psychopathology exam II (Suicide)

Suicide

death caused by self-directed injurious behavior with any intent to die as a result of the behavior

Suicide attempt

a non-fatal self-directed potentially injurious behavior with any intent to die as a result of the behavior

Non suicidal self-directed violence (self-injurious behavior)

self-directed behavior that deliberately results in injury or the potential for injury to oneself, no evidence of suicidal intent

suicide rates

highest for..

• adolescence and early adulthood

• american indians/alaska natives

• women(most likely to attempt) v men(most likely to die bc of lethal means)

• high risk for older individuals(85+) with a second peak around midlife

• worldwide differences hard to determine because of different amounts of stigma/criticism related to suicide leading to it being labelled as something else

interpersonal-psychological theory

1. thwarted belongingness: feeling disconnected, lonely, and isolated from others/that nobody can understand or relate to personal experience

2. perceived burdensomeness on others: feeling that death would improve things for others(may be precipitated by changes in life events(ex. losing a job)

3. acquired capability for suicide: habituated to physical pain and fear of death(possibly through self injury, previous attempts, combat, exposure to bodily harm/means of suicide, self starvation) — necessary to enact lethal self harm

integrated motivational-volitional model of suicidal behavior

1. pre-motivational/background phase: biopsychosocial context, genetic vulnerability, background life events, environmental factors(SES deprivation/discrimination) — creates baseline vulnerability

2. motivational phase: defeat/humiliation triggered by life events accompanied by sense of entrapment/no escape from life circumstances(defeat → entrapment feeling → suicidal ideation affected by rumination, memory biases, poor problem-solving, and lack of social support)

3. volitional phase: accelerators/inhibitors guiding transition from thought to behavior include access to means, exposure to suicidal behavior, acquired capability, planning and implementation intentions, impulsivity, mental imagery about suicide, past suicidal behavior or self harm

preventing suicide

• treating underlying mental disorders when applicable

• limit access to lethal means

• identifying + supporting individuals at high risk (CBT for suicide prevention for people with prior attempts)

• providing crisis support (maintaining supportive and directive contact, helping individuals see that their ability to assess situations/problem solve is impaired, help them see that situation/problem/distress is not endless)

• develop safety plan: stanley-brown safety plan (includes warning signs, list internal coping strategies, people and social settings that provide distraction, people who can be asked for help, professionals/professional services

• making environment safer)

getting people help when they need it

988 suicide + crisis hotline

JIT interventions: EMA demonstrates suicidal thoughts change rapidly, so JITAI is optimized with timing(delivering interventions only when needed), personalization(adapting to individual level changes), accessibility(leveraging common mobile devices), and scalability(timely messages, reminders, and prompts)