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Marcinkevičiūtė M, Vilutytė L, Gailienė D. Experience of pre-suicidal suffering: insights from suicide attempt survivors. Int J Qual Stud Health Well-being 2024; 19:2370894. [PMID: 38913782 PMCID: PMC11198122 DOI: 10.1080/17482631.2024.2370894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 06/18/2024] [Indexed: 06/26/2024] Open
Abstract
PURPOSE Psychache significantly contributes to the suicidal process. However, the transition from pre-suicidal suffering to a suicide crisis remains one of the least explored stages in suicidology. METHODS We retrospectively explored experience of pre-suicidal suffering through semi-structured, in-depth interviews with 12 individuals recruited from the Vilnius City Mental Health Center, Lithuania. Interpretative phenomenological analysis was employed to identify recurring patterns. RESULTS Nine primary group experiential themes emerged: Certain adverse life events occurring during the suicidal process were not immediately perceived as connected; Complex traumatic events laid the groundwork for a profound sense of lack; A compensatory mechanism balanced the experience of profound lack; Exhaustion ensued from efforts to sustain the compensatory mechanism; The main trigger directly challenged the compensatory mechanism; The affective state followed the experience of the main triggering event; Dissociation served to isolate psychache; Thoughts of suicide experienced as automatic; Suicide was perceived as a means to end suffering. CONCLUSION The findings suggest that the suicidal process unfolds over an extended period of suffering, culminating in a crisis to alleviate unbearable psychological pain. In clinical practice, identifying the main triggering event discussed in this study can be pivotal in understanding the essence of suffering characterized by profound lacking and developed compensatory mechanisms.
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Affiliation(s)
- Miglė Marcinkevičiūtė
- Centre for Suicidology, Institute of Psychology, Vilnius University, Vilnius, Lithuania
| | | | - Danutė Gailienė
- Centre for Suicidology, Institute of Psychology, Vilnius University, Vilnius, Lithuania
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2
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Azizy AH, Thontowi HB. Stigma, Support, and Ideation About Suicide in Indonesian Twitter: A Topic Modelling Study. OMEGA-JOURNAL OF DEATH AND DYING 2024:302228241253972. [PMID: 38739857 DOI: 10.1177/00302228241253972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Stigma surrounding suicide is a massive problem in Indonesia. Thus, it is important to study how conversations about suicide take place. We take a machine learning approach and study tweets with suicide keywords to understand how people converse about suicide or express suicide ideation. Tweets with suicide-related keywords were extracted from May to June 2023. 20,057 tweets were subject to topic modelling with an 11-topic solution. While most topics contain negative messages, no purely stigmatizing topics emerge, despite prior research suggesting overwhelming stigma. Various kinds of existential, emotional, and social tweets about suicide take place among Indonesian users, indicating that Indonesian Twitter users utilize the platform to express their thoughts and emotions. Notably, religious-spiritual keywords are highly prevalent, suggesting that in a highly religious society, there is a need for policy makers and awareness campaigns to frame their positive messaging within the society's religious context.
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Affiliation(s)
- Afrizal Hasbi Azizy
- Center for Indigenous and Cultural Psychology, Universitas Gadjah Mada, Sleman, Indonesia
| | - Haidar Buldan Thontowi
- Center for Indigenous and Cultural Psychology, Universitas Gadjah Mada, Sleman, Indonesia
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3
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Adini-Spigelman E, Gvion Y, Haruvi Catalan L, Barzilay S, Apter A, Brunstein Klomek A. Comparative Effectiveness of Ultra-Brief, IPT-A Based Crisis Intervention for Suicidal Children and Adolescents. Arch Suicide Res 2024:1-14. [PMID: 38169321 DOI: 10.1080/13811118.2023.2298499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
BACKGROUND In recent years, suicidal thoughts and behaviors have become increasingly common among children and adolescents, leading to an elevation in the number of visits to emergency departments in pediatric hospitals. In Israel, the rising demand for mental health treatment due to suicidal distress is also salient, creating prolonged wait periods and low case acceptance rates. Addressing the urgent need for streamlined interventions, the present study outlines the design and results of a non-inferiority effectiveness trial of an ultra-brief suicide crisis intervention based on Interpersonal Psychotherapy for Adolescents (IPT-A-SCI). METHODS 309 children and adolescents presenting to the Depression and Suicide Clinic at Schneider Children's Medical Center of Israel with depressive and anxiety symptoms and/or suicidal ideation/behavior were assigned to either IPT-A-SCI, Treatment as Usual (TAU), or waitlist condition. Assessments were conducted pre- and post-intervention/after five sessions/five weeks (as secondary assessments) in accordance with group assignment. RESULTS At secondary assessment, post IPT-A-SCI, suicide ideation, and behavior as well as depression and anxiety symptoms significantly decreased, with no group differences observed between IPT-A-SCI, TAU, and control groups. CONCLUSION IPT-A-SCI is feasible and as effective as the standard treatment in reducing suicidal, depressive, and anxiety symptoms among children and adolescents.
