Treatment of Intrusive Suicidal Imagery Using Eye Movements

Suicide and suicidal behavior are major public health concerns and affect 3-9% of the population worldwide. Despite growing evidence, there are still few effective interventions available to reduce suicide risk. In this article, we describe theoretical models of suicide ideation and behavior and propose to examine the possible effectiveness of a new and innovative preventive strategy. A model of suicidal intrusion (mental imagery related to suicide, also referred to as suicidal flash-forwards) is presented describing one of the assumed mechanisms in the etiology of suicide and the mechanism of therapeutic change. We provide a brief rationale for an Eye Movement Dual Task (EMDT) treatment for suicidal intrusions describing techniques that can be used to target these suicidal mental images and thoughts to reduce overall behavior. Based on the available empirical evidence for the mechanisms of suicidal intrusions, this approach appears to be a promising new treatment to prevent suicidal behavior as it potentially targets one of the linking pins between suicidal ideation and suicidal actions.

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The Involvement of Hypothalamus–Pituitary–Adrenal (HPA) Axis in Suicide Risk

Brain Sciences ◽

10.3390/brainsci10090653 ◽

2020 ◽

Vol 10 (9) ◽

pp. 653 ◽

Cited By ~ 3

Author(s):

Isabella Berardelli ◽

Gianluca Serafini ◽

Natalia Cortese ◽

Federica Fiaschè ◽

Rory C O’Connor ◽

...

Keyword(s):

Hpa Axis ◽

Systematic Reviews ◽

Suicidal Behavior ◽

Suicide Risk ◽

Case Reports ◽

Number Of Patients ◽

Hpa Axis Dysregulation ◽

New Treatment ◽

Meta Analyses ◽

Hpa Axis Activity

Stress and Hypothalamic–Pituitary–Adrenal (HPA) axis dysregulation play a major role in various pathophysiological processes associated with both mood disorders and suicidal behavior. We conducted a systematic review with the primary aim of clarifying the nature and extent of HPA axis activity and suicidal behavior. The second aim of this review was to investigate whether potential biomarkers related to HPA axis abnormalities act as individual susceptibility factors for suicide. The PRISMA statement for reporting systematic reviews was used. Only articles published in English peer-reviewed journals were considered for possible inclusion; we excluded case reports, meta-analyses, and systematic reviews, and studies that did not clearly report statistical analysis, diagnostic criteria, or the number of patients included. Overall, 36 articles on HPA axis and suicide risk met inclusion criteria and were reviewed. Studies that investigated tests detecting biomarkers and the role of early life stressors in suicide risk were also included. We found that HPA axis activity is involved in suicide risk, regardless of the presence or absence of psychiatric conditions. The HPA axis abnormalities, mainly characterized by hyperactivity of the HPA axis, may exert an important modulatory influence on suicide risk. Impaired stress response mechanisms contribute to suicide risk. Targeting HPA axis dysregulation might represent a fruitful strategy for identifying new treatment targets and improving suicide risk prediction.

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Factors in the Assessment of Suicidality in Youth

CNS Spectrums ◽

10.1017/s1092852900020678 ◽

2007 ◽

Vol 12 (2) ◽

pp. 156-162 ◽

Cited By ~ 44

Author(s):

Kelly Posner ◽

Glenn A. Melvin ◽

Barbara Stanley ◽

Maria A. Oquendo ◽

Madelyn Gould

Keyword(s):

Risk Factors ◽

Suicidal Ideation ◽

Young People ◽

Cause Of Death ◽

Suicidal Behavior ◽

Suicide Ideation ◽

Youth Suicide ◽

Standardized Terminology ◽

And Behavior ◽

Clinical Populations

ABSTRACTSuicide remains a leading cause of death among youth, and suicide ideation and behavior are relatively common in both normal and clinical populations. Clinicians working with young people must assess for the presence of suicidal ideation, suicidal behavior, and other risk factors, in order to determine the level of risk. This paper provides the clinician with a summary of risk factors for youth suicide, as well as providing standardized terminology to enhance assessment of suicidal ideation and behavior.

