Shneidman (1993) has theorized that psychache (i.e., intolerable psychological pain) is the key cause of suicide, and accounts for the effect of all other psychological factors. Two studies are presented that test Shneidman’s theory, and compare the influence of psychache on suicidality relative to that of hopelessness. In the first study, a causal hypothesis was examined using a longitudinal design. Undergraduate students (N = 588) completed measures of psychache, hopelessness, and suicide ideation at two time points four months apart. Results supported the hypothesis that psychache has a causal role in suicidality, as change in suicide ideation was predicted by change in psychache. However, the hypothesis that psychache would fully mediate the effect of hopelessness was not supported, as only a small and partial mediation effect was evidenced, and change in hopelessness also contributed unique variance to the prediction of suicide ideation. In a second study, the hypotheses that psychache is necessary and sufficient for suicide were examined. Undergraduate students (N = 1,333) were prescreened for high and low levels of psychache and hopelessness, and those who met cutoff criteria (N = 184) were selected to make up four groups with combinations of these constructs. Groups were compared with respect to various measures of suicide ideation, motivations, and behaviours using one-way multivariate analyses of variance. In general, dependent measures significantly differed by level of psychache, but not by level of hopelessness. This pattern of group differences supported the hypothesis that psychache is necessary for suicide. However, the claim that psychache is sufficient was not consistently supported, as some suicide criteria were significantly elevated only for groups exhibiting high levels of both psychache and hopelessness. Taken together, the results of this dissertation provide strong support for the key role of psychache in suicide and its parity with hopelessness as a statistical predictor of suicidality. These findings improve understanding of the suicidal state of mind, and have important implications for clinical practice. / Thesis (Ph.D, Psychology) -- Queen's University, 2009-11-30 13:33:54.267

Individuals who identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ) are at a higher risk for suicide compared to the general population, but little is known about why this is. Many LGBTQ individuals face some form of discrimination or victimization in their lifetime, and some evidence suggests these experiences may contribute to this group’s higher suicide risk. Unfortunately, research has only examined the impact of direct discrimination/victimization on suicidality and has neglected to examine how ambient discrimination/victimization relates to suicidality. Additionally, although some links exist between discrimination, victimization, and suicide, the mechanisms by which these are related are unknown. This study aims to address these gaps in the literature by exploring the effect of ambient discrimination/victimization on suicidal ideation and examining psychological pain as a mediator and social connectedness as a moderator between various forms of discrimination and victimization and suicidal ideation. Regression, mediation, and moderation analyses were conducted in order to examine these relationships in a sample of 200 LGBTQ-identified individuals. Results of this study may provide insight into why the LGBTQ community is at an increased risk for suicide.

Bakgrund Inom den palliativa vården anammas ett holistiskt synsätt, vilket innebär att fokus ligger på såväl fysiska, psykiska, sociala som existentiella aspekter i patientens livsvärld. Tre grundläggande psykiska behov, autonomi, möjligheter och sammanhang är essentiella i upplevelsen av psykisk hälsa. Även önskningar, värderingar och mål bidrar till patientens psykiska välbefinnande. Det har tidigare visat sig att patienters psykiska behov inte tillgodoses och sjuksköterskor inom den palliativa vården brustit i förmågan att uppmärksamma dessa behov. Syfte Syftet med studien var att beskriva patienters psykiska behov inom den palliativa vården. Metod Litteraturstudien baserades på tolv kvalitativa originalartiklar. Analysen genomfördes induktivt med en manifest innehållsanalys. Resultat Resultatet visade på psykiska behov i fem kategorier och sju underkategorier. Behoven gällde patientens närstående, självständighet, framtiden, vården och att bo hemma. Slutsatser Resultatet visade att psykiska behov kunde grundas i fysiska och sociala aspekter. Patienter som får palliativ vård förekommer på fler ställen inom specifikt den palliativa vården. Därför är det viktigt att belysa patienternas olika uttryck av psykiska behov för att de ska kunna tillgodoses och bidra till välbefinnande hos patienten. / Background In palliative care a holistic approach is embraced, which means that the focus is on physical, psychological, social and existential aspects of the patient's life-world. Three basic psychological needs, autonomy, competence and relatedness are essential concepts in the experience of mental health. Even desires, values ​​and goals contribute to the patient's psychological well-being. It has previously been shown that patients' psychological needs are not being met and that nurses in palliative care lack the ability to identify and address these needs Aim The aim of the study was to describe patients' psychological needs in the palliative care setting. Method The literature review was based on twelve qualitative original articles. An inductive, manifest content analysis was conducted. Result The result showed psychological needs in five categories and seven sub-categories; needs related to patient's family, independence, future, the healthcare system and staying at home. Conclusions The results showed that psychological needs could be based on both physical and social aspects. Patients receiving palliative care often receive that care in different environments that are not necessarily within specific palliative care clinical settings. Therefore, it is important to highlight the patients' expressions of psychological needs so that those specific needs can be addressed and in the process, improve the overall well being of the patient.

