Rozprawy doktorskie: „Suicidal behaviour”

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Ventrice, Domenico. "Memory traces of exposure to suicidal behaviour suicide attempters' memory traces of exposure to suicidal behaviour : a qualitative pilot study /". [S.l.] : [s.n.], 2009. http://www.zb.unibe.ch/download/eldiss/09ventrice_d.pdf.

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Duggan, Danielle Sherree. "Psychological Mechanism Underlying Suicidal behaviour". Thesis, University of Oxford, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.489433.

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The Intention of this thesis was to help elucidate psychological mechanisms underlying suicidal behaviour. Chapter one Introduces risk factors and current treatments for suicidal behaviour before going on to investigate whether a cognitive model of suicidal behaviour, 'the cry of pain', could add to our understanding of discrepant treatment findings, and provide new opportunities for understanding proximal risk factors for suicidal behaviour (in combination with the differential activation hypothesis).

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Kendall, Nicholas. "Psychological predictors of suicidal behaviour". Thesis, University of Canterbury. Psychology, 1989. http://hdl.handle.net/10092/6966.

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It is generally accepted that there is a rising suicide rate among young people in most Western Societies, and the literature is reviewed with particular reference to this. New Zealand statistics suggest there is reason to believe this trend has occurred here also. From the point of view of a psychological model there are at least two pertinent questions to ask regarding suicidal behaviour: (a) why is there a sudden rise in first-ever attempts at suicide at adolescence? (b) what psychological variables predispose an individual to engage in suicidal behaviour? One way to approach an answer to the first question is to examine suicidal behaviour across an age range, with reference to several psychological variables. For the present study data was collected from 34 subjects (14 males and 20 females) at Christchurch Public Hospital, who had either attempted to commit suicide, or had threatened to do so, or had presented to a crisis intervention service with prominent suicidal ideation. The following hypotheses were tested across an age range from the 13.0 years to 54.9 years (mean= 27.9; s.d.= 11.17): (i) that peer-related concerns in comparison to family concerns will be amplified for some adolescents' suicidal behaviour compared to other age groups, (ii) that suicide attempters may use different ways of coping in stressful encounters than suicide ideators and/or threateners, and (iii) that suicide attempters will score more highly on a measure of alexithymia than ideators and/ or threateners. Results indicated that, for this sample, family and peer-related concerns varied to a certain extent across age, but that neither were significant predictors of suicidal behaviour in multiple linear regresson analyses. With respect to the second hypothesis planful-problem solving was found to be related to a general measure of suicidal behaviour. Confrontive coping, escape-avoidance and planful-problem solving were found to be related to the more serious forms of suicidal behaviour. Age effects for coping style were not observed for this sample. With respect to the third hypothesis, alexithymia (at least as measured by the Toronto Alexithymia Scale) was found to be unrelated to suicidal behaviour of any type. The second question related to psychological variables which may predispose an individual to engage in suicidal behaviour. The depression, and alexithymia. Three analyses to elucidate causal factors were performed. The first found that depression was related to a general measure of suicidal behaviour, whilst both reasons for living and coping styles contributed to prediction of current suicidal feelings. The second analysis focused on the subscales, or parts of both reasons for living and coping styles. Evidence for the notion that individuals who used planful ways of coping with problems, and who had less fear of social disapproval with respect to suicide were more likely to engage in suicidal behaviour was observed. The third analysis involved a linear multiple regression model constructed from the data available from all the variables measured in the study. This analysis indicated that there were qualitative differences in psychological predictors across varying degrees of severity of suicidal behaviour. It is concluded that individuals who have engaged in the more serious variety of suicidal behaviour, especially serious attempts, used a coping style characterised by planful solving of problems, and confrontive action. Individuals who have engaged in a high frequency of suicidal ideation were characterised by their belief that it is worth not committing suicide because of what others might think of them, especially in terms of being weak and selfish or out of control. It is suggested that this concern over social disapproval is enhanced by our cultural taboo of suicide. With respect to current ideation, individuals were characterised by ownership of both the planful style of solving problems, and the belief that a reason to live is to avoid the disapproval of others. Limitations of the current research are discussed, as are methodological problems of suicide research in general. The small sample available for the study makes necessary the caution regarding the exploratory nature of the results advanced. Directions for future research are discussed, the single most important thread being that more research is both justified and needed.

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Aldridge, D. R. "Suicidal behaviour : An ecosystem approach". Thesis, Open University, 1985. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.371025.

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Cramer, Ryan. "Experiences of newly qualified south african psychologists dealing with suicidal behaviour". Thesis, Nelson Mandela Metropolitan University, 2016. http://hdl.handle.net/10948/5677.

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Suicidal behaviour is a phenomenon encountered the world over. Recognising and adequately dealing with such behaviours, in a professional setting, is a role expected of a psychologist. Working with suicidal behaviour is influenced by a variety of factors on the part of the psychologist. These may include, inter alia, experiences they may have had with suicidal behaviour, the training they have received in order to deal with such behaviours and their subjective experience of self-efficacy in dealing with such behaviours. The current qualitative study sought to explore and describe the experiences of recently qualified South African psychologists in dealing with suicidal behaviour through semi-structured interviews. The focus was on newly qualified clinical psychologists who received their masters training at a university in the Eastern Cape Province of South Africa. The study aimed to understand how confident, equipped, and ready newly qualified psychologists perceived themselves in dealing with suicidal behaviour. Three major themes emerged from the data. The first describes the strategies psychologists used in order to recognise potential suicidal behaviour, the second was how newly qualified psychologists managed suicidal behaviour, and the final theme described how psychologists could be prepared for their role to deal effectively with these behaviours. Investigating their experiences enabled the participants to contribute towards creating knowledge in this crucial area of psychological practice and allowed for the discovery of invaluable insights which could benefit the future training of psychologists.

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Fraser, Sydney Gordon. "Cognitive and behavioural strategies in the management of suicidal behaviour". Thesis, University of Leicester, 1987. http://hdl.handle.net/2381/34655.

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Study One of this research aimed to assess interpersonal problem-solving ability in individuals who evidenced suicidal behaviour. Suicide attempters were compared with mixed psychiatric outpatients and normal controls on a measure of means-ends problem-solving. The results of Study One suggested that suicidal individuals produced significantly fewer relevant means, story directed responses and sufficient narratives compared to both normal and psychiatric subjects. On qualitative indices of introspection, emotional relevant means and on time and obstacle recognition suicidals were significantly more deficient than control groups. Amongst suicidal subjects greater social dysfunction, stress and affective disturbance was associated with poorer interpersonal problem-solving. A model for the development of suicidal behaviour which suggested possible points of entry for intervention was proposed. In Study Two three treatment strategies for suicidal behaviour - Cognitive Therapy, Problem-solving Training and Psychiatric After Care were compared. In general the results suggested that all treatments were having some positive effects. The most significant changes in problem-solving skills occurred in the group receiving such training but improvement in this area was also noted in the Cognitive Therapy Group. It was proposed that aspects of Cognitive Therapy may have direct influence on problem-solving behaviour. Affective change seen at the end of eight weeks of treatment followed a different time course compared to cognitive change and the maintenance of such change to follow-up was shown to be dependent upon skills learnt during Cognitive Therapy and Problem-solving Training. Problem-solving Training had the most significant impact in improving social dysfunction and all treatments were shown to reduce suicidal ideation but at differing rates. One episode of suicide attempt occurred in the Psychiatric After Care Group representing a 6.25 percent rate of reoccurrence. It was concluded that the acquisition of interpersonal and cognitive skills held implications for the prophylaxis of suicidal behaviour. Suggestions for early primary intervention within the family and education systems were proposed.

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Rein, Amy Susan. "Sexual orientation and suicidal behaviour among adolescents". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape15/PQDD_0015/NQ37745.pdf.

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Heath, C. A. "Adolescent suicidal behaviour in context : expulsive patterns". Thesis, Cranfield University, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.260388.

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Panagioti, Maria. "Suicidal behaviour in post-traumatic stress disorder". Thesis, University of Manchester, 2011. https://www.research.manchester.ac.uk/portal/en/theses/suicidal-behaviour-in-posttraumatic-stress-disorder(0aa2d261-53de-41af-b3e6-e18316fb7806).html.

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A growing body of research has indicated that the levels of suicidal behaviour are particularly heightened among individuals with Posttraumatic Stress Disorder (PTSD). Two theoretical models of suicide, the Cry of Pain Model of suicide (CoP; Williams, 1997) and the Schematic Appraisals Model of Suicide (SAMS; Johnson, Gooding & Tarrier, 2008) have proposed that perceptions of defeat and entrapment are key components of the psychological mechanisms which drive suicidal behaviour. The SAMS has also emphasized the importance of psychological resilience factors for preventing suicide risk. Resilience to suicide has been recently defined as a set of appraisals which buffer the impact of risk factors on suicidal behaviour. The first aim of this thesis was to investigate the role of perceptions of defeat and entrapment in suicidal behaviour in those with full or subthreshold PTSD. The second aim of this thesis was to obtain empirical evidence for the presence of resilience factors to suicidal behaviour in PTSD. Initially, a comprehensive narrative review and a meta-analysis were conducted to examine the magnitude of the association between various forms of suicidal behaviour and a PTSD diagnosis and the role of comorbid depression in this association. Both, the narrative review and the meta-analysis demonstrated a strong positive association between suicidal behaviour and PTSD, and supported the mediating impact of comorbid depression in this association. A re-analysis of a previous dataset of individuals with PTSD was also pursued to establish the relevance of negative perceptions/appraisals to suicidal behaviour in those with PTSD. Next, three empirical studies were designed to investigate the utility of perceptions of defeat and entrapment in explaining suicidal behaviour in those with full or subthreshold PTSD. The outcomes across the three studies supported the hypothesis that defeat and entrapment represent the proximal psychological drivers of suicidal behaviour in PTSD and fully account for the suicidogenic effects of negative self-appraisals and PTSD symptoms. Two additional empirical studies were conducted to examine resilience factors to suicidal behaviour among individuals with full or subthreshold PTSD. The first of these studies provided evidence that high levels of perceived social support buffered the impact of PTSD symptoms on suicidal behaviour. The last study supported the efficacy of a resilience-boosting technique, the Broad-Minded Affective Coping procedure (BMAC), to enhance the experience of positive emotions and improve mood amongst individuals diagnosed with PTSD. Together, the current results support the SAMS' postulation concerning the role of perceptions of defeat and entrapment in the emergence of suicidal behaviour in PTSD and highlight the importance of boosting resilience as a means of targeting suicidal behaviour in those with PTSD. Clinical implications of these findings are outlined throughout the thesis.

