published_or_final_version / Social Work / Master / Master of Social Work

published_or_final_version / Gerontology / Master / Master of Social Sciences

This study examined the relationship between psychological birth order and substance abuse and suicide in adolescents. It was hypothesized that adolescents operating from a perceived inferior position as measured by the Psychological Birth Order Instrument would be more likely to abuse substances and/or engage in self-destructive behavior. Ninety-five adolescents from Southern Arizona volunteered to participate in this study. The forty-eight treatment subjects were current in-patients at a psychiatric hospital. The control group consisted of forty-seven high school students. The results indicated that there was a difference in perceptions between adolescents in treatment versus those not in treatment for substance abuse and/or suicide. There was a significant relationship at the.005 level and it was concluded that adolescents operating from a perceived inferior position are more likely to abuse substances and/or attempt suicide.

Researchers have previously identified substance use and borderline personality disorder as factors that increase risk for suicidal thoughts and behaviors. This study explored the relationship between these factors in samples of students and individuals seeking outpatient treatment. Supplemental data collected via the internet (MTurk) also looked at experiential avoidance (EA) with the Avoidance and Fusion Questionnaire for Youth. The Structured Clinical Interview for the DSM-IV, Alcohol Use Disorders Identification Test, Scale for Suicide Ideation, and Personality Assessment Inventory- Borderline Features Scale elicited information regarding severity and/or frequency of substance use, suicidal thoughts, and borderline features respectively. Additionally, the Psychiatric Diagnostic Screening Questionnaire was administered to the UNT sample. The UNT sample analyses indicate substance use moderates, strengthening, the relationship between borderline features and current suicidal thoughts. However, severity of suicidal thoughts was lower for individuals high in both borderline features and substance use disorder symptoms compared to those low in borderline features and high in substance use symptoms. The MTurk sample analyses suggest substance use functions as a mediator. A robust relationship existed between substance use severity and EA, showing substance use as a behavioral marker for EA. In conclusion, concurrent treatment of substance use and borderline personality features would be beneficial in reducing risk for suicidal thoughts. Further investigation into the role and utility of addressing EA is warranted.

Made available in DSpace on 2015-03-05T19:37:25Z (GMT). No. of bitstreams: 0 Previous issue date: 23 / Nenhuma / Esta dissertação foi disposta em três sessões, dois artigos, sendo um artigo teórico e o outro empírico, além de um relatório de pesquisa. O primeiro estudo teve como objetivo discutir sobre o comportamento suicida e a capacidade para gerar estratégias de solução de problemas em dependentes de substâncias psicoativas. Através de uma análise baseada em artigos selecionados nas fontes eletrônicas do SciELO, LILACS, MEDLINE, PubMed e Web of Science no período de 1995 a 2010 a partir dos seguintes descritores: suicídio (suicide), comportamento suicida (suicide behavior), tomada de decisão (making decision) e drogas (drugs). Pode-se constatar que é relevante a contribuição do abuso de substâncias para a expressão de ideação suicida, como também há uma associação importante com o prejuízo na capacidade para gerar estratégias de solução de problemas. Já o segundo estudo comparou homens dependentes de substâncias psicoativas, com não dependentes, em relação a transtornos cognitivos e emocionais tais como: expressã / This thesis was prepared in three sessions, two articles, one empirical and one theoretical paper, in addition to a research report. The first study aimed to discuss suicidal behavior and the ability to generate strategies for solving problems in substance dependents. We conducted an analysis based on selected articles on electronic sources of SciELO, LILACS, MEDLINE, PubMed and Web of Science for the period 1995-2010 from the following descriptors: suicide (suicide), suicidal behavior (suicide behavior), decision making (decision-making) and drugs (drugs). One can see that is relevant to the contribution of substance abuse for the expression of suicidal thoughts, as there is also an important association with the impairment in the ability to generate strategies for solving problems. The second study compared men with substance use disorders, with no dependents, for cognitive and emotional disorders such as expression of anger, impulsivity, abstract reasoning and the ability to generate strategies for sol

Depressed mood is one of the most common of all psychiatric symptoms occurring in children and adolescents. Population studies suggest a point prevalence of between 10 to 15% of children and adolescents having symptoms of depression. Further, depressed adolescents are also significantly more apt to demonstrate suicidal ideation accompanied by a concomitant sense of helplessness and hopelessness. The overall aim of the study was to identify and characterize profiles of depression and suicidal behavior within the adolescents of the USA in the past 10 years. This study utilized epidemiological, cross-sectional, data from the Youth Risk Behavior Surveillance System (YRBSS), a biennial census that monitors six types of health-risk behaviors that contribute to the leading causes of death and disability among youth. Latent classes of the indicators were generated utilizing latent class regression modeling. Predictors were then regressed on class membership in a multinomial logistic regression simultaneously to assess significance. Finally, a juxtaposition of the profiles and significant predictors followed to allow for observation of differences in number of profiles and other qualities (i.e., proportions of sample in each class, etc.) as well as to visualize and note “carryover” predictors across the past 10 years. Findings revealed a relatively stable pattern of profiles and predictors over the years with the exception of 2015. In the analysis of demographic variables, membership of the “low- risk non-depressed” class was consistently or more frequently associated with being male, older, not of an ethnic minority, and non-ethnically bi-or multiracial, across all time points. Three clusters of behaviors and factors emerged as significant predictors of depressed mood and suicidality. The first cluster consisted of typical adolescent risk behaviors that includes delinquent behaviors (i.e., fight, weapon carrying, or use of over-the-counter drugs), smoking, alcohol use, as well as consensual (non-violent) sexual activity. The second cluster of predictors that was significant consisted of experiences of traumatic events such as bullying, sexual assault, and intimate partner violence. Finally, a third cluster that showed significance consisted of self destructive behavior such as the use of illicit or hard drugs and maladaptive dieting, restricting or purging behavior. Several protective factors such as having sufficient physical activity and getting at least 8 hours of sleep daily also emerged as significant. Limitations to the YRBS and this study were discussed, and recommendations that tie to the implications of the findings were proposed. Future directions for research were also presented in light of the limitations of the study.

