Psychologists’ Experiences Conducting Suicide Risk Assessments: A Phenomenological Study

2020 ◽  
Vol 54 (4) ◽  
pp. 819-845
Author(s):  
Jonathan D. Dubue ◽  
William E. Hanson
Keyword(s):  
Suicide Risk ◽  
Phenomenological Study ◽  
Risk Assessments ◽  
Future Research ◽  
Doctoral Level ◽  
Client Suicide ◽  
Risk Of Death ◽  
Preventative Intervention ◽  
Self Harm ◽  
Study Offer

Psychologists conduct suicide risk assessments (SRAs) regularly to identify and prevent clients’ self-harm and risk of death, although little is known about their experiences of the process. In this phenomenological study, five registered psychologists (master’s and doctoral level) were interviewed to explore the essence of their SRA experiences. Psychologists reported weaving tenets of assessment and therapy throughout their SRAs, relying on their clinical intuition, and investing deeply in their suicidal clients. Also, psychologists reported feeling significant anxiety working with suicidal clients, revealing the ways in which the fear of client suicide guides and motivates their SRA practices. While they have an empathic view of suicide, they believe in preventative intervention. They reported feeling pressure from clients and colleagues to conduct ethical and useful SRAs despite receiving what they consider to be insufficient and ineffectual graduate SRA training. Results from this study offer a qualitative foundation for future research on the ethics, training, and practice of SRA.

Risk of suicide in patients who present to hospital after self-cutting according to site of injury: findings from the Multicentre Study of Self-harm in England

2021 ◽  
pp. 1-9
Author(s):  
Galit Geulayov ◽  
Deborah Casey ◽  
Elizabeth Bale ◽  
Fiona Brand ◽  
Caroline Clements ◽  
...  
Keyword(s):  
Multicentre Study ◽  
Odds Ratio ◽  
Suicide Risk ◽  
Adjusted Odds Ratio ◽  
The Body ◽  
Mixed Effect ◽  
Risk Of Death ◽  
Mixed Effect Models ◽  
Self Harm

Abstract Background We compared the risk of death by suicide following hospital presentation for self-harm according to site of self-cut/stab. Method We included 54 999 self-harm presentations (involving 31 419 individuals) to hospitals in the Multicentre Study of Self-harm in England (1/1/2004–31/12/2014), with mortality follow-up to 31/12/2019. Information on method of self-harm was obtained through monitoring in hospitals. Information about mortality was obtained through linkage with NHS Digital. We assessed the association of site of self-cut with death by suicide using mixed effect models. Results In total, 10 790 (19.6%) hospital presentations involved self-cutting/stabbing, 7489 of which (69.4%) were due to laceration to the arm/wrist alone, 1846 episodes (17.1%) involved cutting elsewhere on the body, and 1455 (13.5%) were due to laceration to unknown site. Controlling for confounders, presentation to a hospital following self-cut/stab to bodily parts other than wrist/arm was associated with greater chance of subsequent suicide relative to presentation after self-poisoning alone [adjusted odds ratio (aOR) 1.75, 95% confidence interval (CI) 1.03–2.96, p = 0.038]. The likelihood of suicide after presentation for cutting/stabbing the wrist/arm alone was comparable to that of patients who had self-poisoned alone. Presentations after laceration involving the neck were associated with a four-fold greater chance of subsequent suicide relative to self-poisoning (aOR 4.09, 95% CI 1.80–9.30, p = 0.001). Conclusions Patients who attend hospital after self-cutting/stabbing are a heterogeneous group in terms of characteristics, methods of cutting/stabbing and risk of subsequent suicide. Risk of suicide is greater in individuals who self-cut/stab to parts of the body other than the wrist or arm, especially the neck.

