Suicide is the second leading cause of death worldwide for adolescents and emerging adults. Despite knowledge of distal risk factors for suicide (i.e., childhood maltreatment), there is a dearth of developmentally informed psychobiological theories of suicide that test potentially modifiable proximal risk factors. Utilizing a multi-method design, this study integrates cognitive and biological risk factors into a model of suicide risk following maltreatment. Undergraduates completed a screener assessing medical history, trait reward and threat sensitivities, history of suicidal thoughts and behaviors (STBs), and childhood maltreatment. Participants without a history of autoimmune disease completed a reward and threat-salient acute stress task with pre- and post-task blood draws to measure peripheral inflammatory biomarkers. Utilizing ecological momentary assessment, a subset of participants with a history of suicidal ideation completed daily measures (three per day) of STBs and state reward and threat sensitivities for two-weeks before completing follow-up measures of STBs. Mediation models found that inflammatory reactivity to acute stress did not explain the relationship between maltreatment and ideation across the two-week follow-up, but those participants with greater TNF-α reactivity to an acute stress task reported more severe ideation at the study visit. Moderated mediation models showed that the association between inflammatory reactivity and suicidality was not significantly amplified by reward or threat sensitivity. But, at trait and state levels, those with histories of maltreatment who were less sensitive to rewards and more aware of potential threats experienced the most severe ideation. This investigation aimed to understand the processes that immediately precede STBs to inform future prevention and intervention efforts. / Psychology

Nursing students' knowledge deficits, lack of experience, personal biases, and anxiety can ultimately create vulnerability, avoidance, and discriminatory behaviours toward people experiencing a mental health disruption. Nursing students express the need for more innovative educational opportunities to refine skills and enhance knowledge specific to suicidal identification and risk assessment. Virtual simulation has increased significantly within healthcare education to supplement, enhance, and support learning since the beginning of the COVID-19 pandemic. A virtual simulation education module focused on suicidal ideation and assessment of risk was designed and implemented to strengthen the learning, preparedness, and confidence of nursing students providing care in a mental health setting. The purpose of this study is to explore the perceived effectiveness of a suicidal ideation – assessment of risk virtual simulation module for undergraduate nursing students. The sample consisted of third-year nursing students enrolled in a mental health in nursing course from Ottawa, Ontario (N = 130). The research design is a mixed methods explanatory sequential design whereby the dominant data resides in the quantitative portion of the research study. The research study was divided into Phase I, referred to as the quantitative portion, and Phase II, referred to as the qualitative portion. In Phase I, the effectiveness of the virtual simulation focused on suicidal ideation and assessment of risk and were measured using the Simulation Effectiveness Tool-Modified (SET-M). The SET-M is a 19-item quantitative Likert scale tool used to measure the effectiveness of a simulation and its components after its completion. In Phase II, semi-structured interviews were the primary method for qualitative data collection to provide greater insight into Phase I of the research study. The quantitative findings demonstrated a simulation experience that was supportive of the nursing students’ learning, specifically in relation to nursing skills and assessments, problem- solving, clinical decision-making, and communication skills. The quantitative results demonstrated the importance of structure and guidance to achieve the desired outcomes of the simulation. Thematic analysis of the semi-structured interviews revealed that the virtual simulation on suicidal ideation and assessment of risk was associated with increases in learning, preparedness, confidence, knowledge, critical reflection, and a decrease in anxiety regarding suicide ideation and assessment of risk. The virtual simulation module on suicidal ideation and assessment of risk reinforces the need for various educational modalities to engage and increase the preparedness of nursing students entering clinical placement.