Suicidal behavior, including ideation and attempts, is a significant public health problem. Due to the complexity of suicidal behavior, it is necessary to consider an array of factors that could serve as risk and protective factors. Previous research has shown that deficits in social problemsolving ability are associated with increased risk for suicidal ideation and attempts; conversely, problem solving strengths are associated with reduced risk. This dissertation project, consisting of 3 individual manuscripts, was designed to explore the relationship between social problemsolving ability and suicidal behavior in low-income primary care patients. Furthermore, additional constructs including health related quality of life, interpersonal needs, neuroticism, and hopelessness were also explored as they related to social problem solving and suicidal behavior. In a sample of 220 primary care patients ages 19-79 (M = 44.08; SD = 12.11), we examined the following: 1) health related quality of life as a mediator of the relationship between social problem solving and suicidal behavior, 2) interpersonal needs as a mediator of the relationship between social problem solving and suicidal behavior, and 3) the potential mediating role of hopelessness on the relation between neuroticism and suicidal behavior and the moderating role of social problem-solving ability on these associations. Participants completed self-report questionnaires including the Social Problem Solving Inventory-Revised-Short Form, Suicidal Behaviors Questionnaire-Revised, Short-Form 36, Interpersonal Needs Questionnaire, NEO-Five Factor Inventory, and the Beck Hopelessness Scale. Scores were analyzed using bootstrapped mediation and moderated mediation techniques. In Manuscript 1 mediating effects were found for mental health related quality of life. In Manuscript 2 thwarted belongingness and perceived burdensomeness mediated the relationship between social problem solving and suicidal behavior. Finally, in Manuscript 3 there was a significant indirect effect of neuroticism on suicidal behavior through hopelessness, and this indirect effect was moderated by social problem-solving ability. Our findings indicate that social problem-solving ability serves as both a risk and protective factor for suicidal behavior and impacts other variables that influence suicide risk among primary care patients. Interventions that bolster social problem-solving ability may reduce suicide risk in primary care.

Suicide is a public health problem and complex relationships exist between intrapersonal suicide risk factors and interpersonal risk factors. Health-related quality of life (HRQL) may interact with difficulties with interpersonal relationships and psychopathology. We examined thwarted interpersonal needs and depressive symptoms as potential mediators on the association between HRQL and suicidal behaviors. It was hypothesized that thwarted interpersonal needs would mediate the association between HRQL and suicidal behavior, and that this mediating effect would be dependent on the moderating effect of depressive symptoms. It was hypothesized that thwarted interpersonal needs and then depressive symptoms would sequentially mediate the association between HRQL and suicidal behavior. The mediating roles of thwarted belongingness and perceived burdensomeness on the association between HRQL and suicidal behaviors were supported. Moderated-mediation results were not significant. Serial mediations analyses were partially supported. Our findings suggest the importance of considering both interand intrapersonal factors on suicidal behavior.

Fibromyalgia, a chronic illness characterized by widespread muscle pain, tenderness, joint stiffness, and fatigue, affects 3-6% of the world’s population. Symptoms of fibromyalgia impact the ability to complete daily activities, such as cooking, cleaning or employment, possibly leading to greater perceived stress and, in turn, to engagement in suicidal behavior. For persons with fibromyalgia, pressure to complete previous routines, and emergence of frustration at the inability to do so, may result in the experience of being overwhelmed by stressors. Further, persons with fibromyalgia are at greater risk for both mental health difficulties and suicidal behavior than persons in the general population; for example, depressive symptoms, including self-blame, are three times more common. However, not all individuals with fibromyalgia experience overwhelming distress or engage in suicidal behaviors, perhaps due to the presence of individual-level protective factors. One such factor is self-compassion, which is composed of self-kindness, common humanity, and mindfulness. Positive emotions directed toward the self may buffer against illness-related stressors and feelings of inadequacy and loss associated with impact of disease and functional impairment, thereby decreasing suicide risk. At the bivariate level, we hypothesized that fibromyalgia impact would be positively related to stress and suicidal behaviors, and that self-compassion would be negatively related to all of these variables. At the multivariate level, we hypothesized that stress would mediate the relation between fibromyalgia impact and suicidal behaviors, and that self-compassion would moderate this mediation effect such that greater self-compassion would weaken the linkages between impairment and stress, impairment and suicidal behavior, and stress and suicidal behavior. Our sample of individuals with fibromyalgia (N=508) were primarily White (91.8%; n=383) and female (95.7%; n=401), and completed self-report measures including: Fibromyalgia Impact Questionnaire-Revised, Depression Anxiety Stress Scales, Self-Compassion Scale-Short Form, and Suicide Behaviors Questionnaire-Revised. Bivariate correlations and multivariate analyses, per Hayes (2013), were conducted covarying age, sex, and ethnicity. In bivariate correlations, fibromyalgia impact was positively related to stress and suicidal behaviors and negatively related to self-compassion (p Supporting hypotheses, our results suggest that self-compassion may protect against the development of stress related to fibromyalgia impact and subsequent risk for suicidal behaviors, and may have clinical implications. Therapeutic interventions focused on alleviating stress (e.g., meditation, stress inoculation therapy) and promoting self-compassion (e.g. mindful self-compassion training, positive self-talk) could ameliorate the perceived impact of fibromyalgia-related stressors and, thus, risk for engagement in suicidal behaviors.

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