The purpose of this phenomenological study was to explore the experience of front-line practitioners working with suicidal children and youth. Five front-line practitioners who had experienced working with children or youth who were suicidal participated in the semi-structured interviews. Transcripts of the interviews were analyzed and summarized under the following three areas of experience: Participants' Descriptions of Working with Suicidal Children and Youth, Knowledge Valued by Participants' to Inform their Practice with Suicidal Children and Youth, and Participants' Physical and Emotional Responses to Suicidal Children and Youth. There were a total of sixteen emergent theme clusters. The themes related to the experience of practice with suicidal children and youth provided a rich context for understanding the nature of meaning of the suicidal behaviors for participants. The emergent themes relating to the knowledge valued by participants to guide their approach provided a specific understanding of the multiple sources of knowledge participants were drawing from in the encounters. The emergent themes relating to the physical and emotional responses participants experienced in relation to their encounters with a suicidal child or youth provided an awareness of the impact the encounters had on participants. The major findings included the participants' broad scope of knowledge they used to guide their approach, as well as that encounters with suicidal children and youth did evoke strong physical and emotional responses amongst participants. The study concludes by describing the implications of these findings for Child and Youth Care practice and for future directions in research.

Research into the phenomenon of youth suicide is typically guided by quantitative methodologies focused on young people who have attempted or died by suicide. Questions related to epidemiology, etiology, and the development of actuarial measures of risk are often the drivers of these particular kinds of research. Similarly, research into school-based youth suicide prevention curricula is predominantly focused on quantitative measures of the degree to which young people acquire knowledge or change attitudes about suicide, after exposure to a delivered program. Grounded in post-structural ideas, the purpose of this thesis is to expand upon these mainstream inquiries into youth suicide prevention education through close exploration and analysis of how “suicide” is discursively produced within the context of a classroom delivered curriculum. This study will pay particular attention to the discursive productions of suicide in the curriculum, as well as how these productions result in the constitution of particular objects, concepts, and subjectivities. Transcripts of “naturally occurring classroom talk” will serve as the site of analysis. Troubling contemporary “truth regimes” about suicide and its prevention through close analysis of the discursive frames by which they are produced offers up the potential of re-imagining new possibilities for thinking about and delivering youth suicide prevention education.

本研究主要目的在於探討在不同情緒經驗及反芻風格對男女性自傷行為的影響。回顧過去研究，情緒被認為是多數自傷者自傷的動機及原因之一。可惜的是，大多數研究聚焦在負向情緒經驗，而較少探討正向情緒及不同激發程度的影響力。Selby（2008）的情緒瀑布理論提出反芻風格能夠增加負面情緒強度的論點，也暗示了反芻風格也是另一個與自傷行為相關認知因子。因此本研究認為情緒經驗與反芻風格可能皆為自傷發生的關鍵。有鑑於許多文獻結果指出，男女性的自傷危險因子可能存在差異，本研究便把性別差異納入考量，欲了解男、女性是否在情緒經驗及反芻風格的自傷預測因子有所不同。 本研究對象為508位北部某私立高職部學生，請學生填寫包含基本資料、反芻風格、自傷狀況及情緒經驗的評估共四部份問卷。研究結果顯示，在預測過去一年自傷行為的因子上，的確有性別差異。對女性來說，預測過去一年是否自傷的有效因子分別為負向情緒及負向低激發情緒，男性則是負向情緒及正向低激發情緒。在自傷頻率方面，對男女性來說，沒有任何情緒經驗或反芻風格為有效預測因子。在自傷種類數方面，沒有任何情緒經驗或反芻風格為女性自傷頻率的有效預測因子；對男性來說，則是負向情緒及低激發情緒能夠有效預測過去一年自傷種類多寡。研究最後針對這樣的結果做進一步討論及提供實務上的意涵及應用。 / The purpose of the present study was to investigate the influence of emotion experiences and rumination styles on Non-suicidal self-injury behavior (NSSI) in males and females. According to past studies, emotion was considered a critical factor in motivating individuals to practice NSSI. However, most studies focused on negative emotion experiences, and ignored the role of positive emotions and the effect of emotion activation level. Moreover, Selby’s Emotional Cascade Model proposes that rumination style will increase the negative affect intensity, suggesting that rumination style may be another key factor to NSSI. In addition, due to several studies have shown gender differences in risk factors for NSSI, the gender difference will be also take into account in the present study. To sum up, the present study aimed to examine gender differences in predictors (i.e., emotion experiences and rumination styles) for NSSI. The participants were 508 high school students from one of the private vocational high school in Northern Taiwan. All participants were asked to fill out the questionnaire pack which included demographic questionnaire, short-form rumination style questionnaire, deliberate self- harm inventory, and affect valuation inventory. The results show that gender differences in predicting NSSI existed: First, in predicting the occurrence of NSSI in the past year, negative affect and low arousal negative emotion were the most effective factors for females; negative emotion and low arousal positive emotion were the most effective ones for males. Second, neither emotion experience nor rumination style can predict the frequency of NSSI in the past year for males and females. Third, in predicting the numbers of types of self-injury used in the past year, there was no effective predictor for females; negative emotion and low arousal emotion were the effective predictors for males. Finally, the results and the practical implication were discussed in the thesis.