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Suicide Risk in High School Students in Slovenia

Crisis ◽

10.1027//0227-5910.20.1.23 ◽

1999 ◽

Vol 20 (1) ◽

pp. 23-27 ◽

Cited By ~ 8

Author(s):

Martina Tomori

Keyword(s):

High School ◽

High School Students ◽

Suicidal Ideation ◽

Psychosocial Factors ◽

Suicidal Behavior ◽

Representative Sample ◽

Suicide Risk ◽

School Students ◽

And Behavior

The objective of this study was to determine the psychosocial factors which differentiate suicidal adolescents from their nonsuicidal peers. By means of a specially designed questionnaire, distributed to a representative sample of 4686 Slovene high school students of both sexes aged 14-19 years, we assessed their general characteristics, suicidal ideation and behavior, family circumstances, self-appraisal of the problems and ways of solving them, engagement in sport, and exposure to suicide in their close circle. Numerous important differences were established between suicidal and nonsuicidal adolescents. The data gathered will help further research into suicidal behavior in adolescents.

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Depression and Suicide in Early Onset Schizophrenia

European Psychiatry ◽

10.1016/s0924-9338(11)73715-4 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 2012-2012

Author(s):

G. Zalsman

Keyword(s):

Suicidal Ideation ◽

Suicidal Behavior ◽

Criminal Behavior ◽

Suicide Risk ◽

Suicide Ideation ◽

First Episode ◽

Control Group ◽

Gender And Age ◽

Actual Suicide ◽

First Episode Schizophrenia

PurposeSuicide is a major cause of death in adolescents with first-episode schizophrenia (FES). We compared suicide-related traits between subjects with FES and with other psychopathologies in order to evaluate risk factors for suicidal behavior.Subjects and methodsTwenty-five inpatient adolescents with FES and a control group of 28 psychiatric inpatients matched for gender and age were assessed for depression, anger, criminal behavior, aggression, and suicidal ideation, risk and potential.ResultsThe adolescents with FES had significantly lower depression (p=0.003) anger (p=0.025) and criminal behavior (p=0.022) than did the controls. However, while suicide ideation was greater in the subjects with FES (p=0.003), suicide risk was significantly lower than controls (p=0.004).DiscussionDecreased levels of both depression and anger as part of affective constriction in the schizophrenia group could explain why the increased suicide ideation did not lead to a higher suicide risk in these inpatients.ConclusionThis study highlights the importance of distinguishing between suicidal ideation and actual suicide risk. We demonstrated that thoughts of suicide do not necessarily translate into an actual risk of suicidal behavior in adolescents with schizophrenia.

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Asuhan Keperawatan Jiwa pada Klien Skizofrenia dengan Risiko Bunuh Diri

Jurnal Keperawatan Jiwa ◽

10.26714/jkj.8.2.2020.211-216 ◽

2020 ◽

Vol 8 (2) ◽

pp. 211

Author(s):

Itsnaini Wahyu Puspita ◽

Erna Erawati

Keyword(s):

