Forgiveness, a cognitive-emotional and behavioral reduction of negative responses to offenses, is directly related to less suicide risk, but may be indirectly related via its relation with future orientation, the ability to envision a positive future. In 100 rural primary care patients, we examined the association between self-forgiveness, other-forgiveness, and forgiveness by God and suicidal behavior, with future orientation as a mediator. Forgiveness was related to greater future orientation and, in turn, to, less suicidal behavior. Addressing the past may promote adaptive views of the future and reduce suicide risk, results suggesting potential temporal and forgiveness-based points for suicide prevention.

We examined an additive and interactive model involving domestic partner violence (DPV) and hope in accounting for suicidal behaviors in a sample of 98 community adults. Results showed that DPV accounted for a significant amount of variance in suicidal behaviors. Hope further augmented the prediction model and accounted for suicidal behaviors beyond DPV. Finally, we found that DPV significantly interacted with both dimensions of hope to further account for additional variance in suicidal behaviors above and beyond the independent effects of DPV and hope. Implications for the role of hope in the relationship between DPV and suicidal behaviors are discussed.

Purpose To evaluate costs associated with hospitalization due to Firearm-Related Violence and Injuries (FREVI) in the United States over the last decade, 2001-2009. We explored the following research questions: 1. Is there an increase in the prevalence of firearm injuries over the last decade (2001-2009)? 2. What are the demographic patterns that characterize FREVIs in the U.S (i.e., age, sex, racial and ethnic variations, urban/rural locations)? 3. What are the costs associated with firearm-related hospitalizations in the US? Methods This is a descriptive cross-sectional study. A stratified sample of 54,875 hospital discharges were extracted from the National Inpatient Sample Database (NIS-HCUP) using E-Codes (ICD-9) for FREVI. We performed trend analyses to determine the cost and prevalence of the firearm related injuries. Results An estimated 268,639 firearm-related hospital discharges were observed from 2001-2009. Homicidal intent was the leading cause of FREVI, followed by accidents. Hispanic and blacks were more likely to become injured by firearms as compared to whites. Young adults aged 18-34 were more prone to firearm injuries than children and the elderly. Male sex, urban residence and being black or Hispanic were the main risk factors for firearm-related hospitalizations. The average cost of firearm-related hospitalization to the United States is $60,000 every hour, $17,700 per firearm injury related admission, and total of $5.28 billion for the last decade. The prevalence of FREVI and cost trends remained constant over the last decade. Conclusion Firearm Related Violence and Injuries (FREVI), and associated costs remain a major source of hospital-related expenditures in the United States. The constant trend in number of firearm injuries per year over the last decade suggests the absence of effective policy measures to curtail firearm injuries

Wildnerness therapy is becoming increasingly popular as a treatment for adolescents. It has been established as an efficacious treatment in previous literature, but the mechanisms as to why have thus far remained a mystery. This research is looking at the connection between wilderness therapy and DBT, another evidence-based treatment. This study will examine 156 adolescents, comparing the efficacy of wilderness therapy to traditional inpatient and intensive outpatient. Pre-treatment assessments of suicidal ideation, emotional regulation, and distress tolerance will be taken. It is expected that there will be main effects for each of the treatments, but that wilderness therapy will be strongest. Additionally, it is expected that emotion regulation and distress tolerance will act as mediators, and their effect on suicidal ideation will be even greater than that of treatment.

This study was conducted to identify what sources of anxiety are most closely associated with experiencing SI among students in a school district in Southern California. Anxiety and suicide rates in youth continue to grow and a need for preventative services is a must. The research design consists of qualitative, biopsychosocial assessments, and qualitative, utilizing the collected data. MSW interns at the district site conducted the assessments and the writers analyzed and reviewed the data to draw out an answer to the research question. Implications for social work practice include gaining a better understanding on the common sources of anxiety as well as other precipitating factors that youth with SI experience. By identifying stressors and common factors social workers will be able to recognize red-flags and provide faster, more targeted preventative services to youth suffering from SI.

