A review of the literature strongly suggests that poor family dynamics play a critical role in an adolescent's choice of suicide. This thesis examines the literature and research findings on adolescent suicide and family functioning. It will bring together recent findings to help professionals access the information on adolescent suicide as it relates to the family. The psychosocial and cognitive theories of development are explored to provide a framework for understanding adolescents and the reasons for the choices and problem solving they make in their quest for identity. Since social workers are increasingly implicated in the prevention of youth suicide, the thesis applies the argument to prevention from a social work perspective.

In recent years there has been a notable increase in the number of suicides amongst South Asian youth in the Region of Peel in Ontario. Using a six-page questionnaire, an exploratory descriptive study was conducted with 104 participants. The purpose of the study was to inquire into the number of South Asian youth that had ever considered committing suicide; determine whether there were any predicting factors; and gain insight as to "why." It was found that close to 30% of the sample had considered suicide and that gender, place of birth and a self-rating scale of depression were significant variables. Of those who had admitted to having considered suicide, 'family pressures' was cited as the number one reason.

Tyrėjai vis dažniau skiria dvi save žalojančių paauglių grupes: mėginančius nusižudyti ir nesuicidiškai save žalojančius, kurie nesiekia mirties. Tačiau iki šiol buvo atlikta mažai populiacinių tyrimų, mėginančių šias dvi grupes tiesiogiai palyginti, todėl informacija apie šių grupių psichologinių ypatumų ir save žalojančio elgesio vidinių veiksnių skirtumus yra gana prieštaringa. Tyrime buvo naudojamas „Gyvenimo būdo ir prisitaikymo klausimynas“ (orig. Lifestyle and Coping Skills Questionnaire), kurį Lietuvoje adaptavo ir paauglių save žalojančio elgesio tyrimui pritaikė A. Laskytė ir N. Žemaitienė. Dalis jų surinktų duomenų analizuojama šiame darbe. Tikslas: ištirti bendros populiacijos paauglių suicidinio ir nesuicidinio save žalojančio elgesio vidinius veiksnius: motyvus, savižudiškus ketinimus, žalojančio elgesio ypatumus ir su šiais faktoriais galimai susijusius asmens psichologinius ypatumus. Taip pat atskleisti būdingus šių veiksnių skirtumus merginoms ir vaikinams. Tiriamieji: 15-17 metų amžiaus Lietuvos moksleiviai, kurie pildydami „Gyvenimo būdo ir prisitaikymo klausimyną“, atsakė, kad bent kartą gyvenime sąmoningai save žalojo. Klausimyno pildymo metu paaiškindami save žalojančio elgesio priežastis, prie teiginio „Aš norėjau numirti“ paaugliai galėjo atsakyti „Taip“ arba „Ne“. Pagal šį atsakymą jie buvo suskirstyti į dvi grupes: suicidiškai save žalojančių – norėjusiųjų numirti (n=163), ir nesuicidiškai save žalojančių – nenorėjusiųjų numirti (n=118). Rezultatai:... [toliau žr. visą tekstą] / Researches often differentiate two groups of self-harming adolescents: those who attempters a suicide, and those who are harming themselves in a non-suicidal way, and they don‘t seek the death. However just a few community-based research, which would directly compare these groups, were done so far, and therefore information about the differences of the psychological peculiarity and self-harming behavior‘s internal factors between the groups is ambivalent. Lifestyle and Coping Skills Questionnaire (Hawton, 2006), adapted and adjusted for the research of adolescents self-harming behavior by A. Laskytė and N. Žemaitienė in 2006, was used in this work. A part of their collected data is also used in this work. The aim: to examine the intrapersonal factors of suicidal and non-suicidal self-harm in a community sample population: the motives, suicidal intentions, the peculiarities of harming self-harm and person‘s psychological traits that could be possibly related to those factors. It also aimed to reveal the typical differences of these factors between the genders. The sample: 15-17 year old Lithuanian pupils who, while answering into Lifestyle and Coping Skills Questionnaire, responded that they were harming themselves at least once in a life time. In the questionnaire while explaining the reasons of self-harming behavior, into the proposition “I wanted to die” they could write “Yes” or “No”- in this way they were separated into two groups: suicidal self-harmers – who wanted to... [to full text]