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Looijmans M, van Bergen D, Popma A, van Eijk N, Mérelle S, van Veen S, Hawton K, Gilissen R. The self-perceived needs of adolescents with suicidal behaviour: a scoping review. Eur Child Adolesc Psychiatry 2023:10.1007/s00787-023-02342-1. [PMID: 38147110 DOI: 10.1007/s00787-023-02342-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 11/28/2023] [Indexed: 12/27/2023]
Abstract
Suicidal behaviour in adolescents is a major public health problem. Much research on this issue has focused on epidemiology and risk factors for suicidal behaviour, paying less attention to the self-perceived needs of adolescents. However, to increase engagement in suicide prevention, it is important to include the views of adolescents. A scoping review was performed to identify the available empirical study findings, of any study design, related to the self-perceived needs of adolescents with suicidal behaviour. The literature databases Medline, Embase, Psycinfo, CINAHL, ERIC, Scopus, and Web of Science were searched. Twenty-nine studies from 14 predominantly Anglo countries were included in the scoping review. The review showed that girls were overrepresented and that studies predominantly used qualitative approaches. The identified needs of adolescents with suicidal behaviour can broadly be grouped into needs related to the following areas: the importance of connecting with other people; adolescents' self-help strategies and personal growth after self-harm; mental healthcare; school or study programs; and needs related to society in relation to taboo on suicidal behaviour. Prevention of suicidal behaviour in adolescents will need to focus on development and strengthening of interventions fitting the needs of adolescents in these areas.
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Affiliation(s)
- Milou Looijmans
- Research Department, 113 Suicide Prevention, Amsterdam, The Netherlands.
- Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam UMC, Amsterdam, The Netherlands.
| | - Diana van Bergen
- Faculty of Pedagogical and Educational Sciences, University of Groningen, Groningen, The Netherlands
| | - Arne Popma
- Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam UMC, Amsterdam, The Netherlands
| | - Nikki van Eijk
- Research Department, 113 Suicide Prevention, Amsterdam, The Netherlands
| | - Saskia Mérelle
- Research Department, 113 Suicide Prevention, Amsterdam, The Netherlands
| | - Sisco van Veen
- Research Department, 113 Suicide Prevention, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands
| | - Keith Hawton
- Centre for Suicide Research, University Department of Psychiatry, Warneford Hospital, Oxford, UK
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Renske Gilissen
- Research Department, 113 Suicide Prevention, Amsterdam, The Netherlands
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5
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Wu C, Bai X, Peng X, Huang T, Zhu X. Fatalism and Suicidal Behaviors Among Chinese College Students: The Mediating Role of Depressive Symptoms and the Moderating Role of Coping Strategies. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231221844. [PMID: 38079188 DOI: 10.1177/00302228231221844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
The aim of this study was to investigate the relationship between fatalism and suicidal behaviors, the mediating role of depressive symptoms, and the moderating effect of coping strategies on the mediating process. A total of 519 participants completed the Multidimensional Fatalism Scale for General Life Events, the Center for Epidemiologic Studies-Depression scale, the Simplified Coping Style Questionnaire, and the Suicidal Behaviors Questionnaire-Revised. Results suggest that depressive symptoms partially mediated the relationship between fatalism and suicidal behaviors. Active coping moderated the mediating effect of depressive symptoms. The higher the active coping level, the weaker the mediating effect. The findings revealed that the mechanism of fatalism affecting suicidal behaviors, and had theoretical and empirical value for the prevention and intervention of suicide among college students.
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Affiliation(s)
- Caizhi Wu
- School of Psychology, Central China Normal University, Wuhan, China
- Key Laboratory of Human Development and Mental Health of Hubei Province, Wuhan, China
- Key Laboratory of Adolescent Cyber psychology and Behavior, Ministry of Education, Wuhan, China
| | - Xin Bai
- School of Psychology, Central China Normal University, Wuhan, China
- Key Laboratory of Human Development and Mental Health of Hubei Province, Wuhan, China
- Key Laboratory of Adolescent Cyber psychology and Behavior, Ministry of Education, Wuhan, China
| | | | - Tingting Huang
- School of Psychology, Central China Normal University, Wuhan, China
- Key Laboratory of Human Development and Mental Health of Hubei Province, Wuhan, China
- Key Laboratory of Adolescent Cyber psychology and Behavior, Ministry of Education, Wuhan, China
- Education & Counseling Central Mental Health, Ocean University of China, Qingdao, China
| | - Xu Zhu
- School of Psychology, Central China Normal University, Wuhan, China
- Key Laboratory of Human Development and Mental Health of Hubei Province, Wuhan, China
- Key Laboratory of Adolescent Cyber psychology and Behavior, Ministry of Education, Wuhan, China
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6
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Florindo Salvador V, Gouveia-Pereira M, Simões B, Duarte E. Young adults who self-harm: Barriers to and facilitators of seeking help. Psychiatry Res 2023; 327:115390. [PMID: 37574602 DOI: 10.1016/j.psychres.2023.115390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 07/27/2023] [Accepted: 07/29/2023] [Indexed: 08/15/2023]
Abstract
In Portugal, the lifetime prevalence of DSH in adolescents is situated between 16% and 35% (Duarte et al., 2020a; Gouveia-Pereira et al., 2016). Help-seeking is an important facilitator to stop these behaviors, although it is known that most individuals who engage in self-harm do not ask for help (Rowe et al., 2014). Study one (n = 222) examines the differences between two groups of young adults with a history of deliberate self-harm (participants who asked for help and participants who did not ask for help) regarding these behaviors' severity and diversity, suicidal ideation, and family conflicts. Participants completed a self-report questionnaire which included an open-ended question focused on the reasons that may or may not contribute for seeking help. Significant differences between the two groups were found for all variables and are further discussed, followed by a qualitative analysis concerning the help-seeking motives. Study two (n = 110) used a self-report questionnaire to analyze the expectations of young adults with a history of deliberate self-harm concerning their social support network and the role of healthcare workers when they asked or thought about asking for help. These expectations included contents related with problem-solving, confidentiality, understanding and trust, support, and unburdening. Identifying facilitators and barriers to help-seeking can be a relevant step in planning and managing interventions within deliberate self-harm. Future directions and limitations are discussed.
