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Disciplines Exam 2 SHEA > Suicide > Flashcards

Suicide Flashcards

1
Q

______ is an attempt to solve a problem of intense emotional pain with impaired problem solving skills

A

Suicide

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2
Q

The following describes what?

  • Hopeless, helpless, ambivalent conflicts between life and unending stress / pain with no apparent possibilities for change or improvement
  • less a wish to die than a wish to escape intense emotional pain
  • Way to obtain temporary attention, support or even popularity
A

Suicide

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3
Q

The following describes what?

  • Irrational component → unaware of the consequences that are obvious to others
  • Do not think about the impact of their death on others
  • Perception they will be reincarnated, reborn or reunited with those they have lost
A

Suicide

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4
Q

What disorder?

  • normal communication has broken down or is ineffective
  • might be way of sending a message or reacting to the isolation they feel
  • Feelings of revenge, power, control or punishment
A

Suicide

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5
Q

Definition of what:

Thoughts about killing oneself; +/- a plan.

A

Suicidal ideation

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6
Q

Definition:

Self-injurious behavior that is intended to kill oneself, but is nonfatal.

A

Suicide attempt

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7
Q

Definition:

Self-injurious behavior that is intended to kill oneself and is fatal

A

Suicide

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8
Q

Definition:

Thoughts of engaging in self-injurious behavior that are verbalized and intended to lead others to think that one wants to die, despite no intention of dying

(e.g. “If you leave me, I will kill myself”).

A

Suicide threat

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9
Q

Definition:

Self-injurious behavior that is intended to lead others to think that one wants to die, despite no intention of dying.

ex: on the phone and say “I want to kill myself” and then firing gun at wall and hanging up the phone

A

Suicide gesture

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10
Q

Definition:

Thoughts of engaging in self-injurious behavior characterized by the deliberate destruction of body tissue in the absence of any intent to die and for purposes that are not socially sanctioned.

A

Non-suicidal self-injurious thoughts

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11
Q

Definition?

Self-injurious behavior characterized by the deliberate destruction of body tissue in the absence of any intent to die and for purposes that are not socially sanctioned.

A

Non-suicidal self-injury

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12
Q

Passive or active suicidal ideation?

“I want to kill myself” or “I want to end my life and die”

A

Active

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13
Q

Passive or active suicidal ideation?

“I would be better off dead” /”I hope I die in my sleep”

A

Passive suicidal ideation

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14
Q

T/F: people that don’t make a suicide plan can stilll commit suicide or attempt suicide

A

TRUE

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15
Q

T/F: suicide is ranked as the 10th leading causes of death among all ages in the US

A

TRUE

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16
Q

What is the most common method of suicide in the US for men vs women

A

Men: Firearms

Women: Poisoning (overdose, etc)

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17
Q

Are men or women more likely to commit suicide and who is more likely to succeed?

A
  • Fatal M:F 4:1
  • But rate of nonfatal attempts is 1:4 M:F

*This means more men have successful suicide attempts but more women attempt

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18
Q

Rate of suicide is 2-4 times greater for_____, ________ and whites

A

American indians/Alaska natives

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19
Q
  • What is the probability of a person attempting suicide if they have an ideation + plan?
  • What is the probability of a person attempting suicide if the have ideation only?
A
  • ideation + plan= 55%
  • ideation only= 15%
20
Q

60% of transitions from suicidal ideation → suicide plan → suicide attempt occur within what time frame?

A

Within the 1st year

21
Q

What is the most common psychiatric dx of ATTEMPTED vs COMPLETED suicide?

A

Attempted= Personality disorder

Completed= Depression

22
Q

What is the most common AFFECT/ emotion of attempted vs completed suicide?

A

attempted= impulsive anger

completed= Hopelessness

23
Q

Most common PRECIPITANT / issue of attempted vs completed suicide?

A

Attempted: Acute relationship difficulty or loss

Completed: Chronic painful or disfiguring illness

24
Q

Most Common goal of attempted vs completed suicide?

A

Attempted: manipulation of others

Completed: death

25
Q

Most common methods for ATTEMPTED suicide vs completed suicide?

A
  • Attempted: wrist slashing, overdosing
  • Completed: Firearm, suffocation, OD, Jumping (Suffocation = carbon monoxide exposure or hanging)
26
Q

Which mood disorder is the most common risk factor of suicide?

A

Depression

27
Q

What are the 6 mental disorders that are considered risk factors for suicide?

