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suicide

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- the intentional, direct, and conscious taking of one's own life - suicide and suicidal ideation (thoughts about suicide) may represent a separate clinical entity

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T/F: Suicide is not classified as a mental disorder

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true, although the suicidal person usually has psychiatric symptoms such as: depression, alcohol dependence, and schizophrenia

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psychological autopsy

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- systematic examination of existing information to understand and explain a person's behavior before death

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suicide survivors are different from those who succeed: describe- typical attempter vs. typical succeeder

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- typical attempter- white female housewife in 20s-30s with marital difficulties; uses barbiturates - typical succeeder- male in 40s or older with poor health or depression; uses gun or hangs himself

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suicide frequency

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- approximately 34,000 people commit suicide each year - among top 11 causes of death in industrialized parts of the world - number of actual suicides is probably 20-30% higher than what is recorded

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gender and suicide

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- men are about 4X more likely to be successful (they use more lethal means) - women are more likely to attempt suicide

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martial status and suicide

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- married people are less vulnerable - divorced and widowed individuals are more vulnerable

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occupation and suicide

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- higher risk for physicians, lawyers, law enforcement personnel and dentists - burnout, stress, and guilt over medical errors may increase risk for surgeons

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T/F: socioeconomic level is not a factor

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true

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choice of method of suicide

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- over 50% of suicides are committed using firearms - 70% of attempts are from drug overdose - most common means for children under 15 are jumping from buildings and running into traffic - most common means for adolescents over 15 are drug overdose and hanging

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religious affiliation and suicide

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- correlated with suicide rates - suicide rates are lower in Catholic and Muslim countries where there is strong condemnation of suicide - where religious sanctions are weaker - e.g., Scandinavian countries, former Czechoslovakia, Hungary - suicide rate is higher

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ethnic and cultural variables

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- highest rates in US are or American Indian; lowest for Asian Americans

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Historical period and suicide

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- tends to decline during times of war and natural disasters - increase during periods of shifting norms and values or social unrest

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T/F: more than 2/3rds of those who commit suicide communicate their intent to do so within 3 months of the act

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true

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4 factors involved in suicide

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biological, psychological, social, and sociocultural

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Biological dimension of suicide

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- influenced bu low serotonin levels in the brain (low amounts of 5-HIAA in suicide patients) - genetics; high rate of suicide and suicide attempts among parents and close relatives of individuals who attempts or complete suicide; unclear relationship

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psychological dimension of suicide

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*depression and hopelessness: - depression plays an important role; relationship is complex - increae in sadness is a frequent mood indicator of suicide - heightened feelings of anxiety, anger, and shame also associated - hopelessness, or negative expectations about future, may be even stronger factor * alcohol consumption: - one of the most consistent correlates (as many as 70% of suicides involve alcohol) - also strong correlation to successful attempt - may lower inhibitions of fear of death - alcohol-induced myopia - may increase distress by focusing thoughts on the negative aspects of their personal situations

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alcohol-induced myopia

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a constriction of cognitive and perceptual processes

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social dimension of suicide

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- many suicides are interpersonal in nature and are influenced by relationships involving a significant other - individuals who are incapacitated or have a terminal illness are often @ higher risk - family instability, stress, and chaotic family atmosphere related to attempts by younger children - social factors that separate people or make them less connected to other things they care about

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interpersonal-psychological theory of suicide

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- perceived burdensomeness - thwarted belongings - acquired capacity for suicide

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sociocultural dimension of suicide

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- Emile Durkheim: inability to integrate oneself into society; lack of close ties deprives one of support systems necessary for adaptive functioning - other factors: - modern mobile society that de-emphasizes importance of family and sense of community - further group goals or achieve greater good - social change and disorganization within one's community

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3 groups of people affected by suicide

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children and adolescents, college students and the elderly

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suicide among children and adolescents

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- suicide rate for children under 14 is increasing @ alarming rate - suicide is 3rd leading COD among teens - teen suicide increased by 18% in 2004 and by 17% in 2005 - high school study: 13.8% considered suicide, 6.3% attempted, and 1.9% required medical attention

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the role of bullying

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- \"bullycide\": bullying leading to suicide - bullying victims are 2-9X more likely to consider suicide than non victims - nearly 50% of young ppl who commit suicide experienced bullying

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copycat studies

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- youngsters mimic a previous suicide - highly publicized suicides increase the number of attempts

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decrease in antidepressant meds in children and adolescents

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- 2004 FDA warning of an increased suicide risk for children taking SSRI antidepressants - recent research suggests that SSRIs may increase suicidal thoughts or behaviors for select few - increase in youth suicide rates since FDA warning b/c antidepressants are less likely to be prescribed

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according to study, suicide rates among college students are no higher than noncollege group but:

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- limited access to lethal means - decreasing proportion of males attending college - nearly 1,000 students commit suicide per year - 44% increase in students with psychiatric disorders - b/w 2009 and 2010 serious thoughts of suicide among college students rose significantly

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college study

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- more than 50% reported suicidal thoughts - 14% of undergraduates and 8% of graduates has made a suicide attempt

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suicide among the elderly

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- unwelcome physical changes, including wrinkling, graying hair, and diminished physical strength - life events connected with \"feeling old\" lead to depression (one of most common psychiatric complaints) - suicide rates for elderly white men are the highest for any age group - firearms are most common method for ppl >65yrs - elderly make fewer attempts per completed suicide - for asian americans, the highest risk is for first-generartion immigrants - lowest rates among american indians and african americans

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3 step process for working with a potentially suicidal person

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- knowing which factors are highly correlated with suicide - determining probability that person will act on suicide (high, moderate, low) - implementing appropriate actions

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indirect behavioral cues

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- puts affairs in order; takes a long trip; gives away prized possessions etc.

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early signs of suicide

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- depression, guilt feelings, insomnia, tension, nervousness, loss of weight, and impulsiveness

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critical signs of suicide

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- sudden changes in behavior; gives away possessions; threats or actual attempts

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crisis intervention

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*clinical level: educate staff at mental health institutions and schools to recognize signs of potential suicide *crisis intervention aimed at providing intensive short-term help to resolve immediate life crisis: patient may be immediately hospitalized, given medical treatment, seen by psychiatric team until stabilized; working with patient and taking charge of person's personal, social and professional life outside facility

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the right to suicide

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- majority of americans believe terminally ill individuals should be allowed to take their own lives - suicide is both a sin and an illegal act in most countries - Oregon (1998): physician-assisted suicide act

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criteria to decide between life and death

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-\"quality of life\" and \"quality of humanness\" are subjective and difficult to define

Ch. 8: Suicide

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