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Bakgrund: Suicid är ett globalt folkhälsoproblem och sjuksköterskan spelar en viktig roll i det suicidförebyggande arbetet. Det finns olika behandlingar för personer med suicidalt beteende, och hur dessa patienter blir bemötta i vården har en viktig betydelse för deras tillfrisknande. Syfte: Syftet var att beskriva sjuksköterskors upplevelser av att vårda suicidnära patienter. Metod: Litteraturöversikt baserad på elva vetenskapliga artiklar; nio kvalitativa, en kvantitativ och en mixad metod hämtade från databaserna Pubmed och Cinahl Complete. Resultat: Resultatet presenteras utifrån tre huvudteman: Brist på erfarenhet och utbildning, Vårdrelationens betydelse samt Uttryckta känslor hos sjuksköterskor. Slutsats: Litteraturöversikten visar främst på en bristande kompetens hos sjuksköterskorna i vårdandet av suicidnära patienter. Den bristande kompetensen drabbar inte bara patienterna utan påverkar även sjuksköterskornas egna mående då oro och stressrelaterade känslor ofta uppstår. En god vårdrelation är av betydelse för att kunna vårda denna patientgrupp på bästa sätt. / Background: Suicide is a global public health issue, and nurses play a crucial role in suicide prevention efforts. There are various treatments available for individuals with suicidal behavior, and how these patients are treated in healthcare settings is of significant importance for their recovery. Aim: The aim was to describe nurses' experiences of caring for suicidal patients. Method: A literature review based on eleven scientific articles; nine qualitative, one quantitative, and one mixed method collected from the databases Pubmed and Cinahl Complete. Results: The results are presented based on three main themes: Lack of experience and training, Importance of the nurse-patient relationship, and Expressed emotions among nurses. Conclusions: The literature review primarily demonstrates a lack of competence among nurses in caring for patients at risk of suicide. This lack of competence not only affects the patients but also impacts the nurses' own well-being as feelings of anxiety and stress often arise. A strong nurse-patient relationship is of great importance in order to provide optimal care for this patient group.

Suicidal ideation and suicide attempt rates are far higher among gender minority individuals than in the general population. In the wake of an unprecedented number of anti-LGBTQ+ legislation being proposed and passed in 2023 in the United States, this study sought to examine the impact of this legislation on gender minority stress and suicidal desire and intent among gender minority adults. Results indicated that anxiety about the legislation was associated with the desire to die, perceived burdensomeness, thwarted belongingness, and the likelihood of attempting suicide in the future. The perceived impact of the legislation was associated with intent to die and thwarted belongingness. Knowledge of the legislation being proposed or passed in their state was associated with anxiety about legislation and its perceived impact on them. Awareness of laws passed in their state was also associated with distal and proximal factors of gender minority stress. Distal stress factors were also associated with the perceived impact of the legislation. Taken together, these results suggest that the discriminatory legislation is negatively impacting the mental well-being of gender minority individuals across the United States and may put them at greater risk for suicidal thoughts.

Introdução: Ideação suicida e tentativas de suicídio são geralmente complicações dos transtornos psiquiátricos. O estudo da freqüência e fatores associados podem contribuir para uma abordagem mais adequada por profissionais de saúde mental. Objetivos: Estimar a prevalência de tentativas e pensamentos suicidas, em pessoas com transtornos mentais graves (TMG) e as associações com características sócio-demograficas, diagnóstico, ajustamento social, sintomas psiquiátricos, uso de substâncias psicoativas, envolvimento familiar e tratamentos realizados. Método: Foram entrevistados e avaliados 192 pessoas que apresentavam TMG, com idade entre 18 e 65 anos e que tiveram contato com os serviços de saúde mental de três regiões definidas do município de São Paulo em período determinado. Utilizou-se anamneses estruturadas com questionários padronizados e escalas psicométricas. As entrevistas foram realizadas no domicílio do paciente. Realizou-se análise descritiva, análise univariada e análise multivariada. Resultados: Da amostra estudada predominaram as pessoas do sexo masculino (53,1%), solteiras (57,3%), com diagnóstico de esquizofrenia (58,3%). Poucas pessoas apresentavam abuso ou dependência de álcool (7,3%) e apenas três pessoas (1,6%) não utilizaram medicações psiquiátricas no período de um ano anterior à entrevista. Cento e nove (57,7%) entrevistados apresentaram pensamentos suicidas ao longo da vida e nos 12 