Research on risk factor for suicidal behaviors has been broadly conducted to enhance knowledge of suicide prevention. However, there are still challenges for risk factor research. Four major research gaps have been identified: (1) uncertain effectiveness of the population approach versus the high-risk approach for suicide prevention; (2) lack of a valid and convenient Chinese-version screening tool for the severity of suicidal ideation among adolescents; (3) demand for testing the prospective associations of risk factors with suicidal ideation using a longitudinal designed population-based sample; and (4) necessity of pathway analysis to explore and confirm how risk factors interact with each other and lead to suicidality. This thesis aims to address these gaps through a combination of five studies. Study 1 introduces an illness and death model to suicide prevention research. Elasticity and sensitivity analyses were performed. The findings revealed that the control of suicide incidence among the healthy population is the most effective prevention strategy whereas treatment of mental illness appears to be the least effective approach to suicide prevention. Study 2 validates the psychometric properties of the Chinese versions of Reynolds’s Suicidal Ideation Questionnaire (SIQ) and Suicidal Ideation Questionnaire Junior (SIQ-JR, a short version of the SIQ) in a sample of Hong Kong adolescents. A short, four-item version of the SIQ-JR has been suggested as an alternative to the SIQ and the SIQ-JR. Study 3 identifies the history of psychiatric treatment, depression, anxiety, hopelessness, unstable marital status, poor economic circumstance, and a recent death of a first-degree relative as significant risk factors for the incidence of suicidal ideation. The associations of change in risk factors with the development of suicidal ideation have been tested. There are gender and age differences in the patterns of such associations. Study 4 focuses on psychological factors associated with the first-ever incidence of suicidal ideation. Psychological factors have been detected generally to differ in their associations with the incidence and persistence of suicidality. The idea that depression partially mediates the effect of average life distress on the persistence of suicidal ideation has clinical value. Study 5 introduces and tests a stressor and illness model as a theoretical framework reference for future risk factor research. Risk factors are classified into stressor, illness, and pattern factors. Both the simple and complex models are tested. Evidence supported the proposed mediating role of mental disorders between negative life events and severity of suicidal ideation. A gender-specific pattern of associations between stressors, illness, and severity of suicidal ideation has also been detected. This thesis has made substantial theoretical, psychometric, and empirical contributions to the existing knowledge of suicide research. / published_or_final_version / Social Work and Social Administration / Doctoral / Doctor of Philosophy

As the second leading cause of death among college students, suicide has become an increasingly prominent focus for campus mental health initiatives. Suicide prevention efforts frequently rely on the induction of students with suicidal ideation into counseling services, either through self-referral or referrals from friends, family members, and university staff. However, nearly half of students who seriously contemplate taking their lives do not tell anyone that they are struggling with suicidal thoughts. Concealment of suicidal ideation, particularly from one‟s informal support network, is not well understood, and no studies to date have examined this phenomenon among college students. Using archival data from a national survey of suicidal crises among college students collected in 2006 by The National Research Consortium of Counseling Centers in Higher Education, this study explored college students‟ self-reported reasons for concealing their suicidal ideation. Content analysis was used to categorize students‟ qualitative responses to an open-ended question asking why they chose not to tell anyone about their suicidal thoughts. Nine primary themes emerged from this inquiry: (1) perceived lack of need for help, (2) concern for the well being of others, (3) dispositional orientation towards privacy, (4) perceived pointlessness of seeking help, (5) anticipated negative reactions from others, (6) internal negative evaluation of suicidality, (7) fear of repercussions, (8) avoidance of interference from others, and (9) perception of having no one to tell. Multilevel modeling was then used to explore associations between demographic characteristics, reasons for concealment endorsed, and likelihood of attempting suicide within the 12-month period under study. Findings from this study contribute to an understanding of help avoidance among suicidal individuals and have implications for campus suicide prevention programming. / text

Despite its potential to enhance the mental health of college student populations, the efficacy of gatekeeper programs in connecting suicidal students with professional help is unclear. Potential negative side effects of peer helping programs, such as gatekeeper training, are rarely examined and there is not a sufficient body of evidence documenting the efficacy or safety of peer helping programs, despite their widespread use. The challenge of implementing a safe and effective peer based gatekeeper campus suicide prevention effort lies in balancing the benefits of connecting suicidal students to professional help more often and sooner, with the potential adverse mental health impacts of participation on gatekeepers. This study examines how a gatekeeper training program might increase suicidal student help seeking and measures the mental health impact of participation on Resident Assistants (RAs) trained in suicide prevention. This study will explore whether a more intensive helping role by the RA amplifies the effect of referring and securing professional help for suicidal students. This study also measures how differing the intensity of help provided by RAs impacts the gatekeepers’ own stress and suicidality levels. RAs will be trained under high versus low intensity helping conditions. RAs in the low intensity helping condition will be trained to identify potentially suicidal students and refer them for professional help. RAs in the high intensity helping condition will be trained to identify potentially suicidal students, engage them in a quasi-professional helping role, and refer them to professional help. This study will also explore whether promotion of telephone counseling as a helping resource will impact referrals to and utilization of professional help, either in-person or through telephone counseling. / text

