Chapter 9 – Suicide

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parasuicide
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a suicide attempt that does not result in death
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suicide
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self-inflicted death in which the person acts intentionally, directly, and consciously. Lower rates among religious peoples. Women attempt more, men are more successful and use more violent methods.
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suicidal behavior disorder
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category of DSM-5 which contains people who have tried to kill themselves within the last two years
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death seekers
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a person who clearly intends to end his or her life at the time of a suicide attempt
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death initator
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a person who attempts suicide believing that the process of death is already underway and that he or she is simply hastening the process
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death ignorer
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a person who attempts suicide without recognizing the finality of death
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death darer
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a person who is ambivalent about the wish to die even as he or she attempts suicide
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subintentional death
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a death in which the victim plays an indirect, hidden, partial, or unconscious role
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retrospective analysis
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a psychological autopsy in which clinicians piece together information about a person’ suicide from the person’s past
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self-injury (self-mutilation)
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behavioral pattern that includes cutting or burning oneself or banging one’s head. Can be suicidal or nonsuicidal
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studying people who survive their suicide attempts
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a strategy researchers employ to attempt to understand suicide
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devoutness
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usually leads to a less change of suicide
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triggers of suicide
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caused by stressful events, mood and thought changes, alcohol and other drug use, mental disorders, and modeling (if one happens, more people will follow in suit). If depression is involved, usually triggered after some mood improvement and they feel more able to act on this.
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hopelessness
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a pessimistic belief that one’s present circumstances, problems, and mood will not change
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dichotomous thinking
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viewing problems and solutions in rigid either/or terms. Only two options.
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social contagion effect
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risk factor of suicide among the relatives and friends of people who recently committed suicide
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postvention
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what clinicians refer to as postsuicide programs, or programs that come up after a “suicide epidemic”
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psychodynamic view of suicide
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theorists believe that suicide results from depression and from anger at others that is redirected toward oneself. “Murder in the 180th degree” (Menninger). Introject the lost loved one, feel lost themselves, therefore experience self-hatred. Childhood losses too. Thanatos applies.
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thanatos
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Freud’s term for the “death instinct” that opposes the “life instinct”. Freud claims that this is directed at others and that suicidal people direct it at themselves. Supported by drop in suicide rates during wartime.
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Durkheim’s sociological view of suicide
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probability of suicide is determined by how attached a person is to such social groups as the family, religious institutions, and community. The more a person belongs, the lower the risk of suicide. Include egoistic, altruistic, and anomic suicide
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egoistic suicide
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committed by people over whom society has little or no control. People are not held to norms/rules of society. People are isolated, alienated, and nonreligious. Durkheim view
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altruistic suicide
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committed by people who are so well integrated into social structure they intentionally sacrifice their lives for its well-being. Durkheim view. Example: soldiers who threw themselves on top of live grenade to save others.
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anomic suicide
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committed by people whose social environment fails to provide stable structures, such as family and religion, to support and give meaning to live. They don’t reject but instead feel let down by disorganized, inadequate, decaying society. Durkheim view
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anomie
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societal condition that leaves people without sense of belonging
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biological view of suicide
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suicide due to genetic factors, low serotonin levels, which may lead to aggressive and impulsive behaviors, and hence suicide.
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young children
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age group that has seen increasing numbers of suicide. Males outnumber females 5:1. Theorized to come from behavioral problems such as running away from home, accident proneness, aggressive acting out, temper tantrums, social withdrawal, sensitivity. Believed that there are some in this group that don’t understand death, but clear that a wide number do understand it completely as well.
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teenagers
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age group in which suicide is third leading cause. Usually tied to clinical depression, low self-esteem, and feelings of hopelessness, serious alcohol or drug problems. Could also be immediate stress caused too. Group tends to react to events more sensitively, angrily, dramatically, and impulsively. Also high suggestibility. 25:1 of attempts vs success, meaning they are less certain usually.
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pro-suicide forums
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websites and chat rooms on the internet that celebrate former users who have committed suicide, help other set up appointments for joint suicides, and several offer specific instructions about suicide methods and techniques
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elderly
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15 out of every 100,000 over age of 65, and even higher as they are older. Factors contributing to this age group include illness, loss of friends and relatives, loss of control over life, loss of social status. Usually more determined and give fewer warnings, so much higher success rate.
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suicide therapy
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goals include to keep individual alive, reduce psychological pain, help them achieve a nonsuicidal state of mind, provide them with hope, guide them to develop better ways of handling stressed. May include drug therapy. Cognitive-therapy seems to be most helpful
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suicide prevention program
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a program that tries to identify people who are at risk of killing themselves and to offer them crisis intervention. Include hotlines and crisis intervention. Employ paraprofessionals. Only small amount actually contact this, but do reduce the number of suicides among those who do call
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crisis invervention
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treatment approach that tries to help people in a psychological crisis to view their situation more accurately, make better decision, act more constructively, and overcome the crisis
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establish a positive relationship
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first step of suicide prevention program
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understand and clarify the problem
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second step of suicide prevention program
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assess suicide potential (lethality scale)
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third step of suicide prevention program
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assess and mobilize the caller’s resources
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fourth step of suicide prevention program
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formulate a plan (no-suicide contract)
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fifth step of suicide prevention program
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Natalie is an extremely religious individual; in fact, some of her friends have described her as a fanatic. Midway through her thirties, Natalie decides that life is “not all it is cracked up to be” and starts obsessing about heaven, the afterlife, and getting to live with God. One afternoon, she mixes some industrial cleaner with a glass of lemonade, says a prayer, and drinks the entire cup. Within five minutes, the poisons in the cleaner have claimed her life. Natalie is BEST described as a death:
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ignorer
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_____ is considered a pioneer in the area of suicide study
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Edwin Shneidman
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Which is NOT one of the types of suicidal individuals, according to Shneidman?
