Approximately 43% of college students report experiencing suicidal ideation in the past year, and suicide is the 2nd leading cause of death among college students, making it a significant public health concern. Development of successful suicide intervention and prevention strategies is predicated on identification of risk (e.g. negative life events, hopelessness) and protective factors (e.g. self-compassion) that may be targeted for treatment. A well-established linkage exists between life stressors and suicidal behavior; however, potential mechanisms of action underlying this association are under-researched. It may be that negative life events contribute to feelings of hopelessness, which is conceptualized as negative beliefs and expectations about one’s self and future. However, not all persons who experience negative life events and hopelessness become suicidal, perhaps due to protective factors such as self-compassion. Comprised of self-kindness, mindfulness and sense of common humanity, self-compassion may contribute to emotional resilience when negative life events occur; however, this premise has not been previously examined. We hypothesized that hopelessness would mediate the relation between negative life events and suicidal behaviors, such that negative life events would be related to increased feelings of hopelessness and, in turn, to greater risk for suicidal behavior. We also hypothesized that self-compassion would beneficially moderate the mediating effect of hopelessness. Our sample of college students (n=338) were primarily female (67%; n=227) and White (89.6%; n=294), with a mean age of 21.8 years (SD=4.7). Participants completed self-report measures including the Life Events Scale, the Beck Hopelessness Inventory, the Suicide Behaviors Questionnaire - Revised, and the Self-Compassion Scale. Supporting our hypotheses, hopelessness fully mediated the relation between negative life events and suicidal behavior (DE=.07, SE=.06, 95% CI=.05,.28,p

Non-suicidal self-injury (NSSI), or deliberate self-harm, and suicidal behaviors are significant public health concerns, and college students may be at particular risk. For instance, approximately 17% of college students engage in NSSI and suicide is the 2nd leading cause of death in college students. Commonalities between NSSI and suicidal behavior exist, including etiology; as an example, misuse of substances and interpersonal difficulties are related to both outcomes. For college students, substance use disorders and social dysfunction are two of the most common psychosocial problems; for instance, 22% of students report illicit drug use and social isolation, loneliness and separation from traditional support systems are common collegiate stressors. According to the Interpersonal Theory of Suicide, two pertinent interpersonal risk factors are perceived burdensomeness (the belief that one is a liability to others) and thwarted belongingness (the unmet need to belong among others). When present, substance misuse and interpersonal dysfunction may facilitate the transition between NSSI and suicidal behavior; however, this premise has not been previously examined. As such, we hypothesized that substance abuse would mediate the relation between NSSI and suicidal behavior, such that engagement in NSSI would be related to greater use of substances and, in turn, to suicidal behavior. Further, we hypothesized that thwarted interpersonal needs would moderate this mediating effect, such that increased TB and PB would exacerbate the mediating effect of substance misuse. Our sample of college students (N=338) was primarily white (89.6%; n=294), female (67%; n=225), and had an average age of 21.8 years (SD=4.7). Participants completed the Suicide Behaviors Questionnaire-Revised, the Self-Harm Inventory, the Interpersonal Needs Questionnaire, and the Drug Abuse Screening Test. Supporting hypotheses, substance abuse partially mediated the relationship between NSSI and suicidal behavior (DE=1.30, SE=.10, p

This thesis examines mortality rates among adults who experienced full-time imprisonment in New South Wales between January 1988 and December 2002, by record linkage to the Australian National Death Index. The cohort included 76383 men and 8820 women. Over a mean follow-up of 7.7 years, 5137 deaths (4724 men, 423 women) were identified. Three hundred and three deaths (295 men, eight women) occurred in custody. The median age at death was 36.6 years for men and 32.7 years for women. The prominent causes of death were drug overdose, suicide, accidental and cardiovascular disease. The crude mortality rate was 797 per 100000 person-years for men and 685 per 100000 person-years for women. Risk of mortality was 3.7 times greater in male and 7.8 times greater in female prisoners than the standard population. The excess mortality was substantially raised following release from prison in both men (standardised mortality ratio 4.0 vs 1.7) and women (standardised mortality ratio 8.2 vs 2.1). The period of highest risk of death was the first two weeks after release. Drug overdose was the main cause of death, responsible for 68% of the deaths in the first two weeks for men and for 90% of the deaths in this period for women. In men, there was also a clustering of suicide directly after release. Prisoners admitted to prison psychiatric hospital, repeat offenders and those in the early stage of followup were at increased risk of mortality. Violent offenders were overrepresented in suicide figures and property offenders in death from overdose. Minority groups, in particular men, had a lower risk of death than white people. The above findings reinforce how disadvantaged prisoners are, measured by mortality as the most fundamental scale of human wellbeing. Prison represents a potential opportunity for treatment and public health intervention to address some of the health problems underlying the high mortality found in this study. The key challenge is, however, to provide a continuum of care between the prison and community.