Das Ziel meiner Magisterarbeit ist die Erscheinung des Selbstmords unter sozial – pädagogischem Aspekt zu ermitteln und die Ansichten der Pädagogen über diese Erscheinung zu erforschen. Außerdem setze ich mir zum Ziel zu erforschen, invieweit die Pädagogen vorbereitet sind, Präventivmaßnahmen zu ergreifen. Die Hypothese der Untersuchung: 1. Die Pädagogen sind bereit, präventive Maßnahmen gegen Selbstmord zu ergreifen. Aber es fehlt ihnen an Information über die Besonderheiten des Selbstmords und über die Möglichkeiten der Präventivmaßnahmen. Selbstmord ist eine komplizierte Erscheinung, die in verschiedenen Kulturen, Epochen und bei den Menschen von unterschiedlichen Rassen vorkommt. Diese Erscheinung widerspiegelt sich in zwischenmenschlichen Beziehungen und im seelischen Leben des Menschen. Sie ist als Kraft, die zu einer bestimmten Tat führt, sie ist als eine bestimmte Form des Protests. Selbstmord kann als Disharmonie der inneren Welt erscheinen, die im Augenblick der menschlichen Unsicherheit auf den Tod des Menschen verlangt. Selbstmord kann auch als das Ergebnis der schweren psychischen Krankheit vorkommen. Am häufigsten ist Selbstmord das Ergebnis des langen Prozesses, der manchmal auch das ganze Leben hindurch dauert. Die Aktualität dieses Problems ist auch in Litauen von besonderer Wichtigkeit. Das bestätigt die Statistik, die davon zeugt, dass jedes Jahr in Litauen etwa 1700 Menschen Selbstmord begehen. Noch mehr, 17000 Menschen versuchen es jedes Jahr, sich... [to full text]

This study gathers the literature on suicidal children and creates guidelines designed to assist professionals with assessing the suicidality of a child. Analysis of the literature reveals that there are varying ages of children used in the research, a lack of standardization for the definition of suicide, and resistance towards a collective research approach to understanding suicidal behaviour. The literature also identifies the important risk factors, which are incorporated into guidelines for determing this sucidality of a child: family discord and violence, depression, significant loss, poor and/or dysfunctional parent/child communication and bonding, aggressive behaviour, stress, physical abuse, parental separation/divorce, hopelessness, academic difficulties, prior suicide attempts, and viewing death as a temporary state of being. / viii, 104 leaves ; 29 cm.

Suicidal behaviour is a phenomenon encountered the world over. Recognising and adequately dealing with such behaviours, in a professional setting, is a role expected of a psychologist. Working with suicidal behaviour is influenced by a variety of factors on the part of the psychologist. These may include, inter alia, experiences they may have had with suicidal behaviour, the training they have received in order to deal with such behaviours and their subjective experience of self-efficacy in dealing with such behaviours. The current qualitative study sought to explore and describe the experiences of recently qualified South African psychologists in dealing with suicidal behaviour through semi-structured interviews. The focus was on newly qualified clinical psychologists who received their masters training at a university in the Eastern Cape Province of South Africa. The study aimed to understand how confident, equipped, and ready newly qualified psychologists perceived themselves in dealing with suicidal behaviour. Three major themes emerged from the data. The first describes the strategies psychologists used in order to recognise potential suicidal behaviour, the second was how newly qualified psychologists managed suicidal behaviour, and the final theme described how psychologists could be prepared for their role to deal effectively with these behaviours. Investigating their experiences enabled the participants to contribute towards creating knowledge in this crucial area of psychological practice and allowed for the discovery of invaluable insights which could benefit the future training of psychologists.

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The research examined mental health practitioners' attitudes towards, satisfaction with and use of suicide prevention contracting (SPC) techniques. Survey respondents comprised consultant psychiatrists, clinical psychologists, occupational therapists, mental health nurses, psychologists, registered medical officers and social workers. A self-report questionnaire was mailed to 1347 potential respondents, together with three follow-up letters sent out at two-week intervals. There was a 31% response rate, producing 420 valid questionnaires. The results of the research re-confirm the historical trajectory of SPC, from its early beginnings as a relationship-based suicide-risk assessment technique to one that is used in contemporary practice by practitioners to meet a range of objectives. The research focused on three SPC techniques in operation in clinical practice: verbal no-suicide assurances, no-suicide agreements, and written no-suicide contracts. Analysis of the data suggests a number of important findings. The first of these is that practitioners perceive different utility among these three techniques. Secondly, the least experienced practitioners were significantly less likely to use no-suicide contracts, despite seeing more suicidality and having more formal training in the use of the technique. Thirdly, a practitioner's gender, and formal training were significant in the perception and application of SPC techniques. Finally, suicidal behaviours and completed suicide was a clinical outcome in some situations irrespective of the use and non-use of SPC. The findings of this research are used to provide an emerging conceptual framework and associated nomenclature that inform clinical decision-making in relation to SPC. In addition, a conceptual model is presented which demonstrates that the potential for injudicious use of SPC techniques is as much precipitated by individual factors as it is by broader environmental factors. Key words: no-suicide contracts, suicide prevention contracts, no-suicide agreements, no-suicide decisions, contingency contracting.

The purpose of this project was to determine if oral interpretation in a social context setting can be used as a persuasive means of suicide prevention. A script on suicide was compiled, directed and performed as a solo performance by the writer. The thesis includes the script, a history of suicide prevention, the process of compiling a script for solo interpretation performance, and an overall evaluation of the production. This Author's evaluation was influenced by audience and critic responses.