Attachment Organization in Suicide Prevention Research

Crisis ◽  
2014 ◽  
Vol 35 (1) ◽  
pp. 60-66 ◽  
Author(s):  
Amanda Venta ◽  
Carla Sharp
Keyword(s):  
Risk Factors ◽  
Suicidal Ideation ◽  
Suicide Attempt ◽  
Interpersonal Relationships ◽  
Suicide Ideation ◽  
Suicide Attempts ◽  
Critical Role ◽  
Self Report ◽  
Future Research ◽  
Self Harm

Background: Identifying risk factors for suicide-related thoughts and behaviors (SRTB) is essential among adolescents in whom SRTB remain a leading cause of death. Although many risk factors have already been identified, influential theories now suggest that the domain of interpersonal relationships may play a critical role in the emergence of SRTB. Because attachment has long been seen as the foundation of interpersonal functioning, we suggest that attachment insecurity warrants attention as a risk factor for SRTB. Aims: This study sought to explore relations between attachment organization and suicidal ideation, suicide attempts, and self-harm in an inpatient adolescent sample, controlling for demographic and psychopathological covariates. Method: We recruited 194 adolescents from an inpatient unit and assigned them to one of four attachment groups (secure, preoccupied, dismissing, or disorganized attachment). Interview and self-report measures were used to create four variables reflecting the presence or absence of suicidal ideation in the last year, single lifetime suicide attempt, multiple lifetime suicide attempts, and lifetime self-harm. Results: Chi-square and regression analyses did not reveal significant relations between attachment organization and SRTB, although findings did confirm previously established relations between psychopathology and SRTB, such that internalizing disorder was associated with increased self-harm, suicide ideation, and suicide attempt and externalizing disorder was associated with increased self-harm. Conclusion: The severity of this sample and methodological differences from previous studies may explain the nonsignificant findings. Nonsignificant findings may indicate that the relation between attachment organization and SRTB is moderated by other factors that should be explored in future research.

Behavior change techniques in mobile apps targeting self-harm in young people: a systematic review

2021 ◽  
Author(s):  
Elena Panagiotopoulou ◽  
Celeste Peiris ◽  
Daniel Hayes
Keyword(s):  
Young People ◽  
Behavior Change ◽  
Dialectical Behavior Therapy ◽  
Mobile Apps ◽  
Mental Healthcare ◽  
Future Research ◽  
Active Components ◽  
Behavior Change Techniques ◽  
Other Information ◽  
Self Harm

Abstract Despite the high prevalence of self-harm among young people, as well as their extensive use of mobile apps for seeking support with their mental healthcare, it is unclear whether the design of mobile apps aimed at targeting self-harm is underpinned by behavior change techniques (BCTs). To systematically analyze and identify (a) what BCTs and (b) what theories are present in self-harm apps for young people in an attempt to understand their active components. Systematic searches in Apple store, followed by thorough screening, were conducted to identify free mobile apps targeting self-harm in young people. Five apps met the inclusion criteria and were used by trained researchers, who coded identified features against the BCT Taxonomy V1. Despite the majority of apps being underpinned by principles of Dialectical Behavior Therapy (DBT), no other information is available about specific theories underpinning these apps. Nineteen of the 93 BCTs were identified across the five apps. The most frequently used BCT was “Distraction” (54.2%), offering ideas for activities to distract users from self-harming. Other techniques that were used often were “Social Support (unspecified)” (27.0%) and “Behavior Substitution” (10.6%). This study provides the first analysis of BCTs present in mental health apps which are designed to target the reduction of self-harm in young people. Future research is needed to evaluate the effectiveness of the apps, as well as assess the effectiveness of the BCTs present.

scholarly journals Repetition of deliberate self-harm and subsequent suicide risk: Long-term follow-up study of 11 583 patients

2004 ◽  
Vol 185 (1) ◽  
pp. 70-75 ◽  
Author(s):  
Daniel Louis Zahl ◽  
Keith Hawton
Keyword(s):  
Relative Risk ◽  
Suicide Risk ◽  
Single Episode ◽  
Deliberate Self Harm ◽  
Young Females ◽  
Follow Up Study ◽  
Increased Risk ◽  
Self Harm

BackgroundRepetition of deliberate self-harm (DSH) is a risk factor for suicide. Little information is available on the risk for specific groups of people who deliberately harm themselves repeatedly.AimsTo investigate the long-term risk of suicide associated with repetition of DSH by gender, age and frequency of repetition.MethodA mortality follow-up study to the year 2000 was conducted on 11583 people who presented to the general hospital in Oxford between 1978 and 1997. Repetition of DSH was determined from reported episodes prior to the index episode and episodes presenting to the same hospital during the follow-up period. Deaths were identified through national registers.ResultsThirty-nine percent of patients repeated the DSH. They were at greater relative risk of suicide than the single-episode DSH group (2.24; 95% CI 1.77–2.84). The relative risk of suicide in the repeated DSH group compared with the single-episode DSH group was greater in females (3.5; 95% C11.3–2.4) than males (1.8; 95% C1 2.3–5.3) and was inversely related to age (up to 54 years). Suicide risk increased further with multiple repeat episodes of DSH in females.ConclusionsRepetition of DSH is associated with an increased risk of suicide in males and females. Repetition may be a better indicator of risk in females, especially young females.

