Les adolescents sont de plus en plus nombreux à chercher des réponses à leurs questions en matière de santé par les technologies de l’information et de la communication (TIC), surtout en santé mentale. Ainsi, plus les adolescents ont un risque suicidaire élevé, moins ils cherchent de l’aide en personne et plus ils se tournent vers les TIC. À ce jour, aucune étude québécoise n’a exploré le processus de recherche d'aide par les TIC chez des adolescents ayant un risque suicidaire. Le but de la présente étude était donc de comprendre et générer une théorie sur le processus de recherche d'aide par les TIC chez des adolescents ayant un risque suicidaire. Les objectifs de recherche étaient : (1) de décrire l’utilisation des TIC par des adolescents à risque de suicide pour rechercher de l’aide et (2) de comprendre le processus de recherche d'aide des adolescents par les TIC pour trouver des ressources en lien avec le suicide. La méthode de la théorisation ancrée a été utilisée pour répondre à ces objectifs et modéliser le processus. La collecte de données a été effectuée à partir d’entrevues individuelles semi-structurées, d’un questionnaire sur la recherche d’aide par les TIC et d’observations d’une recherche d’aide réelle par les adolescents de l’étude. Un n de 15 participants, âgés de 13 à 17 ans ayant un suivi pour leur risque suicidaire a été atteint par la saturation théorique. Les données recueillies ont été transcrites, puis soumises à une analyse de contenu par codification ouverte, axiale et sélective. Le modèle paradigmatique de Corbin et Strauss (2015) et la méthode de la comparaison constante ont été utilisés jusqu’à la saturation des données et l’émergence d’une théorie substantive, soit la théorie de la noyade émotive virtuelle. Il en résulte que les TIC les plus utilisées par les jeunes de l’étude étaient les sites Internet d’information et de ressources, les vidéos en ligne ainsi que les outils d’autoformation. Cette utilisation des TIC s’avérait fréquente, rapide et efficace. Pour « composer virtuellement avec sa noyade émotive » (catégorie centrale), l’adolescent peut adopter plusieurs stratégies, parfois dans une même séance: se distraire, s’informer, se dévoiler et aider les autres. Ces stratégies peuvent entraîner une croissance émotive, l’obtention d’aide, un soulagement temporaire, aucun changement, une exacerbation des idées suicidaires ou un passage à l’acte. Des recommandations pour la pratique clinique, la formation ainsi que la recherche sont émises. / A growing number of adolescents are seeking answers to health problems through Information and Communication Technologies (ICT), especially regarding mental health. Some studies even report that adolescents highly at risk of suicide do not seek help in person and prefer seeking help through ICT. To our knowledge, no study in Quebec has yet explored the ICT help-seeking process of adolescents at risk of suicide. Thus, the aim of this study was to understand and generate a theory on the ICT help-seeking process of adolescents at risk of suicide. The objectives were to: (1) describe the use of ICT by adolescents at risk of suicide seeking help and (2) understand the ICT help-seeking process of adolescents at risk of suicide. Grounded theory methodology was used in response to these objectives to help model the help-seeking process of adolescents at risk of suicide. Data was collected through semi-structured interviews, an ICT help-seeking questionnaire and live observations of ICT help-seeking by the adolescents of this study. Theoretical saturation was reached with a total of 15 adolescents, aged 13 to 17, at risk of suicide. Data was analyzed using Corbin and Strauss’s paradigm model and the constant comparative method until data saturation occurred and a substantive theory was generated called the virtual emotional drowning theory. In order to “virtually cope with emotional drowning” (central category), the participating adolescents tried different strategies and sometimes, more than one strategy was used in the same session. These strategies included distracting themselves, getting informed, revealing themselves and helping others. The use of these strategies resulted in emotional growth, getting help, getting temporary relief, having no changes or sadly, having an exacerbation of suicidal thoughts or an actual suicide attempt. Finally, suggestions for clinical practice, training programs and future research are presented. The results of this study allow a better understanding of the use of ICT by adolescents at risk of suicide in order to develop, implement and evaluate ICT nursing interventions that will better respond to these adolescents’ needs.

Introduction: Mood disorders are a serious burden on Canadians. Physical and sedentary activity are easily modifiable risk factors for many diseases. An association with depression could have important implications Objective: To investigate any cross-sectional or longitudinal association between physical activity, sedentary activity, and depression in the National Longitudinal Survey of Children and Youth (NLSCY). Methods: These studies used both a stacked cross-sectional and a trajectory/latent class analysis design Univariate and multivariate multinomial logistic regressions were used to assess the relationship between physical and sedentary activity and depression using the emotional disorder-anxiety scale for children and youth available in the NLSCY. Results: When accounting for covariates, physically inactive respondents had increased odds of higher depressive symptom scores. Sedentary activity was only statistically significantly associated with depressive symptoms in the cross-sectional design. Conclusions: Physical inactivity is significantly associated to depressive symptomatology. The relationship between sedentary activity and depression is inconclusive.