Background and aim: The number of refugees and unaccompanied children are increasing in Sweden and these people belong to one of the groups that are at higher risk for developing suicidal behavior. At the same time the lack of research on the subject is mentioned several times by different sources. The aim of this study is therefore to investigate suicidal behavior among young refugees between the ages 13 to 18 years in Sweden, from personnel experiences in social services. Method: We have chosen a qualitative approach with seven narrative interviews that each lasted for about one hour and were recorded. The interview guide was semi structured. The respondents in this study consist of one student counselor, workers from two child psychiatry departments and four different residential care homes for unaccompanied children and young persons. Results and conclusions: The respondents had the understanding that young refugees have been through a lot, lost their families and experienced difficult traumas and a tough refuge. The result from the collected data showed that the personnel thought the cause of the suicidal behavior is the long wait during the asylum process, the trauma they have experienced and lack of social networks. Suicidal behaviors among the young refugees were often thoughts and suicide attempts with pills, through self-starving, hanging, or cutting themselves. We have noticed an opinion that a connection between being a refugee and suicide is possible and that a shorter asylum process might help reduce the suicidal behavior among young refugees. / Bakgrund och syfte: Antalet flyktingar och ensamkommande barn ökar i Sverige och dessa människor tillhör en av de grupper som löper större risk att utveckla självmordsbeteende. Samtidigt nämns bristen på forskning inom ämnet av olika källor. Syftet med denna studie är därför att undersöka självmordsbeteende bland unga flyktingar i åldern 13 och 18 år i Sverige, från personals upplevelser i sociala verksamheter. Metod: Vi har valt en kvalitativ ansats med sju narrativa intervjuer, ungefär en timme långa vardera och bandinspelade med diktafon. Intervjuguiden var semistrukturerad. Respondenterna i denna studie utgörs av en kurator, personal från två avdelningar inom barnpsykiatrin (BUP) och fyra olika hem för vård eller boende (HVB-hem) för ensamkommande barn och ungdomar. Resultat och slutsatser: Intervjupersonerna hade uppfattningen att unga flyktingar har gått igenom mycket, förlorat sina familjer och erfarit svåra trauman och en besvärlig flykt till Sverige. Resultatet från insamlad data visade att personalen trodde att orsaken till självmordsbeteende är den långa väntan under asylprocessen, det trauma som de har upplevt och brist på socialt nätverk. Självmordsbeteende bland unga flyktingar var ofta tankar och självmordsförsök genom tabletter, självsvält, hängning eller genom att skära sig. Vi har uppmärksammat respondenters åsikter om att en koppling mellan självmord och att vara flykting är möjlig och att en kortare asylprocess kan bidra till att minska självmordsbeteende bland unga flyktingar.

The purpose of this investigation was to examine the role of suicide-related mental imagery in suicidal behavior. It was hypothesized that engagement (frequency, emotional impact, vividness, realism) with suicidal imagery would be related to suicidality, with greater engagement with imagery associated with more suicidal behaviors. Acquired capability for suicide was expected to be a mediator of this relationship. These hypotheses were tested by surveying 237 undergraduate university students (59% female; mean age = 20). Students completed a packet of self-report measures: The Modified Suicidal Cognitions Interview, The Acquired Capability for Suicide Scale, and the Self-Harm Behavior Questionnaire. Results suggested that engagement with suicide-related imagery was positively correlated with suicidality. The correlational analyses showed that an additional mediational analysis was unwarranted. The implications of these findings are that understanding suicide-related mental imagery could play an important role in clinical risk assessment and treatment for suicidality, and that further research is needed to clarify the mechanisms underlying the relationship between suicide-related mental imagery and suicidal behavior.

