Suicidal Persons Research Articles

“When you are alone you have a narrow mind, but when you are with others you think broader into the other aspects”. A qualitative study on the role of sense of belonging and mattering in attempted suicide in Uganda

ABSTRACT Introduction Suicide is globally a severe problem with an estimated 700.000 deaths annually. Six of the 10 countries with the highest suicide rates worldwide are in Africa, though, reliable statistics are scarce. Method In this qualitative interview study in Uganda, we analysed the stories of 16 people admitted to hospital following a serious suicide attempt. We focussed especially on each person’s decision process towards their resolution to attempt suicide. Findings Despite the huge heterogeneity of the narratives, we could identify problems regarding the sense of belonging and mattering in all the stories. Both the sense of belonging and mattering have been related to suicidal behaviour in earlier theories, but they were never studied together or under consideration of the influence of this specific cultural context. We found that the participants’ sense of belonging and mattering to a large degree was influenced by their traditional communalistic context with a worldview where the line between the natural and spiritual world was blurry. Conclusion This kind of knowledge could be a valuable source for health professionals in their treatment of suicidal persons; it could direct their approach to the core of each person’s relational problems and meaning-making, which is crucial for their decisions with regard to suicide.

Suicidal Behavior and Personality Group Affiliation: Approaches and Research Directions

Introduction. As it follows from a number of scientific works, not only suicide rates, but also their motives and ways of committing suicide vary widely in different countries, strata of society and strata of the population. In recent decades, research on this issue has become interdisciplinary and cross-cultural. Suicidal behavior is increasingly considered in the context of the suicidal person’s belonging to a certain social group or cultural community. Objective. To analyze the impact of an individual’s membership in a large social group or cultural community on suicidal behavior. The main directions of suicidal behavior research. In the vast array of theoretical and research works the following directions of suicidal behavior study can be distinguished: existential, clinical, socio-demographic, socio-cultural and socio-psychological. Starting from E. Durkheim’s sociological etude “Suicide”, the group affiliation of an individual is considered as a leading factor of suicidal behavior. However, the sociological approach appears limited because its proponents place excessive emphasis on demographic variables rather than on the psychological significance of suicide and the values of the individual prone to suicidal behavior. A. Adler’s socio-psychological conceptualization of suicide is partly responsible for overcoming these limitations. Adler’s socio-psychological concept of suicide, which takes into account not only demographic indicators, but also how suicides perceive, evaluate and experience their own group affiliation and the values of their social group. According to A. Adler, the predictors of suicide are a sense of community (belonging) and social interests of the individual. Sense of community and group belonging as a factor of suicidal behavior. Comparison of studies conducted in three countries (Russia / USSR, Japan and the USA) allows us to identify two socio-psychological factors of suicidal behavior: 1) negative attitude to one’s own group or cultural identity; 2) hypertrophy of the sense of community and belonging, leading to a decrease in the value of one’s own personality and individual life. Discussion. As modern cross-cultural studies show, suicidal behavior can be observed both at the deficit of the sense of community and group belonging and at the high level of development of this sense. This is conditioned, on the one hand, by the attitude of a suicide victim to his/her social group and cultural identity, and, on the other hand, by the historically formed attitude of society to suicide.

Crisis negotiation techniques in interactional context: Managing a suicide threat in an emergency service call

Background: Previous research reveals that standard crisis negotiation techniques are useful in assisting suicidal persons, but how routine interactional procedures impact their implementation has not yet been sufficiently examined. Aim: This paper investigates how routine interactional procedures impact the effectiveness of crisis negotiation techniques in an emergency services call involving a suicide announcement. Methods: A publicly released emergency service call was transcribed and analyzed using the qualitative technique of conversation analysis. Results: The call taker used crisis negotiation techniques such as maximizing autonomy, displaying active listening, and distracting the caller to keep them on the phone. These techniques were implemented successfully through routine interactional procedures such as topic shifts, requests, and listener responses. Interrupting or overlapping the caller's speech or replacing requests with demands were less effective. Discussion: Instruction in the routine procedures of interaction may be as important as instruction in standard crisis negotiation techniques when training call takers to handle suicide announcement calls. Conclusions: Qualitative analysis of suicide announcement calls can be an effective means of learning how crisis negotiation techniques are used in practice and how emergency call takers can help prevent suicide by keeping callers on the phone and persuading them to abandon their suicidal plans.

