Purpose: Therapists are often charged with the seemingly impossible task of predicting their client’s future behavior, particularly behavior that may result in harm or death. Adverse events (AE) refer to a constellation of behaviors or events that interfere with treatment and exhibit a risk to the safety of the patient, which include suicide attempts, non-suicidal self injury (NSSI) and suicidal ideation. This is the first study that seeks to identify and associate in-session markers in DBT prior to AEs. Method: The proposed study sought to identify whether ruptures in therapeutic alliance (3RS; Eubanks-Carter, Muran & Safran, 2015), the frequency and intensity of negative-self referential speech (LIWC2015; Pennebaker, Booth, Boyd & Francis, 2015) and periods of psychomotor agitation are associated with AEs within a course of Dialectical Behavior Therapy (DBT). By coding videotaped psychotherapy sessions (n = 98) across 21 patients diagnosed with Borderline Personality Disorder (BPD), the researchers prospectively examined the association between in-session phenomena during the session prior to an AE. Exploratory logistic multilevel modeling, mean comparison and latent profile analysis (LPA) techniques were used to identified in-session markers associated with adverse events across the course of DBT treatment. Results: Using a multilevel model building approach to account for the nested structure, increases in content/affect split was associated with increased likelihood (36% increase in log-odds) of NSSI occurrence reported in the subsequent session when controlling for frequency of past NSSI episodes. When controlling for prior suicide attempts, withdrawal and confrontation ruptures did not predict the occurrence of suicide attempts in the subsequent session. To further examine the heterogeneity of the Level 1 variables (i.e., in-session markers), the LPA fitted afive-profile solution that captured relative differences in mean frequencies of coded markers.The latent “session types” were named based on their in-session characteristics, with AEs identified post-hoc within the identified profiles. While AEs were distributed across multiple profiles, visual inspection aligned with the findings in the multilevel model. Sessions characterized by elevations in content/affect split and behaviors that distance from the therapist preceded NSSI during treatment. The majority of the sessions prior to suicide attempts (70%) during the study period were assigned to the profile with the lowest mean frequency of in-session markers. Clinical implications: The strength of the therapeutic alliance in DBT is an essential component of effective treatment. Therapeutic ruptures, particularly withdrawal ruptures, occur frequently in DBT treatment. Attending to these ruptures, especially occasions when a patient’s affect and verbal content are not congruent, may signal to the therapist that the patient requires additional support. In-session content/affect split may represent a vulnerability factor that puts the patient at increased risk of NSSI behavior due difficulty attuning to their internal experiences and limitations in their emotional flexibility. Limitations: Similar to other studies that examine self-harm, the low base-rate of suicide attempts and NSSI behavior complicates empirical study. Since the study utilized strict inclusion criteria for only individuals diagnosed with BPD, findings cannot be generalized to patients with other psychiatric diagnoses. While some therapist effects are controlled for in the study since one therapist treated all the patient included in the study, the study does not account for therapist factors that may influence the therapy dyad. Given the limited sample size, there was not adequate power to fit more complicated models (e.g., inter-level and intra-level interactions, random effect predictor variables, etc.).

No description available.

With suicide on the rise nationwide, it is important now more than ever to prioritize suicide as a public health issue. This means raising awareness and conducting research aimed at developing new suicide prevention tools and strategies, as well as reevaluating and challenging already existent ones. Media messaging can be a great suicide prevention tool. Suicide depictions and reporting in different forms of media—including newspapers, online publications, film, television, and more—have the power to influence behavior. When reporting in a safe and appropriate manner, the media can influence behavior in a positive way and encourage help-seeking. However, reports that sensationalize and glamorize suicide have the potential to spark suicide contagion. Thus, when reporting on suicide it is crucial to be aware of best practices and recommendations developed by experts. In recent years, media campaigns aimed at suicide prevention have gained traction. While there has been some evidence suggesting the success of such campaigns, more research is needed in this area. Further research is also needed to assess the effects of fictional depictions of suicide in film and television.

The purpose of this thesis is to (a) summarize a sample of the literature that pertains to suicidal behavior; (b) explore the benefits of the group approach for people who experience suicide-related issues; (c) provide information and models for special suicide-related groups; and (d) discuss age-variations of suicidal behavior.