Bakgrund: Många barn upplever medicinska undersökningar som något obehagligt och smärtsamt. Det första besöket ett barn har med sjukvården kan ha en avgörande betydelse för hur barnet upplever vården i framtiden, ett negativt första besök kan leda till sjukhusrelaterad rädsla även i vuxen ålder. För att undvika detta är det viktigt att barnet får en positiv upplevelse i samband med vistelsen vilket kan åstadkommas med olika distraktionsmetoder som finns för att ändra barnets upplevelse och på så sätt minska obehag och smärta. Syfte: Att undersöka om distraktionsmetoder fungerar vid medicinska undersökningar för att minska lidande och obehag hos barn som vårdas inom pediatrisk sjukvård, primärvård samt inom sluten vård. Metod: En systematisk litteraturöversikt baserad på 10 kvantitativa artiklar ur databaserna PubMed, The Cochrane Library och Cinahl. Resultat: Distraktionsmetoder kan grupperas i olika subgrupper beroende på typen av distraktion: distraktion via handling, distraktion med objekt, distraktion av vuxen samt elektronisk distraktion. Denna studie visar att distraktion generellt är effektivt för reducering av smärta och obehag hos barn under medicinska undersökningar. Beroende på barnets ålder är vissa distraktionsmetoder mer effektiva än vad andra är. Två metoder som visat sig vara effektiva i alla åldrar är distraktion via PlayStation och DITTO. Slutsats: Tillämpning av distraktionsmetoder är ett effektivt sätt att reducera smärta och obehag hos barn som utsätts för medicinska undersökningar. Det finns ett stort antal metoder att välja mellan där många är effektiva. Med fördel används distraktioner med objekt eller elektronisk distraktion och med närvarande förälder. / Background: Many children experience medical procedures as something unpleasant and painful. The first visit a child has with healthcare can be crucial for how the child experiences the healthcare in the future, a negative first visit can lead to hospital-related fear even as an adult. To avoid this it is important that the child get a positive experience in relation to the visit. This can be accomplished with various distraction methods that exist to change the child’s experience and in that way reduce distress and pain.     Aim: To examine if distraction methods works at medical procedures to reduce suffering and distress in children receiving care within pediatric care, primary care and inpatient care. Method: A systematic literature review based on 10 quantitative articles from the databases PubMed, The Cochrane Library and Cinahl. Results: Distraction methods can be grouped into different subgroups based on type of distraction: distraction with action, distraction with object, distraction via adult and electronic distraction. This study shows that distraction generally is effective for reducing pain and distress in children during medical procedures. Depending on the child’s age, some distractions are more effective than others are. Two methods that appear effective in all ages is distraction via PlayStation and DITTO.  Conclusion: Appliance of distraction methods is an effective way to reduce pain and distress in children subjected to medical procedures. There are numerous methods to choose from where many are effective. Distractions with object or electronic distraction are effective as well as have parents presents.

This qualitative study is based on interviews about womens experiences of mental pain due to violence in close relationships. Men’s violence against women in close partner relationships is a major societal problem today not only in Sweden but also worldwide. The most common violence that occurs are the ones at home which makes it a hidden problem. Therefore the lack of knowledge about the subject makes it difficult to prevent it from happening. The purpose of this essay was to study women's experiences of violence in close relationships and how they feel that they have been affected by the psychological pain that has arisen as a result of violence in close relationships or harassment that they have experienced. The violence can be psychological, physical and sexual and the abuser successively takes control over the women and her life. A qualitative study was conducted with a thematic analysis and interview guide where women had been in contact with different women’s shelter. The results showed that we need to work further with violence and include preventioned work