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Affiliation(s)
- Vanessa Florindo Salvador
- Applied Psychology Research Center Capabilities and Inclusion (APPsyCI), ISPA, Instituto Universitário, Lisbon, Portugal.
| | - Maria Gouveia-Pereira
- Applied Psychology Research Center Capabilities and Inclusion (APPsyCI), ISPA, Instituto Universitário, Lisbon, Portugal
| | | | - Eva Duarte
- Applied Psychology Research Center Capabilities and Inclusion (APPsyCI), ISPA, Instituto Universitário, Lisbon, Portugal
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7
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Ladis I, Seitov A, Barnes LE, Teachman BA. Perceived Burdensomeness and Thwarted Belongingness in Text Messages of Suicide Attempt Survivors. Arch Suicide Res 2023:1-12. [PMID: 37350046 PMCID: PMC10739607 DOI: 10.1080/13811118.2023.2226692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
OBJECTIVE Perceived burdensomeness and thwarted belongingness are considered interpersonal risk factors for suicide. Examining these themes in personal text messages may help identify proximal suicide risk. METHOD Twenty-six suicide attempt survivors provided personal text messages and reported dates for past periods characterized by positive mood, depressed mood, suicidal ideation (with no attempt), or the two-week period leading up to suicide attempt(s). Texts were then classified into the applicable period based on matching dates. Texts (N = 194,083; including n = 86,705 outgoing texts) were coded for perceived burdensomeness and thwarted belongingness by masked trained raters. Multilevel models were fit to examine whether the target themes (combined into one overall interpersonal risk variable due to low base rate) were more prevalent in texts sent during higher risk episodes (e.g., suicide attempt vs. depressed mood episodes). RESULTS 0.57% of outgoing texts contained either target theme. As hypothesized, logistic models showed participants were more likely to send texts containing the target themes during suicide attempt episodes relative to suicidal ideation (with no attempt) episodes, depressed mood episodes, and positive mood episodes, and during suicidal ideation (with no attempt) episodes relative to positive mood episodes. All contrasts were robust to post-hoc correction except for suicide attempt episodes vs. ideation (with no attempt) episodes. No other significant pairwise differences for episode type emerged. CONCLUSIONS Despite the small sample size and low base rate of target themes in the texts, perceived burdensomeness and thwarted belongingness were associated with intra-individual suicide risk severity in personal text messages.
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Affiliation(s)
- Ilana Ladis
- Department of Psychology, University of Virginia
| | - Arsen Seitov
- Department of Psychology, University of Virginia
| | - Laura E. Barnes
- Department of Engineering Systems and Environment, University of Virginia
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8
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Haasz M, Myers MG, Rowhani-Rahbar A, Zimmerman MA, Seewald L, Sokol RL, Cunningham RM, Carter PM. Firearms Availability Among High-School Age Youth With Recent Depression or Suicidality. Pediatrics 2023; 151:e2022059532. [PMID: 37212021 PMCID: PMC10233739 DOI: 10.1542/peds.2022-059532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/27/2023] [Indexed: 05/23/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Limiting firearm access is essential to decreasing teen suicide. Previous efforts have focused on household firearms; however, less is known about firearm access and possession among teens at increased suicide risk. Our objective was to estimate prevalence of firearm possession and access among high school-aged teens with recent depression and/or lifetime history of suicidality (DLHS). METHODS We conducted a probability-based, cross-sectional Web survey of 1914 parent-teen dyads between June 24, 2020, and July 22, 2020, with data weighted to generate a nationally representative sample of US teenagers (aged 14-18). Logistic regression analyses examined the difference between teens with and without DLHS for: (1) personal firearm possession, (2) perceived firearm access, and (3) method of firearm attainment. RESULTS Among high school-aged teens, 22.6% (95% confidence interval [CI], 19.4-25.8) reported DLHS, 11.5% (95% CI, 8.7-14.3) reported personal firearm possession, and 44.2% (95% CI, 40.2-48.2) endorsed firearm access. Teens experiencing DLHS had increased perceived access (adjusted odds ratio, 1.56; 95% CI, 1.07-2.28) compared with non-DLHS peers. There was no association between DLHS and personal firearm possession (adjusted odds ratio, 0.97; 95% CI, 0.47-2.00). Among teens reporting firearm possession, those with DLHS were more likely to have acquired it by buying/trading for it (odds ratio, 5.66; 95% CI, 1.17-27.37) and less likely receiving it as a gift (odds ratio, 0.06; 95% CI, 0.01-0.36). CONCLUSIONS High school-aged teens experiencing DLHS have higher perceived firearm access compared with lower-risk peers. Providers should speak directly to high school-aged teens at increased suicide risk about firearm access, in addition to counseling parents.