meses anteriores a entrevista, trinta e oito (20,1%) tiveram tais pensamentos. Cinqüenta e nove (30,9%) pessoas já haviam tentado suicídio durante a vida e oito (4,2%) apresentaram tentativas nos 12 meses anteriores à entrevista. Para todas as variáveis de desfecho, apresentaram associação estatística, a presença de sentimentos de culpa e sintomas depressivos. Na análise multivariada, o uso de neurolépticos apresentou associação com pensamentos e tentativas de suicídio ao longo da vida. Conclusão: Ideação e tentativas de suicídio foram bastante prevalentes na população estudada devendo sempre ser investigadas pelos profissionais de saúde mental, para que se possa tomar as devidas condutas, como o manejo dos sentimentos de culpa e depressão, além do ajuste correto da medicação para o transtorno mental. / Introduction: Suicidal ideation and suicidal attempts are usually complications of psychiatric disorders. The study of the frequency and associated factors may contribute for the mental health professionals to have a more appropriate approach. Aims: Estimate the prevalence of attempts and suicidal thoughts, in people who have serious mental disorder (SMD) and the association with social-demographic characteristics, diagnosis, social adjustment, psychiatric symptoms, use of psychoactive substances, family involvement and treatments they have gone though. Method: One hundred ninety two subjects, age 18 - 65, showing SMD and having been in touch with mental health services in three defined zones in the city of Sao Paulo, in the determined period, were evaluated and interviewed. The researchers used structured anamnesis with standardized questionnaires and psychometric scales, the subjects were interviewed at home and a descriptive analysis, a univariate analysis and a multivariate analysis were used. Results: From the sample we studied we’ve found a predominance of men (53,1%), single people (57,3%), having a diagnose of schizophrenia (58,3%). Few people presented abuse or dependence of alcohol (7,3%) and only three people (1,6%) hadn’t used psychiatric medications within one year before the interview. One hundred nine (57,7%) people who where interviewed showed suicidal thoughts during their lives and during 12 months prior to the research, thirty eight (20,1%) had that kind of thoughts. Fifty nine (30,9%) people had tried to commit suicide during their lives and eight (4,2%) showed attempts to it within 12 months before the interview. The presence of guilt feelings and depressive symptoms showed statistics association to all dependant variables. The multivariate analyses showed statistics association to attempts and suicidal thoughts during the patients’ lives to the occasional use of neuroleptics. Conclusion: The presence of suicidal ideation and attempts to suicide were prevalent in the studied population and they should always be investigated by the health mental professionals in order for them manage the prosper procedures, such as the handling of guilt feelings and depression and be able to stablish the proper medication, for the mental disorder.

Submitted by admin tede (tede@pucgoias.edu.br) on 2017-02-23T18:38:39Z No. of bitstreams: 1 Alexandre Castelo Branco Herênio.pdf: 578480 bytes, checksum: 6948b5c1fb497cf043352d677461cbc9 (MD5) / Made available in DSpace on 2017-02-23T18:38:39Z (GMT). No. of bitstreams: 1 Alexandre Castelo Branco Herênio.pdf: 578480 bytes, checksum: 6948b5c1fb497cf043352d677461cbc9 (MD5) Previous issue date: 2016-02-03 / Suicide is a phenomenon present in all stages of life, however, the World Health Organization points to a significant increase in suicide rates among teenagers. Adolescence can be understood as a cultural phenomenon that marks the transition of roles and responsibilities from childhood to adulthood. The literature reports that the typical events of adolescence may contribute to the occurrence of suicide at this time of life. The purpose of this dissertation is to describe aspects related to suicide rates, and identify the incidence of ideations and suicide attempts among adolescents living in the city of Goiânia. For this purpose, three chapters will be presented organized in article format. The first chapter deals with a systematic review of the literature on suicide in adolescence. In this study, we analyzed 9 articles, 2 theses and 2 dissertations. It could be observed that the list of factors associated with suicide is extensive. The second chapter aims to describe the suicide rates of teenagers living in Goiânia from 2003 to 2013, and to investigate associated factors. For this purpose, the data of 10 to 19 yearold subjects provided by the Mortality Information System were analyzed - SIM, part of Ministry of Health responsible for the provision of information on mortality in Brazil. The results indicate a higher incidence of suicide among adolescents between 15-19 years old. However, it emphasizes a trend of increasing suicide among adolescent males