This thesis examines mortality rates among adults who experienced full-time imprisonment in New South Wales between January 1988 and December 2002, by record linkage to the Australian National Death Index. The cohort included 76383 men and 8820 women. Over a mean follow-up of 7.7 years, 5137 deaths (4724 men, 423 women) were identified. Three hundred and three deaths (295 men, eight women) occurred in custody. The median age at death was 36.6 years for men and 32.7 years for women. The prominent causes of death were drug overdose, suicide, accidental and cardiovascular disease. The crude mortality rate was 797 per 100000 person-years for men and 685 per 100000 person-years for women. Risk of mortality was 3.7 times greater in male and 7.8 times greater in female prisoners than the standard population. The excess mortality was substantially raised following release from prison in both men (standardised mortality ratio 4.0 vs 1.7) and women (standardised mortality ratio 8.2 vs 2.1). The period of highest risk of death was the first two weeks after release. Drug overdose was the main cause of death, responsible for 68% of the deaths in the first two weeks for men and for 90% of the deaths in this period for women. In men, there was also a clustering of suicide directly after release. Prisoners admitted to prison psychiatric hospital, repeat offenders and those in the early stage of followup were at increased risk of mortality. Violent offenders were overrepresented in suicide figures and property offenders in death from overdose. Minority groups, in particular men, had a lower risk of death than white people. The above findings reinforce how disadvantaged prisoners are, measured by mortality as the most fundamental scale of human wellbeing. Prison represents a potential opportunity for treatment and public health intervention to address some of the health problems underlying the high mortality found in this study. The key challenge is, however, to provide a continuum of care between the prison and community.

Thesis (Ph.D.) -- University of Western Sydney, 2002. / Bibliography : leaves 247-276.

The purpose of this phenomenological study was to explore the experience of front-line practitioners working with suicidal children and youth. Five front-line practitioners who had experienced working with children or youth who were suicidal participated in the semi-structured interviews. Transcripts of the interviews were analyzed and summarized under the following three areas of experience: Participants' Descriptions of Working with Suicidal Children and Youth, Knowledge Valued by Participants' to Inform their Practice with Suicidal Children and Youth, and Participants' Physical and Emotional Responses to Suicidal Children and Youth. There were a total of sixteen emergent theme clusters. The themes related to the experience of practice with suicidal children and youth provided a rich context for understanding the nature of meaning of the suicidal behaviors for participants. The emergent themes relating to the knowledge valued by participants to guide their approach provided a specific understanding of the multiple sources of knowledge participants were drawing from in the encounters. The emergent themes relating to the physical and emotional responses participants experienced in relation to their encounters with a suicidal child or youth provided an awareness of the impact the encounters had on participants. The major findings included the participants' broad scope of knowledge they used to guide their approach, as well as that encounters with suicidal children and youth did evoke strong physical and emotional responses amongst participants. The study concludes by describing the implications of these findings for Child and Youth Care practice and for future directions in research.

No description available.