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Liu, Ka-yuet. "Pathways to Suicidal Behaviour : A Mechanism-Based Approach". Thesis, University of Oxford, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.504109.

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Herrera, Rodríguez Andrés. "Heaven can wait : studies on suicidal behaviour among young people in Nicaragua". Doctoral thesis, Umeå universitet, Psykiatri, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-944.

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In developed countries, suicidal behaviour is recognised as a significant public health problem among young people, but there are few studies from developing countries on this subject. The present thesis aims at estimating the extent of the problem and at exploring factors related to suicidal behaviour among young people in a developing country, Nicaragua, using a combined quantitative and qualitative approach. Three studies were conducted between 1999 and 2006. In the first study, all hospital admitted suicide attempt cases in the area of León were assessed over a three year period. Secondly, a qualitative study using individual in-depth interviews was conducted with eight girls aged between 12 and 19 admitted to hospital after attempting suicide. Thirdly, a study using the Attitudes Towards Suicides (ATTS) questionnaire was conducted in a community based sample of 278 young people aged 15-24 years to assess own suicidal behaviours, attitudes towards suicide as well as exposure to suicidal behaviour among significant others. The hospital surveillance showed that suicide attempt rates were highest among females in the age group 15-19 years with a female rate three times that of males (302.9 versus 98.9 per 100,000 inhabits per year). Drug intoxication and pesticides were the most commonly used methods for the attempts. A consistent seasonal variation with peaks in May-June and September-October was found in each of the three years, possibly related to exam periods in schools. Findings in the qualitative approach led to a tentative model for pathways to suicidal behaviour based on four main categories: Structuring conditions, triggering events, emotions and action taken. Dysfunctional families, lack of confidential and trustworthy contacts and interpersonal conflicts followed by emotions of shame and anger were some important components in the model. The community studies showed that suicidal expressions (life-weariness, death wishes, suicidal ideation, suicide plans and suicide attempts) were common among young people where more than 44.8% of males and 47.4% of females reported some kind of suicidal expression. Gender differences were small. Exposure to suicidal behaviour among others was associated with higher levels of self-reported suicidal behaviour. The attitude study showed that boys had less pro-preventive attitudes than girls, possibly indicating their higher risk for completed suicide. Exposure to suicidal behaviour and own suicidal behaviour showed an association with specific patterns of attitudes. The findings should be taken into consideration when planning for prevention of suicidal behaviour among young people in a developing country like Nicaragua.

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Hirsch, Jameson K., Jon R. Webb i Elizabeth L. Jeglic. "Forgiveness as a Moderator of the Association Between Anger Expression and Suicidal Behaviour". Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/678.

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Anger is often associated with poor physical and mental health, including suicidal behaviour. Anger expression is typically conceptualised as inward or outward-directed, with each mode of expression having potentially different aetiologies and health manifestations. Individual characteristics such as religion or spirituality may buffer against the effects of anger. One such characteristic, forgiveness, is the voluntary process of changing ones’ beliefs, behaviours, and emotions towards a transgressor from negative to positive. We examined forgiveness of self, forgiveness of others and feeling forgiven by God as moderators of the relationship between anger expression and suicidal behaviours in a sample of 372 ethnically diverse college students. In independent and full models, we found that forgiveness of self was a significant moderator of the association between inward and outward anger and suicidal behaviour. Interventions targeting anger via the promotion of forgiveness may be useful in the prevention of suicide ideation and attempts.

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Goodfellow, Benjamin. "Terms and Definitions for Suicide: Steps Towards the Elaboration of an International and Intercultural Nomenclature for Suicidal Behaviours". Thesis, Griffith University, 2018. http://hdl.handle.net/10072/382741.

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Variability in terms and definitions to describe suicidal behaviours and ideation may have led researchers to duplicate their efforts in suicidology thereby possibly wasting valuable resources in a field where funding is scarce. Published nomenclatures appear not to reach a global use. This situation pushed some scholars to advocate for the use of a common nomenclature and a common classification to describe suicidal behaviour that would appeal to the majority of users, whatever their background and whichever their country. A first step towards a universal nomenclature could be to assess the variability of use of definitions and terms. The aims of this dissertation are to describe the published background in the field of nomenclatures, definitions and classifications, and provide a historical and cultural context to the use of terms and definitions to describe suicidal behaviours and ideation. The experimental part of this research consists in a worldwide study of definitions and terms for suicidal behaviours, the results of which were used to elaborate a universal English-language nomenclature of suicidal behaviours. A systematic literature review of contemporary English language nomenclatures found them to be logically organized according to outcome and intent. It appeared that the range of the nomenclatures was fundamental in how the nomenclature were logically organized. A systematic review of terms and definitions was performed based on the four most common characteristics of the definition of suicide found in the literature, i.e. outcome, intent, knowledge of the consequences of the act, and agency (self- or other-inflicted). These four characteristics appeared to cover the vast majority of the concepts underpinning existing definitions, enabled an explanation of the variability of published definitions and were considered for use as tool for research. Intent to die in the definition of suicide was quite agreed upon. However, some authors suggested that intent should refer to something other than death. A systematic review of contemporary classifications of suicidal behaviour revealed they were becoming increasingly precise and operational for clinical and research purposes. On the other hand, the development of new classification systems despite lack of international consensus on definitions and terms related to suicidal ideation and behaviour could potentially lead to an increased level of confusion. An examination of historical context revealed that the term ‘suicide’ appeared in Europe in a period of deep moral change during the seventeenth century, when attitudes toward suicide became more tolerant. A review in the Pacific Islands suggested that local traditional terms often referred to a method having close ties with the cultural context. The methodology of the Worldwide Study of Definitions and Terms for Suicidal Behaviors© (WSDTSB) was then described. The study rationale was to overcome the confusing landscape and poor agreement among authors of nomenclatures, definitions, terms, and classifications in the field of suicidology. The study questionnaire was developed on the basis of the four main criteria of the definition of suicidal behaviour: outcome, intent, knowledge (of the consequences of the act), and agency (self- or other-inflicted). Two types of participants were invited in the study. ‘Experts’, each representing a country, were recruited through international organizations. IASP members that were not national representatives comprised the comparison sample. Methodological limitations were that the study was conducted in the English-language only, and ‘experts’ were designated among IASP national representatives and in six cases among other international associations; in some cases, it is possible that these persons did not have more expertise than IASP members. The results of the WSDTSB were then analysed. Levels of agreement to statements enabled comparison between responses of samples (‘experts’ vs. IASP members), and countries’ language and income background groups, occupation and professional background groups. Regarding the definition of suicide, the highest levels of agreement and similarities between samples and groups were found for fatal outcome, non-clear-cut statements regarding intent and knowledge, and self-infliction. Regarding non-fatal suicidal behaviour and ideation, the highest levels of agreement and similarities between samples and groups were found for definitions of ‘suicide attempt’, ‘suicidal ideation’, ‘death wishes’, ‘suicide plan’, and ‘interrupted suicide attempt’. The results of the WSDTSB were discussed and a nomenclature of suicidal behaviours and ideation was proposed as a baseline for further steps towards a universal classification of suicidal behaviours and ideation. Other limitations of this study were a relatively low participation rate and the low representation of low- and middle-income countries, especially those of the African continent. The necessity to go further in the search of a universal nomenclature was discussed. It was suggested that further research should move on with the aim of elaborating a universal classification of suicidal behaviours possibly based on the results of the present study. Suggestions were made regarding further steps to take.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
Aust Inst Suicide Res&Prevent
Griffith Health
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Matheson, Gail. "Does the theory of planned behaviour predict suicidal intent?" Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp03/NQ62327.pdf.

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Mittendorfer, Rutz Ellenor. "Perinatal and familial risk factors of youth suicidal behaviour /". Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-476-7/.

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Lopez-Morinigo, Javier David. "Suicidal behaviour in early psychosis : the role of insight". Thesis, King's College London (University of London), 2017. https://kclpure.kcl.ac.uk/portal/en/theses/suicidal-behaviour-in-early-psychosis(03f6d65e-6844-4c02-9229-b7c5b5c11765).html.

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Early psychosis is a high-risk period for suicide. Of concern, suicide rates in psychosis have increased over recent years. Several risk factors have been established, including being male, white, recent loss, previous suicide attempts, depression, illegal drug use and agitation/restlessness. Although insight has been consistently associated with positive outcomes in psychosis, concerns have been voiced regarding the potential link between insight and increased suicidality. Thus, this thesis commences with a literature review on this topic, which reported mixed results and methodological limitations in previous studies, which were addressed in this investigation. Real-world data on suicides by patients with schizophrenia from the South London and Maudsley NHS Foundation Trust are also presented, which supports further the necessity for this work. Data from three large cohorts of first-episode psychosis (FEP) patients from the UK (n=112-181) and Spain (n=397) were analysed to ascertain the role of multiple insight dimensions (illness recognition, symptoms relabelling, awareness of the social consequences and awareness of the need for treatment) in risk for suicidal behaviour. Although bivariate analyses showed significant relationships between insight levels and risk of suicidal behaviour, only previous suicide attempts and depression, both of which were linked with insight, survived the multivariate analyses, hence emerging as the main predictors of suicidal behaviour. In other words, suicidal history and depression appear to explain the apparent association of insight with suicide risk in psychosis. Hence, no evidence was found supporting a direct relationship between insight and suicidal behaviour in early psychosis despite common assertions to the contrary, which has implications on clinical practice and future research. Insight, which is linked with better outcomes, does not increase suicidality. Guidelines should therefore prioritise improving insight interventions (e.g. talking therapies or antipsychotics) from first presentation with psychosis and future studies may examine whether this reduces suicide rates.

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Maloney, Elizabeth Ann National Drug &amp Alcohol Research Centre Faculty of Medicine UNSW. "Opioid dependence: associations with suicidal behaviour and other psychiatric comorbidity". Publisher:University of New South Wales. National Drug & Alcohol Research Centre, 2008. http://handle.unsw.edu.au/1959.4/41455.