Age of onset of major depressive episode and association with lifetime psychiatric disorders, health-related quality of life and impact of gender: A cross sectional and retrospective cohort study

ObjectiveTo assess the long-term impact of the age of onset (AOO) of the first major depressive episode (MDE) according to 3 age groups and considering gender. MethodsData were extracted from NESARC III, a representative U.S. sample. We included 8053 participants with an MDE history in a cross-sectional and retrospective cohort study. We defined 3 AOO groups: childhood-onset (< 13 yo), adolescence-onset (13–18 yo), and adult-onset (> 18 yo). We compared sociodemographic characteristics, lifetime psychiatric disorders per DSM-5 criteria, and health-related quality of life (HRQOL) in each group and performed gender-stratified analyses. ResultsPrevalence of childhood-onset MDE was 10.03 %, adolescence-onset was 14.12 %, and adult-onset was 75.85 %. Suicide attempts (AOR = 3.61; 95 % CI 2.90–4.50), anxiety disorders (AOR = 1.92; 95 % CI 1.62–2.27), and personality disorders (AOR = 3.08; 95 % CI 2.56–3.71) were more frequent in the childhood-onset than in the adult-onset one. Adolescence-onset group showed similar results. Physical Disability scale (p < 0.001) and Mental Disability scale (p < 0.001) were significantly lower in the childhood-onset group. Results were more nuanced in the adolescence-onset group. Women in childhood-onset and adolescence-onset groups had poorer outcomes than the adult-onset group. Differences were less pronounced in men. LimitationsRecall and classification biases inherent to survey design. ConclusionIndividuals, particularly women, who experienced their first MDE during childhood or adolescence exhibit higher lifetime psychiatric disorder prevalence and poorer HRQOL than those with adult-onset MDE. These findings highlight the importance of preventive measures, early diagnosis, and treatment of youth depression.

The assessment of pathways towards suicide in adolescent patients: A PDM-2-oriented approach.

Increasing evidence has supported the mutual relationship between suicidal motivations and personality pathology, especially in adolescence. Distinctive aspects of personality functioning can explain the tendency to resort to suicidal ideation and behaviours, which, in turn, may play a specific role in exacerbating severe impairments in self-regulation mechanisms that underlie personality pathology. This study illustrates, through two clinical cases, the clinical utility of using the Psychodynamic Diagnostic Manual - Second Edition (PDM-2) to better understand distinct pathways of suicidal processes. Two adolescents, named Luis and Gael, who attempted suicide multiple times were assessed using the Psychodiagnostic Chart Adolescent (PDC-A) of the PDM-2 to evaluate their mental functioning, emerging personality styles or syndromes, and symptom patterns. They were interviewed using the Motivational Interview for Suicidality in Adolescence (MIS-A) to identify the motivations underpinning their suicidal behaviour. The results showed that Luis presented a narcissistic personality characterized by the need to deny his vulnerabilities through suicidal fantasies as a form of escape, while Gael presented a borderline personality characterized by the use of suicide attempts to express her inner and unspeakable pain. The study seems to support the reciprocal interconnections between personality functioning and suicidal motivations that should be better identified to plan tailored and more effective interventions.

Samobójstwa wśród młodzieży jako problem kryminologiczny

Suicide is the subject of interest in many scientific disciplines, such as psychology, sociology, law, theology. A serious social problem is the growing number of young people who, in an act of desperation, lack of ability to cope with school and family problems, peer exclusion and low stress resistance, decide to take their own lives. Suicide in this aspect should be considered as a major social crisis of the 21st century. In criminological literature, it is seen as a type of voluntary death and an act of discontinuation of life. Suicide among young people is often preceded by a suicide attempt, which is a “call for help”, an attempt to draw attention to themselves, but above all an act of despair and rebellion against the reality they have to face. Suicidal risk factors intersect and complement each other. These include both those related to the suicidal person, as well as his or her personality traits, cognitive styles, genetic or biological conditions. An important role is played by those linked to the immediate environment, the family, the social group and the media. The aim of this article is to characterise the phenomenon of suicides in Poland with special attention to data on children and adolescents based on the statistics of the Police Headquarters. In addition, the authors attempt to provide a psychological portrait of the person who decides to commit suicide and to draw attention to suicide risk factors among adolescents.