Syftet med denna studie var att genom en enkät kartlägga socialsekreterares upplevelse av beredskap och förekomst av möten med självmordsnära klienter inom socialtjänsten. I Sverige dör cirka 1100 människor årligen genom suicid och det klassas idag som ett folkhälsoproblem. Enligt forskning, kommer socialsekreterare inom socialtjänsten ofta i kontakt med suicidala klienter men hur dessa möten hanteras har inte studerats i någon större utsträckning. Studiens urval har avgränsats till Stockholm samt tre andra län och enheterna försörjningsstöd och vuxen/beroende valdes ut för närmare granskning. Forskning pekar på olika riskfaktorer för självmord, som exempelvis psykisk ohälsa, socioekonomisk utsatthet eller missbruk, därav valet av dessa enheter. Empirin bearbetades med hjälp av programmet SPSS, genom vilket bi- och univariata analyser utfördes. Resultatet analyserades sedan med hjälp av tidigare forskning, samt med teori om suicidprevention. Ett av studiens huvudresultat var att många socialsekreterare stöter på självmordsnära klienter. En majoritet av dessa socialsekreterare har träffat en eller flera självmordsnära klienter det senaste året. Vidare visade resultatet att de medverkande i viss utsträckning upplever sig beredda i möten med dessa klienter. En femtedel av de medverkande uppgav att de genomgått utbildning i suicidprevention och resultatet visade att sådan utbildning har positiv påverkan på deras upplevelse av beredskap. / The purpose of this study was to map out social workers’ preparedness and the occurrence of encounters with suicidal clients within the social services, through a survey. Nearly 1100 people in Sweden dies because of suicide every year and suicide is classified as a public health problem. According to research social workers often encounter suicidal clients, but how these encounters are handled have not been studied in any greater degree. The study’s selection was defined to Stockholm and three other counties. The units within the social services that were chosen for further examination were income support and adult/addiction. Research revolving suicide indicate that socioeconomic vulnerability, addiction and mental illness are risk factors connected to suicide, hence the choice of these units. The collected data material was processed by means of SPSS, through which univariate and bivariate analyses have been executed. The results were interpreted by means of earlier scientific findings, as well as theories concerning suicide prevention. One of the main findings that could be extracted from this study was that many social workers encounter suicidal clients. Most of the social workers have met one or several suicidal clients during the past year. The results also implies that the participants believe that they have preparedness to some extent in encounters with these clients. One fifth of the participants state that they have passed training in suicide prevention and the results show that training of such has a positive impact on their experience of preparedness.

Background: Suicidal behaviour is a major public health problem that has not abated over the past decade. Adopting machine learning algorithms that allow for combining risk factors that may increase the predictive accuracy of models of suicide behaviour is one promising avenue toward effective prevention and treatment. Methods: We used Canadian Community Health Survey – Mental Health and Canadian Forces Mental Health Survey to build conditional inference random forests models of suicidal behaviour in Canadian general population and Canadian Armed Forces. We generated risk algorithms for suicidal behaviour in each sample. We performed within- and between-sample validation and reported the corresponding performance metrics. Results: Only a handful of variables were important in predicting suicidal behaviour in Canadian general population and Canadian Armed Forces. Each model’s performance on within-sample validation was satisfactory, with moderate to high sensitivity and high specificity, while the performance on between-sample validation was conditional on the size and heterogeneity of the training sample. Conclusion: Using conditional inference random forest methodology on large nationally representative mental health surveys has the potential of generating models of suicidal behaviour that not only reflect its complex nature, but indicate that the true positive cases are likely to be captured by this approach.

