The present study attempted to identify demographic and psychological variables predictive of adolescent suicidal ideations and attempts. Data from 90 adolescents, who completed an intake form at a university community mental health clinic or were student volunteers, were utilized. Two judges tabulated information regarding age, gender, number of siblings, ethnicity, parental marital status, drug use, depression, suicidal ideation, and previous suicidal attempts. A multiple regression analysis was performed to identify which variables had predictive significance. Depression was the best predictor of both suicidal ideations and attempts. Ethnicity was also predictive; white adolescents were found to be at higher risk for suicide than individuals from other ethnic groups. It is suggested that additional studies be done exploring other predictors of suicide among adolescents.

The main purpose of this study was to develop a more complete understanding of the deeply situated, ethical and political character of suicide prevention program planning practice through the analysis of everyday narratives or "practice stories." By offering an in-depth view of program planning practice - based on the retrospective analysis of a national conference planning process - this study provides an ideal opportunity for learning about "what matters most" when multiple interest groups come together to plan new programs. Three broad research questions provide the focus for this study: What are the diverse personal and professional understandings that stakeholders bring to the work of suicide prevention? How do these various identities and roles get enacted through language? What are the implications that these various understandings and multiple discourses have for shaping subsequent program planning experiences, decisions and actions? Using an open-ended interview structure, nine conference planning committee members were invited to reflect on their own experiences at the planning table. My own storied account of our planning experience is presented alongside the observations and stories of my planning colleagues. Thus, the varied perspectives of different planning partners and stakeholders are represented in their own words and are woven into an unfolding and textured narrative about planning practice in the mental health field. Several important findings emerged which have relevance for the future study and practice of program planning. First, there was a clear privileging of professional knowledge and interests at our planning table. Second, the tasks of problem framing and discourse shaping are key functions that planners need to bring conscientious attention to in order to advance the overall planning agenda. Finally, critical listening, emotion, empathy, and care are important elements of communication and meaning making and I have argued that these relational attributes should be explicitly cultivated and nurtured at the planning table. / Education, Faculty of / Educational Studies (EDST), Department of / Graduate

Suicidal thoughts and behaviors (STBs) are a problem among young adults. Problem solving deficits have been implicated in suicide outcomes and may be especially relevant to young adults given the developmental demands and increased risk for STBs during this life stage. Emerging research suggests that problem solving and related cognitive processes (e.g., episodic memory) can be modified through a brief cognitive training session, hereafter referred to as the specificity induction. However, it is unknown whether benefits of this specificity induction extend to suicidal populations. The present study tested a web-based version of the specificity induction intended to improve problem solving skills, episodic memory and divergent thinking among suicidal young adults. We recruited and consented a sample of 105 young adults with past year STBs and randomly assigned them to receive either the specificity induction or a control condition (i.e., general impressions induction). Regarding feasibility of conducting an online study with this population 81.90% (n=86) of those who provided informed consent completed the study protocol. Regarding clinical acceptability of the web-based specificity induction, the majority of participants which received this cognitive training rated that they would be unlikely to “use again”, while endorsing that it was “easy to use” across several items of a user experience self-report questionnaire. Contrary to hypotheses,young adults assigned to complete the specificity induction did not show improvement in their performance on measures of problem solving and related cognitive processes compared to those assigned to the control condition. Through post-hoc analyses we investigated candidate sources of systematic variability in task performance (e.g., attention, mood, task order effects), but none were found to account for participants’ demonstrated problem solving performance. In sum, we conclude that testing this brief cognitive training through an online experimental study was feasible, the cognitive training was modestly acceptable in its online format, and it does not immediately improve suicidal young adults’ problem solving or related cognitive processes. By demonstrating what does not necessarily work with suicidal young adults, there remains room for future research to pursue alternative design or modes of single session interventions.

