WHO + O'Connor paper Flashcards
What is the lifetime prevalence of suicidal ideation, plans & attempts worldwide?
O’Connor
9.2, 3.1 & 2.7%, respectively
During which life-phase do suicidal behaviours escalate significantly?
Adolescence
How do psychiatric disorders fit into the image of suicidal risk factors?
Commonly comorbid, but psychiatric disorders alone are not a sufficient predictor of suicide
What are personality related risk-factors for suicidal behaviour? (5)
includes explanation
- Hopelesness = strong predictor for ideation, less so for attempts
- Impulsivity = associated with ideation and attempts, particularly in younger individuals
- Perfectionism = increases suicide risk through social disconnection
- High neuroticism = link to suicidal behaviour
- Low extroversion = link to suicidal behaviour
Two possible personality related protective factors for suicidal behaviour?
Optimism & resilience, but this is understudied
How is cognitive rigidity a risk factor for suicidal behaviour?
Difficulty in adapting thoughts, leading to limited perceived solutions
How is rumination a risk factor for suicidal behaviour?
Excessive focus on distressing thoughts (particularly brooding rumination increases suicide risk)
How is thought suppression a risk factor for suicidal behaviour?
Paradoxically this increased suicide-related thoughts (may be because suppression can lead to increased intrusive thoughts- but this is me just thinking and not in the paper)
How are autobiographical memory biases a risk factor for suicidal behaviour?
It impairs problem-solving capabilities (and may also mean that you have a bias towards negative autobiographical events)
What, central to Joinger’s interpersonal theory of suicide, pose as a risk factor for suicidal behaviour?
Perceived burdensomeness and thwarted belongingness
How are fearlesness and pain insensitivity a risk factor for suicidal behaviour?
Higher tolerance for pain and lower fear of death are associated with greater suicide capability (self-explanatory, but probs because the fear is not a stopping factor & pain tolerance = more methodological options)
How is attentional bias a risk factor for suicidal behaviour?
If biases are centred towards suicide-related cues, well…
What are some cognitive factors (not ones already in the flashcards- think moreso along the lines of thought patterns & feelings) that pose a risk for suicidal behaviour? (6)
- Fewer reasons for living (wow)
- Feelings of defeat/entrapment
- Reduced future-oriented thinking
- Difficulty adjusting personal goals
- Implicit mental associations (with suicidal cues)
- Impaired problem-solving & coping
Social risk factors for suicidal behaviour? (3)
- Social transmission/exposure to suicide/contagion (direct/indirect exposure to suicidal behaviours)
- Social isolation/lackluster support system
- Individualism
How/what negative life events pose a risk factor for suicidal behaviour? (4)
- Childhood adversities
- Traumatic events (in adulthood)
- Chronic illness (physical)
- Interpersonal stressors
Interpersonal theory of suicide (Joiner)?
Suicide results from feelings of perceived burdensomeness (I am a burden), thwarted belongingness (I am alone) and the acquired capability (fearlesness/pain tolerance)
- Note the combination of all three are needed
Integrated motivational-volitional (IMV) Model? (O’Connor)
Suicide emerges through a motivational phase (feelings of defeat and entrapment) and volitional phase (impulsivity, access to means)
In Joiner’s suicide model, what happens when perceived burdensomeness and low belongingness are present, without capabilities for suicide?
Suicidal desire (ideation, possibly plans)
In O’Connor’s IMV model, what is the difference between being in the motivational phase vs. the volitional phase + what do these phases look like?
Motivational:
- defeat & humilation > entrapment > suicidal ideation & intent
Volitional phase:
- motivational stage > suicidal behaviour
Aka, intent/plans vs. active behaviour
In O’Connor’s model, what are threat to self moderators (TSMs), Motivational moderators (MMs) and Volitional moderators (VMs) + what do they moderate?
- TSMs = Social problem-solving, coping, memory biases, rumation, etc. (affects > towards entrapment) - fully internal
- MMs = thwarted belongingness, burdensomeness, future thoughts/goals, norms, resilience, support, attitudes, etc. (affects > towards suicidal ideation/intent) - internal focused on outside & external
- VMs = access to means, planning, exposure to suicide, impulsivity, pain tolerance, fearlesness, imagery, past behaviour, etc. (affects > towards suicidal behaviour) - focused on suicidal possibility
In O’Connor’s model, what is the pre-motivational phase?
Predisposing/inducing factors (Diathesis, environment, life events)
Interventions & future recommendations in O’Connor?
- CBT therapies have shown effectiveness
- But innovative interventions targeting psychological risk factors are needed
Global burden of suicide (WHO, 2019)?
(3)
- 703.000 suicides occured in 2019
- Suicide accounts for more deaths than malaria, HIV/AIDS, breast cancer, war or homicide
- Suicide is the 4th leading cause of deaths among 15-29 year olds
What is the global suicide rate (per 100.000), age-standardized?
9 per 100.000
Gender differences in suicide rates?
Male (12.6 per 100k) > female (5.4 per 100k)
What countries (type, not names) have the highest suicide rates? Gender?
High-income countries, men 16.5 per 100k
Suicide rates, gender-wise, in lower-middle-income countries?
Highest suicide rating among females (7.1 per 100k)
maybe rights are important, who would’ve thunk
Within the global suicide population, in absolute terms (not per capita), where do the most suicides occur (percentage)? Explain this pattern
Low- and middle-income countries account for around 77% of the global suicides
- This is because the populations there tend to be much larger, example:
- Country A (high): 15 per 100k, 1mil. population = 150 suicides/year
- Country B (low): 5 per 100k, 100mil. population = 5k suicides/year
In which three regions are the highest suicide rates (per capita) observed?
African, European and South-Asian regions
Globally, what did the suicide rates look like from 2000-2019?
They decreased by around 36%
Region wise, what did the suicide rates look like from 2000-2019?
Decreased:
- Western-Pacific (49%)
- Europe (47%)
- South-East Asia and Africa (no explicit mention of numbers)
- Eastern Mediterranean (17%)
Increased:
- Americas (17%)
Ages 15-19 years what is an interesting gender difference in the leading cause of death?
For males it is road injury, which is actually the 4th lowest in females
What four suicide prevention approaches are emphasized in WHO’s LIVE LIFE?
- Limiting access to suicide means (pesticides, fire-arms, etc.)
- Responsible media reporting of suicide
- Developing socio-emotional life skills in adolescents
- Early identification, assessment, and management of individuals at risk
WHO’s prevalence data collection limitations?
Registration and reliability of data limited in low and middle-income countries