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Affiliation(s)
- Maya Haasz
- Department of Pediatrics, Section of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado
- Firearm Safety Among Children and Teens (FACTS) Consortium, Ann Arbor, Michigan
| | - Matthew G. Myers
- University of Michigan Injury Prevention Center, School of Medicine
| | - Ali Rowhani-Rahbar
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington
- Firearm Injury & Policy Research Program, Seattle, Washington
| | - Marc A. Zimmerman
- Firearm Safety Among Children and Teens (FACTS) Consortium, Ann Arbor, Michigan
- University of Michigan Injury Prevention Center, School of Medicine
- Michigan Youth Violence Prevention Center
- Department of Health Behavior and Health Education, School of Public Health
- Institute for Firearm Injury Prevention
| | - Laura Seewald
- Firearm Safety Among Children and Teens (FACTS) Consortium, Ann Arbor, Michigan
- University of Michigan Injury Prevention Center, School of Medicine
- Department of Emergency Medicine, School of Medicine
| | - Rebeccah L. Sokol
- Institute for Firearm Injury Prevention
- School of Social Work, University of Michigan, Ann Arbor, Michigan
| | - Rebecca M. Cunningham
- Firearm Safety Among Children and Teens (FACTS) Consortium, Ann Arbor, Michigan
- Department of Health Behavior and Health Education, School of Public Health
- Department of Emergency Medicine, School of Medicine
| | - Patrick M. Carter
- Firearm Safety Among Children and Teens (FACTS) Consortium, Ann Arbor, Michigan
- University of Michigan Injury Prevention Center, School of Medicine
- Department of Health Behavior and Health Education, School of Public Health
- Institute for Firearm Injury Prevention
- Department of Emergency Medicine, School of Medicine
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Weissinger GM, Evans L, Van Fossen C, Winston-Lindeboom P, Ruan-Iu L, Rivers AS. Parent experiences during and after adolescent suicide crisis: A qualitative study. Int J Ment Health Nurs 2023; 32:917-928. [PMID: 36882964 DOI: 10.1111/inm.13137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 01/31/2023] [Accepted: 02/18/2023] [Indexed: 03/09/2023]
Abstract
Parents of adolescents who have suicide crises (i.e. suicide attempt and/or significant ideation) are often highly involved in the care management, treatment and preventing future suicides of their children. How they experience these suicide crises, and the period afterward, has not been well studied. The purpose of this study was to understand parents' (defined in this study as any legal guardian of an adolescent taking on a parental role) experience of adolescent suicide crises and its impact on themselves and the family system. Semi-structured interviews were conducted with parents (N = 18) of adolescents who had a suicide crisis in the past 3 years. Thematic analysis was used with a combined inductive-deductive coding approach, drawing from Diamond's conceptualization of family treatment engagement for suicidal youth and iterative close readings of transcripts. Five themes emerged related to parent experience: Trauma of the Experience (subtheme: Feelings of Failure); Living in Fear; Alone and Seeking Connection; Lasting Impact; and A New Normal (subtheme: Turn the Pain to Purpose). Parents experienced these events as traumatic, damaging their sense of self. They experienced long periods of time where fear and loneliness dominated their lives. Recovery was both an individual and a family process, occurring in tandem with, but distinct from, adolescent experiences. Descriptions and illustrative quotes illustrate parent experiences and their understanding of the impact on the family system. Results highlighted that parents require support both for themselves and as caregivers for adolescents around an adolescent's suicide crisis and that family-focused services are vital.
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Affiliation(s)
- Guy M Weissinger
- Fitzpatrick College of Nursing, Villanova University, Villanova, Pennsylvania, USA
| | - Lili Evans
- Fitzpatrick College of Nursing, Villanova University, Villanova, Pennsylvania, USA
| | - Catherine Van Fossen
- Department of Psychiatry and Human Behavior, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Payne Winston-Lindeboom
- College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA
| | - Linda Ruan-Iu
- College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA
| | - Alannah Shelby Rivers
- Department of Psychology and Philosophy, Texas Woman's University, Denton, Texas, USA
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The effect of childhood adversities on the persistence of suicidal ideation and plans among college students: A longitudinal study. J Affect Disord 2023; 323:354-360. [PMID: 36470554 DOI: 10.1016/j.jad.2022.11.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 10/26/2022] [Accepted: 11/22/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Exposure to childhood adversities (CAs) is known to be associated with the onset of suicidal ideation and plans. However, little is known regarding the contribution of CAs to their persistence. AIMS The study aims to examine the type, number and frequency of CA exposure on the persistence of suicidal ideation and plans at one-year. METHOD Data were drawn from the French portion of the World Mental Health International College Student survey. At baseline (n = 2661, response rate = 7,58 %), exposure to 12 types of CAs prior to age 18, lifetime mental disorders, lifetime and 12-month suicidal ideation and plans were assessed. At one-year follow-up (n = 1221), 12-month mental disorders, suicidal ideation and plans were assessed. Among those with a prior history of suicidal ideation, logistic regressions were performed to examine the role of CAs on the persistence of ideation and plans at one-year. RESULTS At baseline, frequency and number of CAs were associated with 12-month suicidal ideation and plans. Among lifetime ideators, 49.6 % reported 12-month suicidal ideation at follow-up. Physical abuse was associated with an increased risk of suicidal ideation and plan persistence at one year in univariate analyses. However, CAs were not associated with the persistence of suicidal ideation and plans at one-year in multivariate analyses. LIMITATIONS Retrospective report of CA exposure, and low baseline response rate. CONCLUSIONS Using a fine-grained operationalization of CA exposure, CAs were not involved in the persistence of suicidal ideation or plans, their deleterious effect more likely to occur early in the course of psychopathology.