자살충동 노인에 관한 사례 분석: 네트워크와 매트릭스를 활용

This study conducted a case analysis based on the results of psychological counseling for an elderly person who felt suicidal at a senior welfare center in Seoul. Accordingly, through this study, we aim to prevent suicidal impulses by discovering cases where people feel suicidal impulses. As an analysis method, cases where counseling was conducted were analyzed using matrices and networks through family tree analysis of a systematic integrated model. A total of 9 sessions of psychological counseling were conducted for the case patient from March to July 2023. Five sessions of counseling were conducted for the case patient, two sessions of counseling for the case patient's wife, and two sessions of couple counseling. As a result of the analysis, the problems of the family of origin and vulnerable environmental factors that influenced the case patient's suicidal impulse were identified. The suicidal elderly person's primary caregiver changed from his or her family of origin, and there was a change in the dynamic environment that inevitably led to a very low self-esteem. Additionally, this provides the case patient with a vulnerable growth environment, resulting in the formation of unstable attachments and schemas that include excessive defense mechanisms and aggression. Based on the analysis results, it was proposed to select cases with vulnerabilities in the family of origin, provide regular psychological counseling to the elderly who are vulnerable to suicidal impulses, and develop and implement a suicide prevention program accordingly.

Suicide-Related Media Reporting With a Focus on Sexual and Gender Minority Identities.

Background: Little is known about the quality of media reports on suicide and prevention targeting persons with sexual or gender minority identities (LGBTQ+). Aims: To assess the quality of suicide-related media reporting of LGBTQ+ people and its consistency with media guidelines. Method: We conducted a content analysis of 5,652 media items in two US states (Washington and Oregon) published within 1 year. Results: There were only few differences in the reporting about suicide in LGBTQ+ as compared to non-LGBTQ+ reports. LGBTQ+ media items more often portrayed suicide as monocausal [Oregon: OR = 1.75, 95% CI (1.03-2.98), p = .038; Washington: OR = 3.00, 95% CI (1.81-4.97), p < .001] and linked them to adverse life experiences [OR = 2.16, 95% CI (1.38-3.38), p < .001; OR = 2.09, 95% CI (1.30-3.38), p = .002] than non-LGBTQ+ items. They also more often featured mental health experts [OR = 1.79, 95% CI (1.04-3.10), p = .034; OR = 2.12, 95% CI (1.23-3.67), p = .006] and contacts to support services [OR = 2.22, 95% CI (1.41-3.48), p < .001; OR = 2.70, 95% CI (1.64-4.45), p < .001]. Limitations: Aspects possibly influencing the portrayal of LGBTQ+ suicide and prevention beyond the characteristics listed were not investigated. Conclusion: Suicide-related media reporting related to LGBTQ+ issues features potentially beneficial aspects but tends to overlook multifactorial causes of suicide. Diverse factors contributing to LGBTQ+ suicide and prevention warrant greater attention.

Emergency First Responders' Misconceptions about Suicide: A Descriptive Study.

In 2022, suicide was the second leading cause of external death in Spain (the first among young people aged 15-29 years). This study aims to analyze the presence of myths among emergency first responders and identify the most prevalent false beliefs among them. The research is a observational and descriptive study carried out using a questionnaire composed of a total of 25 myths, with the response options being true or false. A total of 543 professionals took part in the study. All of them could intervene before, during, and after a suicide attempt. The main finding of the study is that more than 50% of the participants accept as true the statement "There are more serious and less serious problems", underlining the idea that caring for patients could be related to the importance the health professional gives to the patients' problem. Myths such as "The suicidal person wants to die" and "The suicidal person is determined to die" are also evident. The subjective thought the first responder has about suicide could affect their acts, and there is a need to train first responders in suicidal behavior to be able to create an adequate approach.