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Suicide attempts and opioid dependence are important clinical issues, as both are associated with a high degree of psychiatric morbidity and elevated risk of mortality. Research has identified a number of risk factors for suicide attempts among the general population, and to a lesser extent, among heroin users. Due to a lack of case-control studies, however, it is still not known to what extent opioid dependence per se is a risk factor for suicide attempts. This thesis comprised the first study to directly examine whether opioid dependence is a unique risk factor of suicide attempts. This thesis examined suicide attempts, associated risk factors, and related comorbidity among an opioid-dependent case group and a non-opioid-dependent control group. A structured interview was used to collect data from 726 opioid-dependent cases and 399 non-opioid-dependent controls. This thesis identified a number of important findings. Firstly, although opioid-dependent individuals were more likely to report lifetime suicide attempts compared to controls, the risk factors were largely the same for both groups. It appeared that opioid-dependent individuals were characterised by a higher likelihood of the same risk factors for suicide attempts, rather than having different risks. Cases appeared to be at increased risk of suicide attempts because of increased levels of multiple risk factors. Secondly, borderline personality disorder (BPD) and impulsivity were identified as important risk markers for suicidal behaviour, especially among opioid-dependent individuals. The study concluded that the treatment of BPD should be prioritised among this group. Third, self-mutilation was identified as a clinically significant problem in its own right, however, when combined with a history of attempted suicide, the psychological dysfunction observed was found to be very high. Fourth, non-fatal opioid overdose and suicide attempts were found to be distinct behaviours. The risk factors for each were completely different. While drug-related risks were associated with non-fatal overdose, the risk markers for suicide attempts were related to the presence of psychological disorders. This thesis has highlighted important areas of concern for clinical interventions as well as for future research to explore. Considering this is the first study of its kind, future research should focus on its replication.

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Idenfors, Hans. "Young people's contact with healthcare before and after suicidal behaviour". Doctoral thesis, Umeå universitet, Psykiatri, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-120699.

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Background Self-harm is a major and growing public health issue among young people worldwide. Self-harm is an important risk factor for suicide, which is one of the leading causes of death for young people. Although suicide rates are declining overall, this trend is not seen in young people. Young people with mental distress and/or suicidal thoughts are reluctant to seek help, and often drop out of treatment initiated after a self-harm episode. Many young people who self-harm have had contact with healthcare before their first self-harm episode, but often for reasons other than suicidal thoughts or psychiatric problems. In this context, physical illness is associated with increased risk for self-harm and suicide among young people. The present thesis investigated how young people perceived the help and support they received before and after an episode of self-harm. A further aim was to map the inpatient somatic healthcare contacts young patients had before an episode of self-harm, and determine any relationship to risk for self-harm and suicide. Method Four studies were conducted using qualitative and quantitative methods. Participants were people aged 16-24 years. The definition of self-harm was based on the intentional self-harm criteria in the International Classification of Diseases, tenth revision, which includes all forms of self-harm without ascribing suicidal intent. In the first two studies, 10 respective 9 participants with a first healthcare contact for self-harm were interviewed during 2009-2011. The interviews covered participants’ knowledge and experience of professional care before their healthcare contact for self-harm. Participants were interviewed a second time 6 months later about their experiences with professional care during the period since their initial interview. Qualitative content analysis was used for all interviews. For the next two studies, we selected 16,235 participants with a first hospitalisation for self-harm during 1999-2009 from the Swedish National Inpatient Register. These cases were compared with matched controls to determine the odds of having been admitted with a non-psychiatric diagnosis during the year preceding the self-harm admission. To assess risk for suicide, data were retrieved from the Swedish Cause of Death Register for all deceased participants until 2013, and group differences were determined using survival analysis. Results In the first interview, participants described how they wanted more information on where they could turn for professional help. They also wanted different help-seeking pathways and emphasised the importance of the quality of professional contact. After 6 months, participants stressed the importance of being able to rely on professionals and treatment. Their life circumstances significantly affected their treatment, and practical help was appreciated. The register studies showed that young people admitted for self-harm were more likely to have been hospitalised with symptomatic diagnoses such as abdominal pain and syncope/collapse, and somatic illnesses such as epilepsy and diabetes mellitus type 1. A higher proportion of cases (4.5%; women 2.6%, men 8.8%) died during the study period than controls (0.3%; women 0.2%, men 0.6%) (p<0.001). For both cases and controls, a higher proportion of those with a previous somatic admission died from suicide during the study period than those without a somatic admission (cases: 4.2% vs. 2.8%, p<0.05). For cases with a somatic admission, the hazard ratio was 1.43 (95% confidence interval 1.04-1.98) compared with those without somatic admissions (controlled for age, sex and psychiatric admission). Survival of cases with a previous somatic admission compared with those without was 98.4% versus 99.2% after the first year, 97.8% versus 98.9% after the second year, and 95.5% versus 96.9% after the tenth year. Conclusion These findings suggest that healthcare providers need to find new ways to reach young people at risk for suicidal behaviour. Access to professional help should be easy and direct. Treatment for young people after self-harm should be flexible, and be receptive to input from the patient. The importance of and need for basic practical help should not be overlooked. Somatic healthcare contact provides an opportunity for intervention, particularly as psychiatric problems can manifest as physical symptoms, and physical illness is a risk factor for self-harm and suicide.

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Barnett, Leda R. "First Australian Holistic Health: Development of a Multi-Dimensional Model of Suicidal Ideation and Suicide-Related Behaviour". Thesis, Griffith University, 2020. http://hdl.handle.net/10072/399972.

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Despite the prevalence of First Australian deaths by suicide there is a lack of services developed and delivered by First Australians and limited evidence for the effectiveness of mainstream programs. This dissertation is focused on developing a better understanding of First Australian suicidal ideation and suicide-related behaviours in order to inform effective responses to suicide in our communities. As a First Australian researcher I subscribed to a research model based on an Indigenist paradigm. The Indigenist paradigm entails a cultural alliance with the First Australian community and participants in this research. My enculturation as a First Australian obliges me to work with the First Australian community to pursue emancipation by challenging structures and societal issues that oppress First Australians. My established professional, family and personal relationships within the First Australian community in the regional city of Mackay (Queensland, Australia) facilitated my engagement with the community in this research. My engagement with this research began at the time of a cluster of deaths by suicide of First Australian youth within Mackay’s First Australian community. I participated in an initial investigation of this suicide cluster to strengthen the community’s knowledge about deaths by suicide. My work has been overseen by an Indigenous Critical Reference Group consisting of highly respected community representatives. Given deaths by suicide continued to affect Mackay’s First Australian community, the Indigenous Critical Reference Group requested a deeper understanding of the issues that needed to be addressed and proposed my involvement in continued research. Their request led to this thesis, ensuring that this dissertation represents true community-driven research. To respond to the request of the Indigenous Critical Reference Group, I revisited the initial investigation. During the initial interviews, some participants shared their own personal experiences of suicide-related behaviours and suicidal ideation. It was envisaged further investigation of these interviews would provide valuable insight into antecedents and precursors beyond what was available in coroners’ reports. The 14 interviews included in this research are comprised of three (M=0, F=3) participants who shared their own experiences of suicide-related behaviour and eleven (M=3, F=8) participants who shared their own experiences of suicidal ideation. These participants’ interview transcripts were reviewed and the portions of the transcripts directly relating to their suicide-related behaviour and suicidal ideation were re-analysed. The findings of this analysis were discussed with key informants and Critical Reference Group members to build an explanatory model, which is described in this thesis. In subscribing to an Indigenist research paradigm, my cultural identity and experiences as a First Australian informed the entire research project, making me a participant-observer. My partnership with Mackay’s First Australian community, especially in my relationships with the Indigenous Critical Reference Group members and the research participants, featured collective ownership of the research process to produce research outcomes that initiate change. I conducted qualitative interviews with research participants who had engaged in suicide-related behaviours or experienced suicidal ideation. To deepen the analysis of the qualitative data, I developed a data analysis matrix defined by the intersection between five health domains (drawn from a First Australian perspective on holistic health) and the three dimensions of experience (time, space and distance). The latter dimensions allowed me to establish a broader context of participants’ life experiences. The data analysis matrix enabled analysis from multiple perspectives to provide a more comprehensive understanding of participants suicide-related behaviours and suicidal ideation. To broaden my understanding even further, I approached the interviews and analysis from the perspective of a multi-layered Ecological Theory incorporating the micro, meso, exo, macro and chrono-systems (see Chapter 1). This Ecological Theory ensured that I examined the data and my interpretation from a complex rather than simplistic perspective. Data analysis was conducted in three phases. The first phase involved analysing participants’ experiences to develop an understanding of the Social, Intellectual, Physical, Emotional and Spiritual (SIPES) domains of health. In the second phase, participants’ SIPES experiences were analysed across the dimensions of time, space and distance. The third and final phase comprised meetings with Indigenous Critical Reference Group members, alongside ongoing engagement with the data, to develop an explanatory model, namely the Empowerment to Prevent Suicidality (EPS) Model, that depicts First Australian experiences of suicidal ideation and suicide-related behaviours. The EPS Model emphasises the social and spatial nature of suicidality, located in the interpersonal environment and the places that have most meaning to people. Rather than being a personal and emotional experience, suicidal ideation and suicide-related behaviour begins in a social spatial context of powerlessness where it escalates until it reaches an emotional threshold. Once the emotional threshold has been breached, the energy created is driven by a sense of urgency that is steeped in history, judgements about the future, physical and emotional distancing and spatial/social influences or reactions. This distress-filled period often continues until such time as there is an intellectual realisation, usually triggered and supported by a social ally. The role of the ally is as a social guide who can prompt a shift into an empowerment cycle where people can again take control over their time, space and connections in a more positive way. Allies, unlike many other social connections that dominated the chaotic environment, refused to be complicit in defining a space that trapped participants and instead created a space that allowed participants to move to safety. Many traditional medical responses to deaths by suicide rely on interventions delivered by authorities. These authorities are steeped in the historical, social/spatial and interpersonal challenges that contributed to cycles of chaos and powerlessness in the first place. Consequently, these interventions often contribute to further powerlessness. Rather than contributing to powerlessness, interventions for First Australians must focus on strategies for facilitating empowerment at crucial points in time, addressing the powerlessness cycle and preventing threshold breaches. Interventions for First Australians must focus on development and mobilising social allies and building safe empowering spaces, but also allowing the time to support people back to a place of empowerment. Most importantly, interventions must recognise and respect the social/spatial nature of First Australian suicidality rather than focusing on individual mental health conditions. The First Australian experience of suicidality identified in my research has been investigated through a culturally informed method of acquiring and interpreting information that has revealed a new way of thinking about suicidality. This research highlights features of First Australian experiences of suicidality that can be integrated into interventions, particularly in the case of clusters of youth deaths by suicide. Findings suggest a more effective approach to address First Australian suicidality can be developed using a social/spatial orientation, that is mindful of history and the impact of time on First Australian people. Additionally, it is important to examine the connections and disconnections that have occurred in First Australian people’s lives to understand ways in which the social environment facilitates suicide-related behaviours and triggers shifts into both powerlessness and empowerment.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Human Serv & Soc Wrk
Griffith Health
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McDermott, Laura. "An interpretative phenomenological analysis of the lived experience of suicidal behaviour". Thesis, University of Glasgow, 2016. http://theses.gla.ac.uk/7569/.