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11
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Fenton C, Kingsley E. Scoping review: Alternatives to self-harm recommended on mental health self-help websites. Int J Ment Health Nurs 2023; 32:76-94. [PMID: 36104975 DOI: 10.1111/inm.13067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/23/2022] [Indexed: 01/14/2023]
Abstract
Less than half of all young people with mental health difficulties will seek professional treatment. Due to the private nature of self-harm it is estimated that only 1:28 young males and 1:18 young females who self-harm ever present to hospital. Self-help supports improved coping strategies and life changes without reliance on a clinical intervention which could be used to reduce self-harming behaviours. The study objective is to review self-help alternatives to self-harm on mental health websites that can be accessed by young people. Google, Bing, and Yahoo search engines were used to search for appropriate websites. Eighty-two unique websites on mental health were identified, of which 55 met the inclusion criteria. A total of 1177 self-help suggestions were found for those struggling with self-harm urges. The average number of suggestions per site was 42 (Range 3-252). The main techniques suggested were: seeking social contact/help, physical activity, displacement/mimicking techniques, relaxing/comforting techniques, sensory techniques, fun/diverting techniques, aggressive techniques, creative/reflective techniques. This review found not all strategies were suitable for young people and that the large number of possible strategies could be challenging for a young person to navigate. However, mental health self-help websites were generally of high quality and gave a range of potentially helpful strategies. The categories created from this review could be used as a guide to consider with the young person when making an individualized self-help plan to manage self-harm urges. Further research is required to assess if and how these techniques could be used individually or in combination to reduce self-harm.
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Affiliation(s)
- Clare Fenton
- COMIC Research, Leeds and York Partnership NHS Foundation Trust, York, England.,Hull York Medical School, University of York, York, England
| | - Ellen Kingsley
- COMIC Research, Leeds and York Partnership NHS Foundation Trust, York, England
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12
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Yunitasari E, Yusuf A, Aditya RS, Acob JRU, Solikhah FK, Alrazeeni DM. Nursing Students Facilitating the Transition from Suicidal Ideation to Action in the Rural: A Qualitative Study. Neuropsychiatr Dis Treat 2023; 19:171-180. [PMID: 36698698 PMCID: PMC9869691 DOI: 10.2147/ndt.s387362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 11/15/2022] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE This study aims to increase understanding of the process of nursing students at risk of completing suicide attempts that facilitates the transition from suicidal ideation to action. And The Central Bureau of Statistics, there were 812 suicide cases throughout Indonesia. METHODS The qualitative research involved 15 nursing students who were selected purposively. data collection in rural East Java Data were collected through semi-structured interviews and analyzed using the Colaizzi phenomenological method. RESULTS We identified six main themes; 1 (the dimension of individual history). 2 (socio-cultural dimension) describes the problems experienced by nursing students on campus and off campus. 3 (interpersonal dimension). 4 (intrapersonal dimension); Factors of family conflict, peer conflict, and psychiatric and/or medical disorders. 5 (emotional dimension). 6. (be a good listener). CONCLUSION The intrapersonal element is the most influential catalyst in the progression from suicidal ideation to action. As prospective targets for preventive interventions and practices with nursing students at risk of suicide, our findings suggest the need for specific measures addressing freshman recruitment during selection for faculty, emotional dysregulation, and feelings of invalidity and entrapment. Nursing students need intrapersonal training. Being a good listener for all students, lecturers and staff is important to create a support system for suicide prevention in the nursing environment.
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Affiliation(s)
- Esti Yunitasari
- Department of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | - Ah Yusuf
- Department of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | - Ronal Surya Aditya
- Department of Public Health, Universitas Negeri Malang, Malang, Indonesia
| | - Joel Rey U Acob
- Department of Nursing, Visayas State University, Visayas, Philippines
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13
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Nook EC, Jaroszewski AC, Finch EF, Choi-Kain LW. A Cognitive-Behavioral Formulation of Narcissistic Self-Esteem Dysregulation. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2022; 20:378-388. [PMID: 37200882 PMCID: PMC10187391 DOI: 10.1176/appi.focus.20220055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Narcissistic personality disorder (NPD) is a commonly encountered diagnosis, affecting approximately 1%-6% of the population, with no evidence-based treatments. Recent scholarship has focused on self-esteem dysregulation as a key component of NPD: Excessively high expectations for oneself and how one should be treated leads to brittle self-esteem and maladaptive reactions to self-esteem threats. The current article builds on this formulation, introducing a cognitive-behavioral model of narcissistic self-esteem dysregulation that clinicians can use in providing a relatable model of change for their patients. Specifically, symptoms of NPD can be seen as a set of cognitive and behavioral habits that serve to regulate difficult emotions emerging from maladaptive beliefs and interpretations of self-esteem threats. This perspective renders narcissistic dysregulation amenable to cognitive-behavioral therapy (CBT) in which patients learn skills that help them gain awareness around these habitual reactions, reshape cognitive distortions, and engage in behavioral experiments that serve to transform maladaptive belief systems that consequently free them from symptomatic reactions. Here, we provide a precis of this formulation and examples of how CBT skills can be used to treat narcissistic dysregulation. We also discuss future research that could provide empirical support for the model and test the efficacy of CBT approaches to NPD. Conclusions focus on the notion that narcissistic self-esteem dysregulation likely varies continuously in the population and transdiagnostically across disorders. Greater insight into the cognitive-behavioral mechanisms of self-esteem dysregulation could foster tools for ameliorating distress both in people with NPD and the general populace.
