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This study examined the influence of social support on the relationship between posttraumatic stress disorder and comorbid psychopathology, suicidal behaviour, and mental and physical health functioning in the general population. Data came from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) (N=34,653). Results showed a differential impact of posttraumatic stress disorder and social support depending on gender. For men, social support had a moderating effect, where social support had a greater influence on the prevalence of comorbid psychopathology for men with posttraumatic stress disorder compared to those without the disorder. In contrast, social support had an additive effect for women, where social support was associated with decreased psychopathology and posttraumatic stress disorder was associated with increased psychopathology. This study suggests that social support should be included in the treatment of men with posttraumatic stress disorder and encouraged among women regardless of mental disorder diagnosis.

SAMMANFATTNING Suicid och suicidförsök är ett stort folkhälsoproblem i världen och de senaste 45 åren har suicid ökat med ca 60 procent. Sjuksköterskor som arbetar inom ambulanssjukvården möter ofta patienter med psykisk ohälsa. Detta påverkar sjuksköterskan på olika sätt. Vid självmordsförsök, hot om självmord eller vid misstänkt självmord kan ambulans larmas. I den akuta situationen är ibland ambulanssjuksköterskan den första kontakten med sjukvården. En prehospital vård ställer höga krav på ambulanspersonalens förmåga och kunskap att möta olika typer av patienter i olika situationer. De flesta inom prehospital sjukvård har en mental beredskap för att möta svåra händelser, men trots detta kan omständigheter göra att personalen kan få svårt att hantera vissa händelser. Syftet var att ta beskriva sjuksköterskans upplevelser vid prehospitalt omhändertagande av suicidnära patienter. Metoden var kvalitativ med intervjuer som datainsamlingsmetod. Sju sjuksköterskor inom ambulanssjukvården intervjuades. Materialet spelades in och transkriberades för att sedan avidentifieras och analyseras med en kvalitativ manifest innehållsanalys. Resultatet redovisas i följande kategorier: Emotion och påverkad empati hos sjuksköterskan, kunskap, kompetens och erfarenhet, vården otillräcklig samt i mötet med patienten. Resultatet visade att sjuksköterskan upplevde en frustration och maktlöshet i vårdmötet. Ilska, brist på empati och osäkerhet var också upplevelser som kom fram. Det framkom att det råder en kunskapsbrist hos en del av sjuksköterskorna inom den prehospitala vården när det gäller bemötande och omhändertagande av psykiskt sjuka personer. Slutsatsen var att sjuksköterskor inom prehospital akutsjukvård behöver mer kunskap om bemötande och omhändertagande av suicidala patienter.

Non-Suicidal Self-Injury (NSSI) is the self-inflicted damage to one’s bodily tissues without the intent to die. Previous research has sought to discover the motivation of an individual to perform such behavior and differences in the experience of pain among those who self-injure. The goals for the current study were to reveal any relationships between the function of NSSI, the subjective experience of pain, and an objective measurement of pressure pain threshold. Participants completed the Inventory of Statements About Self- Injury (ISAS; Klonsky & Glenn, 2009), which measures the functions that NSSI serves, and a measure assessing subjective pain experience, specifically frequency and severity of pain. Pain thresholds were also induced and recorded using a pressure algometer. The findings suggest that pain frequency significantly predicted pain threshold, whereas subjective pain severity did not. Furthermore, marking distress, the function of NSSI which serves as creating a tangible representation of emotional distress, was significantly associated with pain frequency, such that as marking distress increases in relevance, the less often one would be expected to experience pain. Therefore, the current study has implications relevant to both future research and the clinical setting.

The incidence of suicide attempts and completions during academically gifted students' attendance at state-supported, residential high schools was the subject of this study. School personnel's perceptions of this environment, roles in identifying students at-risk for attempting suicide, and knowledge about suicide were also studied. Five schools participated in this study. Initial interviews were conducted with each school's director, measuring the incidence of suicide utilizing an adaptation of a survey developed by M. Hayes and R. Sloat (1990). Questionnaires distributed to personnel included questions about knowledge about the school's history concerning suicide, perceptions of the environment, and knowledge about suicide. The adaptation of Hayes and Stoat's survey was included in questionnaire materials, along with the School-Level Environment Questionnaire (Rentoul & Fraser, 1983) and 11 true/false statements measuring knowledge of suicide. A total of 83 questionnaires were completed. Telephone interviews were conducted with a random sample of 21 personnel who completed the questionnaire. These interviews consisted of open-ended questions measuring the environment of these schools and perceived roles of personnel in identifying students at-risk for suicide. Descriptive and qualitative analyses were conducted. Ten attempts and two completions occurred among 4899 students. Suicide attempts and completions were measured to be .20% and .04% respectively. These findings indicate that these schools need to be prepared in order to prevent suicide among this population. The environment of these schools was one of affiliation, autonomy, and innovativeness. However, affiliation predominately existed within specific departments and/or divisions. Personnel characterized their roles in suicide prevention as unofficial because of lack of time, academic priorities, and other individuals who were better equipped to respond to students. Even though personnel considered their roles unofficial, they attempted to meet students' emotional needs through support, observation, and involvement. Knowledge of suicide was observed in the areas of incidence of suicide among adolescents, importance of warning signs, factors increasing risk, and need for intervention. Respondents were less knowledgeable about the rate of suicide among adolescents, factors not increasing risk, and myths about suicide. / Department of Educational Psychology