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Background: In Scotland, suicide prevention is a major public health challenge, with two people, on average, dying every day due to suicide. Any efforts to prevent suicide should be aided by research. Existing research on suicide is dominated by quantitative research that has largely focused on providing explanatory accounts of suicidal phenomena. Research providing rich and detailed accounts of suicidal behaviour among individuals who have directly experienced it is growing but remains relatively embryonic. This study sought to supplement existing understanding of attempted suicide specifically by exploring the processes, meaning and context of suicidal experiences among individuals with a history of attempted suicide. Methods: The study used a retrospective qualitative design with semi-structured in-depth interviews. Participants were patients (n=7) from a community mental health service in Glasgow, Scotland who had attempted suicide within the previous 12-month period. The interviews were transcribed verbatim and were analysed for recurrent themes using interpretative phenomenological analysis (IPA). Results: Three super-ordinate themes, each with inter-related sub-themes, emerged from the analysis. 1) “Intentions”: This theme explored different motives for suicide, including providing relief from upsetting feelings; a way of establishing control; and a means of communicating with others. 2) “The Suicidal Journey”: This theme explored how individuals’ thinking can change when they are suicidal, including feeling overwhelmed by a build-up of distress and a narrowing of their perspective. 3) “Suicidal Dissonance”: This theme explored how people can feel conflicted about suicide and can be fearful of the consequences of their suicidal behaviour. Conclusion: Participants’ accounts were dominated by experience of significant adversity and psychological suffering. These accounts provided valuable insights into the suicidal process, highlighting implications for clinical practice and future research.

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Meissner, Birte Linda. "Attitudes, beliefs and myths about suicidal behaviour : a qualitative investigation of South African male students". Thesis, Stellenbosch : Stellenbosch University, 2013. http://hdl.handle.net/10019.1/80464.

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Thesis (MSc) -- Stellenbosch University, 2013.
ENGLISH ABSTRACT: Suicidal behaviour is a serious public health problem. Globally and in South Africa a gendered pattern of suicide rates has been observed, with males being more likely to kill themselves than females. To date little quantitative and qualitative research is available on young male suicidal behaviour in South Africa. This study investigated the attitudes, beliefs and myths young male students hold about suicidal behaviour. Thirteen male university students (ages 20 to 25 years; with and without a history of suicidal behaviour), who volunteered to take part in the present study in response to an email invitation, were interviewed. The attitudes, beliefs and myths identified from the qualitative data are grouped into four themes: 'Moral acceptability of suicidal behaviour', 'Perceived causes and risk factors of suicidal behaviour', 'Perceived motives of suicidal behaviour', and 'Perceived prevention and protective factors of suicidal behaviour'. Besides these four themes, two underlying narratives are identified and discussed: (1) 'Apart or a part: Belonging and suicidal behaviour' is centred on the idea that perceiving oneself to be an integral part of a social system is protective against suicidal behaviour, while a thwarted sense of belonging increases vulnerability to suicidal behaviour. (2) 'Dying to be a man: (Re) negotiating masculinity and suicidal behaviour' is concerned with participants' views that men's relational position to hegemonic (socially most dominant) forms of masculinity is a factor in male suicidal behaviour. Participants regard hegemonic forms of masculinity to be both a part of the problem of suicidal behaviour and a potential solution to suicidal behaviour. These findings are interpreted through a social constructionist lens of gender as performance. Finally, implications of findings for future research, prevention and treatment are discussed.
AFRIKAANSE OPSOMMING: Selfmoordgedrag is 'n ernstige openbare gesondheidsprobleem. Wêreldwyd en in Suid-Afrika is mans meer geneig as vrouens om selfmoord te pleeg. Tot op hede is daar min kwantitatiewe en kwalitatiewe navorsing beskikbaar van jong manlike selfmoordgedrag in Suid-Afrika. Hierdie studie ondersoek die houdings, oortuiging en mites oor selfmoordgedrag van jong manlike studente. Dertien manlike universiteitstudente (ouderdomme 20 tot 25 jaar, met en sonder 'n geskiedenis van selfmoordgedrag) het vrywillig aan die huidige studie deel geneem in reaksie op 'n e-pos uitnodiging. Die houdings, oortuiging en mites wat vanaf die kwalitatiewe data geïdentifiseer is, is in vier temas gegroepeer: 'Morele aanvaarbaarheid van selfmoordgedrag', 'Siening van die oorsake en risiko faktore van selfmoordgedrag', 'Waargenome motiewe van selfmoordgedrag', en 'Waargenome voorkoming en beskermende faktore van selfmoordgedrag'. Naas hierdie vier temas, is twee onderliggende temas geïdentifiseer en bespreeek: (1) 'Samehorigheid en selfmoordgedrag' is gemoeid met die idee dat om 'n integrale deel van 'n sosiale sisteem te wees is beskermend teen selfmoordgedrag, terwyl 'n persepsie van isolasie tot selfmoordgedrag kan lei. (2) 'Onderhandeling van manlikheid en selfmoordgedrag' is gemoeid met die deelnemers se sienings dat mans se verhouding tot hegemoniese vorme (sosiaal mees dominante vorme) van manlikheid 'n faktor in manlike selfmoordgedrag is. Deelneemers beskou hegemoniese vorme van manlikheid as beide 'n deel van die probleem en 'n moontlike oplossing vir selfmoordgedrag. Hierdie bevindinge is geïnterpreteer deur middel van 'n sosiale konstruksionistiese lens van geslag as prestasie. Die implikasies van die bevindings vir toekomstige navorsing, voorkoming en behandeling word ten slotte bespreek.

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Dale, Rosanna. "The role of parental bonding and early maladaptive schemas in suicidal behaviour". Thesis, University of Edinburgh, 2007. http://hdl.handle.net/1842/24508.

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60 participants completed the study following their presentation at Accident & Emergency with suicidal behaviour, and routine Liaison Psychiatry psychosocial assessment. A semi-structured interview was conducted, in which participants completed measures of parental bonding (Parental Bonding Instrument); schemas (Young Schema Questionnaire); suicidal intent (Pierce Suicide Intent Scale); risk of repeating suicidal behaviour (Risk of Repetition Scale); anxiety (Beck Anxiety Inventory); and depression (Beck Depression Inventory). In the first phase of the study, measures of parental bonding, schemas, anxiety and depression were compared between this suicidal behaviour group and a primary care mental health group and a non-clinical group, collected in a previous study. The second phase of the study utilised a within-group design and examined relationships on all measures within the suicidal behaviour group. Initial analysis of variance exploration indicated that the three groups significantly differed on measures of anxiety, depression, parental care/control and schemas. Post-hoc analysis demonstrated that there were no significant differences, however, between the suicidal behaviour group and primary care mental health group on measures of parental bonding. Within the suicidal behaviour group, significant associations were indicated between parental care and risk of repetition; parental control and risk of repetition; and schemas and risk of repetition. Suicidal intent was not found to be associated with any of the variables. Schemas were found to mediate the relationship between parental bonding (care and control) and risk of repetition. Further, the schema of Social Alienation was found to mediate the above relationship between parental bonding (care and control) and risk of repetition. The schema of Defectiveness/Shame was found to mediate the relationship between parental control and risk of repetition. The findings support a 3-stage model for suicidal behaviour.

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Herrera, Rodríguez Andrés. "Heaven can wait : studies on suicidal behaviour among young people in Nicaragua /". Umeå : Univ, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-944.

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Lalovic, Aleksandra. "The relationship between lipid metabolism and suicidal behaviour : clinical and molecular studies". Thesis, McGill University, 2007. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=103207.

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Suicide continues to claim hundreds of thousands of lives worldwide each year, in spite of the significant progress of research efforts aimed at understanding the complexity of this tragic behaviour. Data accumulated over the last decades suggest a certain biological predisposition to suicidal behaviour. Among the possible biological risk factors, cholesterol has frequently been cited. Several lines of evidence support the relationship between altered lipid metabolism, particularly low levels of serum cholesterol, and suicidal behaviour, yet the possible mechanisms governing the relationship remain to be elucidated. Three separate strategies were employed in order to explore the link between lipid metabolism and suicidal behaviour, each one from a novel perspective on this issue. The first approach aimed to substantiate the existing evidence of an association between low serum cholesterol and suicidality by examining psychiatric data, suicidality and related behavioural characteristics in a sample of Smith-Lemli-Opitz syndrome heterozygotes---a clinically normal population with altered cholesterol metabolism due to an inherited partial deficiency in the 7-dehydrocholesterol reductase enzyme---compared with controls. The second approach consisted in measuring the lipid profile in brain tissue from suicide completers, in order to address whether there are alterations in cholesterol and/or fatty acids in the brain. The final approach involved the use of exploratory gene expression studies to identify novel candidate genes and proteins that may be involved in mediating the link between lipid metabolism and suicidality. The results of these studies will be presented and discussed.

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Moloney, Anne. "Substance misuse in women prisoners : relationship to self-harm and suicidal behaviour". Thesis, University of Manchester, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.492841.

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Prevalence rates of substance misuse among prisoners are significantly higher than rates among the general population. Prevalence rates of self-harm and suicidal behaviours are higher in female prisoners when compared to male prisoners. Substance misusers are known to be at increased risk of suicide during the early period of custody. There is a gap current knowledge regarding the relationship between substance misuse, self-harm and suicidal behaviour in women prisoners.

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Caldera, Aburto José Trinidad. "Mental health in Nicaragua : with special reference to psychological trauma and suicidal behaviour". Doctoral thesis, Umeå universitet, Psykiatri, 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-346.