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Affiliation(s)
- Erik C Nook
- Department of Psychology, Princeton University, Princeton, New Jersey (Nook); Department of Psychiatry, Harvard Medical School, Boston (Jaroszewski, Choi-Kain); Department of Psychiatry, Massachusetts General Hospital, Boston (Jaroszewski); Department of Psychology, Harvard University, Cambridge, Massachusetts (Finch); McLean Hospital, Harvard Medical School, Boston (Choi-Kain)
| | - Adam C Jaroszewski
- Department of Psychology, Princeton University, Princeton, New Jersey (Nook); Department of Psychiatry, Harvard Medical School, Boston (Jaroszewski, Choi-Kain); Department of Psychiatry, Massachusetts General Hospital, Boston (Jaroszewski); Department of Psychology, Harvard University, Cambridge, Massachusetts (Finch); McLean Hospital, Harvard Medical School, Boston (Choi-Kain)
| | - Ellen F Finch
- Department of Psychology, Princeton University, Princeton, New Jersey (Nook); Department of Psychiatry, Harvard Medical School, Boston (Jaroszewski, Choi-Kain); Department of Psychiatry, Massachusetts General Hospital, Boston (Jaroszewski); Department of Psychology, Harvard University, Cambridge, Massachusetts (Finch); McLean Hospital, Harvard Medical School, Boston (Choi-Kain)
| | - Lois W Choi-Kain
- Department of Psychology, Princeton University, Princeton, New Jersey (Nook); Department of Psychiatry, Harvard Medical School, Boston (Jaroszewski, Choi-Kain); Department of Psychiatry, Massachusetts General Hospital, Boston (Jaroszewski); Department of Psychology, Harvard University, Cambridge, Massachusetts (Finch); McLean Hospital, Harvard Medical School, Boston (Choi-Kain)
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14
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Kang B, Hwang J, Woo SI, Hahn SW, Kim M, Kim Y, Jin H, Jeon HJ, Lee YJ. The Mediating Role of Depression Severity on the Relationship Between Suicidal Ideation and Self-Injury in Adolescents With Major Depressive Disorder. Soa Chongsonyon Chongsin Uihak 2022; 33:99-105. [PMID: 36203886 PMCID: PMC9513406 DOI: 10.5765/jkacap.220014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 07/25/2022] [Accepted: 07/25/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives Suicide is the leading cause of death among adolescents in South Korea, and depression and personality profiles have been identified as significant risk factors for self-injurious behavior. This study examined the influence of depressive mood and temperament/ character on self-injury in adolescents. Methods A total of 116 adolescents (aged 12–18 years) with a primary diagnosis of major depressive disorder (MDD) and their parents were enrolled in this study. The participants were divided into three groups based on adolescent’s self-injury frequency, and their Children’s Depression Inventory (CDI), Youth Self-Report (YSR), and Temperament and Character Inventory (TCI) scores were compared. Finally, mediation analysis was conducted to investigate the relationship between suicidal ideation and self-injury. Results Of study participants, 75.9% answered that they had suicidal ideation, and 55.2% answered that they had engaged in self-injurious behavior in the last six months. There were significant differences in CDI and suicidal ideation among the groups. After adjusting for age and sex, mediation analysis indicated that depressive mood mediated the relationship between suicidal ideation and self-injury. Conclusion This study emphasizes the importance of evaluating and managing depressive mood severity in adolescents with MDD as these factors partially mediate the transition from suicidal ideation to self-injury.
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Affiliation(s)
- Byungjoo Kang
- Department of Psychiatry, Soonchunhyang University Seoul Hospital, College of Medicine, Soonchunghyang University, Seoul, Korea
| | - Jaeuk Hwang
- Department of Psychiatry, Soonchunhyang University Seoul Hospital, College of Medicine, Soonchunghyang University, Seoul, Korea
| | - Sung-il Woo
- Department of Psychiatry, Soonchunhyang University Seoul Hospital, College of Medicine, Soonchunghyang University, Seoul, Korea
| | - Sang-Woo Hahn
- Department of Psychiatry, Soonchunhyang University Seoul Hospital, College of Medicine, Soonchunghyang University, Seoul, Korea
| | - Minjae Kim
- Department of Psychiatry, Soonchunhyang University Seoul Hospital, College of Medicine, Soonchunghyang University, Seoul, Korea
| | - Younggeun Kim
- Department of Psychiatry, Soonchunhyang University Seoul Hospital, College of Medicine, Soonchunghyang University, Seoul, Korea
| | - Hyeonseo Jin
- Department of Psychiatry, Soonchunhyang University Seoul Hospital, College of Medicine, Soonchunghyang University, Seoul, Korea
| | - Hong Jun Jeon
- Department of Psychiatry, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Yeon Jung Lee
- Department of Psychiatry, Soonchunhyang University Seoul Hospital, College of Medicine, Soonchunghyang University, Seoul, Korea
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15
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Malak-Akgün B, Üzar-Özçetin YS, Aydin A. Association between resilience, self-esteem and suicide probability among university students in Turkey. Perspect Psychiatr Care 2022; 58:2524-2533. [PMID: 35411610 DOI: 10.1111/ppc.13089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 03/22/2022] [Accepted: 03/24/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE This descriptive and correlational study was conducted to determine whether the self-esteem and resilience levels of students were predictors of suicide probability. DESIGN AND METHODS The survey included the demographic data sheet, Resilience scale for adults, the Rosenberg self-esteem scale, the Suicide probability scale. FINDINGS Resilience and self-esteem scores of the students were high, while the suicide probability was low. Self-esteem and resilience levels were predictors of suicide probability. PRACTICE IMPLICATIONS This highlights the need for assessing the ongoing adjustment of students' resilience and self-esteem levels over a period and providing effective programs to help them improve their resilience and self-esteem.
