Research has long documented beneficial associations between forgiveness and numerous health outcomes; however, its relationship to suicidal behavior has been relatively neglected. Both cynicism, and psychache, or agonizing psychological pain, have displayed deleterious associations with suicidal behavior, but have rarely been incorporated into more comprehensive models of suicidal behavior. Recent work has resulted in the development of a theoretical model of the forgiveness-suicidal behavior association, which can incorporate several mediator variables including cynicism and psychache. The present study used an undergraduate sample of college students (N = 312) to test a serial mediation model of the cross-sectional associations between forgiveness, cynicism, psychache, and suicidal behavior. Forgiveness of self and of uncontrollable situations were indirectly associated with suicidal behavior via psychache, while forgiveness of others was indirectly associated via cynicism and psychache in serial fashion. Implications in the context of previous literature and treatment, particularly acceptance-based interventions, are discussed.

Suicide in rural areas has not received significant attention in the research literature to this point, although suicide rates are higher among adults and older adults in rural areas than in urban areas. The aims of the study were as follows: (1) establish the feasibility of assessing suicide ideation and history of suicidal behavior; (2) determine preliminary estimates of the prevalence of suicide ideation, and history of suicide attempts; and (3) examine the effectiveness and acceptability of safety and referral plans for individuals whose responses indicated elevated suicide risk, in rural communities with limited access to referral care. Participants were 96 adults aged 40 to 85 years old (M = 57.34, SD = 11.47) residing in West Texas. Our results indicate that 26% of participants endorsed a lifetime history of suicide ideation and/or suicide attempt(s) and 12.5% reported suicide ideation in the past year. In addition, 93.4% of participants reported that participation in our suicide-focused study was an excellent or good experience. Results suggest that individuals in rural communities are willing to talk about suicide, found the experience helpful, and were satisfied with the referral process.

Suicidal behavior represents the most severe, yet inherently preventable, outcome of psychiatric disease. Despite tremendous efforts to improve the awareness and treatment of psychiatric illness, suicidal behavior rates have been on the rise. The greatest challenge to confronting this crisis is the effective identification and treatment of those at risk for suicide. This challenge has been difficult to address due, in part, to the lack of a clear biological basis for suicidal behavior. Toward addressing this knowledge gap, evidence has been identified of a significant heritable component to suicidal behavior. Subsequent genetic research efforts have focused on the examination of common sites of genetic variation within candidate genes and throughout the genome. These efforts have identified many potentially important risk loci, but the majority of the risk expected to arise from genetic variation remains unexplained by current data. The primary objective of this dissertation was to examine the contribution of largely unexplored rare and potentially damaging genetic variation within suicidal behavior. To do this, targeted next-generation sequencing approaches were employed within a cohort of individuals diagnosed with bipolar disorder, a group particularly enriched for suicidal behavior. Sequence data was generated that examined essentially all protein-coding regions of the human genome (“exome”), with expanded sequencing around and within candidate genes hypothesized to play a role in suicidal behavior risk. The secondary objective of this dissertation focused on the assessment of rare variation within bipolar disorder through sequenced pedigrees and followup in a large collaborative bipolar disorder versus normal control sequencing dataset. These objectives were addressed through the thoughtful application of diverse and complimentary methods. These methods were selected to investigate individual variants, genes, and biological pathways. This approach offered examinations of the potential impact of rare genetic variation within focused regions and across complex biological process pathways that could be disrupted through damaging variation in many different genes. The presented efforts represent the largest examinations of rare functional variation with suicidal behavior and bipolar disorder performed, to date. No individual variant or gene survived correction for multiple testing for either phenotype. These results are consistent with other initial sequencing efforts in complex psychiatric phenotypes, offering conclusions that larger samples will likely be required to identify significant associations for single variants and genes. Within pathway analyses, however, we identified a significant enrichment of rare damaging variation that segregated within bipolar disorder pedigrees in genes that have been implicated in de novo studies of autism. This finding was further replicated within three large case/control sequencing samples, providing support to emerging evidence of a potential overlap of risk loci for autism and bipolar disorder. Many additional results approached significance that bear further consideration. These results offer potential candidate genes and pathways that could be utilized in future sequencing efforts for suicidal behavior and bipolar disorder. In addition, highly valuable resources in the form of datasets strongly enriched for novel rare loci were produced that can significantly contribute to ongoing efforts to investigate bipolar disorder and suicidal behavior. These data can be used in combination with other emerging datasets to generate more powerful meta- and mega-analyses to confidently identify risk loci for both phenotypes.