Non-suicidal self-injury (NSSI), such as intentionally cutting, burning or hitting oneself, is a behavior with potentially detrimental consequences and empirical studies are necessary to gain knowledge of how to prevent NSSI in adolescents. The aims of this thesis were to investigate the prevalence, methods, characteristics and functions of NSSI in a large community sample of Swedish adolescents, and to examine the relationship between NSSI and adverse life events and trauma symptoms. All empirical studies had a cross-sectional design and were based on 3,097 adolescents in the county of Östergötland, aged 15-17 years, in their first year of high school. Participating school classes were selected through a randomization process and administered self-report questionnaires. In study I (n = 3,060) a single item NSSI question resulted in a prevalence rate of 17.2%, while 35.6% of adolescents reported having engaged in NSSI at least once during the past year when given a checklist. The most commonly reported type of NSSI in this sample was “bit yourself”, followed by “hit yourself on purpose”, “erased your skin” and “cut or carved on your skin”. Applying the proposed DSM-5 diagnostic criteria of NSSI resulted in a prevalence rate of 6.7%. Results in study II (n = 2,964) showed that after controlling for gender, parental occupation and living conditions, adolescents with no self-injurious behavior reported the lowest level of adversities and trauma symptoms, while adolescents with both NSSI and suicide attempts (5.7%) reported the highest levels compared to those with only NSSI or a suicide attempt. Adolescents reporting frequent NSSI reported more adversities and trauma symptoms than those with less frequent NSSI. Automatic functions, such as affect regulation, self-punishment and feeling-generation, were the most commonly reported functions of NSSI. Attempts in study I to confirm Nock and Prinstein’s (2004) four-factor model of underlying factors of NSSI functions resulted in a close to acceptable fit. An attempt to refine the factor analysis on this community sample of Swedish adolescents, using Mplus with cross-validation, was made in study III (n = 836). An exploratory factor analysis resulted in a three-factor model (social influence, automatic functions and non-conformist peer identification), which was validated in confirmatory analysis. In order to adhere more closely to learning theory and the concept of negative and positive reinforcement, the third factor was then split into two factors, resulting in a four-factor model (social influence, automatic functions, peer identification and avoiding demands), which showed excellent fit to the data in the confirmatory factor analysis. Study IV (n = 816) showed that NSSI frequency, gender (female), self-reported experience of emotional and physical abuse, having made a suicide attempt, prolonged illness or handicap and symptoms of depression and dissociation were significant predictors in the final model of the automatic functions, indicating that these variables are important in understanding the mechanisms underlying the need to engage in NSSI to regulate emotions, generate feelings, gain control or to self-punish. Symptoms of depression and dissociation mediated the relationship between sexual, physical and emotional abuse and the automatic  functions. Furthermore, frequency of NSSI, gender, emotional abuse, prolonged illness or handicap and symptoms of depression uniquely predicted automatic functions but not social functions. Self-reported experience of physical abuse, having made a suicide attempt, symptoms of anxiety and dissociation were significant in the final model of social functions, i.e., performing NSSI to influence or  communicate with others, to avoid demands or to identify with peers. Of these, symptoms of anxiety were uniquely associated with social functions. Symptoms of anxiety and dissociation mediated the relationship between physical abuse and social functions of NSSI. Taken together, this thesis has shown that NSSI is prevalent in Swedish adolescents and findings contribute to the discussion of a potential NSSI diagnosis. It is important to consider the effect of different types of negative life events and trauma symptoms in relation to NSSI in adolescents. Assessing the specific reinforcing functions of NSSI and the