Cette recherche s’intéresse à la façon singulière dont l’adolescent ou le jeune adulte suicidant se représente ses liens familiaux et extra-familiaux. Elle explore la façon dont ces jeunes s’inscrivent dans leur histoire familiale, se repèrent dans leur généalogie, mais aussi la façon dont ils construisent, dans le monde qui les entoure, leur réseau d’appartenance. Comprenant l’accès aux transmissions familiales et la possibilité de tisser un réseau de lien extra-familiaux, comme un élément capital de la construction identitaire, ce travail envisage l’hypothèse selon laquelle l’acte suicidaire de l’adolescent traduirait une revendication de l’unicité et de l’authenticité de son existence. L’intention de se faire exister serait plus prégnante que l’intention de se donner la mort. De telles conduites, à valeur ordalique, témoigneraient d’un affrontement avec le monde, dont l’enjeu serait de vivre plus. Elles amèneraient l’adolescent à s’imposer, inconsciemment, de frôler la mort pour se transformer, renaître, revivre après le traumatisme, pour enfin exister. A l’aide d’entretiens cliniques et d’outils d’évaluation systémique comprenant la réalisation de génogrammes libres et imaginaires, seize études de cas ont été réalisées. Ces données ont permis d’effectuer une analyse qualitative individuelle et groupale et, plus particulièrement une exploration familiale tri-générationnelle. Sans confirmer la valeur ordalique de la conduite suicidaire, nos résultas suggèrent que les jeunes rencontrés tentent de se faire exister en cherchant une enveloppe généalogique mais aussi affiliative, contenante au sein de laquelle ils se sentent inscrits et reconnus. Le sentiment d'appartenance qui permet la différenciation et qui donne sens à l’existence fait défaut chez tous. Ces résultats ouvrent une piste de réflexion sur la signification du geste suicidaire à l’adolescence: il s’agit d’une quête de sens, mais aussi de reconnaissance, qui passe par l’épreuve personnelle et le fait d’y survivre. <p> / Doctorat en Sciences Psychologiques et de l'éducation / info:eu-repo/semantics/nonPublished

Objetivo. La presente investigación busca conocer y describir las características en la dinámica familiar ante la presencia de un miembro joven que tuvo ideación suicida. Método. Se utilizó el método cualitativo, con un diseño fenomenológico; se aplicó el análisis de contenido y el instrumento de recolección de información fue la entrevista semiestructurada, aplicada en los familiares del miembro joven que tuvo ideación suicida. Resultados. Fueron agrupados en cuatro categorías: contexto familiar, grado de relación entre los familiares, maneras de adaptarse y comunicación. Conclusión. Se concluyó que la dinámica familiar evidencia características que permiten conocer y describir el contexto en el que se encontraba la familia antes de la ideación suicida de su miembro joven, tales como antecedentes familiares de suicidio, diagnóstico de trastorno mental en el miembro joven y los conflictos a nivel familiar. Así como, características que se presentan a partir de las maneras en las que los familiares se adaptan ante la ideación suicida, mediante el cambio en las funciones de los roles y los acuerdos que llegan a establecerse. Otras características son las que se presentan en el grado de relación entre los familiares, evidenciándose en algunas familias, como cercanas, mientras que en otras las relaciones se encuentran lejanas. Por último, las características en la comunicación se ven reflejadas en la apertura que tienen algunos miembros para comunicarse entre ellos sobre aspectos personales y emocionales y, por otro lado, algunos familiares solo consiguen hablar de temas superficiales. / Objective. The present research seeks to know and describe the characteristics on the family dynamics with the presence of a young member who had suicidal ideation. Method. The qualitative method was used, with a phenomenological design; content analysis was applied and the information collection instrument was the semi-structured interview, applied to the family of the young member who had suicidal ideation. Results. They were grouped into four categories: family context, degree of relationship between family members, ways of adapting and communication. Conclusion. It was concluded that family dynamics show characteristics that allow knowing and describing the family context in which the family was before the suicidal ideation of its young member, presenting characteristics such as a family history of suicide, diagnosis of mental disorder in the young member and conflicts at the family level. As well as, characteristics that arise from the ways in which family members adapted to the suicidal ideation, through the change in the functions of the roles and the agreements that they came to be established. Other characteristics are those that appear in the degree of relationship between family members, being evidenced in some as close, while in others the relationship are distant. Finally, the characteristics of communication are reflected in the openness that some members have to communicate with their relatives about personal and emotional aspects, and on the other hand, some relatives only manage to talk about superficial topics. / Tesis

