xx, 562 leaves : / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (M.D.)--University of Adelaide, Dept. of Psychiatry, 1979

Objectives. This thesis aimed to examine a series of personality and cognitive factors as prospective predictors of suicidal thinking and psychological distress. A secondary objective was to examine any causal relationship between rumination and attentional biases. Method. In order to achieve the above objectives, a series of four studies were conducted. Studies one and three were prospective studies, using analogue samples, to examine the role of personality and cognitive factors in distress and suicidal thinking. In addition, study one also investigated the effect on attentional bias of manipulating rumination. Study two was an experimental study in which two different methods of manipulating attentional bias were piloted. The final study in this thesis employed a clinical sample of general hospital parasuicide patients to investigate whether relationships between personality and cognitive factors were replicable in a clinical population. Results. The personality and cognitive factors understudy were investigated within a research framework to examine their interactive effects. Hierarchical regression analyses revealed a number of moderating and mediating relationships between these personality and cognitive factors to prospectively predict both suicidal thinking and psychological distress. In addition, rumination was found to have a causal influence on positive attentional bias. Conclusions. Evidence from this thesis links personality and cognitive factors to both suicidal thinking and psychological distress in a series of moderating and mediating relationships. These are discussed in relation to the possible theoretical and clinical implications.

M.Cur. (Psychiatric Nursing) / Suicide is the intentional, self-induced action leading to death - an action regarded by the World Health Organisation (WHO) as the third largest cause of death among people under the age of 20 years in the Western World. In South Africa the occurrence of suicide has risen from'0,73 percent of the population in 1987 to 1,12 percent. Suicide has both financial and emotional implications for the community, who pays for it, either directly or indirectly. Suicides and attempted suicides place a burden on the health system and the public by way of higher taxes, increased medical fund contributions and higher insurance premiums. Health and welfare costs escalate because disability pensions are paid of work functions have become impeded in cases where suicide attempts have failed and for the rehabilitation (physical and psychological) of the person whose suicide attempt has failed, as well as for the surviving members of a family where a suicide attempt was successful. Between seven ten people are affected by every person who commits suicide. Not only do they experience shock, denial and helplessness as in the case of a 'normal' death, but also feelings of anger guilt and emotional distress, together with the development of physical symptoms. They become anxious, weepy and are afraid to be alone. They tend to use more sedatives and, tragically, become higher suicide risks themselves than the average population. Therefore, suicide is not only the beginning of an unprepared, intense grief reaction, but also a psychiatric trauma which leaves people emotionally vulnerable and thereby negatively influences their quest for wholeness. People close to suicide victims require the mobilisation of resources to facilitate their quest for wholeness. This study is aimed at exploring the experiences of people close to suicide victims and to determine guidelines for supporting people close to suicide victims, to enable to nurse and mobilise the resources that will facilitate their quest for wholeness. The researcher used the Nursing for the Whole Person Theory as a point of departure. The research is of an exploratory and descriptive nature and contextually bond due to the fact that an effort was made to obtain new perceptions and understanding of the experiences of people close to suicide victims. A phenomenological method of naive sketches was used to obtain data. The random sample population consisted of ten participants obtained by way of purposive, convenient random test and which complied with specific selection criteria. Data was analysed by way of content analysis. The experiences of persons close to suicide victims are contained in experiences in the internal environment, the external environment and patterns of interaction according to the results of the research and a literary control. Certain themes are identified according to which guidelines can be set, namely: chaos immediately after being notified of the suicide, avoidance and denial as defence mechanisms, deranged perceptions concerning the suicide, mixed feelings, the development of empathy, a need for reason and meaning in the suicide, disturbed relationships, a need for ventilating and the occurrence of questions concerning the suicide. Guidelines for support are discussed in three phases of support. The first phase entails support immediately after being notified of the suicide, the second phase offers support by way of helping the persons close to the suicide victim to integrate the reality of the suicide, while the third phase of support addresses the lengthened grief process. General information, non-professional support and professional support are regarded as sources of support.

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.