scholarly journals High-Risk Medication Use and Polypharmacy in Older Veterans Who Attempt Suicide

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 747-747
Author(s):  
Ruth Morin ◽  
Yixia Li ◽  
Michael Steinman ◽  
Ilse Wiechers ◽  
Amy Byers
Keyword(s):  
High Risk ◽  
Suicide Risk ◽  
Medication Use ◽  
Late Life ◽  
Health Concern ◽  
Prescription Medications ◽  
Similar Time ◽  
Medical Diagnoses ◽  
Risk Of Death ◽  
Time Period

Abstract Late-life veteran suicide is a public health concern, and may overlap with recent high-risk medication use. We identified use in the 6 months prior to attempt and assessed salient risk factors. 13,872 veterans aged 50 years and older that attempted suicide were compared with demographically-matched controls utilizing VHA healthcare in a similar time period. Medications potentially related to suicide risk were included. Other variables were psychiatric and medical diagnoses, fatality of attempt and means. Compared with controls, veterans who attempted were nearly 3 times more likely to have been prescribed benzodiazepines and opioids, even when controlling for other diagnoses. Those taking 3 or more high-risk medications were between 7 and 11 times more likely to attempt than controls, with a higher risk of death particularly by drug overdose. These findings begin to uncover the complex contribution of prescription medications and polypharmacy to late-life veteran suicide, with implications for prevention. Part of a symposium sponsored by the Aging, Alcohol and Addictions Interest Group.

scholarly journals Musculoskeletal Injury Profile of Circus Artists: A Systematic Review of the Literature

2017 ◽  
Vol 32 (1) ◽  
pp. 51-59 ◽  
Author(s):  
HEG Wolfenden ◽  
M Angioi
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Injury Rate ◽  
Future Research ◽  
Search Terms ◽  
Preventative Intervention ◽  
Item Checklist ◽  
Preventative Interventions ◽  
High Degree ◽  
Injury Definition

BACKGROUND: The circus arts involve a high degree of acrobatic, athletic, and aesthetic ability with extreme physical demands placed on performers. An understanding of the injury profile is required to guide prevention. AIM: To provide the first systematic review to enhance understanding of circus-related injuries and to provide a foundation for future preventative intervention. METHODS: MEDLINE, Scopus, and Web of Science were searched from conception to March 2016 using key search terms relating to circus artists and injury. Studies were limited to English-language human studies and included all levels and ages of circus artists. Risk of bias was assessed using a novel seven-item checklist based on the STROBE statement. RESULTS: Eight studies of varying design, populations, outcomes, and quality were analysed. Results suggest that the injury rate is relatively low among professional circus artists at 7.37 to 9.27/1,000 artist exposures. The spine and ankle are frequently injured, and most injuries are to soft tissue structures. In the professional setting, injuries appear minor, resulting in few treatments, few missed or altered performances, and a low risk of re-injury. CONCLUSIONS: The spine and ankle should be targeted for preventative interventions in circus artists due to their high frequency of injury. The heterogeneity of studies included in this review highlights the need for consistency within future research, particularly in terms of injury definition and outcome measurements.

A Systematic Review and Meta-Analysis of Personality Disorder Prevalence and Patient Outcomes in Emergency Departments

2020 ◽  
Vol 34 (3) ◽  
pp. 324-347
Author(s):  
Alexander Collins ◽  
Kirsten Barnicot ◽  
Piyal Sen
Keyword(s):  
Systematic Review ◽  
Clinical Outcomes ◽  
Emergency Departments ◽  
Meta Analysis ◽  
Assessment Method ◽  
Screening Tools ◽  
Future Research ◽  
Prevalence Rates ◽  
Self Harm ◽  
Improve Patient Management