Psykologer är en utav de yrkesgrupper som löper störst risk att under sin karriär mista en patient i suicid. Trots det saknas svenska studier på psykologer och deras arbete med suicidala patienter. Föreliggande studie syftade därför till att öka kunskap och förståelse för psykologers föreställningar om patientsuicid samt hur de upplever att det talas om det. Sju semistrukturerade intervjuer genomfördes med psykologer som inte hade egen erfarenhet av patientsuicid. Dessa analyserades utifrån en tematisk analys, vilken resulterade i fyra teman: Mellan förnuft och känsla, Två sidor av samma mynt, Ensam är inte stark och Individen bakom statistiken. Resultatet visade att enskilda psykologer och organisationer (universitet och arbetsplatser) hanterar och talar om suicidalitet på olika sätt. De olika aktörernas förhållningsätt bottnar antingen i förnuftet, i känslan eller i båda delar. Arbetet med suicidala patienter karakteriseras av oförutsägbarhet där kollegorna utgör ett viktigt stöd för psykologen i detta arbete. Därtill framkom att både den enskilda psykologen och samhället i stort har en vilja att humanisera den suicidala patienten. Slutligen verkar psykologers möte med suicidalitet vara ett underprioriterat ämne, vilket är framträdande både inom forskning, utbildning och på arbetsplatser. / Psychologists are one of the professions that are at a higher risk of losing a patient to suicide. Despite this, there is a lack of Swedish studies focusing on psychologists and their encounter with suicidal patients. Therefore, the present study aimed to increase knowledge and understanding for the notions that psychologists have regarding patient suicide and their opinions about how it is being talked about. Seven semi-structured interviews were conducted with psychologists who themselves had not lost a patient to suicide. The interviews were analysed through a thematic analysis which resulted in four themes: Between sense and sensibility, Two sides of the same coin, Alone is not strong and The individual behind the statistics. The findings showed that psychologists and the organizations (universities and workplaces) they were or had been a part of, were handling and talking about suicidality in different ways. The approach these different actors had to patient suicide was based on either sense, sensibility, or both. Working with suicidal patients is characterized by unpredictability thus highlighting that colleagues make up an important source of support. Furthermore, results showed that both individual psychologists and the society at large have a desire to humanize the suicidal patient. Finally, psychologists' encounter with suicidality seems to be an under-prioritized area, which is prominent in both research, education and in workplaces.

Non-suicidal self-injury (NSSI) is increasingly understood as representing a public health concern and a behavioral marker of emotional and psychological distress among young people. NSSI is prevalent during the period of young adulthood, including among emerging adults pursuing a university education, yet the vulnerability factors associated with NSSI in this population merit more in-depth and contextualized investigation. The current dissertation's overarching objective was to better understand the risk context surrounding university students' engagement in NSSI. Using a sample of 2,579 students (75.2% female; Mage=18.97; SDage=1.54), Study 1 first explored the roles of parental (mother and father pressure) and intrapersonal (emotion dysregulation, academic coping, perfectionism subtypes) risk factors in university students’ likelihood and frequency of engagement in NSSI in the past year. An integrated latent structural equation model revealed that higher levels of perceived mother and father pressure were associated with a greater likelihood of past-year NSSI engagement in the university student sample. Among intrapersonal risk factors, only emotion dysregulation was found to be associated with higher NSSI likelihood and frequency. Building upon these results, Study 2 sought to narrow in further on understanding the emotion regulation profiles of university students with a past-year history of NSSI. Using a person-centered statistical approach, university students who reported having engaged in NSSI within the past year (n = 479; 83.8% female; Mage = 18.77; SDage = 1.43) were classified into latent profiles based on their self-perceived difficulties in regulating both positive and negative emotions. Independent samples of students who had a past history of NSSI but had not self-injured within the previous year (n = 439; 82.9% females; Mage = 19.03, SDage = 1.62) and who had no history of NSSI (n = 1551; 69.9% females; Mage = 19.02, SDage = 1.55) were included as comparison groups. Latent cluster analyses uncovered three emotion regulation profiles within the NSSI sample - the Average Difficulties (47.4%), Dysregulated (33.0%), and Low Difficulties (19.6%) profiles - each of which differed meaningfully from both comparison samples on mean levels of emotion regulation difficulties. Students across the three profiles also differed in their self-reported experiences with parents, particularly with fathers (perceived pressure, antipathy, unresolved attachment, psychological control), and in the extent to which they felt alienated from parents. Lastly, students across profiles differed in the frequency, methods, functions, and addictive properties of their NSSI. Taken together, findings from the current dissertation expanded our awareness of vulnerability factors for NSSI that have historically been understudied (e.g., parental pressure, father-child relationships, dysregulated positive emotions), while also bringing into focus the notion that even well-established NSSI risk factors (emotion regulation difficulties) can manifest quite heterogeneously amongst university students with a history of self-injurious behavior.