This research developed two best-fitting structural equation models of risk factors for adolescent depression and suicidality: a core model, which included parenting factors, gender, depression, and suicidality, and an extended model, which also encompassed personality traits (Introversion and Impulsivity) and mood factors (Anxiety and Anger). Further, this research investigated the consistency of model fit across time (Le., 1 month & 12 months) and samples, and explored the effectiveness of the ReachOut! Internet site as a psychoeducational prevention strategy for adolescent depression and suicidality. Gender, age, and location differences were also explored. Participants were 185 Year-9 students and 93 Year-10 students aged 14 - 16 years, from seven secondary schools in regional and rural Victoria. Students were given a survey which included the Parental Bonding Instrument (Parker, Tupling, & Brown, 1979), the Millon Adolescent Personality Inventory (Millon, Green, & Meagher, 1982), the Profile of Mood States Inventory (McNair & Lorr, 1964), items on suicidal behaviour including some questions from the Revised Adolescent Suicide Questionnaire (Pearce & Martin, 1994), and questions on loss and general demographics. Results supported an indirect model of risk factors, with family factors directly influencing personality factors, which in turn influenced mood factors, including depression, which then influenced suicidality. At the theoretical level, results supported Attachment Theory (Bowlby, 1969), demonstrating that perceived parenting styles that are warm and not overly controlling are more conducive to an adolescent's emotional well-being than are parenting styles that are cold and controlling. Further, results supported Millon's theory of personality (1981), demonstrating that parenting style influences a child's personality. Short-term intervention effects from the internet site were a decrease in Introversion for the full sample, and decreased Inhibition and Suicidality for a high-risk subgroup. Long-term age effects were decreased Inhibition and increased Anxiety for the fall sample. There was also a probable intervention effect for Depression for the high-risk subgroup. No location differences for the risk factors were found between regional and rural areas.

Since 1979 Iranians have experienced a variety of events that reasonably will have lasting effects on their mental health. In 1979 the Islamic Revolution took place and in 1980 eight years of Iraq-Iran war started. In recent years there has developed conflicts between Iran and the International society because of the Iranian activities in developing nuclear energy. To these can be added the social and religious limitations on the behavior of people. These limitations are experienced especially strong in the life of adolescents and young people. This thesis covers four different aspects of the mental health of Iranians. General health questionnaire (GHQ-12) was utilized to investigate the mental health of 4599 Iranian 3rd grade high school students (aged 17-18 years). The GHQ cut off was taken 7 or more. A considerable proportion of the students were at risk of suffering from mental health problems (29.5 %), girls more than boys. Periodic mental health surveys in high schools are proposed to identify students at risk and activities to improve their coping skills and problem-solving abilities. To study the methods of poisoning used for deliberate self harm, 2039 medical records in Loghman Hospital in Tehran were reviewed (52.3 % were females). Loghman Hospital is a specialized hospital for intoxication cases. In both genders the greatest proportions of individuals were in the ages 20-29. Drugs, pesticides and other agricultural chemicals were the most commonly used methods in each age group regardless of gender. Females outnumbered males especially in the youngest age group of 10 to 19 years of age. In a cross sectional study of 214 subjects from Tehran the Attitude Towards Suicide (ATTS) instrument was translated and validated in Farsi language. The coefficient alpha for all sections was more than 0.70 except for the Attitude section which was 0.68. Ten latent factors were extracted from the attitude section accounting for 61 % of the variance in the data. It is concluded that the instrument can be used to study suicide ideation and attempts in Iranian populations, but new items with special attention to Iranian cultural characteristics should be added to the attitude section. To make a cross cultural comparison of personality using the Temperament and Character Inventory (TCI) samples of 300 Germans, 300 Swedes and 316 Iranian subjects were studied. The factorial structural analysis using procrustes rotation method showed the structure of personality to be generally rather equivalent across cultures. It is apparent, however, that there are cultural differences between the Iranian and the European subjects mainly concerning character dimensions. These results support the theoretical assumptions that character development is mainly determined by socio-cultural factors during the socialization process. Based on our studies on independent samples in Iran a significant number of people are at risk of various mental health problems. A considerable number of young and adults are at risk of attempting self harm and suicide. Because of many limitations on specific topics of research in Iran including self harm and suicide we cannot present a realistic picture of this phenomenon in our society. There are different sources of tension in adolescent's life in Iran including familial and social sources. They are ever increasing in nature and in number. Besides these domestic sources of inconvenience our people is living in a kind of cold war situation which increases tension over life of all people.

