Mental Health and Well-Being Lecture 4 Notes

Mental Health and Well-Being Lecture 4

Content Advisory

  • Suicidal ideation and behavior
  • Support available listed on Teams post

Suicidal Behavior

  • Key Statistics:
    • Women attempt suicide more than men.
    • Men are more likely to die by suicide.
    • Over 700,000 people die by suicide each year.
    • It's the 4th leading cause of death in 15-19 year-olds.
    • 4% of people being treated for depression die by suicide (O’Connor, 2019).
  • Considerations: 96% of individuals who die by suicide were not in the depths of depression; various factors contribute.
  • Risk Factors:
    • Comorbidity of anxiety and depression increases suicide risk.
    • Schizophrenia is a major risk factor.
    • Rates are higher in discriminated groups such as migrants, indigenous people, LGBTQIA+, and prisoners.
  • References: O'Connor, R. & Kirtley, O. (2018).

Suicidal Ideation: Mental Health Risk Factors

  • Research Findings:
    • Elevated risk factors include:
    • Family history of mental health issues
    • Previous suicide attempts
    • Severe depression psychopathology
    • Feelings of hopelessness
    • Current substance misuse
    • Anxiety and personality disorders.
  • Systematic Review Reference: Hawton et al. (2013).
Bipolar Disorder and Suicide Risk
  • Elevated Risks:
    • Male individuals
    • Living alone
    • Divorced individuals
    • Age < 35 years or > 75 years
    • Unemployed
    • Previous suicidal ideation
  • Reference: Miller & Black (2020).

Suicide in LGBT Populations

  • Study Samples:
    • Berona et al. (2020): N=285 youths, 41.8% LGBT receiving psychiatric services; no significant differences in history of suicidal behavior, but higher non-suicidal self-injury in LGBT.
    • Mustanski & Lui (2013): LGBT-specific risk factors include early same-sex attraction and victimization; gender non-conformity not a risk factor.

Predicting Transition from Suicidal Thinking to Action

  • Study Findings:
    • Aim: Difference between multiple attempters, single attempters, and zero attempters.
    • Higher scores in Beck Depression Inventory (BDI) among multiple attempters.
    • Earlier onset of depression in multiple attempters; they exhibit more frequent depressive episodes.
    • Reference: Gibb et al. (2009).

Integrated Motivational-Volitional Model of Suicidal Behavior

  • A theoretical framework discussing the transition from suicidal thoughts to actions.
    • Paper reference: O'Connor & Kirtley (2018).

Obsessive-Compulsive and Related Disorders

  • Disorders Include:
    • Obsessive-Compulsive Disorder (OCD)
    • Trichotillomania (hair-pulling disorder)
    • Excoriation disorder (skin-picking disorder)
    • Abramowitz & Jacoby (2015) provided critical review on OCD.
Obsessive-Compulsive Disorder (OCD)
  • Prevalence:
    • 1% in men, 1.6% in women (Fawcett et al., 2020).
    • Ranked among top 10 most debilitating conditions by the WHO (lost income, decreased quality of life).
  • DSM-5 Diagnostic Criteria:
    • Obsessions: Persistent, intrusive thoughts causing anxiety.
    • Compulsions: Repetitive behaviors aimed at reducing distress, often disconnected from their purpose.
    • Must be time-consuming or cause significant distress or impairment in functioning.
Trichotillomania (Hair-Pulling Disorder)
  • Characteristics:
    • Compulsive hair pulling, with subtypes identified (Automatic vs. Focused).
    • Associated with negative mood states; rituals may precede or follow pulling.
  • Ages affected: variety from children to adults, with increased prevalence in adult females (Franklin, 2015).
Excoriation Disorder (Skin-Picking Disorder)
  • Characteristics:
    • Compulsive picking of skin leading to lesions.
    • Patients often experience issues associated with emotions and maladaptive thought processes.
  • DSM-5 Criteria:
    • Recurrent skin picking must result in skin lesions, causing distress or impairment in functioning.

Impact of Skin Picking and Hair Pulling Disorders

  • Research Findings:
    • Projects exploring the phenomenological experiences reported:
    • Concealment issues, inability to find treatment, and high rates of relapse.
    • Low self-esteem and avoidance of social situations.
    • TTM and skin-picking symptoms correlate with severity and functional impairment.

Key Terms to Remember

  • Suicidal behavior
  • Risk factors for suicide
  • Integrated motivational-volitional model of suicidal behavior
  • Obsessive-compulsive disorder
  • Obsessive-compulsive and related disorders (including TTM and excoriation disorder)