underlying factor structure can be helpful in developing functionally relevant individualized treatment. / Självskadebeteende, t ex att avsiktligt skära, bränna eller slå sig själv är potentiellt skadliga beteenden. Empiriska studier är viktiga för att kunna förebygga självskadebeteende hos ungdomar. Föreliggande avhandling syftar till att undersöka självskadebeteendets förekomst, funktion, karaktäristik och metoder hos svenska ungdomar, samt att undersöka relationen till negativa livshändelser och traumasymptom. Samtliga fyra empiriska studier hade en tvärsnittsdesign och baserades på 3,097 ungdomar i Östergötland, 15-17 år, i gymnasieskolans årskurs 1, vars skolklasser valts ut slumpmässigt och som besvarat självskattningsformulär. I studie I (n = 3,060) angav 17.2%, som svar på en allmän självskadefråga, att de avsiktligt skadat sig under sin livstid. När ungdomarna däremot svarade på en checklista med olika självskadebeteenden, angav 35.6% att de hade ägnat sig åt någon typ av självskadebeteende under det senaste året. De vanligaste metoderna var att avsiktligt bita eller slå sig själv, sudda på huden och att skära sig. De föreslagna diagnoskriterierna för icke-suicidal självskada i DSM-5 resulterade i en förekomst av 6.7%. Studie II (n = 2,964) visade att ungdomar utan självskadebeteende rapporterade de lägsta antalet negativa livshändelser och traumasymptom, medan de med erfarenhet av både självskadebeteende och självmordsförsök (5.7%) rapporterade de högsta antalen jämfört med de med endast självskadebeteende eller självmordsförsök. Ungdomar med fler självskadetillfällen rapporterade fler negativa livshändelser och traumasymptom än de med färre tillfällen. Automatiska/intrapersonella funktioner, såsom att generera och reglera känslor samt att straffa sig själv var de vanligaste funktionerna som rapporterades. Försök att konfirmera Nock och Prinsteins (2004) fyrfaktormodell av underliggande funktionsfaktorer i studie I resulterade i en modell med nära acceptabel passform. Ett försök att förbättra faktoranalysen på den aktuella urvalsgruppen gjordes med Mplus i studie III (n = 836). En exploratorisk analys resulterade i en trefaktormodell (interpersonell påverkan, automatisk/intrapersonell funktion samt ”icke-konformistisk” kamratidentifikation), vilken även validerades i den konfirmatoriska analysen. Med utgångspunkt i inlärningsteori och begreppen negativ och positiv förstärkning delades därefter den tredje faktorn upp i två faktorer. Det resulterade i en fyrfaktormodell (interpersonell påverkan, automatisk/intrapersonell funktion, kamratidentifikation samt undvikande av krav). Fyrfaktormodellen visade utmärkt passform i den konfirmatoriska analysen. Studie IV (n = 816) visade att självskadebeteendets frekvens, kön (flicka), självrapporterade erfarenheter av psykisk och fysisk misshandel, självmordsförsök, kronisk sjukdom eller handikapp under uppväxten, liksom symptom på depression och dissociation predicerade automatiska självskadefunktioner. De variablerna är potentiellt viktiga för förståelsen av de mekanismer som är involverade när ungdomar skadar sig själva för att generera och reglera känslor, få kontroll, liksom att straffa sig själva. Relationen mellan psykisk och fysisk misshandel och de automatiska funktionerna medierades av symptom på depression och dissociation. Självskadefrekvens, kön, psykisk misshandel, sjukdom/handikapp och symptom på depression predicerade enbart automatiska men inte sociala funktioner. Självrapporterad fysisk misshandel, självmordsförsök, symptom på ångest och dissociation var signifikanta prediktorer för de sociala funktionerna (att påverka/kommunicera med andra, undvika krav eller identifiera sig med kamrater). Ångestsymptom var unikt associerade med sociala funktioner. Symptom på ångest och dissociation medierade vidare relationen mellan fysisk misshandel och sociala självskadefunktioner. Sammanfattningsvis visade resultaten att självskadebeteende är vanligt förekommande hos ungdomar. Avhandlingen bidrar med empiri till diskussionen gällande icke suicidal självskada i DSM-5. Det är viktigt att beakta olika negativa livserfarenheter och traumasymptom i relation till självskadebeteende hos ungdomar. Att undersöka självskadebeteendets funktioner kan vara kliniskt hjälpsamt för att utveckla och utvärdera individuellt anpassade behandlingsstrategier.

