El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. / Antepartum suicidal behaviors are a leading cause of maternal injury and death. Previous research has not investigated associations between antepartum suicidal ideation and perinatal complications. Our study objective was to evaluate the relationship of antepartum suicidal ideation with low infant birthweight, small for gestational age, and preterm birth. A cohort study was conducted among 1,108 women receiving prenatal care in Peru. Suicidal ideation was measured using the Patient Health Questionnaire-9 during pregnancy. Birth outcomes were extracted from medical records. Linear regressions and multivariable logistic regressions were used to estimate were used to investigate associations between suicidal ideation and pregnancy outcomes. The prevalence of suicidal ideation was 8.7%, preterm delivery was 5.7%, low birthweight was 4.4%, and small for gestational age was 3.4%. In an adjusted model, infant birthweight was 94.2 grams lower for mothers with antepartum suicidal ideation (95% CI: −183.0, −5.5, p = 0.037) compared with those without suicidal ideation. After adjusting for confounders including depression, participants with suicidal ideation had a nearly four-fold increased odds of delivering a small for gestational age infant (OR: 3.73; 95% CI: 1.59–8.74). These findings suggest suicidal ideation during pregnancy is associated with adverse perinatal outcomes, especially low infant birthweight. / Revisión por pares

This study focused on the quantitative and qualitative aspects of suicidal behaviour of 90 people who had come to the attention of the Accident and Emergency Department of Westmead Hospital, Sydney, N.S.W., after an attempt to harm themselves. The risk factors identified in the study were combined with the circumstances and motive of attempt. Participants were regrouped according to whether the problems the respondent described were chronic (longstanding) or acute (pivotal). The participants were further classified according to the persistence of thoughts of self-harm ( impulsive or non-impulsive/deliberate) and the presence or absence of these feelings at the time of the interview (the resolution of the attempt) and the types of problems/situations and triggering events the person described as wanting to escape. By developing strategies and treatments for the problems as they were identified in this study and by raising the awareness that there is help available for these different issues, we may be able to reduce the pain which results in an attempt to self harm. / Doctor of Philosophy (PhD)

Suicide embodies a considerable but often preventable loss of life. As the second leading cause of death for young people in Canada between the ages of 15 and 24, nearly one-quarter of all annual deaths for this age group are accounted for by those who have died by suicide. Greater still is the prevalence of suicidal behaviour. Annually, suicide and suicidal behaviours across the age span are estimated to cost the Canadian economy $2.2 billion. Given the high personal costs to victims, survivors, and taxpayers, it seems crucial that prevention strategies be implemented to reduce the high rate of suicide and suicidal behaviours, as well as to promote mental health, particularly in youth. The promotion of positive mental health and well-being is especially relevant for youth living in rural areas. Fewer mental health resources are available in rural communities than in urban centres. Moreover, youth living in rural, low population density areas often do not believe that their anonymity and right to privacy would be protected if they were to seek mental health services. The present research was carried out to provide a potential foundation for stimulating mental health promotion and suicide prevention approaches, differing by rural and urban community and by gender, before such concerns emerge. Through a survey of 813 (459 rural youth; 354 urban youth) secondary school youth in Eastern Ontario, we examined the inverse association between suicidal ideation and engagement in extracurricular activities, such as sports, music, drama, or community groups. Who is at greatest risk: It was found that rural youth reported significantly more suicidal thoughts than did urban youth (p < .01). Perceived social support accounted for rural and urban differences, while difficulties coping with daily stressors accounted for gender differences, in self-reported suicidal ideation. Thus, “red flags” for communities at risk could include perceived deficits in social support within a given community, as well as having a number of young females who indicate poor coping with daily stressors. What factors to target: Depressive symptoms, risk behaviours, self-esteem, and social support differed in importance in the prediction of suicidal ideation based on rural-urban setting and gender. Results reflecting differences underscore the importance of examining such factors in mental health research. A “one size fits all” approach to youth mental health promotion and suicide prevention does not appear to be a prudent strategy. How to intervene: Youth engagement was explored as one possible means of intervention. In rural youth, personally meaningful engagement and engagement in a number of activities was directly inversely related to suicidal ideation. Regression analyses involving interaction analyses were carried out with youth engagement as a moderator for mental health indicators such as depressive symptoms, risk behaviours, self-esteem, and social support in the prediction of suicidal ideation. Through simple slope analyses, it was found that youth engagement significantly reduces the relationships between suicidal ideation and mental health indicators, particularly for males (p < .001). Therefore, youth engagement appears to be more universally beneficial for rural youth, given that rural dwelling appears to be a risk factor for suicidal ideation. Moreover, for male youth at risk for suicidal ideation, given depressive symptoms, risk behaviours, low self-esteem, and low perceived social support, youth engagement may be of particular benefit. With knowledge of who is at greatest risk for suicidal ideation, what factors to target, and a possible intervention road map, we can reach youth and foster resiliency before suicidal thoughts emerge.