between 10-14 years old. The third chapter aims to carry out an assessment of the prevalence of suicidal ideation and attempted suicide among teenagers in the city of Goiania in 2013. Also in this chapter, we evaluate the relationship between ideation and attempted suicide with self-reported problems behaviors through the Youth Self Report - YSR. The results indicate an association between ideation and suicide attempt with all behavioral problems. We also found that attempted suicide rates are higher than the rates of suicidal ideation among adolescents in this county. It is emphasized the importance of studies that understand the variables involved in suicidal behavior of adolescents, since it is the first step for the implementation of contention measures for this phenomenon. / O suicídio é um fenômeno presente em todas as etapas da vida, entretanto, a Organização Mundial de Saúde chama a atenção para um aumento significativo nas taxas de suicídio entre os adolescentes. A adolescência pode ser compreendida como um fenômeno cultural que marca a troca de papéis e responsabilidades da infância para os papéis e responsabilidades típicos da vida adulta. A literatura relata que os acontecimentos típicos da adolescência podem contribuir para a ocorrência do suicídio neste momento da vida. A proposta desta dissertação é descrever aspectos relacionados às taxas de suicídio, bem como identificar a incidência de ideações e tentativas de suicídio entre adolescentes residentes na cidade de Goiânia. Para tanto, serão apresentados três capítulos organizados no formato de artigo. O primeiro capítulo trata de uma revisão sistemática da literatura sobre o suicídio na adolescência. Neste estudo, foram analisados 9 artigos, 2 teses e 2 dissertações. Foi possível observar que é vasta a lista de fatores associados ao suicídio. O segundo capítulo tem por objetivo descrever as taxas de suicídio de adolescentes residentes na cidade de Goiânia durante o período de 2003 a 2013, bem como investigar características associadas. Para tanto, foram analisados os dados sobre suicídio de sujeitos de 10 a 19 anos disponibilizados pela Sistema de Informações sobre Mortalidade - SIM, órgão do Ministério da Saúde responsável pela disponibilização das informações sobre mortalidade no Brasil. Os resultados indicam uma maior incidência do suicídio entre os adolescentes de 15 a 19 anos. Entretanto, ressalta-se uma tendência de aumento do suicídio entre adolescentes do sexo masculino de 10 a 14 anos. O terceiro capítulo tem por objetivo realizar uma avaliação da prevalência de ideação e tentativa de suicídio entre os adolescentes da cidade de Goiânia no ano de 2013. Ainda neste capítulo, avalia-se a relação entre ideação e tentativa de suicídio com o autorrelato de problemas de comportamentos por meio do Youth Self Report - YSR. Os resultados indicam uma associação entre ideação e tentativa de suicídio com todos os problemas de comportamento. Encontraram-se também taxas de tentativa de suicídio superiores às taxas de ideação suicida entre adolescentes deste município. Ressalta-se a importância de estudos que compreendam as variáveis envolvidas no comportamento suicida de adolescentes, uma vez que este é o primeiro passo para que medidas de contenção deste fenômeno sejam implementadas.

Background: Although insomnia has been identified as a robust predictor of suicidal ideation and behaviors, little is known about the mechanisms by which sleep disturbances confer risk for suicide. We investigated thwarted belongingness as an explanatory link between insomnia symptoms and suicidal ideation across three military service member and veteran samples. Methods: Data were collected among United States military service members and veterans (N1=937, N2=3,386, N3=417) who completed self-report measures of insomnia symptoms, thwarted belongingness, suicidal ideation, and related psychiatric symptoms (e.g., anxiety, hopelessness). Bias-corrected bootstrap mediation analyses were utilized to examine the indirect effects of insomnia symptoms on suicidal ideation through thwarted belongingness, controlling for related psychiatric symptoms. Results: Consistent with study hypotheses, thwarted belongingness significantly accounted for the relationship between insomnia and suicidal ideation across all three samples; however, insomnia symptoms did not significantly account for the relationship between thwarted belongingness and suicidal ideation, highlighting the specificity of our findings. Limitations: This study utilized cross-sectional self-report data. Conclusions: Insomnia may confer suicide risk for military service members and veterans, in part, through the pathway of thwarted belongingness. Additional prospective studies are warranted to further delineate this model of risk. Our results offer a potential therapeutic target for the prevention of suicide, via the promotion of belongingness, among service members and veterans experiencing insomnia symptoms.