Fatal Police Shootings of Victims with Mental Health Crises: A Descriptive Analysis of Data from the 2014-2015 National Violent Death Reporting System.

One in five fatal police shooting victims may have been experiencing a mental health crisis (MHC) at the time of their death [1]. We use data on fatal police shootings from the National Violent Death Reporting System (2014-2015) to (a) identify incidents where the victim is reported to have experienced an MHC at the time of their death, (b) describe the characteristics of these incidents, and (c) compare the characteristics of MHC to fatal police shootings where the victim was not experiencing an MHC at the time of their death. We systematically coded 633 fatal police shootings from 27 states. Descriptive statistics characterized fatal police shootings, including victim characteristics; their mental health status; and contextual information regarding the police encounter (e.g., reason for police call). Overall, 203 of 633 fatal police encounters (32%) involved victims who showed signs of an MHC at the time of their death. Victims were predominantly white, male, and in possession of a firearm. In 3 of 4 cases, the MHC manifested as suicidal ideation despite any relevant documented history among most victims. Among half of suicidal victims, suicidal ideation was expressed verbally and in-person to a family member/intimate partner who subsequently called the police. Dispatch was aware of the MHC in 1 of 4 of total police calls. Overall, fatal police encounters involving those experiencing an MHC accounted for 1 in 3 of our caseloads. Approximately, 3 of 4 mental health calls involved a suicidal person who mainly expressed intent to a loved one in-person.

Development and Evaluation of Online Suicide Preventive Tool iAlive to Increase Competences in Engaging With a Suicidal Person.

Background: Online implementation of suicide prevention interventions offers many advantages, facilitating the dissemination of large-scale suicide prevention interventions. An online tool iAlive aimed at raising awareness and increasing suicide prevention competences in lay people was developed and implemented in Slovenia. Aims: To develop, implement, and evaluate the iAlive tool. Method: Following the development and implementation of the tool, a nonrandomized controlled study with 310 participants was conducted. One hundred fifty-six of them fully completed the study [intervention group (used the iAlive tool): N = 85, control group (did not use the tool): N = 71]. Perceived competences in engaging with a suicidal person were assessed in both groups at baseline and at follow-up (3-4 weeks apart), which also represents the time of the intervention. Results: A significant effect of time and condition [F(1,149) = 6.62, p = .011, ηp2 = .043] showed that the intervention group assessed their perceived competences on intervention exposure more positively compared to the control group. Limitations: Additional data on different populations and people's engagement with the tool in relation to perceived competences are needed. Conclusion: The study suggests that the interactive online tool iAlive effectively increases perceived competences in engaging with a suicidal person. These results provide a background for further dissemination of the tool.

Frequency of Cysts by Immunofluorescence Assay in Human Brain Tissue of Suicide, Traffic Accident and Homicide Decedents

