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Unformatted text preview: Suicide Suicide
Definition: Intentional, willful effort to end one’s life. not a mental disorder. but 50% linked to diagnosable disorder (mood disorders, substance abuse, schizophrenia) Prevalence Prevalence 1. Within next hour: 68 attempts and 34 deaths in U.S. 2. Annually: 600,000 attempts, 30,000 deaths in U.S. note, many may be classified as accidents 3. Occurs in all age groups higher rates among elderly 4. Highest rate in white men (middle aged) 3 times more deaths than women 3 time more attempts by women Causes of Suicide Causes of Suicide A) Pain, despair, sense of hopelessness B) Stressful events: Death or relationship dissolution Role failure Abusive environment Illness exacerbates Longterm stressors can include: Serious illness Suicides related to serious illness have become more common in recent years Abusive environment Prisoners of war, inmates of concentration camps, abused spouses, abused children, and prison inmates have tried to end their lives Occupational stress Psychiatrists and psychologists, physicians, nurses, dentists, lawyers, farmers, and unskilled laborers have particularly high suicide rates C) Shneidman’s Classification C) Shneidman’s Classification Death seekers – clearly intend to end their lives Death initiators – intend to end their lives because they believe that the process of death is already underway Death ignorers – do not believe that their selfinflicted death will mean the end of their existence Death darers – have ambivalent feelings about death and show this in the act itself D) Modeling and mass suicides “copy cat” suicides mass suicides probably fit any of Shneidman’s categories E) Cultural Factors less common in cultures that strictly forbid it Durkheim (1897), “anomie” of modern society among adolescents, 34 times more likely for gay, lesbian, and bisexual youths F) Mental Illness 1. Associated with 3 disorders major depression alcoholism schizophrenia 2. Alcohol or drug use may be involved in most attempts releases inhibitions 3. Anger & despair, paired with poor impulse control G) Vulnerability: 1. early loss 2. suicide in family Early Detection Early Detection A) Suicidal Ideation and Talk always considered dangerous graded re: specificity & lethality B) Other precursors: 1. in children: behavior problems exacerbate, running away, accidents, self deprecation 2. mood changes: increased vegetative signs of depression (no sleep, appetite loss), withdrawal, substance abuse increases, giving away possessions 3. in major depression: danger may increase as depression begins to lift and energy increases 4. life threatening illness but note: decision to end life may be related to depression, not a reasoned choice. Suicide Prevention Suicide Prevention 1) Assist with coping with current stressors 2) Assess lethality – nonsuicidal statement not a promise “Can you assure me that you will not be injured either by accident or on purpose?” 3) Mobilize resources and involve others in monitoring and prevention plan (family, friends, physician, police) 4) Be active, intrusive, demanding don’t just “hear pain” ...
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