A
  1. Mood disorders → especially depression
  2. Alcohol and other substance use disorders
  3. Personality disorders
  4. Schizophrenia → command hallucinations
  5. Anxiety disorders
  6. PTSD
28
Q

The following are some risk factors for:

  1. Mental disorders
  2. Traumatic brain injury ↑ with severity
  3. Chronic pain
  4. Hopelessness / worthlessness
  5. Insomnia
  6. Impulsivity and/or aggressive tendencies
  7. History of trauma or abuse
  8. Previous suicide attempt → 1/100 survivors will die by suicide within 1 year of initial attempt → risk of death is 100x general population → highest risk in first 3 months
A

suicide

29
Q

A person with family history of suicide in first degree relatives have ___x higher risk of suicide

A

8x

30
Q

The following are risk factors for:

  1. Stressful life event
  2. Job or financial loss
  3. Relational or social loss
  4. Recent illness diagnosis
  5. Dropping out of school
  6. Homelessness
  7. Single, divorced or widowed
  8. Lack of social support → sense of isolation
  9. Easy access to lethal means
  10. Cyber bullying (how many children are bullied online)
A
  • Suicide
  • 1/3 of ALL children, every 30 mins child attempts suicide due to this
31
Q

5 risk factors of suicide

“SCREB”

A
  1. Stigma associated with help-seeking behavior and/or suicidal thoughts
  2. Barriers to accessing health care
  3. Certain cultural and religious beliefs
  4. Local cluster of suicides that have a contagious influence
  5. Exposure to and influence of others who have died by suicide
32
Q

What are some predictive tools for preventing suicide in patients that clinicians can implement?

A

None.

There is no data to support routine screening or use of scales to assess risk

–>clinical judgement guides the decision making process!!

33
Q

Suicide: What screening tools should a provider consider utilizing?

A

Screening tools for comorbid conditions (ex: PHQ-9 for depression)

34
Q

What is the SAD PERSONS scale?

S: Male sex → 1

A: Age 15-25 or 59+ years → 1

D: Depression or hopelessness → 2

P: Previous suicide attempts → 1

E: Excessive ethanol or drug use → 1

R: Rational thinking loss → 2

S: Single, widowed or divorced → 1

O: Organized or serious attempt → 2

N: No social support → 1

S: State future intent → 2

A
  • Example of a scale that might be seen in clinical practice- used to look at risk factors and determine risk of suicide (has low sensitivity of 49% and specificity of 60%)
  • Score is mapped to a risk assessment scale:
  • 0-5: May be safe to discharge
  • 6-8: Probably requires psychiatric consultation
  • >8: Probably requires hospital admission
35
Q

What are the following considered?

  1. Feeling hopeless and/or trapped
  2. Seeing no reason for living or having no purpose in life → feeling worthless
  3. Feeling rage, uncontrolled anger or seeking revenge
  4. Acting reckless or engaging in risk activities
  5. Increasing alcohol or drug use
  6. Withdrawing from friends, family and society
  7. Feeling anxious, agitated or unable to sleep or sleeping all the time
A

Warning signs for suicide

36
Q

The following are _______ factors for suicide

  1. Effective clinical care for mental, physical and/or substance abuse disorders
  2. Easy access to variety of clinical interventions
  3. Support through ongoing medical care
  4. Restricted access to highly lethal means of suicide
  5. Strong connections to family and community support
  6. Skills in problem solving, conflict resolution and nonviolent handling of disputes
  7. Cultural and religious beliefs that discourage suicide
A

Protective factors for suicide (these decrease likelihood of suicide)–> enhances resilience and may counterbalance risk factors

37
Q

What are the 3 most important things to do when approaching the patient about suicide?

A
  1. Show you care
  2. Ask about suicide (asking does not increase rate of suicide)
  3. Get help (make sure you also ask about treatment- therapist, meds, etc)
38
Q

T/F: if you believe the patient is low risk for suicide attempt, you can let them go home with someone that is part of their support system (i.e. parent, etc)

A

True.

39
Q

Patients with suicidal thoughts deemed safe for outpatient care must agree to what?

A

agree to call if they reach a point of uncertainty about their ability to control impulses → transport to ED if they cannot do this

40
Q

For patients w/ suicidal thoughts that are deemed safe for outpatient care, the support system should stay with the patient for how long

A

at least 24 hours

41
Q

For patients w/ suicidal thoughts that are deemed safe for outpatient care, how soon should the follow up in office?

A

Follow up next day in the office

42
Q

The following are some additional indicators for _______

  1. Psychosis
  2. Command hallucinations
  3. History of impulsive behavior
  4. Intoxication with drugs or alcohol
  5. Suicide attempt that includes steps to avoid detection
  6. Uncontrolled comorbid conditions
  7. Absence of strong social support system
  8. No change in affect or symptoms despite intervention with practitioner, family and friends
  9. Family exhaustion
A

Emergency care/admission

43
Q

What is the SAD score of pt who “may be safe to discharge home”

A

0-5

44
Q

What is the SAD score of pt who “probably requires psych consult”

A

6-8

45
Q

What is the SAD score of pt who “probably requires hospital admission”

A

>8

46
Q

What are the 4 targets you should hit in conversation when asking patient about suicide?

“TIPA”

A
  • Thoughts
  • Plans
  • Intent
  • Attempts

Disciplines Exam 2 SHEA (11 decks)

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