Nursing Care ◽

Suicidal Behavior ◽

Suicide Risk ◽

Attempted Suicide ◽

Suicide Ideation ◽

Field Research ◽

Qualitative Approach ◽

Verbal Responses ◽

Suicide Threats ◽

The Right

Kesehatan mental merupakan sektor penting dalam mewujudkan kesehatan manusia secara menyeluruh. Berbagai solusi dapat dilakukan seseorang ketika muncul stressor, salah satunya bunuh diri. Beberapa orang menganggap bunuh diri adalah solusi yang tepat untuk menyelesaikan masalah. Bunuh diri merupakan tindakan yang secara sadar dilakukan oleh seseorang untuk mengakhiri kehidupannnya. Salah satu seseorang yang mempunyai resiko untuk melakukan bunuh diri adalah pasien skizofrenia. Perilaku bunuh diri terdiri dari tiga tingkatan yaitu ide/isyarat bunuh diri, ancaman bunuh diri, dan percobaan bunuh diri. Tujuan penelitian menggambarkan pengelolaan asuhan keperawatan skizofrenia dengan fokus studi risiko bunuh diri. Penelitian ini termasuk field research (penelitian lapangan) dengan menggunakan pendekatan deskriptif kualitatif, langkah-langkah yang dilakukan peneliti dalam penelitian ini yaitu wawancara, observasi, dokumentasi, dan reduksi data. Hasil penelitian ini menunjukkan bahwa pemberian asuhan keperawatan pada klien skizofrenia dengan risiko bunuh diri menunjukkan hasil yang signifikan adanya intervensi dari perawat sesuai dengan respon verbal dan non verbal klien. Kata kunci: asuhan keperawatan, klien skizofrenia, risiko bunuh diri NURSING CARE FOR SCHIZOPHRENIA CLIENTS WITH RISK OF SELF-RISK ABSTRACTMental health is an important sector in realizing overall human health. Various solutions can be done when someone appears stressor, one of them suicide. Some people consider suicide to be the right solution to solve a problem. Suicide is an act that is consciously carried out by someone to end his life. One person at risk for suicide is a schizophrenic patient. Suicidal behavior consists of three levels, namely suicide ideation / cues, suicide threats, and attempted suicide. The aim of the study is to describe the management of schizophrenia nursing care with a focus on suicide risk studies. This research includes field research using a descriptive qualitative approach, the steps taken by researchers in this study are interviews, observation, documentation, and data reduction. The results of this study indicate that the provision of nursing care to schizophrenic clients with suicide risk shows a significant result of the intervention of the nurse in accordance with the client's verbal and non verbal responses. Keywords: nursing care, schizophrenia clients, suicide risk

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Association Between Psychopathology and Suicidal Behavior In Schizophrenia

Crisis ◽

10.1027/0227-5910/a000211 ◽

2013 ◽

Vol 34 (6) ◽

pp. 374-381 ◽

Cited By ~ 9

Author(s):

Nikolina Jovanović ◽

Anja Podlesek ◽

Vesna Medved ◽

Jasmina Grubišin ◽

Alma Mihaljevic-Peleš ◽

...

Keyword(s):

Suicidal Behavior ◽

Negative Symptoms ◽

Suicide Ideation ◽

Principal Component ◽

Psychiatric Interview ◽

Suicide Attempters ◽

Comparative Group ◽

And Behavior ◽

Reality Distortion ◽

Positive And Negative Symptoms

Background: Suicide in schizophrenia is a serious problem – ideation rates go up to 40%, and approximately one half of patients attempt suicide at least once. The distinction between attempters and ideators is vital in everyday clinical practice. Aim: To explore the association between psychopathology and suicidal behavior in a comparative study of three groups of patients with schizophrenia: suicide ideators, suicide attempters, and subjects without suicide ideation and behavior. Method: The study included 509 patients: suicide attempters (n = 159), ideators (n = 180), and a comparative group (n = 170). The clinical assessment consisted of a structured psychiatric interview and an evaluation of sociodemographics, suicidality (SIBQ), psychopathology (PANSS), and depression (CDSS). Results: Suicide attempters were more depressed than ideators, and both groups had higher CDSS scores than the comparative group. The overall contribution of positive, negative, and general PANSS symptoms was not statistically significant enough to differentiate ideators from attempters. A principal component analysis of the PANSS items revealed five components: disinhibition, withdrawal, anxiety and guilt, reality distortion, and disorganization. Two logistic regression analyses showed that suicide ideation or attempt was significantly related to depression, anxiety, guilt, gender, age, and number of previous hospitalizations. Compared to suicide ideators, attempters were more depressed, had a higher number of previous hospitalizations, and lower education. Conclusion: The results indicate that clinicians should look for depression, anxiety, and guilt feelings, while positive and negative symptoms seem to be less relevant for suicide assessment in schizophrenia.

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Perceptions of Adjunctive Mindfulness-Based Cognitive Therapy to Prevent Suicidal Behavior Among High Suicide-Risk Outpatient Participants

Crisis ◽

10.1027/0227-5910/a000519 ◽

2018 ◽

Vol 39 (6) ◽

pp. 451-460 ◽

Cited By ~ 2

Author(s):

Megan S. Chesin ◽

Beth S. Brodsky ◽

Brandon Beeler ◽

Christopher A. Benjamin-Phillips ◽

Ida Taghavi ◽

...