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Affiliation(s)
- Bahanur Malak-Akgün
- Ardahan University Faculty of Health Sciences, Nursing Department, Ardahan University, Ardahan, Turkey
| | - Yeter Sinem Üzar-Özçetin
- University College Dublin School of Nursing, Midwifery, and Health Systems, Belfield-Dublin, Ireland
| | - Adeviye Aydin
- Sinop University Faculty of Health Sciences, Nursing Department, Sinop, Turkey
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16
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Bradford DRR, Biello SM, Russell K. Defeat and Entrapment Mediate the Relationship Between Insomnia Symptoms and Suicidal Ideation in Young Adults. Arch Suicide Res 2022; 26:1632-1643. [PMID: 33616024 DOI: 10.1080/13811118.2021.1885537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AIM In recent years, there has been a growing interest in understanding the relationship between sleep disturbance and suicide. The current study aimed to advance understanding of the psychological processes driving these relationships by examining whether insomnia symptoms are related to suicidal ideation via perceptions of defeat and entrapment. METHODS Young adults (n = 259; 202 students [78.0%], 45 employed [17.4%], 12 unemployed [4.6%]) completed an anonymous self-report survey that was advertised via social media, university participant pools, and fliers. The survey was described as being related to sleep and mood/mental health. Validated measures were used to assess insomnia symptoms, chronotype, defeat, entrapment, suicidal ideation, and affective covariates. RESULTS Bivariate associations found insomnia severity to be related to poorer affective outcomes including severity of suicidal ideation. Insomnia and depression were significant independent variables in multiple linear regression with suidical ideation as the dependent variable. The relationship between insomnia and suicidal ideation was mediated by perceptions of defeat and entrapment. CONCLUSION Taken together, these findings shed light on the psychological mechanisms linking sleep disturbance and suicidal ideation by highlighting the role of defeat and entrapment. These findings have the potential to improve suicide risk assessment and prevention in young adults experiencing difficulties initiating or maintaining sleep.HighlightsDefeat and entrapment mediate relationship between insomnia and suicidal ideationEvidence for Integrated Motivational-Volitional Model of Suicidal Behavior in community sampleUses validated multi-item suicide measure.
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17
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Rosario-Williams B, Rowe-Harriott S, Ray M, Jeglic E, Miranda R. Factors precipitating suicide attempts vary across race. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:568-574. [PMID: 32407183 PMCID: PMC8006410 DOI: 10.1080/07448481.2020.1757680] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 02/24/2020] [Accepted: 04/13/2020] [Indexed: 05/28/2023]
Abstract
OBJECTIVE Although research has identified interpersonal, intrapersonal, and achievement-related factors that precipitate suicide attempts (SAs), how these factors vary by race/ethnicity is unknown. We examined racial/ethnic differences in SA precipitants in a racially/ethnically diverse sample of young adults (YAs) with a SA history. METHOD Two-hundred twenty-nine young adults, ages 18-33 (87% women), reported their method of attempt, and 200 of those reported on their SA precipitants. The latter were coded by three independent judges (Data were collected March 2012-December 2016.). RESULTS SAs were most often precipitated by intrapersonal factors, followed by interpersonal factors. Logistic regressions revealed that Hispanic, Asian, and Biracial YAs had higher odds of reporting interpersonal precipitants compared to Black YAs. CONCLUSION Suicide prevention and intervention should address both interpersonal and intrapersonal factors that increase vulnerability to SA across racial/ethnic groups, although interventions with Black YAs might focus more on intrapersonal than on interpersonal factors.
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Affiliation(s)
| | | | - Marielle Ray
- Hunter College, City University of New York, New York, New York, USA
| | - Elizabeth Jeglic
- John Jay College of Criminal Justice and The Graduate Center, City University of New York, New York, New York, USA
| | - Regina Miranda
- Hunter College and The Graduate Center, City University of New York, New York, New York, USA
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18
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Hechinger M, Fringer A. Professional Care Experiences of Persons With Suicidal Ideation and Behavior: Model Development Based on a Qualitative Meta-Synthesis. JMIR Form Res 2021; 5:e27676. [PMID: 34709191 PMCID: PMC8587187 DOI: 10.2196/27676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 07/27/2021] [Accepted: 08/16/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Health care professionals (HCPs) are challenged in caring for persons with suicidal ideation or behavior. For affected persons, professional care is essential, and being interviewed about their experiences can be stressful. The experiences of persons ideating or attempting suicide are essential to designing eHealth products to support them in crises and provide continuous care. OBJECTIVE This study aimed to synthesize published qualitative research about how persons with suicidal thoughts or behavior experience inpatient or outpatient care. A model will be derived from the meta-synthesis to guide HCPs in their work with affected persons and provide a thorough needs assessment for eHealth development. METHODS A qualitative meta-synthesis was conducted using an inductive approach, as proposed by Sandelowski and Barroso. The inclusion criteria were studies in English and German that dealt with persons who ideated or attempted suicide. Relevant articles were identified by searching the PubMed and Cinahl databases and by hand searching relevant journals and reference lists. The findings of each study were analyzed using initial and axial coding, followed by selective coding. Finally, a conceptual model was derived. RESULTS In total, 3170 articles were identified in the systematic literature search. Articles were screened independently by 2 researchers based on the eligibility criteria. Finally, 12 studies were included. The central phenomenon observed among persons ideating or attempting suicide is their process from feeling unanchored to feeling anchored in life again. During inpatient and outpatient care, they experience being dependent on the skills and attitudes of HCPs. While helpful skills and attitudes support persons ideating or attempting suicide to reach their feeling of being anchored in life again, adverse interactions are experienced negatively and might lead to prolonging or maintaining the feeling of being unanchored in life. CONCLUSIONS The study promotes a differentiated view of the experiences of persons ideating or attempting suicide. The derived conceptual model can guide HCPs in their work with affected persons to support affected persons during their recovery. Moreover, the conceptual model is useable as a springboard to develop eHealth solutions for crisis situations and long-term care.
