Ch. 25: Suicide/ Non-Suicide Injury

Suicide is the ____ leading cause of death for ages 35-54

4th

Suicide is the ____ leading cause of death for ages 55-64

8th

White LGBT and Hispanic bisexual females are ______ likely to be bullied than white heterosexuals

more

Treatment of Suicide

treatment of the actual suicide crisis

Diathesis-stress model

combination of suicidal fantasies and significant loss

Suicide is the ____ leading cause of death in the US

10th

Suicide is the ____ leading cause of death for ages 10-34

2nd

Assisted Suicide in the United States

Individual states can allow, regulate, or prohibit assisted suicide

Suicide

Intentional act of killing oneself by any means

African American protective factors

Religion, role of the extended family

Hispanic American protective factors

Roman Catholic religion and importance of extended family

Sexual minority youths were more likely to report

suicidal ideation

DSM-5 Suicide bombing

excludes religious and political suicides from its criteria

Veterans have _______ suicide rates compared to the _______ population

increasing; general

Assisted suicide in Netherlands, Belgium and Switzerland

assisted suicide is legal

Suicide Behavior Disorder DSM-5

- Attempt within last 24 months - Attempt was not initiated in delirium or confusion - Attempt was not undertaken for a religious or political objective

Interventions for Suicide include

- Caring for injuries - Establishing therapeutic alliance - Teaching coping skills - Promoting reflective dialogue - Treatment of underlying mental health disorders

Biological factors for suicide

- Familial tendency - Lowered SKA2 gene expression - Low serotonin levels

Self assessment: Health professionals may experience

- Fear - Grief - Anger - Puzzlement - Condemnation of suicidal feelings/intent

LGBT Youth and Bullying include

- Online bullying - Name calling - Verbal harassment - Physical harassment

Risk factors for suicide

- Psychiatric disorders - Alcohol or substance use disorders - Male gender - Increasing age - Race (mostly Caucasian) - Religion - Marriage - Profession - Physical health

Environmental Safety Guidelines

- Use (and count) plastic utensils - No private room; keep door open at all times - Jump-proof and hang-proof bathrooms - Lock doors to non-patient areas - Monitor for and remove potentially harmful gifts - In patient's presence, assess belongings and search patient for harmful objects - Ensure that patients do not bring or leave harmful objects

Six-step planning approach

1. Limit setting for safety 2. Developing self-esteem 3. Discovery of motive and its role 4. Discovering self-control 5. Replacement with coping skills 6. Entering maintenance phase

Menninger's three parts to suicide hostility

1. Wish to kill 2. Wish to be killed 3. Wish to die

Asian American protective factors

Adherence to religions that tend to emphasize interdependence between the individual and society

A person with which psychiatric problem is most likely to complete suicide? a. Personality disorder b. Major Depression c. Substance-abuse disorder d. Schizophrenia

Correct answer: B Between 32% and 47% of patients who have major depression or bipolar disorder (during the depressed phase) will complete suicide.

Gina is hospitalized suicidal ideation after two suicide attempts. For the first 2 days of hospitalization, the patient eats 20% of meals and stays in her room between groups. By the fourth day, the nurse observes that the patient is more sociable, is eating meals, and has a bright affect. Considering Gina's behavior on the fourth day of hospitalization, which factor should the nurse consider? a. The patient is showing improvement and may be ready for discharge. b. The patient may have decided to commit suicide; the nurse should reassess suicidality. c. The patient is feeling rested, supported by the therapeutic milieu, and less depressed. d. The patient is benefiting from the antidepressant she has been taking for 4 days.

Correct answer: B It is always wise to consider the possibility that a patient who was recently suicidal may be exhibiting positive traits because he or she is at peace with a final suicide decision and is feeling relief, or even exhilaration about this. Do not just assume that they are immediately better until you have had more time for observation.

Which method of suicide has the highest lethality? a. Ingesting pills b. Wrist cutting c. Inhaling natural gas d. Self-inflicted gunshot wound

Correct answer: D A self-inflicted gunshot wound is considered a high-risk method, or "hard" method.

Completed Suicide

Suicide successfully resulting in death

Nonsuicidal self-injury

Self-injury directed to the surface of the body to induce relief from a negative feeling/cognitive state or to achieve a positive mood state

Suicidal Ideation

Thinking about killing oneself

Suicide rates among _____ _____ _____ ______ has surpassed civilian rates

active-duty service members

Prevention of Suicide

activities that provide support, information, and education to prevent suicide

Freud and suicide

aggression turned inward

Aaron Beck and suicide

central emotional factor is hopelessness

Postvention for Suicide

interventions with a circle of survivors left by individuals who completed suicide to reduce the traumatic aftereffects