The objectives of this study were to perform a systematic review and meta-analysis of studies reporting prevalence of personality disorders (PDs) in emergency departments (EDs) and evaluate the effect of comorbid PDs on clinical outcomes. A systematic search of five databases along with manual searching and expert consultation was performed. A quality appraisal was conducted. A total of 29 articles were included. Prevalence of PDs in ED attendees varied depending on presenting complaint, Q(4) = 577.5, p < .01, with meta-analytic prevalence rates of suicide and self-harm at 35% and 22%, respectively. The assessment method had a significant effect on prevalence rates, Q(3) = 17.36, p < .01. Comorbid PD was a risk factor for repeating presenting complaint, subsequent ED return, and hospitalization. Better identification of PDs using screening tools in EDs could improve patient management and clinical outcomes. Future research should focus on PD prevalence in unselected ED populations using validated diagnostic interviews.

scholarly journals Suicide following presentation to emergency departments with suicidal ideation: a population-wide study

2019 ◽  
Vol 4 (3) ◽  
Author(s):  
Emma Ross ◽  
Aideen Maguire ◽  
Denise O'Hagan ◽  
Dermot O'Reilly
Keyword(s):  
Emergency Departments ◽  
Suicide Ideation ◽  
Cox Regression ◽  
Factors Associated ◽  
Risk Of Death ◽  
Emergency Department Staff ◽  
Completed Suicide ◽  
Target Prevention ◽  
Self Harm ◽  
The Uk

Background Little is known about the association between suicide ideation and completed suicide. As NI has the highest suicide rate in the UK and Ireland it is vital to understand who is most at risk in order to target prevention strategies effectively. Aim To explore the risk factors for completed suicide following presentation with suicide ideation. Methods The Northern Ireland Registry of Self-Harm and Suicide Ideation contains information on all presentations to all Emergency Departments in NI for self-harm and suicide ideation. Data from 2012-2015 were linked to centralised electronic data relating to primary care, prescribed medication and mortality records. Initial analyses were completed to explore the profile of those who present with suicide ideation, and logistic regression was utilised to examine the likelihood of mortality post presentation. Cox regression was utilised to examine the factors associated with completed suicide following presentation with ideation. Results The cohort consisted of 1,483,435 individuals born or resident in NI from 1st January 1970 until 31st December 2015 (maximum age in 2015, 45 years). Between 2012-2015, 4,975 (0.3%) individuals presented with suicide ideation and 583 (0.04%) individuals died by suicide. Ideation is more likely in men compared to women (OR=1.87, 95%CI 1.76,1.98), in those aged 18-24 years, and in more deprived individuals. Of those who presented with ideation, 66 (1.3%) subsequently died by suicide. In fully-adjusted models, those who presented with suicide ideation were 25 times more likely to die by suicide compared to those who did not (HR=25.0, 95%CI 19.3,32.5). Amongst suicide ideators, male gender (HR=2.67, 95% CI 1.39,5.10) and multiple presentations (HR=1.95, 95% CI 1.09,3.50) were associated with the greatest risk of death by suicide. Conclusion These findings could help emergency department staff identify individuals at greatest risk of suicide and could be utilised in the development of targeted intervention strategies.

scholarly journals 13 Reasons Why: Can a TV Show About Suicide Be 'Dangerous?’ What is the Responsibility of a Producer?

2019 ◽  
Author(s):  
Marco Scalvini
Keyword(s):  
Suicide Risk ◽  
Scientific Evidence ◽  
Public Concern ◽  
Ethical Perspective ◽  
Individual Vulnerability ◽  
Media Portrayal ◽  
Self Harm ◽  
Potential Impact ◽  
Graphic Content ◽  
Tv Show

<p><i>The release of the Netflix’s show </i>13 Reasons Why<i>caused significant public concern about the risk of suicide contagion among teenagers – particularly those who have suicidal thoughts. Practitioners and researchers expressed apprehension about the show for its apparent praise of suicide and for allegedly increasing suicide risk among vulnerable teenagers. However, there is a lack of clear evidence for the influence of fictional content on self-harm. Little is known about variations in media effects between news and fiction. The literature focuses mainly on non-fictional media reporting, without making any distinction between individual vulnerability and the type of media portrayal. The present article criticises the assumption that risk of self-harm is reduced by sanitising fictional content. The absence of scientific evidence is precisely why this article re-addresses the problem through an ethical perspective by focusing on the moral responsibility of Netflix in creating graphic content for young adults. Censoring fiction may do more harm than good, but producers have the responsibility to evaluate in advance the potential impact that such content has on vulnerable people and support viewers as well as parents, educators, practitioners through an adequate campaign of prevention.</i></p>

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