Research into the phenomenon of youth suicide is typically guided by quantitative methodologies focused on young people who have attempted or died by suicide. Questions related to epidemiology, etiology, and the development of actuarial measures of risk are often the drivers of these particular kinds of research. Similarly, research into school-based youth suicide prevention curricula is predominantly focused on quantitative measures of the degree to which young people acquire knowledge or change attitudes about suicide, after exposure to a delivered program. Grounded in post-structural ideas, the purpose of this thesis is to expand upon these mainstream inquiries into youth suicide prevention education through close exploration and analysis of how “suicide” is discursively produced within the context of a classroom delivered curriculum. This study will pay particular attention to the discursive productions of suicide in the curriculum, as well as how these productions result in the constitution of particular objects, concepts, and subjectivities. Transcripts of “naturally occurring classroom talk” will serve as the site of analysis. Troubling contemporary “truth regimes” about suicide and its prevention through close analysis of the discursive frames by which they are produced offers up the potential of re-imagining new possibilities for thinking about and delivering youth suicide prevention education.

The purpose of this phenomenological study was to explore the experience of front-line practitioners working with suicidal children and youth. Five front-line practitioners who had experienced working with children or youth who were suicidal participated in the semi-structured interviews. Transcripts of the interviews were analyzed and summarized under the following three areas of experience: Participants' Descriptions of Working with Suicidal Children and Youth, Knowledge Valued by Participants' to Inform their Practice with Suicidal Children and Youth, and Participants' Physical and Emotional Responses to Suicidal Children and Youth. There were a total of sixteen emergent theme clusters. The themes related to the experience of practice with suicidal children and youth provided a rich context for understanding the nature of meaning of the suicidal behaviors for participants. The emergent themes relating to the knowledge valued by participants to guide their approach provided a specific understanding of the multiple sources of knowledge participants were drawing from in the encounters. The emergent themes relating to the physical and emotional responses participants experienced in relation to their encounters with a suicidal child or youth provided an awareness of the impact the encounters had on participants. The major findings included the participants' broad scope of knowledge they used to guide their approach, as well as that encounters with suicidal children and youth did evoke strong physical and emotional responses amongst participants. The study concludes by describing the implications of these findings for Child and Youth Care practice and for future directions in research.

Research into the phenomenon of youth suicide is typically guided by quantitative methodologies focused on young people who have attempted or died by suicide. Questions related to epidemiology, etiology, and the development of actuarial measures of risk are often the drivers of these particular kinds of research. Similarly, research into school-based youth suicide prevention curricula is predominantly focused on quantitative measures of the degree to which young people acquire knowledge or change attitudes about suicide, after exposure to a delivered program. Grounded in post-structural ideas, the purpose of this thesis is to expand upon these mainstream inquiries into youth suicide prevention education through close exploration and analysis of how “suicide” is discursively produced within the context of a classroom delivered curriculum. This study will pay particular attention to the discursive productions of suicide in the curriculum, as well as how these productions result in the constitution of particular objects, concepts, and subjectivities. Transcripts of “naturally occurring classroom talk” will serve as the site of analysis. Troubling contemporary “truth regimes” about suicide and its prevention through close analysis of the discursive frames by which they are produced offers up the potential of re-imagining new possibilities for thinking about and delivering youth suicide prevention education.

This thesis examines mortality rates among adults who experienced full-time imprisonment in New South Wales between January 1988 and December 2002, by record linkage to the Australian National Death Index. The cohort included 76383 men and 8820 women. Over a mean follow-up of 7.7 years, 5137 deaths (4724 men, 423 women) were identified. Three hundred and three deaths (295 men, eight women) occurred in custody. The median age at death was 36.6 years for men and 32.7 years for women. The prominent causes of death were drug overdose, suicide, accidental and cardiovascular disease. The crude mortality rate was 797 per 100000 person-years for men and 685 per 100000 person-years for women. Risk of mortality was 3.7 times greater in male and 7.8 times greater in female prisoners than the standard population. The excess mortality was substantially raised following release from prison in both men (standardised mortality ratio 4.0 vs 1.7) and women (standardised mortality ratio 8.2 vs 2.1). The period of highest risk of death was the first two weeks after release. Drug overdose was the main cause of death, responsible for 68% of the deaths in the first two weeks for men and for 90% of the deaths in this period for women. In men, there was also a clustering of suicide directly after release. Prisoners admitted to prison psychiatric hospital, repeat offenders and those in the early stage of followup were at increased risk of mortality. Violent offenders were overrepresented in suicide figures and property offenders in death from overdose. Minority groups, in particular men, had a lower risk of death than white people. The above findings reinforce how disadvantaged prisoners are, measured by mortality as the most fundamental scale of human wellbeing. Prison represents a potential opportunity for treatment and public health intervention to address some of the health problems underlying the high mortality found in this study. The key challenge is, however, to provide a continuum of care between the prison and community.

Thesis (Ph.D.) -- University of Western Sydney, 2002. / Bibliography : leaves 247-276.