BACKGROUND: Several studies link toxoplasmosis with neuropsychiatric disorders. There are no previous reports of the frequency of the presence of parasite tissue cysts in autopsy cases from violent death or how is the distribution of frequency according to brain regions related with behavior (amygdala or hippocampus). The immune fluorescent antibody technique (IFAT) detects specific target antigens that allow the observation of bradyzoites within tissue cysts. We describe the frequency of tissue cysts using the IFAT detection in human brain tissue samples from immunocompetent persons deceased by suicide, traffic accidents and homicide. METHODS: 21 brains from the National Institute of Legal Medicine and Forensic Sciences chapter “Eje Cafetero” (including cities of Armenia, Pereira, and Manizales) of violently deceased (which includes suicide, traffic accidents and homicide) persons were obtained, subsequently sections of the amygdala and hippocampus areas were processed in paraffin and thick sections were cut from paraffin blocks and mounted on slides by means of the IFAT, by using specific monoclonal anti BAG1 protein of the bradyzoite. Serum samples from the decedents were also examined for the presence of IgG and IgM antibodies to establish the existence of a previous infection. Data such as age, gender, sociodemographic data, and type of death were also obtained. Evaluation of the differences in the percentage of positivity according to the cause of death were assayed by using the Fisher exact test. RESULTS: Two decedents (9.5%) were female and 19 (90.4%) were male. The age ranged from 14 to 65 years; most completed or were in high school level of education. By city, 9 were from Armenia (42.8%%) and 12 from Manizales (57.1%). By type of death, 11 samples (52.3%) were victims of homicide, 9 samples (42.8%) were suicide, and one sample (4.7%) was a traffic accident. We identified tissue cysts containing the bradyzoites in two cases in amygdala (9.5%), in amygdala and hippocampus in tree (14.2%), and one case only in hippocampus (4.7%). In total we have six of 23 (26%) were positive for cysts in the brain. No statistically significant differences were found between groups in the percent of positivity. After counting we found a mean 1,3 ± 0,4 cysts by 20 microscopy fields of positive brain tissue examined. We found one of 21 positives for IgG antibodies in blood (47%). Within six cases with positive by IFAT in brain tissue five were also positive in antibodies (83%) only one case was negative for antibodies. CONCLUSION: The presence of bradyzoite was demonstrated in brain tissue samples from immunocompetent patients who suffered a violent death in the cities of Armenia and Manizales, Colombia. The results suggest that the bradyzoite after infection is permanently localized in brain tissue. A higher prevalence of bradyzoite parasites is observed in amygdala samples, an important region for behavior control.

Adding cultural variables to improve assessments and interventions with suicidal persons of color.

Adding cultural variables to improve assessments and interventions with suicidal persons of color.

Inside the mind of a suicidal person

Inside the mind of a suicidal person

Trajectory of suicide as a transformation in obscurity-As told by the deceased's next of kin.

There is a collective call from the field of suicide research for studies on the individual dynamics of suicidality in order to understand the deadliness of the suicidal process. This study examines the deceased next of kin's ('survivor's) experience of the suicidal process in order to gain perspectives that can be used in the preventive care of suicidal patients. The aim of this study was to explore the suicide process through the suicide survivor's experience. The study is designed and conducted through a phenomenological, reflective lifeworld approach. Twelve in-depth interviews concerning lived experiences of a suicide were conducted. The suicide process is described as the emerging of an obscured transformation of self, and an aligning to this changing understanding of self that forms a unique suicidal death course. This death course contains the co-occurrence of life and death orientations. Survivors' collected knowledge of a suicidal trajectory helps us understand the life conditions of a suicidal person that has ended their life. Life orientation and experiences of self-governance are critical parts of a suicidal trajectory and can have great preventive potential for care and assessments during suicidality. The Consolidated Criteria for Reporting Qualitative Research (COREQ) were used for the reporting structure of this article.

A Cry for “Help”? How Crisis Negotiators Overcome Suicidal People's Resistance to Offers of Assistance

This paper explores how police negotiators offer “help” to suicidal persons in crisis. The phrase “a cry for help” is long associated with suicide ideation, and “help” is a key offer made in crisis situations. However, we know little about how “help” is formulated, and received, in crisis encounters as they actually unfold. Fourteen cases (31 h) of UK-based police crisis negotiations with (suicidal) individuals in crisis were transcribed and analyzed using conversation analysis. Our analysis shows that persons in crisis typically reject negotiators’ offers of “help.” However, when negotiators propose that (and how) matters can be “sorted out,” or refocus “help” as actions that the person in crisis can do themselves, progress is made. The paper contributes to the growing literature on the management of resistance in institutional encounters, and to our understanding of how negotiators may minimize or de-escalate resistance in crisis communication.

Prevalence of hikikomori and associations with suicidal ideation, suicide stigma, and help-seeking among 2,022 young adults in Hong Kong.