Objective. Previous research has implicated personality and cognitive factors in the experience of suicidal thoughts and behaviours. On the basis of two psychological models of suicide (Escape from Self; Baumeister, 1990; Cry of Pain, Williams, 1997), this thesis investigated an integrative model involving the relationship between perfectionism, motivation, and autobiographical memory recall to predict psychological distress (hopelessness, depression/anxiety, suicide ideation). Methodology. Four inter-related, but independent, prospective studies were conducted to address a number of research questions in both university students (Studies 1,2 & 3) and parasuicide patients (Study 4). Results. The main findings of this thesis are that slow or over-general recall of negative and positive memories moderates the relationship between perfectionism and psychological distress. Furthermore, it was found that perfectionism serves as a mediator in the relationship between behavioural inhibition motivation (BIS) and psychological distress. Overall, the results suggest that much knowledge can be gained from investigating the psychological processes underlying suicidal behaviour, and we highlight the utility of employing integrative psychological models. The results are discussed in terms of their therapeutic implications, as well as their implications for future research.

A mail survey was conducted with 49 suicide survivors from 13 different suicide support groups across Canada. Participants were asked about their experiences of grieving a suicide and if the suicide was part of a cluster. Quantitative and qualitative research methodology was used in the coding and analysis of the data. A theory diagram was devised to test four hypotheses. Results of the regression analyses contradicted one hypothesis: showing that an increase in coping mechanisms may heighten levels of grief for a suicide survivor. The number of possible suicide linkages was highly significant with 5 of the 49 participants answering positively when asked if the suicide they were grieving was part of a cluster. Suicide bereavement groups were consistently rated as beneficial or very beneficial by participants. Lastly, content analysis of the open-ended questions showed a common experience of stigma associated with a suicidal death for survivors.

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Although the suicide literature is replete with studies approaching risk assessment from the standpoint of the external observer, research into the intrapsychic mechanisms involved is rare. This study investigated the importance of hope, threat, competence, succorance, helplessness, and control among inpatients hospitalized for suicidal behavior.

Suicide, the endpoint of the continuum that begins with suicide ideation, is known to be an important precursor of attempted suicides. The purpose of this study was to determine the level of suicide ideation of police members and to determine the differences between suicide ideation of various demographic variables, in particular, the gender, rank and race groups of police members. The convenience sample (N = 111) was drawn from police stations in the Nelson Mandela Metropole in the Eastern Cape Province. The Adult Suicide Ideation Questionnaire (ASIQ) and a Biographical Questionnaire were administered. The results indicated that 1.4 % of the sample showed significant levels of suicidal ideation scoring a high score above 31 (i.e., above the 97th percentile by ASIQ). The T-test, One-way (ANOVA) and the Pearson Chi-Square analysis showed no significant differences between suicide ideation and the demographic variables based on the police station, age, gender, race, rank, years of service, years of current position, educational qualifications, marital status, presence of medical conditions, number of alcoholic drinks consumed per week, smoking behaviour and exercise behaviour. However, participants with previous suicide attempts had significant high scores on ASIQ.

The suicide rate in Hong Kong has been increasing since 1997, and the suicide rate among the 30-49-year-olds has increased from 294 in 1996, to 484 in 2003, surging about 65% since 1996. Despite the fact that an increasing trend had been observed, the characteristics of suicides among this age group were not known because no empirical research had been conducted among this age group in Hong Kong. The present study is the first psychological autopsy study conducted on the 30-49 age group in a Chinese society. The aims of this study were to identify and examine the magnitude of the risk factors of middle-aged suicide among the Hong Kong citizens, to determine the similarities and applicability of Western findings into local situation, and to recommend culturally specific evidence-based preventive and intervention strategies. These findings suggest that there are more commonalities than differences in risk factors for suicide found in other psychological autopsy studies; however, the magnitude of some of these identified risk factors were inconsistent with suicide research conducted in other countries. Given the multi-faceted and distinctive nature of middle-age suicide in Hong Kong, a public health approach of suicide prevention strategy, which targets both individuals and the population, is considered to be appropriate than the clinical approach in order to reduce larger population developing greater suicidal risk.