published_or_final_version / Nursing Studies / Master / Master of Nursing

Titel: Ingen aning utan spaning – Skolsköterskors självmordspreventiva arbeteFörfattare: Eberhard, Charlotte; Lundgren, SannaInstitution: Institutionen för vård och natur, Högskolan i SkövdeProgram: Examensarbete i omvårdnad, 15 HpHandledare: Källerwald, SusanneExaminator: Westin, LarsSidor: 22Månad och År: juni, 2013Nyckelord: Skolsköterska, självmordsprevention, elevhälsa_________________________________________________________________________Bakgrund: I rapporter som Nationellt centrum för Suicidforskning och Prevention av psykisk ohälsa (NASP) tagit fram, framgår att självmord är ett stort samhällsproblem bland barn och ungdomar. Unga individer spenderar en stor del av sin tid i skolan och förutom själva undervisningen utgör skolan en social plattform. Självmord är för såväl män som kvinnor den vanligaste dödsorsaken i åldersgruppen 15-24 år. Självmordsnära människor långt in i skeendet är ambivalenta till om de egentligen vill dö. Skolsköterskan kan vara den första person som upptäcker de elever som mår dåligt.Syfte: Syftet var att belysa skolsköterskors erfarenheter av arbetet med självmordsnära ungdomar och att arbeta med självmordsprevention.Metod: Sex intervjuer genomfördes med skolsköterskor. Datamaterialet analyserades med kvalitativ manifest innehållsanalys med induktiv ansats.Resultat: Ur analysen av datamaterialet framträdde tre kategorier; Att fånga upp och möta eleverna, Att agera och överlämna och Att ge preventivt stöd till elever efter skett självmord.Konklusion: Självmord och självmordstankar förekommer hos gymnasieelever. Studien visar att skolsköterskan kan spela en mera aktiv roll än idag vad beträffar förebyggande arbete och krishantering för dessa elever. / Background: Reports made by National Centre for Suicide science and Prevention of physical illness (NASP) developed, shows that suicide is a major social problem among children and adolescents. Young people spend much of their time in school and in addition to actual teaching school is a social platform. Suicide is for both men and women, the most common cause of death in the 15-24 age group. Suicidal people is ambivalent as to whether they really want to die. The school nurse may be the first person who discovers the students who are depressed. Aim: The aim of this study was to highlight the school nurses ́ experiences of the work with suicide prone adolescents and to work with suicide prevention. Method: Six interviews were conducted with school nurses. Data were analyzed using qualitative manifest content analysis with an inductive approach. Results: From the analysis of the data emerged three categories; To catch up and meet the students, To act and communicate and To provide preventative support to students after suicide occurred. Conclusion: Suicide and suicidal ideation occurs in high school. The study shows that the school nurse can play a more active role than today in terms of prevention and crisis management for these students.

Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009. / Full text also available online. Scroll down for electronic link.

Appendices A-D were not provided by the author. The goal of the study was to explore the perceptions of the station commissioners of Waterberg District regarding the Suicide Prevention Workshops targeted at police officers. The study was conducted with the station commissioners of Waterberg District in Limpopo. The population in this study was composed of 15 station commissioners who were regarded as the sample due to the fact that the population is small. The research approach used in the applied study was a qualitative approach. A semi-structured interview schedule was used to collect data from the station commissioners in order to uncover their perceptions regarding the Suicide Prevention Workshops. A theoretical background about suicide in general and police suicide was provided through a literature study. In the literature study the background information about factors contributing towards police suicide were indicated, together with methods used to commit suicide. Causes of suicide in general as compared to those of police members, were also clarified. The focus in the literature was also on gender whereby an indication was mentioned about who exactly are at risk of committing suicide. The attitude of police officers and the society’s expectations and perceptions regarding police members has been discussed. The empirical study focused on the perceptions of station commissioners of Waterberg District in Limpopo regarding the Suicide Prevention Workshops targeted at police officers. A semi-structured one-on-one interview was held with each station commissioner on individual basis where by questions were asked about his or her perception of the Suicide Prevention Workshops. The findings of the study revealed that station commanders appreciate the role played by social workers, chaplains and psychological services in presenting suicide prevention programmes to police officers. They indicated that at some point they fail to nominate police officers to attend the workshops because some of the subordinates are not cooperative and they might even submit sick notes in order to be excused from attending. It was also reported that if there is a shortage of personnel due to other core business of SAPS, police officers might not be nominated. Based on the findings of the study, conclusions and recommendations were made with regard to how the suicide prevention program and workshops can be improved in SAPS. Copyright / Dissertation (MSW)--University of Pretoria, 2013. / Social Work and Criminology / unrestricted

The purpose of this study was to explore how social work practitioners employed in schools perceive their level of competency in suicide prevention, assessment, and intervention and to identify educational and professional challenges specific to this area of inquiry. This study sought to explore the following research questions: 1) How do school social workers perceive their level of competency in suicide prevention, assessment, and intervention with at-risk suicidal children and youth? 2) What are school social workers educational or professional challenges in providing suicide prevention, assessment, and intervention? This research study was predicated on a qualitative research design and conventional content analysis. The research design allowed for an in-depth examination of school social workers’ ability to make critical decisions when providing suicide prevention, assessment and intervention to youth at risk of suicide. The findings of this study suggest that, despite past and current education, training, and clinical practice experience working with at-risk suicidal youth, continual training is necessary in increasing perceived professional competency and addressing familial, organizational and societal challenges pertinent to at-risk suicidal youth. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2020. / FAU Electronic Theses and Dissertations Collection

Suicide is a major health concern worldwide. Nurse practitioners must possess suicide assessment skills and treatment knowledge to ensure appropriate identification of persons with suicidal ideation. The purpose of this project was to assess psychiatric nurse practitioners' knowledge of suicide prevention in rural Kentucky. The conceptual framework was Orlando's nursing process theory, which emphasizes the importance of nurse-patient interaction. A 13-item survey of suicide-related knowledge and skills was administered to 10 psychiatric nurse practitioners in rural Kentucky. Only 3 participants responded correctly to a question related to suicidality in persons with borderline personality disorder. Regarding competency and support for assessing suicide, 100% of participants reported that they were comfortable asking direct and open-ended questions regarding suicide. Nine of the 10 respondents assessed their knowledge and skills as sufficient to engage effectively with patients contemplating suicide, which indicates that psychiatric nurse practitioners may overestimate their ability to identify and treat persons with suicidal ideation. Healthcare providers in all specialties can benefit from this project by improving competencies and guiding continuing education to bridge any gaps in knowledge for adequately assessing suicide. Further education is needed for psychiatric nurse practitioners to promote positive social change for suicidal persons, their families, and their communities.