Ch. 8: Suicide

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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

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