Objective: The relationship between alcohol use and suicidal behaviors is well-accepted, but less is known about the contribution of its early initiation. This study was designed to test the association of early alcohol initiation versus later initiation with suicidal ideation and attempt in an ethnically diverse sample. Methods: The Collaborative Psychiatric Epidemiology Surveys (CPES), 2001-2003 (n = 20,013), database was used. A total of 13,867 participants were selected included 56.9% females and 43.1% males. Race and ethnicity were reported as 28.8% non-Hispanic White, 39.1% Black, 20.3% Latino, and 11.9% Asian. Logistic regression analyses tested the associations between early (< =14 years) and later (> =15) age alcohol initiation with suicide ideation and attempts. Alcohol initiation was indexed by self-report of the first time that any alcohol product was consumed. Potential confounders were controlled. Results: Early alcohol initiation was associated with higher odds (AOR = 3.64, 95% CI [2.51, 5.28]) of suicide ideation as compared with adults who had initiated > = age 15 (AOR = 2.11, 95% CI [1.46, 3.04]). Early age initiation was also associated with higher odds (AOR = 3.81, 95% CI [2.02, 7.18]) of lifetime suicide attempt versus later age initiators (AOR = 2.03, 95% CI [1.08, 3.79]). Significant differences were found between early and later age of initiation. Conclusion: Early age of alcohol initiation has profoundly increased odds of suicide ideation or attempt. It is critical that effective prevention programs for children and their caregivers be implemented to prevent or delay alcohol initiation and lessen the risk for future suicidal behaviors.

Psykisk ohälsa ses som ett folkhälsoproblem bland barn och ungdomar. Psykiska besvär tidigt i livet ökar risken för suicidförsök. I åldersgruppen 10–19 år begår ungefär 50–60 personer suicid per år i Sverige. Psykologer på barn- och ungdomspsykiatrin (BUP) arbetar bland annat med suicidnära barn och ungdomar. Syftet med studien var att undersöka psykologers upplevelse av att arbeta med suicidnära barn och ungdomar. Studien har även ämnat till att undersöka vilket stöd organisationen erbjuder psykologerna i arbetet med suicidnära barn och ungdomar samt hur stödet upplevs. Sju psykologer på BUP intervjuades med semistrukturerade intervjuer som analyserades med tematisk analys. Majoriteten av deltagarna upplevde arbetet med suicidnära barn och ungdomar som ensamt, utmanande och emotionellt belastande samt att känslorna följde med efter arbetstid. Stödet från organisationen beskrevs som svagt och bestod oftast av handledning, riktlinjer och utbildning. Det kollegiala stödet upplevdes som bra men otillräckligt. Det stöd som psykologerna upplevde som viktigast att få från organisationen var emotionellt stöd. Slutsatsen var att psykologerna upplever en obalans i arbetskrav och arbetsresurser som har resulterat i känslor som stress och oro. Förslag till framtida forskning är att studera patienternas och ledningens perspektiv på BUP samt jämföra arbetet på privatiserade BUP för att undersöka skillnader i upplevelse och stöd från organisationen. / Mental illness is seen as a public health problem among children and adolescents. Mental disorders early in life increase the risk of suicide attempts. In Sweden, approximately 50 to 60 people between the ages of 10 and 19 commit suicide each year. Among other things, psychologists in child and adolescent psychiatry (BUP) work with suicidal children and adolescents. The purpose of this study was to examine psychologists' experiences of working with suicidal children and adolescents. The study also aimed to investigate what organizational support is offered to psychologists working with suicidal children and adolescents and how the support is experienced. Semi-structured interviews of seven psychologists in BUP were conducted and analyzed using thematic analysis. The majority of the participants experienced their work with suicidal children and adolescents as lonely, challenging, and emotionally draining and that these emotions followed them home after working hours. The organizational support was described as weak and usually consisted of supervision, guidelines, and training. The support from colleagues was perceived as good but insufficient. The organizational support that psychologists felt was most important to receive was emotional support. The conclusion was that psychologists experience an imbalance in professional demands and resources that has resulted in emotions such as stress and anxiety. Suggestions for future research are to study patient and management perspectives on BUP and compare existing research with the work in privatized BUP to see if there are differences in experiences and organizational support.

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