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This thesis explores mental health problems relating to war and natural disaster and suicidal behaviour in the Nicaraguan population. The more specific aims of the study were to assess the prevalence and sociodemographic correlates of mental disorder in a community-based study during time of war (Paper I), to assess the mental health impact of Hurricane Mitch in 1998 (Paper II), to assess the incidence of hospitalized parasuicide cases and groups at risk (Paper III), and to examine suicide intent among attempters relating to gender, suicide method and sociodemographic factors and identify predictors for repetition of an attempt (Paper IV). Method: Based on 4453 family food ration books for families living in an urban area of León, Subtiava, 219 families including 746 adults were selected through a systematic sampling procedure. The study was conducted in 1987 during the war. We were able to reach 584 adults for interview according to the Present State Examination for ICD-9 diagnoses and Self-Report Questionnaire (Paper I). In Paper II, 496 adult primary health care attendees were interviewed six months after Hurricane Mitch according to the Harvard Trauma Questionnaire and were diagnosed for post-traumatic stress disorder (PTSD) according to DSM-IV. In Papers III and IV, all cases from León city admitted to HEODRA Hospital for a suicide attempt over a three-year period (n=233) were interviewed regarding sociodemographic factors and method, time and place of the suicide attempt. A subgroup of 204 cases was interviewed using the Suicide Intent Scale (SIS). Out of those 106 cases were followed-up regarding repetition of attempt or completed suicide after a mean period of 1172 days. Results: In the Paper I study, the one-month prevalence of any mental disorder was 28.8% for men and 30.8% for women. Among men, alcoholism was the most common diagnosis, whereas neurosis, crisis reaction and depression were dominant among women. Alcoholism was scored as the second most severe disorder after psychosis in terms of functional level. In the Mitch study six months after the hurricane, traumatic events were common and 39% reported death or serious injury of a close relative as a result of the hurricane. The prevalence of PTSD ranged from 4.5% in the least damaged area to 9.0% in the worst damaged area. At the prolonged follow-up six months later, half of the cases still retained their diagnosis. Trauma-related symptoms were common and death of a relative, destroyed house, female sex, illiteracy and previous mental health problems were associated with a higher level of symptoms. Suicidal ideation was reported among 8.5% and was significantly associated with previous mental health problems and illiteracy. The studies regarding hospitalized parasuicides showed the highest rate among girls aged 15–19 years (302 attempts per 100 000 inhabitants and year). After drug intoxication, pesticide was the second most common method and most often used by men (23%). Half of the women had recent contact with health care services before attempting suicide. There were significant peaks regarding time of attempt in terms of seasonal and diurnal distribution. Overall scores regarding seriousness of the intent (SIS) were equal between the sexes, but the pattern of SIS items showed significant gender differences in terms of relation to background factors and method used. For women, having a child was one factor associated with higher seriousness. Factor analysis of SIS items revealed a four-factor solution, explaining 59% of the variance. Risk for fatal repetition was 3.2% after three years and for non-fatal repetition 4.8%. During follow-up, three men (11%) had completed suicide but no women. We failed to identify any predictors for repetition from background factors or SIS. Conclusion: The studies have identified different groups at risk for mental health problems relating to war and disasters. Parasuicide rates equalled those from European countries. Whereas young girls dominated, attempts among men were more severe in terms of the methods used and completed suicide at follow-up. SIS seemed to give a meaningful pattern among women but not for men. In our study, seriousness of attempt in terms of method or suicide intent did not predict repetition. Overall non-fatal repetition rate was very low as compared to other studies.

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White, Jennifer H. "Understanding married women's suicidal behaviour : counsellors' perceptions of self-concept and marital dynamics". Thesis, University of British Columbia, 1991. http://hdl.handle.net/2429/31221.

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Counsellors' perceptions of married suicidal women were investigated through a qualitative analysis of counsellors' clinical records and follow-up interviews. Four suicide intervention counsellors, ranging in age from 29 to 52, who collectively had 24 years of experience at a suicide intervention counselling agency were the subjects in this study. The experiences of their clients - three suicidal women and one husband of a suicidal woman - provided the material for the analysis of counsellors' clinical reports and follow-up interviews with the investigator. The suicidal women ranged in age from 20 to 41 and the husband was 34 years old. Analysis consisted of three concurent activities: data reduction, data display, and drawing/verifying conclusions. The clients, including one husband were found to suffer from negative self-concepts, previous suicide attempts, depression, and yet they indicated a willingness to get help. According to counsellors, the three wives could be characterized as "overfunctioning", fearful of spouses, prone to minimizing abuse, and committed to the relationships "at any cost." Counsellors found that husbands of the suicidal women tended to abuse alcohol and had explosive tempers. The marital relationships were characterized by intimacy problems, communication problems, and dependency. The families of the clients were found to be plagued by alcoholism, abuse, and mental illness. Counselling approaches included personal empowerment of client, educating about abuse, use of outside resources, making links with the past, and coaching on certain skills. The findings were meaningful as they offered a preliminary framework for understanding married women's suicidal behaviour by acknowledging the social, historical, familial, marital and intrapersonal levels of influence.
Education, Faculty of
Educational and Counselling Psychology, and Special Education (ECPS), Department of
Graduate

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Caldera, Aburto José Trinidad. "Mental health in Nicaragua : with special reference to psychological trauma and suicidal behaviour". Umeå : Univ, 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-346.

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Schaub, Kristin. "Non suicidal self-injury as an addictive behaviour in adolescents and young adults". Thesis, McGill University, 2014. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=121217.

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Researchers have speculated about the addictive features of Non Suicidal Self-Injury (NSSI) for several years; however, little empirical research has examined this characteristic. The present study sought to advance knowledge of addiction and NSSI by demonstrating the presence of self-reported addictive features in high school and university students who engage in NSSI. A second aim was to identify a clinical profile of students who engage in NSSI with addictive features as compared with students with NSSI who lacked the addictive features. Results of this study indicated that clinically significant addictive features were endorsed by approximately 20% of individuals who self-injure in both the university and high school samples. In addition, significant differences were identified between those students with and without addictive features. University students with NSSI who showed clinically significant addictive features experienced more difficulties in emotion regulation, were more likely to have higher frequencies of NSSI, and were more likely to have engaged in uncontrolled drug abuse and risky sexual behaviour compared to their NSSI peers who lacked the addictive features. For high school students, those who engaged in NSSI with addictive features showed more difficulties in emotion regulation and higher severity of NSSI (significantly more methods, locations of injury, and frequency), as well as reported a higher likelihood of suicidal ideation, self reported depression, at-risk eating behaviours, and physical abuse, compared to those students with NSSI who did not show addictive features. Finally, the present study sought to examine which factors could predict whether addictive features would be present in an individual with NSSI. Across both samples, frequency of NSSI was a significant predictor of addictive features, with high frequencies predicting higher likelihood of addictive features. Emotion regulation difficulties were also a significant predictor in the university sample, while total number of methods of NSSI was a predictor in the high school sample. The results of this study provide new information regarding NSSI as an addictive behaviour as well as the presence of a subtype of NSSI with clinically significant addictive features. These findings are explored in relation to current literature and implications for both researchers and service providers are discussed.
Pendant des années, des chercheurs ont émis des hypothèses sur les caractéristiques addictives de l'automutilation non suicidaire (NSSI); cependant, peu de recherches empiriques ont examiné cet aspect. La présente étude a essayé de faire progresser les connaissances sur l'addiction et le NSSI en démontrant la présence d'aspects addictifs auto-déclarés chez les étudiants souffrant de NSSI dans les lycées et les universités. Un deuxième objectif a visé à identifier un profil clinique d'étudiants souffrant de NSSI avec des caractéristiques addictives en les comparant à ceux souffrant de NSSI sans aspect addictif. Les résultats de cette étude ont montré que des caractéristiques addictives cliniquement significatives ont été montrées par environ 20 % des individus qui s'automutilent aussi bien pour les sujets à l'université que pour ceux du lycée. De plus, on a constaté d'importantes différences entre les étudiants avec ou sans caractéristiques addictives. Les étudiants d'université avec le NSSI qui ont montré des aspects addictifs cliniquement significatifs avaient plus de mal à maîtriser leurs émotions, avaient généralement de plus grandes fréquences de NSSI et avaient une plus grande tendance à abuser de la drogue ou à avoir un comportement sexuel dangereux en comparaison avec leurs semblables sans aspect addictif. En ce qui concernent les lycéens, ceux atteints de NSSI avec des caractéristiques addictives avaient plus de mal à maîtriser leurs émotions et montraient un taux de gravité plus élevé de NSSI (bien plus de méthodes, de localisations de blessures et une fréquence plus élevée), de même ils ont signalé une plus grande probabilité d'idéation suicidaire, de dépression auto-déclarée, de comportement alimentaire à risque et d'abus physique, en comparaison avec les lycéens avec NSSI sans aspect addictif. Enfin, l'étude présente a cherché à examiner les facteurs susceptibles de prédire des caractéristiques addictives chez un individu avec NSSI. Au travers de ces deux échantillonnages, la fréquence de NSSI a été un indicateur significatif des caractéristiques addictives, une plus haute fréquence signifiant une plus grande probabilité d'addiction. Les difficultés à maîtriser ses émotions a aussi représenté un indicateur significatif pour l'échantillon à l'université, alors que le nombre total de méthode de NSSI a été un indicateur pour l'échantillon au lycée. Les résultats de cette étude apporte de nouvelles informations concernant le NSSI en tant que comportement addictif ainsi que la présence d'un sous-type de NSSI avec des aspects addictifs cliniquement significatifs. Ces conclusions sont examinées en relation avec la littérature actuelle et on discute de ses implications aussi bien dans le domaine des chercheurs que dans celui des prestataires de service.

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Welsh, Merran. "Adolescent suicidal behaviour in the 'lost city' : the experiences of mental health workers". Master's thesis, University of Cape Town, 1995. http://hdl.handle.net/11427/13859.

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Bibliography: leaves 86-99.
This study examines the high levels of anxiety and stress of mental health workers when dealing with cases involving adolescent suicidal behaviour. Mental health workers including nursing sisters, social workers and paraprofessionals were interviewed: Initially an unstructured interview schedule was used to explore the nature of adolescent suicidal behaviour in the course of their work. A semi-structured interview schedule, using focus groups was utilised to elicit the experiences and reactions of mental health workers to adolescent suicidal behaviour. A year after the initial interviews a few respondents were interviewed using a semi-structured interview schedule. The aim was to evaluate the effects of the research intervention. A thematic analysis highlights factors which disorganise the work of mental health professionals and paraprofessionals and contribute to their high levels of anxiety and stress.

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Wyder, Marianne, University of Western Sydney, College of Social and Health Sciences i School of Applied Social and Human Sciences. "Understanding deliberate self harm : an enquiry into attempted suicide". THESIS_CSHS_ASH_Wyder_M.xml, 2004. http://handle.uws.edu.au:8081/1959.7/644.

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This study focused on the quantitative and qualitative aspects of suicidal behaviour of 90 people who had come to the attention of the Accident and Emergency Department of Westmead Hospital, Sydney, N.S.W., after an attempt to harm themselves. The risk factors identified in the study were combined with the circumstances and motive of attempt. Participants were regrouped according to whether the problems the respondent described were chronic (longstanding) or acute (pivotal). The participants were further classified according to the persistence of thoughts of self-harm ( impulsive or non-impulsive/deliberate) and the presence or absence of these feelings at the time of the interview (the resolution of the attempt) and the types of problems/situations and triggering events the person described as wanting to escape. By developing strategies and treatments for the problems as they were identified in this study and by raising the awareness that there is help available for these different issues, we may be able to reduce the pain which results in an attempt to self harm.
Doctor of Philosophy (PhD)

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Du, Toit Andrea. "'n Maatskaplikewerk–ondersoek na lewensbegeleiding vir adolessente dogters wat selfmoordgedrag toon / Andrea du Toit". North-West University, 2011. http://hdl.handle.net/10394/6920.