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.

Suicide attempts and opioid dependence are important clinical issues, as both are associated with a high degree of psychiatric morbidity and elevated risk of mortality. Research has identified a number of risk factors for suicide attempts among the general population, and to a lesser extent, among heroin users. Due to a lack of case-control studies, however, it is still not known to what extent opioid dependence per se is a risk factor for suicide attempts. This thesis comprised the first study to directly examine whether opioid dependence is a unique risk factor of suicide attempts. This thesis examined suicide attempts, associated risk factors, and related comorbidity among an opioid-dependent case group and a non-opioid-dependent control group. A structured interview was used to collect data from 726 opioid-dependent cases and 399 non-opioid-dependent controls. This thesis identified a number of important findings. Firstly, although opioid-dependent individuals were more likely to report lifetime suicide attempts compared to controls, the risk factors were largely the same for both groups. It appeared that opioid-dependent individuals were characterised by a higher likelihood of the same risk factors for suicide attempts, rather than having different risks. Cases appeared to be at increased risk of suicide attempts because of increased levels of multiple risk factors. Secondly, borderline personality disorder (BPD) and impulsivity were identified as important risk markers for suicidal behaviour, especially among opioid-dependent individuals. The study concluded that the treatment of BPD should be prioritised among this group. Third, self-mutilation was identified as a clinically significant problem in its own right, however, when combined with a history of attempted suicide, the psychological dysfunction observed was found to be very high. Fourth, non-fatal opioid overdose and suicide attempts were found to be distinct behaviours. The risk factors for each were completely different. While drug-related risks were associated with non-fatal overdose, the risk markers for suicide attempts were related to the presence of psychological disorders. This thesis has highlighted important areas of concern for clinical interventions as well as for future research to explore. Considering this is the first study of its kind, future research should focus on its replication.

Tez (Tıpta Uzmanlık) - Süleyman Demirel Üniversitesi, Tıp Fakültesi, Psikiyatri Anabilim Dalı, 2005. / Bibliyografya var.

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

Thesis (Ph. D.)--Florida State University, 2006. / Advisor: Thomas E. Joiner, Florida State University, College of Arts and Sciences, Dept. of Psychology. Title and description from dissertation home page (viewed Sept. 15, 2006). Document formatted into pages; contains x, 92 pages. Includes bibliographical references.

<p>Sjuksköterskor inom somatiken möter patienter med psykisk ohälsa i sitt dagliga omvårdnadsarbete. Syftet med studien var att belysa sjuksköterskans upplevelser av omvårdnad av en patient som utfört suicidal handling och vårdas på somatisk akutavdelning/akutmottagning. Författarna använde sig av en kvalitativ metod med intervjuer som datainsamlingsmetod. Tio sjuksköterskor intervjuades som arbetade inom akutsjukvård och hade minst ett års erfarenhet. Resultatet bestod av fyra teman; svårigheter i omvårdnaden, känslor i mötet med patienten, resurser och samarbete med psykiatrin. Resultat visade att allmänsjuksköterskan önskade mer psykologisk grundkunskap för att utveckla sin omvårdnad av den suicidala patienten, med exempelvis samtalsteknik, eftersom de ansåg att kommunikationen med patienten var utmanande. Även ett bättre tillvägagångssätt för att närma sig, bemöta och knyta an i en vårdrelation med patienterna. Samarbetet mellan psykiatrin och den somatiska vården var inte tillfredställande vilket gjorde sjuksköterskans omvårdnadsarbete svårare. Det behövdes en tydlighet i utförandet av omvårdnad och arbetsrutiner för patienter som vårdades inom både somatik och psykiatri.</p> / <p>Nurses’ within the somatic care are encountered with patients with mental illness in their daily work. The aims of the study were to enlighten nurses’ experience of caring for a patient that has committed a suicidal act and are cared for in a somatic acute ward. The authors used a qualitative method with interviews for collecting data. Ten nurses’ were interviewed that worked with acute care and had at least one year experience. The result contains four themes; difficulties with caring, feelings in meeting with the patient, resources and cooperation with psychiatry. Result showed that general nurses’ described a wish for more psychological knowledge to improve their care for the suicidal patient, for example dialogue technique, because they thought that the communication with the patient was challenging. Also a better way to get close, meet and connect in a relationship with the patient. The cooperation between psychiatry care and somatic care were not satisfying which made caring more difficult for the nurse. There were needs to clarify the caring and working routines for patients that are cared for in both the somatic and psychiatry care.</p>