Bakgrund: Antalet fastställda suicid i Sverige år 2019 var 1269. Omvårdnaden av suicidala patienter ställer höga krav på sjuksköterskor när det kommer till kompetens, engagemang och empatisk förmåga. Grundutbildade sjuksköterskor kan komma att möta patienter med eller suicidtankar i olika instanser, även utanför psykiatrin. Den omvårdnad som sjuksköterskan ger dessa patienter består till stor del av professionella samtal och kräver att sjuksköterskan besitter förmåga att identifiera och hantera de känslor som kan uppstå hos denne i vården av den suicidala patienten. Syfte: Studien ämnar kartlägga vilka känslor som uppkommer hos sjuksköterskor då de vårdar suicidbenägna patienter. Metod: Databaserna CINAHL och PsycInfo användes för litteratursökningar. Latent innehållsanalys användes som analysverktyg. Resultat: Sex kategorier av närliggande känslor identifierades: Osäkerhet, otrygghet och känslan av att vara oförberedd, Ansvar och skuld, Ilska, frustration och aversion, Maktlöshet, hopplöshet, meningslöshet och hjälplöshet, Ångest, oro och rädsla, Medkänsla, intimitet och trygghet. Konklusion: Studien visar att sjuksköterskorna upplevde vården av suicidbenägna patienter som emotionellt påfrestande, vilket väckte många olika känslor. Känslospektrat innehöll inte enbart påfrestande känslor, utan också känslor som var gynnsamma för omvårdnadsarbetet. I flera fall efterfrågades möjlighet till reflektion och ventilering, något som kan understryka vikten av att införa verktyg som omvårdnadshandledning på fler arbetsplatser. / Background: The official number of suicides committed in Sweden were 1269 in 2019. Caring for suicidal patients put high demands on the nurses’ competence, dedication and empathic ability. Nurses who are not specialized in the field of psychiatry can still come across and care for these patients in other, more generalized wards. The care provided by the nurse consists to a great extent of professional conversations which demands the ability to identify, and deal with, the feelings which can arise in the care for the suicidal patient. Aim: The aim of the review is to map which emotions nurses’ feel when caring for suicidal patients.Method: The databases CINAHL and PsycInfo were used in the search for articles. Latent content analysis was used as a tool for the analysis. Findings: Six categories were identified: Insecurity, feeling unsafe, and feeling unprepared, Responsibility and guilt, Anger, frustration and aversion, Powerlessness, hopelessness, meaninglessness and helplessness, Anxiety, worry and fear, Empathy, intimacy and security. Conclusion: The study shows that the nurses experienced the care of suicidal patients as emotionally challenging, which awoke various feelings. The spectra of feelings did however not only contain strenuous emotions, but also feelings which were benefiting to the care. The nurses expressed a need to reflect and ventilate in multiple studies, which may underline the importance of implementing tools like clinical nursing supervision in more workplaces.

The present study examined presence of sexual assault history and perfectionism (viz., positive strivings & evaluative concerns) as predictors of self-destructive behaviors (viz., NSSI & suicidal behaviors) in a sample of 287 women college students. Results obtained from conducting a series of hierarchical regression analyses indicated several notable patterns. Sexual assault history was a consistent predictor of both NSSI and suicidal behaviors. Moreover, the inclusion of perfectionism was also found to consistently predict additional unique variance in NSSI and suicidal behaviors, even after accounting for sexual assault history. These patterns remained largely unchanged even after accounting for shared variance between NSSI and suicidal behaviors. Within the perfectionism set, evaluative concerns emerged as the most consistent unique predictor of both indices of self-destructive behavior. Finally, we did not find evidence for a significant Positive Strivings × Evaluative Concerns interaction effect in our analyses. Overall, our findings indicate that beyond the presence of sexual assault history, perfectionism remains an important predictor of self-destructive behaviors in women college students.

Adolescent suicide is a serious and growing problem among adolescents. Therefore, the goal of the current study was to try and identify predictors of suicidal ideation. The first objective was to examine whether the level of engagement in risky behavior predicts an increase in total suicidal ideation above and beyond other well-known risk factors (i.e., family functioning, gender, and problem-solving skills). The second objective was to investigate whether different types of risky behaviors (i.e., internalizing versus externalizing) predict different forms of suicidal ideation (i.e., passive versus active) above and beyond perceived family functioning, gender, and problem-solving skills. The pre-test archival data of 358 students who participated in a weekly problem-solving group were analyzed. Using four questionnaires, their perceived family functioning, knowledge of the problem-solving process, number of risk-taking behaviors, and level of suicidal ideation were assessed during the first and last sessions. Gender and perceived family functioning uniquely and consistently contributed to the variance in active, passive and total suicidal ideation scores. The active, passive and total suicidal ideation scores of adolescent males were consistently lower than adolescent females. When compared to adolescents who described having no relationship with their families, those adolescents who reported having a good or great relationship with their families consistently reported lower passive, active, and total suicidal ideation scores. Having an okay relationship produced mixed results. Total risky behavior scores significantly predicted adolescents’ total suicidal ideation scores above and beyond perceived family functioning and gender. In addition, internalizing behaviors, but not externalizing behaviors, predicted an increase in passive, active, and total suicidal ideation scores above and beyond perceived family functioning and gender. Based on these findings, current screening, prevention and treatment programs would benefit from adding questions designed to determine an adolescent’s engagement in internalizing behaviors and how they perceive their family relationships. This may help in identifying at-risk adolescents earlier so that they can receive the help and support they require.