Gay males have higher than average rates of suicidal ideation, which has been attributed in part to the pressure to conform to societal religious norms. Using the theoretical frameworks of Durkheim and of Pescosolido and Georgianna, the purpose of this quantitative study was to explore the role of religiosity as a factor of suicidal ideation in gay males. In this study, 113 gay males completed an online survey regarding their level of religiosity as measured by the Religious Background and Behaviors Questionnaire, past suicidal ideation as measured by the Suicidal Ideation Measure, and certain predictor variables, including being "out" to family members, family being supportive, age, religious affiliation (current and during childhood), ethnicity, and population of town during childhood. Regression analyses found no direct statistical significance between level of religiosity and suicidal ideation. There was a predictive relationship, however, between level of family support, level of religiosity, and suicidal ideation. These findings support the Pescosolido and Georgianna theory that belongingness reduces suicidal ideation. The implications for positive social change include the need for mental health professionals to highlight the importance of positive support for gay males as a potential buffer to suicidal ideation.

Suicidal behaviors have continued to increase in the United States (U.S.) Army population since the beginning of the wars in Iraq and Afghanistan. Suicide rates are higher in men compared to women; yet, the rate of suicidal ideation is higher in women than men. The purpose of this study was to determine if there is a correlation between suicidal ideation and protective factors, if social support and resiliency are different for men and women within the U.S. Army population, and if gender acts as a moderating variable between suicidal ideation and protective factors. The interpersonal-psychological theory of suicidal behavior was used as the foundation for this study. Secondary data were collected from the U.S. Army Public Health Center. After removing missing responses, the total sample size for this study was N = 3,446. Chi-square, independent samples t test, and multiple logistic regressions were used to determine the relationship between gender, suicidal ideation, resiliency, and social support in the U.S. Army active duty population. The percentage who reported suicidal ideation was 3.6% versus 4.9% for males and females, respectively. Social support was statistically significantly correlated with suicidal ideation (p = 0.002) while resiliency was not statistically significantly correlated with suicidal ideation (p = 0.68). Neither scale was effective in detecting differences among gender groups. Refined instruments are needed for evaluation of small changes in regard to protective factors. To promote social change, this study can be used to enhance knowledge about protective factors and gender in the context of the suicidal process, thus furthering the knowledge about how to prevent suicide in the U.S. Army population.

Policing has long been recognized by experts in the field as a stressful, unpredictable, emotionally exhausting, and dangerous occupation. Stress and contributing risk factors have lasting and sometimes fatal results among police officers. The purpose of this quantitative study was to determine if there is a relationship between symptoms of depression and 3 constructs of the Personal Observation Wellness and Evaluation Report--Power Portfolio (PP) survey, specifically administrative and organizational pressures, emotional, physical, psychological threats, and lack of administrative support. Archival data from the National Police Suicide Foundation were used. The independent variable was symptoms of depression as measured by the PP. The dependent variables were administrative and organizational pressures, physical and psychological threats, and lack of support as measured by the work-related problems domain of the PP. The participants (N = 150) consisted of officers employed by local, state, and federal law enforcement agencies throughout the United States. The results of the regression analysis and ANOVA were significant for the 3 research questions. The independent variable depression was related to work-related problems, work-related punishments, and the overall score reflecting participants feelings about their work as police officers. The results illustrate that police officers encounter organizational/administration demands with added stressors that accumulatively can develop into maladaptive coping mechanism and skills. Implications for positive social change include the development of mandatory interventions tailored to meet the need of individual police officers. These and other regulations, training, and protocols may reduce officers' work-related stress and improve the relationship between line and administrative personnel.

This study seeks to attain understanding of attempted suicide in young women from non-English speaking backgrounds, constructing meaning(s) of attempted suicide and eliciting information about sociocultural influences and guided by philosophical hermeneutics and narrative inquiry using life story methods. Thematic analysis was used to explicate from the text 30 sub-themes, five themes (being in a gap between cultures and creating space for themselves, being traumatised and diminished by abuse, surviving dangerous relationships, suffering psychic pain, expressing the self by attempting suicide), and a meta-theme (paradoxically asserting the indefinite self). Interpretation was predicated on the belief that life stories are statements about self-identity, and represent coming into being through the interaction of coherence (the ability to establish connections between events, unifying themes, frames of reference and goal states), continuity (a longitudinal and sequential perspective on life) and connectedness (intrapersonal, interpersonal and transpersonal relationships). The paradox is that being unable to overcome the uncertainties of incoherence, discontinuity and problematic connectedness, participants were predisposed to act against self as a means of asserting agency. This understanding of attempted suicide represents a hermeneutic narrative reconceptualisation of the phenomenon, which places it outside discourses that sanction the language of psychopathology and provides a basis for developing alternative nursing theory and informing education and practice / Doctor of Philosophy (PhD)

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.