Worldwide, fatal traffic injuries and drowning deaths are important problems. The aim of this thesis was to investigate the cirumstances of fatal and non-fatal traffic injuries and drowning deaths in Sweden including analysis of the presence of alcohol and drugs, which are considered to be major risk factors for these events. Data where obtained from the database of National Board of Forensic Medicine. In the first study, we investigated 420 passenger deaths from 372 crashes during 1993-1996. There were 594 drivers involved. In total, 21% of the drivers at fault were alcohol positive compared to 2% of drivers not at fault (p<0.001) (Paper I). During 2004-2007, crashes involving 56 fatally and 144 non-fatally injured drivers were investigated in a prospective study from Northern Sweden (Paper II). The drivers were alcohol positive in 38% and 21%, respectively. Psychoactive drugs were found in 7% and 13%, respectively. Benzodiazepines, opiates and antidepressants were the most frequent drugs found in drivers. Illict drugs were found 9% and 4% respectively, with tetrahydrocannabinol being the most frequent of these drugs (Paper II). We investigated 5,125 drowning deaths in Sweden during 1992-2009 (Paper III). The incidence decreased on average by about 2% each year (p<0.001). Unintentional drowning was most common (50%). Alcohol was found in 44% of unintentional, 24% of intentional, and 45% of undetermined drowning deaths. Psychoactive substances were detected in 40% and benzodiazepines were the most common substance. Illicit drugs were detected in 10%. Of all drowning deaths, a significantly higher proportion females commited suicide compared with males (55% vs. 21%, p<0.001). Suicidal drowning deaths (n=129) in Northern Sweden were studied further in detail (Paper IV). of these, 53% had been hospitalized due to a psychiatric diagnosis within five years prior to the suicide. Affective and psychotic disorders were the most common psychiatric diagnoses. Almost one third had performed a previous suicide attempt. One fourth had committed suicide after less than one week of discharge from hospital. Alochol was found in 16% and psychoactive drugs in 62% of these cases, respectively.  In conclusion, alcohol and psychoactive drugs are commonly detected among injured drivers and drowning victims, and probably play a role in these events. Most of the individuals that tested positive for alcohol and high blood concentrations, indicating alochol dependence or abuse. This association warrants futher attention when planning future prevention.

Bipolar disorder is a psychiatric illness characterized by recurrent fluctuations in mood and increased risk of suicide. Twin and family studies have identified the highly heritable nature of the disorder, but the limitations of the current DNA-centric paradigm underscore the need for a new perspective to gain a clearer understanding of its basis. This project investigates various facets of bipolar disorder from an epigenetic standpoint. We used mass spectrometry-based mapping of individual DNA modification differences of the brain-derived neurotrophic factor gene. Moreover, the epigenetic basis of suicidal behaviour in bipolar disorder was investigated using DNA methylation microarrays. We also used a newly-developed enrichment technique, mTAG, to interrogate chromosome-wide DNA modification profiles using tiling microarrays in post-mortem brains of bipolar disease patients and controls. Findings from these experiments highlight observable features of epigenomes of patients affected with mood disorders, and may further the understanding of the molecular origin of psychiatric diseases.

BACKGROUND: Non-suicidal self-injury (NSSI) occurs in 13% to 20% of adolescents, and is often indicative of deeper internal or social problems. A close review of current explanatory models of NSSI suggested that underlying individual sensory preferences may contribute substantial explanations for the self-regulatory functions of NSSI, as well as have implications for treatment approaches. In the context of integrating sensory processing models with prominent functional NSSI models, this dissertation research compared sensory preferences in youth who engaged in NSSI to sensory preferences of youth who did not engage in NSSI. OBJECTIVE: NSSI-engaging youth were hypothesized to have lower threshold sensory preferences (sensation avoiding and sensory sensitive), and higher sensitivity (low threshold) in touch processing, auditory processing, and modulation of sensory input affecting emotional response. Sensory preferences were hypothesized to predict NSSI functionality, and trauma history and symptomology were hypothesized to predict NSSI and sensory preferences. METHODS: Youth (n = 108; 56% female; 43% Hispanic) aged 8-14 completed self-report items regarding knowledge, thoughts, and engagement in NSSI, the Functional Assessment of Self-Mutilation (FASM) to evaluate type and functionality of NSSI, and the Adolescent / Adult Sensory Profile to evaluate sensory preferences (low registration, sensation seeking, sensory sensitive, sensation avoiding). Parents (90% female; Mage = 39.4 (SD = 6.9)) completed the Sensory Profile as a secondary measure of youth sensory preferences and the UCLA post- traumatic stress disorder reaction index (PTSD-RI) to evaluate youth trauma history and symptomology. RESULTS: NSSI-engaging youth (N = 14) scored significantly higher than Non-NSSI-engaging youth (N = 85) in the sensation avoiding (Cohen's d = .83) and low registration (Cohen's d = .66) domains. Auditory sensitivity (youth-reported) significantly predicted NSSI after controlling for age. While parent-reported sensory preferences and trauma history and symptomology were not predictive of NSSI, auditory sensitivity (parent-reported) predicted PTSD symptomology in youth with trauma history. CONCLUSIONS: Results provide preliminary insight into better understanding the self-regulatory role of NSSI, and offer insight into specific sensory preferences of young adolescents who engage in NSSI. In combination with future research, findings contribute to existing comprehensive models of NSSI, and provide evidence for sensory considerations in NSSI treatment.