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According to the World Health Organisation (WHO), suicide is one of the three main causes of deaths in the age group 15 to 34 years. Persons who previously attempted to commit suicide are more inclined to succeed with a second attempt. With the eventual focus on suicide prevention by means of life guidance as an assistance strategy in social work, the researcher undertook qualitative exploration amongst a specific group of adolescent girls between ages 15 and 21 years. These girls were each admitted to hospital after having attempted to commit suicide. The researcher used semi–structured in–depth interviews as a qualitative data collection method until data saturation was reached. The investigation was discussed against the backdrop of the strength perspective, crisis intervention, the system theory and existentialism. A discussion was led in Article 1 about findings regarding the psychosocial needs of adolescent girls who displayed suicidal behaviour. From the interviews, three overarching needs were foregrounded, namely the need for love and acceptance, the need for communication and the need for a secure future. The psychosocial needs were subdivided into sub–themes, which were discussed respectively. In Article 2 a discussion followed regarding the findings in terms of the support systems adolescents possess. Life guidance was eventually based on the needs of adolescent girls, as identified in Article 1, and the involvement and responsibility of the support systems, as discussed in Article 2. The guidelines for life guidance, as set out in Article 3, serve as a guiding recommendation and framework for intervention programmes for adolescent girls who display suicidal behaviour, as well as for the support systems involved.
Thesis (M.A. (MW))--North-West University, Potchefstroom Campus, 2012.

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Sfakinos, Despina. "Femininity, masculinity, and social change : a discourse analytic study of gender and suicidal behaviour /". Title page, contents and abstract only, 2000. http://web4.library.adelaide.edu.au/theses/09ARPS/09arpss522.pdf.

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Amin, Margi. "Mediating role of childhood abuse and emotion regulation between parental bonding and suicidal behaviour". Thesis, University of Edinburgh, 2012. http://hdl.handle.net/1842/6307.

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Introduction: Experiences of negative parenting and childhood abuse can have adverse consequences for the child‟s development particularly in relation to the ability to regulate emotions effectively. There has been extensive research in this area and attachment theory is pivotal. Problems in regulating emotions can involve not being able to recognise, label or manage internal and external states of mind and behaviour. Therefore research has shown that problems in emotion regulation skills due to negative parental and/or abusive experiences can result in long-term psychosocial problems such as depression. Research has suggested that adults with adverse childhood experiences exhibit risky behaviours as a means of managing their emotions such as self-harming, dangerous sexual encounters and substance misuse. Although research has shown that there is an association between these factors no real understanding of the pathways and the potential mediating roles these factors play has been investigated with people presenting with suicidal behaviour, which could be argued as the ultimate form of managing emotions and therefore the internal and external self. Therefore this study aims to answer the following question: Does childhood abuse and dysfunctional emotion regulation mediate the relationship between parental bonding and suicidal behaviour. Method: This study involved sixty participants from a suicidal behaviour sample presenting at an Accident and Emergency department aged between 18 - 65. Measures assessing childhood abuse, emotion regulation, parental bonding, suicidal intent, risk of repeating suicidal behaviour, depression and anxiety were completed. Results: Childhood emotional abuse was found to significantly mediate the relationship between low parental care and risk of repeating suicidal behaviour. A lack of external functional emotion regulation strategies was also found to mediate the relationship between parental care and risk of repeating suicidal behaviour. Finally, a lack of internal functional emotion regulation strategies was found to mediate the relationship between childhood physical abuse and risk of repeating suicidal behaviour. Conclusion: Preliminary findings of this study suggest that childhood emotional abuse and dysfunctional emotion regulation play a crucial role in further understanding those who engage in and are at risk of repeating suicidal behaviour. Therefore, emotions and emotion regulation within a developmental framework are important when considering long-term adult psychosocial functioning.

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Crnek-Georgeson, Kylie. "Retirement Pathways, Mental Wellbeing and Suicidal Behaviour in Older Rural Australians: A qualitative study". Thesis, University of Sydney, 2020. https://hdl.handle.net/2123/23146.

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This research aims to provide an evidence base on the transition to retirement, and its impact on the mental and physical wellbeing of individuals and family members, and health services, with a focus on suicidal behaviours in older rural Australians. Method. This study used a phenomenological approach to investigate the lived experiences of retirement transition and its impact on health, wellbeing and suicidal ideation in two groups in the rural population in New South Wales Australia: rural residents and rural stakeholders. The study was approved by the Human Research Ethics Committee of Western Sydney University (Protocol Number [H12022]. Participants were recruited using flyers, advertisements, radio interviews, stakeholder networks in rural communities, and suicide prevention and support services. Results Findings suggest that the transition from paid work into retirement leads to expectations and feelings that are difficult to predict or comprehend. The participants’ experienced social isolation, decreasing physical and psychological health, loss of identity, ‘place’ in society and feelings of disconnectedness. Conversely, rural stakeholders commented on a deterioration of resilience in rural residents (particularly because of ongoing drought) but supported the feelings of isolation, loss of place and loss of identity in those forced to retire. This study highlights a ‘disconnect’ between the perception of resilience in rural residents and stakeholder observations of residents’ resilience. The research also highlights the implications of drought and environmental factors on the health status of rural people and their ability to plan for retirement and future activities. Conclusions With these traits commonly linked to suicidal behaviour, it is important to highlight the impact that retirement has on individuals. This suggests a need to; increase the profile and provision of health promotion programs, educate health professionals on issues facing older rural Australians, monitor levels of resilience in relation to physical and psychological deterioration (pre-and post-retirement) and continue health promotion programs that increase awareness of the effects of living in long term drought conditions and improve the level of health literacy in rural residents.

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Edwards, Stephen J. "No-suicide contracts, no-suicide agreements and no-suicide assurances : an exploratory study of their nature, utilization and perceived effectiveness". University of Western Australia. Social Work and Social Policy Discipline Group, 2008. http://theses.library.uwa.edu.au/adt-WU2008.0149.

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The research examined mental health practitioners' attitudes towards, satisfaction with and use of suicide prevention contracting (SPC) techniques. Survey respondents comprised consultant psychiatrists, clinical psychologists, occupational therapists, mental health nurses, psychologists, registered medical officers and social workers. A self-report questionnaire was mailed to 1347 potential respondents, together with three follow-up letters sent out at two-week intervals. There was a 31% response rate, producing 420 valid questionnaires. The results of the research re-confirm the historical trajectory of SPC, from its early beginnings as a relationship-based suicide-risk assessment technique to one that is used in contemporary practice by practitioners to meet a range of objectives. The research focused on three SPC techniques in operation in clinical practice: verbal no-suicide assurances, no-suicide agreements, and written no-suicide contracts. Analysis of the data suggests a number of important findings. The first of these is that practitioners perceive different utility among these three techniques. Secondly, the least experienced practitioners were significantly less likely to use no-suicide contracts, despite seeing more suicidality and having more formal training in the use of the technique. Thirdly, a practitioner's gender, and formal training were significant in the perception and application of SPC techniques. Finally, suicidal behaviours and completed suicide was a clinical outcome in some situations irrespective of the use and non-use of SPC. The findings of this research are used to provide an emerging conceptual framework and associated nomenclature that inform clinical decision-making in relation to SPC. In addition, a conceptual model is presented which demonstrates that the potential for injudicious use of SPC techniques is as much precipitated by individual factors as it is by broader environmental factors. Key words: no-suicide contracts, suicide prevention contracts, no-suicide agreements, no-suicide decisions, contingency contracting.

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Rusu, Corneliu. "Risk Factors for Suicidal Behaviour Among Canadian Civilians and Military Personnel: A Recursive Partitioning Approach". Thesis, Université d'Ottawa / University of Ottawa, 2018. http://hdl.handle.net/10393/37371.

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Background: Suicidal behaviour is a major public health problem that has not abated over the past decade. Adopting machine learning algorithms that allow for combining risk factors that may increase the predictive accuracy of models of suicide behaviour is one promising avenue toward effective prevention and treatment. Methods: We used Canadian Community Health Survey – Mental Health and Canadian Forces Mental Health Survey to build conditional inference random forests models of suicidal behaviour in Canadian general population and Canadian Armed Forces. We generated risk algorithms for suicidal behaviour in each sample. We performed within- and between-sample validation and reported the corresponding performance metrics. Results: Only a handful of variables were important in predicting suicidal behaviour in Canadian general population and Canadian Armed Forces. Each model’s performance on within-sample validation was satisfactory, with moderate to high sensitivity and high specificity, while the performance on between-sample validation was conditional on the size and heterogeneity of the training sample. Conclusion: Using conditional inference random forest methodology on large nationally representative mental health surveys has the potential of generating models of suicidal behaviour that not only reflect its complex nature, but indicate that the true positive cases are likely to be captured by this approach.

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Anderson, Martin. "A study of nurses' and doctors' perceptions of young people who engage in suicidal behaviour". Thesis, University of Nottingham, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.342497.

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Hewitt, Anthea. "Causal modelling of the relationship between attribution style, coping and suicidal behaviour : a comparative study". Thesis, University of Portsmouth, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.271446.

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Jarbin, Håkan. "Long-term Outcome, Suicidal behaviour, Quality of Life and Expressed Emotion in Adolescent Onset Psychotic Disorders". Doctoral thesis, Uppsala University, Department of Neuroscience, 2003. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-3341.

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This study investigated a consecutive cohort of 88 youngsters with onset of a psychotic disorder at age 15.7 (sd 1.5) years and followed-up 10.6 (sd 3.6) years after first admission at the age of 26.5 (sd 3.7) years. A subsample of 15 subjects were assessed with the Five Minute Speech Sample for measuring Expressed Emotion and subsequent recording of relapses during a two year period.

A diagnostic split between schizophrenia spectrum psychosis and affective psychotic disorder was usually stable over time. The main diagnostic shift was an influx to schizophrenia spectrum disorder of subjects with a better premorbid function and less insidious onset as compared to those with a stable schizophrenia diagnosis.

Early onset schizophrenia spectrum disorder usually had a poor functional outcome. Most subjects needed support in the form of a disability pension. Early onset affective psychotic disorder usually had a good functional outcome. Most subjects worked and enjoyed regular friendships. The functional level before onset of illness was the best predictor of future functional level in psychotic disorders. A family history of non-affective psychosis predicted a worse function in schizophrenia. Frequent episodes and low intelligence predicted a worse function in affective disorders.