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Affiliation(s)
- Mareike Hechinger
- Institute of Nursing, School of Health Professions, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - André Fringer
- Institute of Nursing, School of Health Professions, Zurich University of Applied Sciences, Winterthur, Switzerland
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19
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A qualitative exploration of young people's experiences of attempted suicide in the context of alcohol and substance use. PLoS One 2021; 16:e0256915. [PMID: 34464418 PMCID: PMC8407575 DOI: 10.1371/journal.pone.0256915] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 08/18/2021] [Indexed: 11/19/2022] Open
Abstract
The aim of this study was to explore young people’s experiences of the role and the processes underpinning the use of alcohol and/or other substances in attempts to end their life. Seven young people, aged 16–25 years old, were interviewed using in-depth, semi-structured interviews. Interpretative Phenomenological Analysis was used to analyse these interviews and develop an understanding of how young people understand their attempted suicide in the context of alcohol and/or other substance use. The analysis identified four superordinate themes reflecting young people’s experiences across the seven interviews. Superordinate themes included: i) The complexity of relationships; ii) The double-edged sword of alcohol and substance use; iii) The straw that broke the camel’s back; and iv) Reflecting on the on-going processes of recovery. The results of this study highlight the complex and multifaceted functions of the consumption of alcohol, and other drugs, in the experiences of young people attempting suicide. Young people described a number of inter and intrapersonal factors which impact upon their suicidal experiences including suicidal ideation and attempts. Participants reported using alcohol and substances as methods of coping with distress, low mood, hearing voices, anxiety and mania. However they also reflected on the impact that this has on their own suicidal ideation and attempts.
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20
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Grattan RE, Karcher NR, Maguire AM, Hatch B, Barch DM, Niendam TA. Psychotic Like Experiences are Associated with Suicide Ideation and Behavior in 9 to 10 Year Old Children in the United States. Res Child Adolesc Psychopathol 2021; 49:255-265. [PMID: 33294964 PMCID: PMC8188961 DOI: 10.1007/s10802-020-00721-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2020] [Indexed: 11/26/2022]
Abstract
Those experiencing psychotic like experiences (PLEs) are at higher risk for suicide ideation and behavior. However, it is unclear if PLEs are related to suicide ideation and behavior in children, and whether other factors such as impulsivity or emotion dysregulation might moderate the relationship. We hypothesize that PLEs are associated with suicide ideation and behavior, with impulsivity and emotion dysregulation moderating this relationship, in middle childhood. History of PLEs, suicide ideation and behavior, depression, emotion dysregulation, and impulsivity were assessed for 10,624 children aged 9 to 10.9 years (47.8% female, 34.4% minority race, 20.0% Hispanic) as part of the Adolescent Brain Cognitive Development℠ study. Hypotheses about associations between variables were assessed using hierarchical linear modeling. PLEs were associated with suicide ideation and suicide behavior even when controlling for depression severity. Emotion dysregulation and impulsivity were also associated with suicide ideation and moderated the relationship between PLEs and suicide ideation. Variation in suicide ideation due to impulsivity and emotion dysregulation appears to be strongest when people are experiencing low levels to no PLEs. Only impulsivity and PLEs were associated with suicide behavior. Depression was associated with suicide ideation, but not suicide behavior. PLEs may be an important risk factor for suicide ideation and behavior in 9 to 10-year-old children, comparable to adult and adolescent populations. When considering prevention of suicidality, these data suggest that considering the relations between PLEs, impulsivity and emotion dysregulation may be important.
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Affiliation(s)
- Rebecca E Grattan
- Department of Psychiatry & Behavioral Sciences, University of California-Davis, 4701 X St, Sacramento, CA, 95817, USA
| | - Nicole R Karcher
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Adrienne M Maguire
- Department of Psychiatry & Behavioral Sciences, University of California-Davis, 4701 X St, Sacramento, CA, 95817, USA
| | - Burt Hatch
- Department of Psychiatry & Behavioral Sciences, University of California-Davis, 4701 X St, Sacramento, CA, 95817, USA
| | - Deanna M Barch
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Tara A Niendam
- Department of Psychiatry & Behavioral Sciences, University of California-Davis, 4701 X St, Sacramento, CA, 95817, USA.
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