Young adults are at elevated risks of hikikomori (severe social withdrawal) under the COVID-19 pandemic, which could lead to psychological distress and suicidal ideation. The present study aimed to examine the associations among hikikomori, suicide stigma, suicidal ideation, and help-seeking behaviors among young adults in Hong Kong. This study recruited a large sample of 2,022 young adults in Hong Kong via an online survey at the end of 2021. The participants completed the Hikikomori Questionnaire and validated measures on psychological distress, suicide stigma, and suicidal ideation severity and report their help-seeking behaviors. Multivariate analysis of variance was conducted to compare the profiles of the hikikomori groups. Path analysis evaluated the effects of hikikomori and suicide stigma on occurrence and severity of suicidal ideation and their associations with help-seeking behaviors. Hikikomori showed significant and positive indirect effects on prevalence and severity of suicidal ideation via psychological distress. Glorification positively predicted hikikomori and suicidal ideation severity among suicidal persons. Hikikomori was associated with reduced help-seeking. Isolation and suicidal ideation were associated with greater barriers to seek help among the non-help-seekers. Perceived helpfulness of sought help was negatively associated with hikikomori and suicidal ideation among the help-seekers. The present findings demonstrated greater prevalence and severity of suicidal ideation and less help-seeking in young adults with hikikomori. Suicide stigma showed differential associations with hikikomori, suicidal ideation, and help-seeking behaviors.

Suicidal Attempt among Psychiatry Patients Presented to the Department of Emergency of a Tertiary Care Centre: A Descriptive Cross-sectional Study.

More than 700, 000 people die due to suicide every year. Suicide is the fourth leading cause of death among 15-29 year-olds. A total of 77% of global suicides occur in low- and middle-income countries. There is an increasing number of suicide all over the world. There is limited data regarding this issue. The available data are based on police reports or on specific populations. The aim of this study was to find out the prevalence of suicidal attempts among psychiatry patients presented to the Department of Emergency of a tertiary care centre. A Descriptive cross-sectional study was done in a tertiary care centre from January 2019 to July 2020 after taking Ethical approval from the same institute. Beck Suicide Intent Scale, MINI-7, IPDE and PLESS were used to assess suicidal intent, psychiatric comorbidities, personality disorder and life stress event scores respectively. Bronfenbrenner's Social Ecological Model was used to access various stressors. Point estimate and 95% Confidence Interval were calculated. The Prevalence of suicidal attempts among psychiatry patients in the emergency department was 265 (24.50%), (21.66-26.74, 95% Confidence Interval). The majority were females 135 (51%). The majority attempted at home 238 (89.81%). Poisoning was the most common mode of attempting suicide. The Prevalence of suicidal attempts among psychiatry patients was higher than in the other studies done in similar settings. comorbidity; cross-sectional studies; prevalence; psychosocial factors; suicide attempt.

Stigma and Suicide From the Perspective of Balinese Adults.

Research on stigma toward suicide has grown dramatically but limited is studying in Bali, Indonesia. This qualitative research conducted to explore the stigma and suicide from Balinese perspective. Eighty-four Balinese Hindus participated in this study, which 27.38% of them had a history of suicidal thoughts or attempted suicide. Our research found that the cultural belief of Balinese view suicide as an act of ulah pati, which means taking death inappropriately and for an inappropriate reason, which carries the consequence that the suicidal person and the family will incur bad karma. Public stigma and self-stigma toward suicide exist among Balinese, i.e. the act of suicide due to a mental disorder and people who die by suicide are weak. The findings of this study suggest mental health professionals and local governments to pay attention to Balinese cultural belief and Hinduism religious teaching to prevent suicide.

Exploring the role of religion in the recovery experiences of suicide attempt survivors in Ghana

BackgroundReligion performs a doubled edged role in a suicide crisis. On the one hand, it elicits empathic responses towards suicidal persons. On the other, it condemns and shames them. Although there is evidence that religion promotes better health and general wellbeing, little attention has been given to its role in recovery, especially after a suicide attempt. The current study explored how religion facilitated recovery among suicide attempt survivors.MethodsUsing a semi-structured interview guide, we interviewed suicide attempt survivors who had attended a psychiatric unit. Thematic analysis was used to analyse the data.ResultsTen suicide attempters were interviewed, six females and four males. Three major themes were identified: Reasons in context, Religion in the recovery process and Renewed commitment to religious rituals/practices.ConclusionsThe role of religion in suicide prevention as a resource, is a complex one. Suicide preventionists need to carefully guide and gauge their prevention efforts in context where religion is rife to provide suicide attempt survivors the most effective religious resource in their recovery trajectory.