Keyword(s):

Cognitive Therapy ◽

Suicidal Behavior ◽

Group Treatment ◽

Suicide Risk ◽

Qualitative Data ◽

Descriptive Analysis ◽

Treatment Engagement ◽

Suicidal Thinking ◽

Prevention Interventions ◽

Risk Patients

Abstract. Background: Few investigations of patient perceptions of suicide prevention interventions exist, limiting our understanding of the processes and components of treatment that may be engaging and effective for high suicide-risk patients. Aims: Building on promising quantitative data that showed that adjunct mindfulness-based cognitive therapy to prevent suicidal behavior (MBCT-S) reduced suicidal thinking and depression among high suicide-risk patients, we subjected MBCT-S to qualitative inspection by patient participants. Method: Data were provided by 15 patients who completed MBCT-S during a focus group and/or via a survey. Qualitative data were coded using thematic analysis. Themes were summarized using descriptive analysis. Results: Most patients viewed the intervention as acceptable and feasible. Patients attributed MBCT-S treatment engagement and clinical improvement to improved emotion regulation. A minority of patients indicated that factors related to the group treatment modality were helpful. A small percentage of patients found that aspects of the treatment increased emotional distress and triggered suicidal thinking. These experiences, however, were described as fleeting and were not linked to suicidal behavior. Limitations: The sample size was small. Conclusion: Information gathered from this study may assist in refining MBCT-S and treatments to prevent suicidal behavior among high suicide-risk patients generally.

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Stress, Cortisol and Suicide Risk

10.31234/osf.io/92b7z ◽

2019 ◽

Author(s):

Daryl Brian O'Connor

Keyword(s):

Risk Factors ◽

Suicidal Behavior ◽

Suicide Risk ◽

Stressful Events ◽

Additional Risk ◽

Global Health Issue ◽

History Of ◽

Hpa Axis Activity ◽

The Impact

Suicide is a global health issue accounting for at least 800,000 deaths per annum. Numerous models have been proposed that differ in their emphasis on the role of psychological, social, psychiatric and neurobiological factors in explaining suicide risk. Central to many models is a stress-diathesis component which states that suicidal behavior is the result of an interaction between acutely stressful events and a susceptibility to suicidal behavior (a diathesis). This article presents an overview of studies that demonstrate that stress and dysregulated hypothalamic-pituitary-adrenal (HPA) axis activity, as measured by cortisol levels, are important additional risk factors for suicide. Evidence for other putative stress-related suicide risk factors including childhood trauma, impaired executive function, impulsivity and disrupted sleep are considered together with the impact of family history of suicide, perinatal and epigenetic influences on suicide risk.

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The Role of Past Suicidal Behavior on Current Suicidality: A Retrospective Study in the Israeli Military

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18020649 ◽

2021 ◽

Vol 18 (2) ◽

pp. 649

Author(s):

Leah Shelef ◽

Jessica M Rabbany ◽

Peter M Gutierrez ◽

Ron Kedem ◽

Ariel Ben Yehuda ◽

...

Keyword(s):

Suicide Attempt ◽

Suicidal Behavior ◽

Military Service ◽

Suicide Ideation ◽

Rating Scale ◽

Suicide Attempts ◽

Significant Risk ◽

Significant Risk Factor ◽

Severity Rating ◽

Significant Difference

Past suicide attempts are a significant risk factor for future suicidality. Therefore, the present military-based study examined the past suicidal behavior of soldiers who recently made a severe suicide attempt. Our sample consisted of 65 active-duty soldiers (61.5% males), between the ages of 18 and 28 years old (M = 20.4, SD ± 1.3). The inclusion criterion was a recent severe suicide attempt, requiring at least a 24 h hospitalization. This sample was divided into two groups, according to previous suicidal behavior, namely whether their first suicide attempt was before or after enlistment (n = 25; 38.5% and n = 40; 61.5%, respectively). We then examined the lethality and intent of the recent event in regard to this division. Four measures were used to assess the subjects’ suicidal characteristics: the Columbia Suicide Severity Rating Scale, the Self-Harm Behavior Questionnaire, the Suicidal Behaviors Questionnaire-Revised, and the Beck Scale for Suicide Ideation. No significant difference in the severity of the suicide attempts (either actual or potential severity) were found between those who had suicide attempts before enlistment and those who had their first attempt in the service. As a matter of fact, most of the suicide attempts that occurred for the first time during military service had used a violent method (58.3%, n = 21). Finally, using multivariate analyses, we found that current thoughts and behavior, rather than past suicidality, was the strongest predictor for the lethality of suicide attempts.

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