Suicide

ancient rome

• lucieta was assaulted by dong og king of rome

• sign of beauty

Was suicides acceptable

• not for slaves because they technically devoted themselves to the empire

altruistic suicide

• sacrifice for the greater “good”

suicide attempt

• effort to die by suicide that may or may nor result in death 

suicicde ideation

• recurrent thoughts of dying

  • very common

Joiner’s interpersonal theory 

• people who die by suicide stand out or those with ideation or attempts 

perceived burdensomeness

• belief that one’s existence poses significant hardships to family friends or society

thwarted belongingness

• feeling alienated from and a lack of connection or acceptance with others

aquired capability

• people are born with intrinsic desire towards self-preservation

• acting on suicidal behavior requited overcome their inherent drive to stay alive

• acquired through repeated exposure to painful experiences that result in high levels of pain and tolerance and a fearlessness or lack of sensitivity to possibility of death

How does stigma affect people with suicide?

• they don’t seek for treatment

preventive interventions

• educational

• risks, what you should watch for

• attempts to destigmatize have been backfired and suggest it is understandable response to a stressful circumstance

Crisis interventions

• hotlines and crisis centers 

Non-suicidal self injury

• any act that deliberately harms or damages one’s body but without the explicit desire to die by..

chronic NSSI

• people cite numerous reasons:

  • to allevitae negative emotions

  • self punishment

  • to feel something when feeling numb

  • influence others

  • resist urge to harm self further— anti -suicide

  • sensation seeking, to generate excitement

Nock & Prinstein’s Functional Model: why people self harm

• automatic: to gain reinforcement by accomplishing something within oneself

• social: to gain reinforcement by accomplishing something in relation to another person

• the most common is automatic negative reinforcment

what is a way to alleviate change

• self harm seems to be a strategy to regulate emotions

• they do this because they cannot otherwise seem to change how they are feeling

What do individuals that chronically self injury show compared to those who don’t ?

differences in interoceptive awareness

How is pain processed in the brain?

• the ACC acts as an “alarm system’

• the insula perceives “how wrong” something is and the degree of it

Pain and the Brain

• brain activates ACC and insula

• surgeons used to remove sections of the ACC to alleviate chronic pain

• people who are more sensitive to physical pain show greater activations of ACC and insula in brain scans

Is Sadness a pain in the ACC and insula?

yes

• emotionally painful experiences are shown

• same brain regions responsible for the sensation of physical pain are responsible for the processing of emotional pain

True or False: chromic self-injurers can withstand even more pain than usual when they are upset

TRUE

what happens when we expose chronic self-injurers to intense physical pain?

• we see decreased activations in the ACC and insula (which is the opposite of what most have)

• this effect is accentuated if we first induce distress of some kind in participants

• suggests that NSSI alleviates rather than increases pain for some people

Treating NSSI

• DBT was developed to address chronic self-injury

• can be adapted to address NSSI in populations without borderline personality disorder

• CBT and SSRIs are also effective