Suicide embodies a considerable but often preventable loss of life. As the second leading cause of death for young people in Canada between the ages of 15 and 24, nearly one-quarter of all annual deaths for this age group are accounted for by those who have died by suicide. Greater still is the prevalence of suicidal behaviour. Annually, suicide and suicidal behaviours across the age span are estimated to cost the Canadian economy $2.2 billion. Given the high personal costs to victims, survivors, and taxpayers, it seems crucial that prevention strategies be implemented to reduce the high rate of suicide and suicidal behaviours, as well as to promote mental health, particularly in youth. The promotion of positive mental health and well-being is especially relevant for youth living in rural areas. Fewer mental health resources are available in rural communities than in urban centres. Moreover, youth living in rural, low population density areas often do not believe that their anonymity and right to privacy would be protected if they were to seek mental health services. The present research was carried out to provide a potential foundation for stimulating mental health promotion and suicide prevention approaches, differing by rural and urban community and by gender, before such concerns emerge. Through a survey of 813 (459 rural youth; 354 urban youth) secondary school youth in Eastern Ontario, we examined the inverse association between suicidal ideation and engagement in extracurricular activities, such as sports, music, drama, or community groups. Who is at greatest risk: It was found that rural youth reported significantly more suicidal thoughts than did urban youth (p < .01). Perceived social support accounted for rural and urban differences, while difficulties coping with daily stressors accounted for gender differences, in self-reported suicidal ideation. Thus, “red flags” for communities at risk could include perceived deficits in social support within a given community, as well as having a number of young females who indicate poor coping with daily stressors. What factors to target: Depressive symptoms, risk behaviours, self-esteem, and social support differed in importance in the prediction of suicidal ideation based on rural-urban setting and gender. Results reflecting differences underscore the importance of examining such factors in mental health research. A “one size fits all” approach to youth mental health promotion and suicide prevention does not appear to be a prudent strategy. How to intervene: Youth engagement was explored as one possible means of intervention. In rural youth, personally meaningful engagement and engagement in a number of activities was directly inversely related to suicidal ideation. Regression analyses involving interaction analyses were carried out with youth engagement as a moderator for mental health indicators such as depressive symptoms, risk behaviours, self-esteem, and social support in the prediction of suicidal ideation. Through simple slope analyses, it was found that youth engagement significantly reduces the relationships between suicidal ideation and mental health indicators, particularly for males (p < .001). Therefore, youth engagement appears to be more universally beneficial for rural youth, given that rural dwelling appears to be a risk factor for suicidal ideation. Moreover, for male youth at risk for suicidal ideation, given depressive symptoms, risk behaviours, low self-esteem, and low perceived social support, youth engagement may be of particular benefit. With knowledge of who is at greatest risk for suicidal ideation, what factors to target, and a possible intervention road map, we can reach youth and foster resiliency before suicidal thoughts emerge.

Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2008. / Full text also available online. Scroll down to electronic link.

published_or_final_version / Public Health / Master / Master of Public Health

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

published_or_final_version / Sociology / Master / Master of Social Sciences

No description available.

Whilst much has been written about the determinants of suicidal behaviour within a South African context, few studies have investigated suicidal behaviour from a developmental context. This study explored the relationship between suicidal tendencies, coping styles, and Intimacy vs. Isolation. There were 175 participants between the ages of 18 to 24 years. Scales measuring coping, suicidal attitudes, and intimacy resolution were administered. The data was analysed quantitatively. Most significant in the findings is the relationship that exists between intimacy resolution, suicidal attitudes and active coping styles. These and other findings provide an initial but empirically important platform for future research endeavours that aim to understand the incidence of suicide amongst one of the most at-risk groups in South Africa today. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2010.