Bipolar disorder is a psychiatric illness characterized by recurrent fluctuations in mood and increased risk of suicide. Twin and family studies have identified the highly heritable nature of the disorder, but the limitations of the current DNA-centric paradigm underscore the need for a new perspective to gain a clearer understanding of its basis. This project investigates various facets of bipolar disorder from an epigenetic standpoint. We used mass spectrometry-based mapping of individual DNA modification differences of the brain-derived neurotrophic factor gene. Moreover, the epigenetic basis of suicidal behaviour in bipolar disorder was investigated using DNA methylation microarrays. We also used a newly-developed enrichment technique, mTAG, to interrogate chromosome-wide DNA modification profiles using tiling microarrays in post-mortem brains of bipolar disease patients and controls. Findings from these experiments highlight observable features of epigenomes of patients affected with mood disorders, and may further the understanding of the molecular origin of psychiatric diseases.

Mūsų šalis vis dar išlieka tarp pirmaujančių pagal paauglių savižudybių skaičių, taip pat egzistuoja tokios problemos kaip, bloga paauglių sveikata, psichoaktyvių medžiagų vartojimas. Todėl svarbu išsiaiškinti paauglių polinkio į savižudybę, sveikatą bei psichoaktyvių medžiagų vartojimo sąsajas. Tyrimo tikslas: nustatyti 5-12 klasių mokinių polinkio į savižudybę sąsajas su savo sveikatos vertinimu ir psichoaktyviųjų medžiagų vartojimu kaimo ir miesto mokyklose. Darbe taikytas polinkio į savižudybę, sveikatos vertinimo bei psichoaktyvių medžiagų klausimynas ( prof. A. Goštautas, 1999). Metodikos pasirinktos kaip tinkamos savo sveikatos vertinimo, psichoaktyvių medžiagų vartojimo bei polinkio į savižudybę nustatyti. Tyrimas atliktas vieno Lietuvos rajono miesto ir kaimo mokyklose. Tyrime dalyvavo 960 5-12 klasių mokinių (amžius10-19 metų)- 480 (240 mergaičių, 240 berniukų) miesto mokyklų ir 480 (240 mergaičių ir 240 berniukų) kaimo mokyklų ( po 30 berniukų ir po 30 mergaičių iš klasės). Tyrimo rezultatai: 5-12 klasių kaimo ir miesto mokyklų mokinių polinkis į savižudybę yra susijęs su savo sveikatos vertinimu ir psichoaktyvių medžiagų vartojimu kaimo ir miesto mokyklose. Nustatyta, kad mokinių, tiek berniukų, tiek mergaičių polinkis į savižudybę siejasi su savo sveikatos vertinimu: berniukų ir mergaičių polinkis į savižudybę didėja esant blogesniam savo sveikatos vertinimui. Taip pat, pereinant į aukštesnę klasę berniukų ir... [toliau žr. visą tekstą] / Our country still remains among the leading countries in the number of the suicides of teenagers; such problems as poor health of teenagers, usage of psychoactive substances also exist. Therefore, it is important to find out about the correlation among suicidal tendencies, health and usage of psychoactive substances. The aim of the research: to specify the correlation between the suicidal tendency of the pupils of 5- 12th forms with the evaluation of their health and usage of psychoactive substances in city and rural schools. In the thesis the questionnaires about suicidal tendency, health assessment and psychoactive substances consists by prof. A. Goštautas (1990) are used. Methodologies are chosen as suitable for analysing the peculiarities of subjectively evaluated health, usage of psychoactive substances and suicidal tendencies. The research was completed in the city and rural schools of Lithuania. 960 pupils of 5 – 12th forms (aged 10 – 19) participated in the research – 480 (240 girls, 240 boys) in city schools and 480 (240 girls, 240 boys) in rural schools (30 boys and 30 girls from each class). The results: suicidal tendency of the students of 5 – 12th forms from city and village is related with their subjectively evaluated health and usage of psychoactive substances in city and rural schools. It was found that suicidal tendency of the students, boys and girls is associated with their subjectively evaluated health:... [to full text]