published_or_final_version / abstract / toc / Social Work and Social Administration / Doctoral / Doctor of Philosophy

published_or_final_version / abstract / toc / Social Work and Social Administration / Master / Master of Philosophy

Patients with psychosis comprise a high-risk group in terms of suicide behaviors especially in the early phases. Suicide ideation on the other hand acts as the starting point along the chain of suicide. However less is known about suicide ideation among patients at their first-episode psychosis (FEP). Present study investigated contributing factors in suicidal ideation among FEP patients in Hong Kong. FEP outpatients (N=20) and normal controls (N=20) were invited to complete a set of self-assessment questionnaires. These questionnaires measured a wide range of potential risk factors including hopelessness, impulsiveness, reasons for living, insight, drug-attitude and treatment satisfaction. Results showed that patients have a higher occurrence-rate of suicide ideation (45%) compared to patients without ideation. Ideators were significantly more hopeless, impulsive, more aware of their illness and having fewer survival & coping beliefs. Taken together, current study extended the stress-diathesis model in explaining suicidal behaviors among psychotic patients. We also demonstrated that insight in patients plays a role in interacting with suicide ideation. Further, since hopelessness appeared to be the strongest associative factor among all, this study has implications on prevention work focusing on hope maintenance. / published_or_final_version / Psychological Medicine / Master / Master of Psychological Medicine

The suicide and the media research field are generally concerned with the effect, content, and production of mass-disseminating suicide information. Most of the previous studies in the field were conducted in western countries. This dissertation is devoted to extending the research map to the Chinese contexts and moving the field forward into the new media era. It proposes a conceptual framework based on the social construction of reality theory and refines the framework through a combination of five studies. Study 1 might be the first investigation on mass-disseminating suicide information’s effect on suicide occurrences in Mainland China, using the Foxconn suicides as a case study. It finds that the Foxconn suicides were temporally clustered and influenced by inter-person contagion within the company, as well as the newspapers’ reporting about the topic in Beijing, the nation’s capital. Study2 examines the prominence and representation patterns of reporting the Foxconn suicides in Mainland China, Hong Kong, and Taiwan in 2010 calendar year. It demonstrates that the media coverage of the Foxconn suicides in the three societies generally experienced a three-phase evolving process in 2010. Meanwhile, within every phase, the media in different societies showed differences in their representations. Furthermore, the study investigates how the representation can be influenced by news sources and social contexts and explores possible explanations why the Beijing media’s reporting influenced the occurrences of the Foxconn suicides. Study3 compares representation of suicides in case-control psychological autopsy studies with representation of the same suicides in Hong Kong media. Considering the psychological autopsy as relatively more rigorous and validated, the comparison examines the suicide news representation’s accuracy and stereotyping tendencies. It finds a strong homogenisation of the Hong Kong newspapers in accurately reporting suicide methods but inaccurately reporting suicide risk factors, and that their reporting was problematic in stereotyping of gender-and method-specific suicides. Study 4 is a qualitative study of 33newspaper journalists’ experiences with producing suicide news from representative daily newspapers in Mainland China, Hong Kong, and Taiwan. Utilising the grounded theory method, it extracts how the journalists construct media reality of suicide within a social context. The study summarises criteria of suicide news values, identifies three types of key agents which are often engaged by the journalists in constructing suicide news, and also generates a comparative framework of suicide news production in the Chinese contexts. Study 5 examines what suicide-related information is easily accessible online in Mainland China and Hong Kong and compares it with its counterparts in English. It explores how the comparative framework proposed by Study 4 can also be applied to understand the nature of the online suicide information and serves as a bridge connecting the thesis with future studies on suicide and the new media. The five studies collectively contribute to understanding the nature and mechanism of constructing media reality of suicide in the Chinese contexts. By applying the research findings, suicide prevention professionals would be able to develop context-sensitive strategies to cooperate with the media and prevent suicide. / published_or_final_version / Social Work and Social Administration / Doctoral / Doctor of Philosophy

published_or_final_version / Social Work / Master / Master of Social Work

published_or_final_version / Social Work and Social Administration / Doctoral / Doctor of Philosophy

Background Early interventions (EI) for psychosis are predicted to have an effect in reducing suicidal attempts and self harms for first episode psychosis (FEP) patients. However there is little evidence to reveal that early intervention has a long term effect in reducing suicidal behaviors. Also, the longitudinal patterns of suicidal behavior of patients under EI and standard care (SC) programme were remained unclear. Therefore, this study was performed to explore the longitudinal pattern of suicidal behaviors for EI and SC patients. The long term effect of EI in reducing suicidal attempts and self harms and possible predictors for suicide were also explored and analysed. Method A secondary analysis was performed with data retrieved from medical data in different hospitals. The data are matched up for SC patients and EI patients based on their demographic information. Data related to suicidal behaviors are collected. Longitudinal patterns of suicidal behaviors were analysis with generalized linear model (GENLIN) and descriptive analysis. Univariate regression was also performed to investigate predictors for suicide. Results EI has a significant effect in reducing the total number of suicidal attempts (X^2=5.779, p=0.016) and deliberate self harm (X2=7.817, 0.005) over 10 years but no effect on suicidal attempts in the first three year when effect was expected. However, data indicated EI has an effect of reducing the number of complete suicide. Patients do not receive EI is a significant predictor for increase in the suicidal attempts and younger age is a predictor for latter deliberate self harm behaviors. Conclusion The result demonstrated that EI has a long term effect in reducing suicidal behavior rather only short term and non-lasting effect as suggested by other researches. However, EI treatment might have a short term negative effect on suicidal ideations as suggested by the increase of suicidal attempts in the second and third years. EI services do not only improve in symptoms and quality of life but a long term effects in reducing the number suicidal behaviors. Although, there is a possible negative effect on suicidal attempts, it might be beneficial if EI programme can be apply to all psychotic patients. / published_or_final_version / Psychological Medicine / Master / Master of Psychological Medicine