Four men (4.5% of the sample) committed suicide. The risk of suicide was increased about 30 times. Almost a third of subjects attempted suicide. Females made more attempts. Suicide attempts were related to more depressive symptoms but less negative symptoms at first episode, to readmissions and to dependence on nicotine.

Subjects with schizophrenia spectrum psychoses were less satisfied with life than those with affective psychotic disorder. Subjective satisfaction in schizophrenia was strongly associated to depressive mood while in affective disorders it was associated to degree of employment.

Adolescents with psychosis in families rated high or borderline high in Expressed Emotion either during first episode or after discharge had an increased risk of relapse.

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Jarbin, Håkan. "Long-term outcome, suicidal behaviour, quality of life and expressed emotion in adolescent onset psychotic disorders /". Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2003. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-3341.

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Hultén, Agnes. "Suicidal behaviour in children and adolescents in Sweden and some European countries : epidemiological and clinical aspects /". Stockholm, 2000. http://diss.kib.ki.se/2000/91-628-4254-4/.

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Lalovic, Aleksandra. "Genetic studies of suicidal behaviour : investigation of genes involved in the serotonergic system and cholesterol metabolism". Thesis, McGill University, 2002. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=79022.

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Substantial evidence has accumulated indicating that a genetic predisposition underlies suicidal behaviour, and that the mediating mechanism may involve decreased serotonergic activity and/or low serum cholesterol level. Most association studies have focused on genes involved in the serotonergic tophan hydroxylase (TPH) gene has been extensively examined and conflicting findings have been reported. The meta-analysis presented here was conducted to clarify the role of the TPH gene in suicidal behaviour. No overall association between the TPH gene and suicidal behaviour was found. A shift in focus to genes related to regulation of cholesterol level may provide useful clues. Thus, five genes encoding proteins involved in cholesterol biosynthesis and metabolism were investigated for a role in suicidal behaviour. No association was detected between any of the genes examined and suicide, suggesting that none of the genes investigated plays a major role in the etiology of suicide. Further studies in a larger sample are necessary to exclude possible small genetic effects.

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Hepker, Natalie. "A qualitative investigation into the determinants of perceived stress by intern clinical/counselling psychologists in consultation with a non-fatal suicidal client". http://hdl.handle.net/10413/2355, 2007. http://hdl.handle.net/10413/2355.

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Aim: This study aims to investigate the experience of stress and the factors that impact on the intern psychologist in relation to first consultation with a non-fatal suicidal client. Intra and interpersonal factors, as well as institutional/environmental factors that influence/impact on intern clinical/counselling psychologist level of stress when assessing and managing a non-fatal suicidal client were identified. Methodology: The research methodology chosen for this study is based on the aim of the study, which is to investigate the experience of stress perceived by intern clinical/counselling psychologists in relation to consultation with a non-fatal suicidal client. A qualitative methodological approach will be used in this study as it allows for greater in-depth investigation and understanding of the experiences of intern clinical/counselling psychologists towards suicidal clients than would be generated by quantitative research methods. Five intern clinical/counseling psychologists were used in this qualitative study. They were interviewed using a semi-structured in- depth interview. The data was transcribed and analysed using thematic analysis. Findings: A variety of stressors were identified by the interns, but the majority described common variables. The main sources of stress for the interns was first contact with suicidal clients and lack of practical training and experience. The working environment, which included work load, administrative work and academic and competency based requirements, was also deemed stressful. In terms of personal stress, interns reported family and friends to be a source of stress at times. Personality also contributed to the interns levels of stress. Socio-cultural factors which impacted on the interns experience of stress in relation to consultation with non-fatal suicidal clients included, language difficulties and cultural differences. Recommendations: The internship was generally described as stressful. Recommendations included more practical experience and training prior to the commencement of the internship. This will equip interns with the skills and abilities necessary in successfully assessing and managing high risk clients. Organisational and professional factors can also be modified and include support as well as an understanding of the policies and procedures of the institution in which the internship is being done.
Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2007.

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McKay, Kathryn Miranda. "Beautiful Destruction: Inscriptions of Self-Harm and Non-Fatal Suicidal Behaviour on 'Good' Women in Australia and Japan". Thesis, Griffith University, 2011. http://hdl.handle.net/10072/367321.

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This thesis explores how the ideals and expectations attached to the female body in Australia and Japan affect women’s self-harm and suicidal behaviours. In the majority of cultural contexts, traditional ideas of sex (male/female) and gender (masculine/feminine) still affect the modern constructions of sex and gender and the ideals and expectations prescribed to them. All behaviours have the potential to be performed but the ideals and expectations prescribed to a male or female body can influence the behaviours performed by a ‘good’ man or woman. Consequently, at a foundational level, male suicides have been very differently conceptualised and perceived than female suicides. Depending on the performance, the selfharm and suicidal behaviours some women choose to inscribe upon their bodies can be read as ‘good’; they have complied with feminine ideals. However, since the time of Durkheim, it has been argued that women have been protected from suicide by their ‘inside’ social role and adherence to social ideals. Durkheim’s inside role constructed the female body in frames which evolved into the constructions of beauty, sexuality and marriage considered traditional today. It was implied that complying with the ideals of a ‘good’ woman — being a beautiful and sexually faithful wife – would protect a woman from suicide. Yet, this assumption may neither be relevant nor realistic to the lives of modern Australian and Japanese women. Further, ‘good’ women may still be vulnerable to performing harmful inscriptions upon their bodies.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Health Science
Griffith Health
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46

Roaldset, John Olav. "Risk assessment of violent, suicidal and self-injurious behaviour in acute psychiatry– a bio-psycho-social approach". Doctoral thesis, Norges teknisk-naturvitenskapelige universitet, Institutt for nevromedisin, 2010. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-11932.

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De psykiatriske avdelingene i Norge har vært utsatt for tildels sterk kritikk etter voldsdhandlinger og selvmord begått av pasienter under innleggelse, etter utskriving eller ved manglende innleggelse. Med innleggelsespress og kort liggetid er akuttavdelinger særlig utsatt. Ofte legges alene klinisk skjønn til grunn for en risikovurdering. Det foreligger imidlertid instrumenter til formålet, men de er tidkrevende og forutsetter spesiell ekspertise. Et av siktemålene med dette ”risikoprosjektet” ved Ålesund sjukehus var å identifisere tidlig hvilke pasienter som trenger videre utredning og oppfølging. Forskjellige metoder ble prøvet i et prospektivt, naturalistisk design. Denne avhandlingen tar for seg resultater fra deler av ”risikoprosjektet” og omfatter ulike metoder brukt til vurdering av risiko for vold, selvmord og selvskading: (i) Biologisk basert: Serotonin og lipider målt i blod, (ii) Pasientbasert: Pasientenes egen risikovurdering (SRS), samt (iii) et personalbasert, strukturert screening instrument for volds-risiko (V-RISK-10, utviklet for bruk i akuttpsykiatrien) . ”risikoprosjektet” og omfatter ulike metoder brukt til vurdering av risiko for vold, selvmord og selvskading: (i) Biologisk basert: Serotonin og lipider målt i blod, (ii) Pasientbasert: Pasientenes egen risikovurdering (SRS), samt (iii) et personalbasert, strukturert screening instrument for volds-risiko (V-RISK-10, utviklet for bruk i akuttpsykiatrien) . SRS og V-RISK-10 ble skåret ved innleggelse og utskriving. Blodprøver ble tatt ved innleggelse. Risikovurderingene og blodprøvesvarene ble sammenliknet med suicidalitet, selvskading og vold registrert under oppholdet og i løpet av første året etter utskriving. Målgruppen var alle akutt innlagte pasienter gjennom ett år, fra 07.03.06 – 07.03.07. Studien av biologiske variabler og SRS ble utført på ett sykehus (n=489 pasienter). V-RISK-10 studien ble gjennomført på to sykehus (n=1017). Antallet pasienter var henholdsvis 254 innlagte og 196 utskrevne for den biologiske studien, 429 og 266 for SRS, og 980 og 381 for V-RISK-10. Vold og sucidalatferd under innleggelse, dessuten vold de tre første månedene etter utskriving, ble predikert av lave verdier av total kolesterol. Noen få pasienter med flere innleggelser og gjentatte voldshandlinger var kjennetegnet ved lave verdier av HDL. Disse funn samsvarer med tidligere undersøkelser. Høye triglyceridverdier predikerte selvskade i løpet av oppholdet, og også suicidalitet og selvskade etter utskriving. Presisjonsnivået var størst for dem som ble registret med både suicidalatferd og selvskading. Resultatet støtter tre studier om virkningen av kortvarig og kronisk psykologisk stress, men er det motsatte av tidligere funn om lave triglyceridverdier ved sucidalitet. I vårt materiale ble det ikke funnet noen sammenheng mellom serotoninnivå og aggresjon. SRS predikerte vold, suicidalitet og selvskade. I løpet av innleggelsen var SRS mest presis for suicidalitet og selvskade. Etter utskriving var den mest nøyaktig for vold. Vi har ikke funnet andre rapporter om pasienters egne risikovurderinger. Valideringen av V-RISK-10 var like god eller bedre enn for andre etablerte risikoinstrumenter. Våre funn var gyldige både for kvinner og menn. Nøyaktigheten var størst ved alvorlige voldsepisoder. V-RISK-10 gav signifikante resultater for pasienter uten kjent voldshistorie. Resultatene for lipider og SRS var ikke gode nok til at disse metodene kan anbefales å bli brukt alene som screening instrumenter. De kan imidlertid vise seg nyttige som tillegg til etablerte prosedyrer. V-RISK-10 viste gode egenskaper som screeninginstrument. Resultatene bør bekreftes av annen forskning før metodene kan bli brukt med ønsket sikkerhet.
Recently, psychiatric hospitals in Norway have been criticised for premature discharges and for poor assessments of patients’ risks of violence or self-harm. Due to the high turnover of patients and the obligation to admit all acutely ill patients who are in need of hospitalisation, the acute wards are particularly exposed to such criticism. Unstructured clinical judgements alone still appear to be the dominant approach to risk assessments. Currently used instruments for risk assessment are time consuming, and their use require special expertise. The goal of the “Risk Project” at Ålesund Hospital was early identification of patients in need of risk assessments. Various screening methods were tested in a prospective, naturalistic design. This dissertation is a part of the larger Risk Project. In the dissertation, different approaches towards risk analyses of violence, suicide and self-injury were examined: (i) Biologically based, in which lipids and serotonin are measured in the blood; (ii) Patient based, in which patients’ self-reports of risk (SRS) are employed, and (iii) Structured professional, by applying a violence screening instrument developed for use in acute psychiatry (V-RISK-10). SRS and V-RISK-10 were scored both at the time of admittance and discharge. Blood was drawn at admission. These measures were then compared with the episodes of violent, suicidal and self-injurious behaviour recorded during the patient’s hospital stay and also, during the first year after discharge. The study sample for the biological markers and the SRSs included all of the acutely admitted patients during one year (n=489) in one acute psychiatric unit. The V-RISK-10 study included all admissions of two units (n=1017). The numbers of patients who completed the study were 254 during their hospital stay and 196 after discharge, all with regard to lipids/serotonin, 429 and 266 for SRS, and 980 and 381 for V-RISK-10, respectively. Similar to findings from other studies, low concentrations of total cholesterol were found to predict inpatient suicidal and violent behaviour and also, violent behaviour three months after discharge. Low HDL levels were predictive of violence repeaters. High triglyceride levels predicted self-injurious behaviour (SIB) during the hospital stay, and both suicidal behaviour and SIB during the first year after discharge. The best results were obtained among patients who had recorded episodes of both suicidal behaviour and SIB. This finding contradicts prior studies on self-harm but concurs with three recent studies that look at the effects of short-term and chronic psychological stress. No significant correlations between serotonin levels and violence, suicidal behaviour or SIB were found in our sample. SRS predicted violence, suicidal behaviour and SIB both during the hospital stay and at three months after discharge. In addition, SRS of violence was also significant at 12 months after discharge. The accuracy was higher for self-harm during the hospital stays and for violence after discharge. We found no other validation studies of patients’ self-reported risk of suicide or violence. The predictive validity of the V-RISK-10 was equal to or better than those of the comprehensive risk assessment instruments, and it was very high in relation to severe violence. The screening instrument was sensitive to the risk of violence independent of gender and even for patients without any known history of violence. Despite significant findings for the lipids and SRS, these methods are not recommended for regular clinical use as single predictor variables, but they may be used together in combination with established risk procedures or clinical judgements. V-RISK-10 demonstrated good psychometric properties as a violence screening tool for acute psychiatry. Further research should be undertaken to confirm the findings

