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Abnormal 3 - suicide
Suicide
23
Psychology
03/24/2009

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Cards

Term

 

 

 

 

Schneidman's Definition of Suicide

Definition
Currently, in the western world, suicide is a conscious act of self-induced annihilation, best understood as a multidimensional malaise in a needful individual who defines an issue for which suicide is perceived as the best solution.
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Shneidman's 10 characteristics

of Suicide

Definition
  1. Unedurable psychological pain
  2.   Frustrated psychological needs
  3. Pupose—to find a solution. Long term solution to a short term problem
  4.  Goal – cessation of suffering
  5.  Hopelessness/helplessness
  6. Ambivalence
  7. Cognition is constricted
  8.  Communication of intention
  9. Action – to escape
  10.  Represents a lifelong coping pattern
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Prevalence of Suicide

Definition

Approx. 11 out of every 100,000 people commit suicide

o   3rd leading cause of death for ages 15-24

o   11th leading cause of death overall

-  Highest: New Mexico: 19.8

-  Lowest:  New York: 6.6

o   3X more women attempt suicide

o   Men 4X more likely to succeed

-  Except in China: Women equally likely

o   Countries

-  Top Three:  Hungary (by far), Finland, Austria

-  Lowest: Northern Ireland, Italy, England and Wale

 

·         Age differences

o   Risk highest in adolescence and “old-old”

·         Ethnic and racial diff.

o   European-Americans at highest risk

o   African-Americans at lowest

o   Also gender effect

·         Mental illness

o   More than 90% of people who commit suicide have a diagnosable mental disorder.

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Cultural issues in prevalence of suicide

Definition

·         Leading cause of death among 15-24 year olds in Japan  & Denmark

·         Very high rates in Sri Lanka

o   35 in 100,000

o   During 16-year civil war more people have killed themselves (80,000) than have been killed in combat (60,000)

o   Lack of mental health

o   “culture of suicide”

o   Easy access to poison

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Suicide: By the numbers

(black and white)

Definition

·         White males 20.1

·         W females 5.3

·         Black about half that for each gender 12 men  2.1 women  per 100,000.

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Social Perspective on Suicide

(5 reasons?)

Definition

·         Economic hardship

·         Serious Illness

·         Loss & abuse

·         Durkheim’s theory

·         Suicide contagion

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Psychodynamic theories of suicide

Definition
suicide is the extreme expression of anger at the love object who has abandoned the person
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Mental Disorders theory of suicide

Definition
several mental disorders increase risk for suicide, including
 
depression,
BPD,
schizophrenia,
substance abuse,
anxiety disorders
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Impulsivity theory of suicide

Definition
people who commit suicide have a general tendency toward impulsive acts
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Cognitive theories of suicide

Definition
hopelessness and dichotomous thinking increase the risk for suicide
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Durkenheim's Theory

(of suicide. 3 types)

Definition
  1. Egoistic Suicide: committed by people who feel alienated from others, empty of social contacts, and alone in unsupportive world
  2. Anomic Suicide:committed by people who experience severe disorientation because of a major change in their relationships to society
  3. Altruistic Suicide: committed by people who believe that taking their own lives with benefit society in some way
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Suicide contagion

Definition
when one member of a group commits suicide, other members are at increased risk. Perhaps because of
 
"contagion effects"
modeling
increased acceptibility of suicide
impace of traumatic events on already vulnerable ppl
 
suicide cluster - two or more suicides are non-randomly bunched in space or time
Term

 

 

 

 

4 types of suicideh

Definition
  1. Death seekers - clearly and explicitly seek to end their lives (these people prepare for death and, if confronted, are ambivalent about desire to die)
  2. Death initiators - have intention to kill self in order to hasten an inevitable death (ex-ppl with HIV)
  3. Death ignorers - intend to end their lives but do not believe this means the end of their existence. (ex-Heaven's Gate religious cult, suicide bombers)
  4. Death Darers - ambivalent about dying, and take actions to increase risk of death, but do not guarantee that they will die (like loading a gun with one bullett and seeing if they die. may want attention or to make someone else feel guilty more than they want to die)
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Subintentional death

Definition
Shneider
 
people who indirectly contribute to their own death, perhaps unconsciously
 
someone who smokes cigs even after a heart attack
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Biological theories of suicide

(2)

Definition
genetic theory - disordered genes increase the risk for suicide
 
neurotransmitter theory - deficiencies in serotonin lead to impulsive, violent, and suicidal behavior
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Suicide: Comorbidity

Definition

·         Most often major depress40-60%

o   Alcohol 20%

o   Bipolar Disorder 20%

o   Schizophrenia 10%

 

·         Higher Risk associated with

o   Number of previous attempts

o   Hopelessness

o   Beginning treatment

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Recent Shifts in Suicide Rates

Definition

·         Increase among men ages 15-34

o   Narrows gap between younger & middle aged men

·         Increase among black men

Term

 

 

 

 

Teenage suicide

Definition

·         Rate rose 300% between '64 and '88

·         Every year:

o   1 in 5 teenagers seriously consider suicide

o   Nearly 9% attempt

o   3% make a serious attempt that requires medical attention

·         Risk Factors for suicide among teenagers

o   Depression

o   Interpersonal problems

-  Poor relationship with parents

o   Hopelessness

o   Substance abuse

o   Aggression: (Impulsivity-more likely to hurt themselves)

o   Suicide attempt by a friend (contagious)

o   Being gay or bisexual

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3 common myths about suicide

Definition

·         People who talk about it don’t do it

o   Over half had communicated intent less than 3 months prior

·         They aren’t serious, they just want attention

o   Higher number of previous attempts is greater risk for completion

·         Talking about it will put the idea in their heads or strengthen the idea

o   Talking usually helps

-  Especially about plans (safety plans)

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Suicide prevention

Definition
Crisis Intervention
Suicide hot lines
Counselor-short term treatment
 
Voluntary/involuntary hospitalization
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Suicide:

Drug Treatments

Definition
#1 -Lithium (bad side effects)
 
more recently - 
 
SSRI's (although some say they increase risk)
 
for people with psychotic disorders, antipsychotics may help reduce risk of suicide
 
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Suicide:

Dialectical Behavior Therapy:

Definition
Cognitive-Behavioral: psychological treatment:
  • focuses on difficulties in managing negative emotions and in controlling impulsive behaviors
  • techniques aimed at increasing problem-solving skills, interpersonal skills, and skills in managing negative emotions
  • often, spouses and family members are included in treatment
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euthanasia

Definition
"mercy killing"
 
not legal in US, but not uncommon
 
20% or more doctors have assisted in suicide or hastened the death of a seriously ill patient