
Imminent Risk of Suicide
Do not leave person alone
If things seem better for the moment:
- Have a plan of action for getting professional help –
before leaving them - Offer to accompany them
- Get a commitment to call you if they feel unsafe
If you cannot stay, get someone else to be with them
