Browsing by Subject "Suicide, Attempted"
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Item Assessing the Interpersonal Dynamics Associated with Serious Suicide Attempts: The Concept of Problem Irresolvability(2005-04-29) Roaten, Kimberly Dayle; Claassen, Cynthia A.Suicide represents a significant threat to a large number of individuals each year. This study sought to create an adult version of an adolescent suicide prediction instrument created by Orbach and colleagues (Subject Experience of Problem Irresolvability, 1999). An additional objective was to examine the relationship between the suicide attempters' experience of certain previously-researched interpersonal dynamics and lethality of suicide attempts. Eighty-three participants from a large, publicly-funded teaching hospital emergency department in Dallas completed a battery of questionnaires including a newly developed adult version of the SEPIA . Of the 83 participants, 42 individuals presented for psychiatric evaluation after a suicide attempt, and 41 patients presented for treatment of unintentional traumatic injury. An independent samples t-test suggested that the SEPIA-A accurately discriminates between individuals who have attempted suicide and those who have not (t =5.41, p = 0.00). In addition, analysis of the internal reliability of the SEPIA-A yielded a Cronbach's alpha of 0.97. Further analyses were conducted to refine and examine the items included on the newly constructed SEPIA. Finally, a significant positive correlation was noted between scores on the SEPIA-A and the BHS (r = 0.64). Overall, the results of the current study support further development of the SEPIA-A and provide encouraging results regarding its ability to distinguish between suicidal and non-suicidal individuals. The final step in the present study was the compilation of a revised version of the SEPIA, based on item-to-scale analyses, to be used in future studies examining the instrument's utility as a risk assessment measure.Item Consistency of Self-Reported Suicidal Intent Following a Suicide Attempt(2010-05-14) Rose, Lindsey Christine; Stewart, Sunita M.Suicide is a major problem in the U.S., but the empirical basis for assessment of suicidal risk is severely lacking. Critical to understanding the level of risk present after an act of self-harm is the degree to which the self-injuring patient intended to die via the act, which is called the degree of suicidal intent. In most studies, suicidal intent is identified at baseline as the self-reported intent of the self-injurer: however, clinicians commonly encounter cases where patients’ self-reported suicidal intent immediately after an injury episode is denied a few days later. This study tested the hypothesis that subjects would retrospectively report reduced levels of suicidal intent and fewer motives for their self-injury at follow-up (7 to 12 days after the attempt) than they did at baseline (within 48 hours after the attempt). Intent and motives were assessed using the Oxford Reasons for Parasuicide Interview and the Suicide Intent Scale (SIS). Statistical analyses found that subjects scored significantly higher on the SIS at baseline than they did at follow-up, confirming the hypothesis that retrospective self-reported suicidal intent would decrease with increasing time since the event. Although subjects reported fewer motives on average at follow-up than at baseline, the hypothesis that subjects would significantly decrease the number of reported motives at follow-up was not supported due to a lack of statistical significance. The findings of this study suggest that self-reports of suicidal intent are not consistent over time and are thus not necessarily reliable. Therefore, clinicians may do well to group suicide attempters and non-suicidal self-harmers together and treat them with similar precaution, as is done in Europe.Item Examining the Feasibility and Acceptability of a Phone Application for Safety Planning in Youth with Suicidality(2020-08-01T05:00:00.000Z) Wolfe, Kristin Linette; Kennard, Beth D.; Brent, David; Emslie, Graham; Foxwell, Aleksandra; King, Jessica D.; Nakonezny, PaulSuicide is the second-leading cause of death in adolescents. Despite the documented efficacy of the safety plan, research has suggested that youth do not always refer to their plans when experiencing suicidal ideation. Accessibility is often cited as a primary concern. Addressing this concern in youth may mean turning to technological means, such as phone applications, to improve access and utilization. To date, there are relatively few suicide specific apps available, and even fewer that have been empirically tested. In response to this gap in the literature, BRITE was developed as a means of utilizing technology for safety planning. This study examined the feasibility and acceptability of BRITE as a stand-alone intervention in a group of 40 youth who had been recently hospitalized for suicidality. This was measured utilizing