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47

Picken, Alicia. "An examination of suicidal ideation, plans and behaviour in individuals with a schizophrenia diagnosis and comorbid PTSD". Thesis, University of Manchester, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.503079.

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Šeibokaitė, Laura. "The changes of harmful behaviour towards self and others from 5th to 12th grades and psychosocial factors related to this behaviour". Doctoral thesis, Lithuanian Academic Libraries Network (LABT), 2008. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2008~D_20080721_124707-05702.

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The study analyses harmful behaviour towards self and others among students studying in the 5th to 12th grades. Harmful behaviour towards self and others is defined as substance use, suicidal and aggressive behaviour. This study explores an assumption that tobacco, alcohol and other drug abuse, suicidal and aggressive behaviour constitute one problem behaviour syndrome, as they perform the same functions in the life of an adolescent. The study is aimed to determine whether harmful behaviour towards self and others can be identified with the same psychosocial factors. Due attention is focused in the study on the changes of this behaviour from grades 5 to 12, in the duration of three years in different student groups. The empirical part of the dissertation presents a study of a large group of secondary school students during a period of 3 years. The results illustrate that substance use, suicidal behaviour and aggressive behaviour can be understood as a problem behaviour syndrome, but only in the girls’ group. Depressive mood, poor relations with teachers and negative learning attitudes predict all three forms of harmful behaviour towards self and others. Prevalence of this behaviour becomes increasingly evident during adolescence, but its different forms undergo different transformation processes. Changes in harmful behaviour towards self and others occur due to the age effect, but not the cohort effect.
Disertacijoje nagrinėjamas 5 – 12 klasių mokinių save ir kitus žalojantis elgesys, kuris apibrėžiamas kaip tabako, alkoholio, kitų narkotinių medžiagų vartojimas, agresyvus ir savižudiškas elgesys. Darbe tikrinama prielaida, kad šios save ir kitus žalojančio elgesio formos paauglystėje sudaro vieną elgesio konstruktą, nes atlieka tas pačias funkcijas paauglio gyvenime. Siekiama įvertinti, ar save ir kitus žalojantis elgesys gali būti aprašytas tais pačiais psichosocialiniais veiksniais. Darbe didelis dėmesys skiriamas šio elgesio kitimams nuo 5 iki 12 klasės ir per tris tyrimo metus skirtingose mokinių amžiaus grupėse. Empirinėje darbo dalyje pristatomas 3 metus trukęs didelės mokinių grupės tyrimas. Išanalizavus rezultatus, nustatyta, kad tabako, alkoholio, kitų narkotinių medžiagų vartojimas, agresyvus ir savižudiškas elgesys gali būti suprantami kaip vieno elgesio konstrukto dalys, tačiau tik mergaitėms. Pablogėjusi nuotaika, prasti santykiai su mokytojais ir neigiamas požiūris į mokymąsi geriausiai nusako paauglių save ir kitus žalojantį elgesį. Šio elgesio kitimų analizė atskleidė, kad save ir kitus žalojančio elgesio paauglystės laikotarpiu daugėja, tačiau kinta jo pasireiškimo forma. Save ir kitus žalojančio elgesio kitimai atsiranda dėl amžiaus įtakos, bet ne dėl kohortos efekto.

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Sun, Jiandong. "Educational stress among Chinese adolescents : measurement, risk factors and associations with mental health". Thesis, Queensland University of Technology, 2012. https://eprints.qut.edu.au/53372/3/Sun_Jiandong__Thesis.pdf.

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Academic pressure among adolescents is a major risk factor for poor mental health and suicide and other harmful behaviours. While this is a worldwide phenomenon, it appears to be especially pronounced in China and other East Asian countries. Despite a growing body of research into adolescent mental health in recent years, the multiple constructs within the ‘educational stress’ phenomenon have not been clearly articulated in Chinese contexts. Further, the individual, family, school and peer influencing factors for educational stress and its associations with adolescent mental health are not well understood. An in-depth investigation may provide important information for the ongoing educational reform in Mainland China with a special focus on students’ mental health and wellbeing. The primary goal of this study was to examine the relative contribution of educational stress to poor mental health, in comparison to other well-known individual, family, school and peer factors. Another important task was to identify significant risk factors for educational stress. In addition, due to the lack of a culturally suitable instrument for educational stress in this population, a new tool – the Educational Stress Scale for Adolescents (ESSA) was initially developed in this study and tested for reliability and validity. A self-administered questionnaire was used to collect information from convenient samples of secondary school students in Shandong, China. The pilot survey was conducted with 347 students (grades 8 and 11) to test the psychometric properties of the ESSA and other scales or questions in the questionnaire. Based on factor analysis and reliability and validity testing, the 16-item scale (the ESSA) with five factors showed adequate to good internal consistency, 2-week test-retest reliability, and satisfactory concurrent and predictive validity. Its factor structure was further demonstrated in the main survey with a confirmatory factor analysis illustrating a good fit of the proposed model based on a confirmatory factor analysis. The reliabilities of other scales and questions were also adequate to be used in this study. The main survey was subsequently conducted with a sample of 1627 secondary school (grades 7-12) students to examine the influencing factors of educational stress and its associations with mental health outcomes, including depression, happiness and suicidal behaviours. A wide range of individual, family, school and peer factors were found to have a significant association with the total ESSA and subscale scores. Most of the strong factors for academic stress were school or study-related, including rural school location, low school connectedness, perceived poor academic grades and frequent emotional conflicts with teachers and peers. Unexpectedly, family and parental factors, such as parental bonding, family connectedness and conflicts with parents were found to have little or no association with educational stress. Educational stress was the most predictive variable for depression, but was not strongly associated with happiness. It had a strong association with suicide ideation but not with suicide attempts. Among five subscales of the ESSA, ‘Study despondency’ score had the strongest associations with these mental health measures. Surprising, two subscales, ‘Self-expectation’ and ‘Worry about grades’ showed a protective effect on suicidal behaviours. An additional analysis revealed that although academic pressure was the most commonly reported reason for suicidal thinking, the occurrence of problems in peer relationships such as peer teasing and bullying, and romantic problems had a much stronger relationship with actual attempts. This study provides some insights into the nature and health implications of educational stress among Chinese adolescents. Findings in this study suggest that interventions on educational stress should focus on school environment and academic factors. Intervention programs focused on educational stress may have a high impact on the prevalence of common mental disorders such as depression. Efforts to increase perceived happiness however should cover a wider range of individual, family and school factors. The importance of healthy peer relationships should be adequately emphasised in suicide prevention. In addition, the newly developed scale (the ESSA) demonstrates sound psychometric properties and is expected to be used in future research into academic-related stress among secondary school adolescents.

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McLafferty, Margaret. "The impact of early childhood experiences on psychopathology and suicidal behaviour in Northern Ireland : risk and protective factors". Thesis, Ulster University, 2018. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.736778.

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Childhood adversities can impact negatively on the stress response, which is associated with psychological disorders and suicidal behaviour. Parenting practices such as overcontrol, over-protection and over-indulgence can also be detrimental. Additionally, harmful childhood experiences may result in reduced social networks, poor emotion regulation and coping strategies, factors which can be protective. Mild to moderate levels of adversity may also be protective. However, there is a paucity of research in this area. This thesis aimed to uncover links between childhood experiences and psychopathology and suicidality, identifying risk and protective factors. Secondary data analyses were conducted utilising data from the Northern Ireland Study of Health and Stress (n= 1,986), an epidemiological study conducted as part of the WHO World Mental Health (WMH) Survey Initiative. Primary data was also collected for the Ulster University Student Wellbeing Study (n=739), part of the WMH International College Student Project. Both surveys use the well validated WHO-CIDI to examine psychopathology and associated risk factors (Kessler & Ustun, 2008). The studies revealed that elevated levels of childhood adversities, parental over-control and over-indulgence were significant risk factors for mental health problems and suicidality. Such experiences also had an indirect impact as they were related to lower levels of social networks, poor emotion regulation strategies and maladaptive coping. These factors when available were protective. Moderate levels of adversity were also protective in some instances. The findings highlight areas for early intervention and prevention programmes to reduce the likelihood of childhood adversities or negative parenting practices and to minimise the impact of such experiences. Programmes and initiatives which aim to build resilience, social networks, good emotion regulation and coping strategies in offspring, would be particularly beneficial. The findings also provide backing for campaigns and promotions to encourage help seeking and the establishment of support programmes within schools, universities and the wider community.

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