Thesis (Ph. D.)--York University, 2001. Graduate Programme in Psychology. / Typescript. Includes bibliographical references (leaves 191-220). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://wwwlib.umi.com/cr/yorku/fullcit?pNQ67919.

published_or_final_version / Community Medicine / Master / Master of Public Health

Objectives This thesis aimed to investigate the relationship between intimate partner abuse and suicidality, to deepen our understanding of the factors and mechanisms involved in increasing suicide risk in this group. This investigation was carried out using the framework of the Integrated Motivational-Volitional (IMV) Model of Suicidal Behaviour (O’Connor, 2011), and this research aimed to act as a test of this theoretical model. Method In order to achieve the above objectives, two major studies were conducted. These were prospective studies, with Study one being exploratory and utilising a large scale survey design, and Study two carrying out an in-depth investigation. These studies utilised a general population sample consisting of both males and females, and compared those with and without experience of intimate partner abuse. Both studies are reported over two chapters, one focusing on the relationship between intimate partner abuse and suicidality, and the other reporting the testing of the IMV Model. Results This research identified a number of key aspects relating to intimate partner abuse which are involved in increasing suicide risk within this group, such as the frequency of the abuse experienced, levels of control within the abusive relationship, and severity of stalking and harassment behaviours experienced. Investigation of the key elements of the IMV Model revealed that perceptions of internal entrapment play a significant mediating role in the relationship between intimate partner abuse and suicidality. In addition, social support and future thinking were found to act as moderators of this relationship. Conclusions This research makes a valuable contribution to the understanding of intimate partner abuse and suicidality, and highlights a number of important issues with regards to the conceptualisation and measurement of IPA. It has also identifies the importance of considering aspects such as stalking, perceptions of internal entrapment, and levels of control within relationships, when investigating suicidality within this group. This research used the context of IPA and suicidality to test the IMV Model, which has significantly increased out understanding of suicidality in relation to IPA. The IMV Model was shown to be a useful framework for understanding this relationship, however limitations of the model were identified. Further research is needed to test the model further and to explore the relationship of some of the elements within the context of IPA and suicidality.

A review of the literature strongly suggests that poor family dynamics play a critical role in an adolescent's choice of suicide. This thesis examines the literature and research findings on adolescent suicide and family functioning. It will bring together recent findings to help professionals access the information on adolescent suicide as it relates to the family. The psychosocial and cognitive theories of development are explored to provide a framework for understanding adolescents and the reasons for the choices and problem solving they make in their quest for identity. Since social workers are increasingly implicated in the prevention of youth suicide, the thesis applies the argument to prevention from a social work perspective.

In recent years there has been a notable increase in the number of suicides amongst South Asian youth in the Region of Peel in Ontario. Using a six-page questionnaire, an exploratory descriptive study was conducted with 104 participants. The purpose of the study was to inquire into the number of South Asian youth that had ever considered committing suicide; determine whether there were any predicting factors; and gain insight as to "why." It was found that close to 30% of the sample had considered suicide and that gender, place of birth and a self-rating scale of depression were significant variables. Of those who had admitted to having considered suicide, 'family pressures' was cited as the number one reason.