the Post-Study System Usability Questionnaire (Lucas & Spitler, 1999; Davis, 1989), an exit interview containing both qualitative and quantitative questions, and data gathered on app usage from the BRITE clinician portal. Additional exploratory analyses around efficacy of the app were conducted utilizing the Concise Health Risk Scale- Self-Report (Trivedi et al. 2011). Results from this study indicated good feasibility and acceptability of the BRITE app. The majority of participants approached for the study gave consent and were retained in the study at four-week follow-up. Most participants (85.7%) utilized the app at least once, and many (66.7%) of these participants went on to engage with app-recommended activities. Analysis showed that there was a significant improvement in pre- and post-app usage ratings of distress. Surveyed participants, on average, rated the app as helpful, accessible and useful and reported that the platform was effective for safety planning. Qualitative analyses supported the quantitative findings, and participants reported overall satisfaction with the app as a whole and its specific components. Despite feasibility and acceptability of the app, exploratory analyses did not reveal any difference in the suicide propensity or suicide risk scores between groups. These findings suggest that BRITE compares favorably to other suicide prevention apps on the market, and adds to the literature suggesting the use of technology in suicide prevention for adolescents.Item Frequency, Versatility, and Duration of Nonsuicidal Self-Injury in Relation to Acquired Capability for Suicide among Adolescents(2015-08-31) Matney, Jacquelyn Deanna; Stewart, Sunita M.; Westers, Nicholas; Hughes, Jennifer L.Suicide is the 2nd leading cause of death among youth, and those who present to inpatient settings have been shown to have higher rates of suicidal behaviors (World Health Organization, 2012). Nonsuicidal self-injury (NSSI) is a leading risk factor for suicide. We propose that an increase in frequency, versatility, and/or duration of NSSI is associated with an increased risk for suicide attempt (SA) by means of the Acquired Capability for Suicide (ACS) proposed in Joiner's (2005) Interpersonal Psychological Theory of Suicide (IPTS) regardless of demographic or diagnostic factors. Preliminary results from this sample of inpatient adolescents (N = 150) were consistent with our proposed hypotheses. Yet, depressive symptoms appeared to interact with the association between these NSSI variables and ACS. These findings suggest that inpatient youth with greater NSSI versatility, frequency and duration, are at an increased risk for future SA by means of increased ACS. Consistent with the IPTS, the link between engagement in NSSI and history of SA appeared to be mediated by the ACS component. While limited by its cross-sectional design, the findings from this study have clinical implications regarding suicide risk assessment and prevention.Item Peer and Media Exposure to Nonsuicidal Self-Injury and Suicide Attempts in Adolescents(2014-07-25) Zhu, Lian; Kennard, Beth D.; Emslie, Graham; Hughes, Carroll W.; Stewart, Sunita M.; Westers, NicholasNon-suicidal self-injury (NSSI) is a highly concerning behavior that most often emerges during adolescence, and poses a major risk for attempting suicide. Research has shown that peer and media exposure to NSSI and suicide are both related to engagement in these dangerous behaviors. Our study examined the relationship between specific types of exposure to NSSI and suicide and engagement in these behaviors among inpatient adolescents. Participants included 88 adolescents, ages 12 to 17, who completed a structured interview and self-report questionnaires. We found that adolescents who have engaged in NSSI reported significantly higher amount of prior exposure to NSSI (especially cutting), knowing more friends who engaged in NSSI, and higher amount of prior exposure to NSSI via social networking sites than adolescents who have not engaged in NSSI. Adolescents who have attempted suicide reported significantly higher amount of prior exposure to suicide attempts, knowing more friends and celebrities who have attempted suicide, and higher amount of prior exposure to suicide via social networking sites than adolescents who have not attempted suicide. We also examined the relationship between multidimensional perceived social support (friend, family and significant other), exposure, and engagement in NSSI or suicide attempts. Adolescents who have attempted suicide reported significantly lower levels of perceived social support from family members than adolescents who have not attempted suicide. The dangerous outcomes for NSSI and suicide attempts make them important topics for research, especially in adolescents. These results implicate multiple types of exposure to NSSI and suicide as strongly related to engagement in these behaviors, which may offer directions for future interventions.