INTRODUÇÃO: O Transtorno Bipolar (TB) é um transtorno psiquiátrico crônico e debilitante e sua etiologia e patologia ainda não são completamente conhecidos, apesar de um componente genético importante ser evidenciado em estudos de família, adoção e gêmeos. Recentemente, o TB tem sido relacionado a um processo de envelhecimento acelerado, com alguns estudos mostrando telômeros encurtados nesta população. O objetivo do presente estudo foi investigar a associação entre o comprimento telomérico, um dos parâmetros do processo de envelhecimento celular, com a ausência ou presença de TB em famílias com muitos membros afetados, além de associar a sintomatologia clínica e outras variáveis a esse parâmetro. Procurou-se também avaliar as influências genéticas e ambientais sobre o comprimento telomérico nessas famílias, estimando-se a herdabilidade desta característica. MÉTODOS: O comprimento telomérico (T) foi mensurado em uma amostra de 143 indivíduos de 22 famílias (60 deles com TB), em relação a um gene de cópia única (S) - beta-globina, através do método de PCR (Polymerase Chain Reaction) em tempo real quantitativo, no qual forneceu uma proporção do número de cópias de T por S (razão T/S). Considerando a estrutura familiar na análise estatística foi ajustado para cada análise o modelo misto poligênico. RESULTADOS: O efeito do TB no comprimento dos telômeros foi pequeno, não tendo sido observada uma associação estatisticamente significante entre TB e comprimento telomérico quando comparado com familiares saudáveis (p > 0,05). No entanto, observou-se associação do comprimento telomérico à covariável ideação suicida (p = 0,02) e à interação entre ideação suicida e curso da doença (p = 0,02). Associação do comprimento telomérico com idade materna e TB também foi observada (p < 0,05). Por fim, estimou-se em 68% a herdabilidade do comprimento telomérico nas 22 famílias do estudo. CONCLUSÕES: A teoria do envelhecimento acelerado em TB, vista pela óptica do comprimento dos telômeros, não pôde ser confirmada no presente estudo, pois não foi encontrada diferença no comprimento telomérico entre indivíduos saudáveis e com TB nas famílias. Por outro lado, covariáveis que indicam gravidade da doença, como a ideação suicida e a interação entre ideação suicida e curso da doença foram associadas ao comprimento telomérico (p < 0,05), ou seja, um encurtamento telomérico foi correlacionado à gravidade clínica do TB. Associação do comprimento telomérico com idade materna e TB (p < 0,05) sugeriu que a idade materna avançada não só pode ser um marcador de longevidade, como também o fenótipo TB pareceu reforçar essa condição. Por fim, a alta herdabilidade estimada do comprimento telomérico (0,68) revelou uma importante variabilidade genética desse fenótipo entre as famílias do estudo. Em súmula, este é o primeiro estudo que relatou uma associação entre ideação suicida, curso da doença, idade materna e comprimento telomérico em famílias com vários membros afetados pelo TB. Outras investigações independentes são necessárias para confirmar esses resultados preliminares / BACKGROUND: Bipolar Disorder (BD) is a debilitating and chronic mental illness. It is etiology and pathology are not completely known yet, despite the evidence of an important genetic component from family, twin and adoption studies. Recently, BD has been related to a process of accelerated aging, with some studies showing shortened leukocyte telomeres in this population. The purpose of the present study was to investigate the association between leucocyte telomere length (LTL) in BD patients compared with healthy relatives of 22 families with several affected members by this illness, besides associating clinical symptomatology and other covariates with this parameter. It was also examined the genetic and environmental influences on telomere length trait in these BD families, using a variance component approach, by estimating the heritability of this trait as well as covariate effects. METHODS: Telomere length (T) was estimated in a sample of 143 individuals, including 60 BD patients from 22 families, which was measured in relation to the single copy gene (S) - beta-globin gene, using a singleplex real time PCR (Polymerase Chain Reaction), providing a ratio of number of copies of T by S (T/S ratio). Taking in consideration the family structure, the statistical analysis was adjusted for the polygenic mixed model. RESULTS: The effect of BD illness in telomere length was small and we found no association between BD group and LTL (p > 0.05). However, LTL was associated with the variable suicidal ideation (p = 0.02) and interaction between suicidal ideation and course of disorder (p = 0.02). Association of LTL and maternal age and BD was also observed (p < 0.05). In addition, an important genetic component for telomere length was also observed (heritability = 0.68) in these families. CONCLUSIONS: The hypothesis of accelerated aging in BD, investigating the telomere length as one of its components, was not confirmed in our study. We found no difference between LTL and BD in our family group. However, using covariates that indicate severity of disease, both suicidal ideation and interaction between suicidal ideation and course of disorder were statistically significant with LTL, showing that shorter LTL was associated with worse clinical course (p < 0.05) and suicidal ideation (p < 0.05) in BD patients. Association of LTL with maternal age and BD (p < 0.05) suggests that advanced maternal age may not only be a marker of longevity, but also the BD phenotype may reinforce this condition. A high heritability for telomere length (0.68) also suggests an important genetic variability of this trait presented among those families. To our knowledge, this is the first study that found association between suicidal ideation, course of disorder, maternal age and LTL in families with several members affected by BD. Further investigations, including replication studies in other BD families, are needed to confirm these new findings