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death collaborator
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Sixty-eight-year-old Ruth suffers from advanced breast cancer that has spread to her lymph nodes. Her doctors have told her that there are no more treatments they can offer her and have suggested that she consider enhancing the quality of the short time she has left instead of continuing to fight what will be a losing battle. She is not ready to give up on beating the cancer, and yet she seems to constantly mismanage her medications. She takes the wrong doses, sometimes takes the wrong pills, and occasionally “forgets” to take her medications at all. One afternoon, she makes such a serious mistake that the wrong pills interact with each other in a fatal manner. Ruth’s death would be an example of what Shneidman refers to as:
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sub intentional death
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In order to understand the causes and contributing factors to a suicide, researchers often gather information about a person who has ended his or her life. They may talk to friends, family members, or colleagues. They may examine paperwork or records. With appropriate permission, they may talk to doctors or other professionals in an attempt to build a picture of the suicide victim’s state of mind and motivation. This kind of “psychological autopsy” is formally called a(n):
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retrospective analysis
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Suicide can be caused by immediate or long-term stressors. Which circumstance would NOT be considered a long-term stressor?
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loss of a loved one through death
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Research has found a strong link between the use of alcohol or drugs and suicidal actions. For example, as many as 70 percent of those who commit suicide have some alcohol in their blood when they die, and approximately _____ percent of them are legally intoxicated.
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25
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Research suggests that as many as 70 percent of all suicide victims had been experiencing:
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severe depression
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Research indicates that suicides by people with schizophrenia reflects:
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the fear of further mental deterioration.
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One suicide setting off a rash of other suicides is referred to in the text as suicide:
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contagion
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“No one kills himself who has not wanted to kill another or at least wished t
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Wilhelm Stekel.
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During World War II, the Japanese military got a reputation for being ruthless warriors, largely based on the kamikaze pilots who would sacrifice their own lives to crash their planes into enemy installations. In the theory of Emile Durkheim, this would be an example of _____ suicide.
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altruistic
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When someone commits suicide because they don’t have a sense of belonging within society, this is an example of _____ suicide.
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anomic
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Which influential psychiatrist referred to suicide as “murder in the 180th” degree, emphasizing the idea that suicide is an internalization of aggression and anger that is really focused on another person?
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Karl Menninger
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The rate of _____ suicides has been rising more than that of any age group in recent years, a trend that is not fully understood.
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middle age
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It is estimated that approximately 1 out of every _____ children attempts to harm him- or herself in a given year, with many ending up hospitalized for self-injurious behavior.
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100
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Clinical interviews with schoolchildren have revealed that between _____ percent have thought about suicide.
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6 and 33
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In 1997, the state of _____ passed the “Death with Dignity” Act, which allows a physician to assist with a suicide by administering a lethal dose of drugs, provided that several diagnostic criteria have been met and multiple factors are considered.
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Oregon
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Approximately how many people are admitted to a U.S. hospital each year for injuries resulting from efforts to harm themselves?
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500,000
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Research indicates that _____ therapy may be of the MOST help for suicidal individuals.
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cognitive-behavioral
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The first suicide-prevention program in the United States was established in _____, in 1955.
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Los Angeles
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Which is NOT one of the initial responsibilities of a counselor at a suicide-prevention program when responding to a caller?
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alerting law-enforcement authorities to the caller
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Many theorists have argued that _____ is the ultimate form of suicide prevention.
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education
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According to a recent review, around _____ percent of teens who have attempted suicide terminate treatment against their therapists’ advice.
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18
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Which group has the highest suicide rate in the United States?
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american Indians
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Men commit suicide with far greater frequency than women do, although women attempt to kill themselves quite a bit more frequently than men do. One reason for this involves the methods the different genders choose for committing suicide, with men relying on violent means, such as the use firearms, with greater frequency. Annually, around _____ percent of all male suicides involve the use of a gun, as compared with only _____ percent of female suicides.
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56; 31
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Which Hispanic American group attempts suicide MOST often?
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Costa Rican
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Shneidman believed that the key to suicide is a feeling of psychological:
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pain
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Suicide programs that are put into action following an individual’s suicide are referred to as:
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retrospective action plans (RAPs).
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The activity level of the neurotransmitter _____ has been found to be low in people who commit suicide.
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serotonin
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The world anomie, which is at the heart of one of the three types of suicide proposed by Emile Durkheim, means:
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without law
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The extreme suicide rates found on American Indian reservations are called _____ suicides.
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cluster

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