Psykisk ohälsa är ett växande problem i samhället där ambulansteam möter patienterna i prehospital miljö. World Health Organization belyser att psykisk ohälsa ökar och suicid är den näst vanligaste dödsorsaken bland 15–29 åringar. I Sverige år 2020 vårdades 6 666 personer hospitalt efter suicidförsök och samma år omkom 1 168 person till följd av suicid. Studiens syfte var att belysa ambulanssjuksköterskors upplevelser av att möta och vårda suicidala patienter. En intervjustudie genomfördes med sex informanter som alla var ambulanssjuksköterskor. Intervjuerna analyserades med kvalitativ metod med induktiv ansats. Resultatet visar att ambulanssjuksköterskorna upplever det vårdande mötet som komplex och en svår utmaning. De upplever att de är beroende av ett välfungerande kollegialt samspel inför mötet med patienten. Svårigheterna i vårdmötet handlade om att vårda utan frivillighet, känna osäkerhet kring den vårdande kompetensen och att möta hot och våld. Att vara öppen och ärlig, lyssna och ge patienten tid upplevs vara en nödvändig grund i det vårdande mötet. Deltagarna belyser även att mötet berör på ett personligt plan. Ambulanssjuksköterskors upplevelser av det vårdande mötet och vårda suicidala patienter är ett relativt outforskat ämne. Ökad kunskap om hur ambulanssjuksköterskor bör förhålla sig till, möta och vårda suicidala patienter kan förhoppningsvis bidra till ett bättre och ett mer patientsäkert omhändertagande. / Mental illness is a growing problem in society where ambulance teams meet patients in prehospital environments. The World Health Organization highlights that mental illness is increasing and suicide is the second most common cause of death among 15–29-year-olds. In Sweden in 2020, 6,666 people were treated in hospital after suicide attempts and in the same year 1,168 people died because of suicide. The purpose of the study was to shed light on ambulance nurses' experiences of meeting and caring for suicidal patients. An interview study was conducted with six informants, all of whom were ambulance nurses. The interviews were analyzed using a qualitative method with an inductive approach. The results show that the ambulance nurses experience the caring meeting as complex and a difficult challenge. They feel that they are dependent on a well-functioning collegial interaction before the meeting with the patient. The difficulties in the care meeting were about caring without volunteering, feeling insecure about the caring competence, and facing threats and violence. Being open and honest, listening and giving the patient time is perceived as a necessary foundation in the caring meeting. The participants also highlight that the meeting touches on a personal level. Ambulance nurses' experiences of meeting and caring for suicidal patients is a relatively unexplored topic. Increased knowledge of how ambulance nurses should relate to, meet, and care for suicidal patients can hopefully contribute to better and more patient-safe care.

The present study compares two types of treatments designed to reduce suicidal ideations: social problem-solving therapy and supportive therapy. Social problem-solving therapy is based on research indicating that suicidal individuals have deficits in problem-solving skills in general and in interpersonal problem-solving skills, in particular. Supportive therapy was chosen as a comparative treatment to control for nonspecific effects of problem-solving therapy and to provide an ethical alternative treatment. The results indicated that problem-solving therapy was more effective than supportive therapy for reducing depression and for improving interpersonal problem-solving self-efficacy at posttest. At 3 month follow-up there continued to be differences between the groups in depression, but not in problem-solving self-efficacy. In addition, at follow-up problem-solving therapy was more effective than supportive therapy for reducing hopelessness and loneliness. Although there were no differences between the groups on severity of suicidal ideations, within group analyses revealed that problem-solving therapy significantly reduced severity of ideations over time. The findings suggest that social problem-solving therapy is a more effective treatment than supportive therapy for reducing depression, hopelessness, and loneliness of suicidal individuals. This may be due to social problem-solving deficits being a key problem for suicidal individuals. Although there are several limitations to the study, such as small sample sizes, it provides an example of treatment research with suicidal individuals. Similar studies would be useful to further evaluate empirically-based treatments for suicidal individuals. / Ph. D.

published_or_final_version / Social Work / Master / Master of Social Sciences

Attitudes toward suicide have been linked to the way health professionals and lay people behave toward suicidal individuals. In some instances negative attitudes toward suicidal persons seem to have contributed to repeated attempts or to suicide completion. This study examines attitudes held by college students toward suicide, explores whether their attitudes are related to their skills at recognizing therapeutic verbal interventions, and seeks to identify personality variables that might predict attitudes toward suicide as well as skills at recognizing therapeutic interventions. Three instruments, the Suicide Opinion Questionnaire (SOQ), the Suicide Intervention Response Inventory (SIRI), and the California Psychological Inventory (CPI), were administered to 215 volunteer undergraduates (122 males and 93 females) from introductory psychology classes. Subjects' modal age range was 18 to 21 years. Forty-five attitudinal items from the SOQ yielded a total favorableness score for each subject; skills at recognizing suicide intervention responses to imaginary suicide callers was rated by a SIRI score from 0 to 25. The first hypothesis, that favorableness in attitudes toward suicide would correlate positively with skills at recognizing facilitative suicide intervention responses, was not supported by test data. The second hypothesis was accepted in that both, favorableness in attitudes toward suicide (SOQ scores) and recognition of faciliative intervention responses (SIRI scores), can be predicted from a personality test. SOQ scores were predicted positively by CPI scales Flexibility, and Achievement via independence, and negatively by Achievement via conformance. SIRI scores were predicted positively by Intellectual efficiency and Dominance, and negatively by Good Impression. The literature identifies flexibility as one of the behaviors of good crisis intervention workers. An implication from this study is that students showing more flexibility and autonomy are likely to show also more favorableness in attitudes toward suicide. Another implication is that students who are more intelligent and quick at making use of their intellectual abilities, who show initiative, and who have a moderate concern about their impression on others, are more likely to recognize intervention responses that may be helpful to suicidal persons.