objective 4 Flashcards by Kaitlyn Dominie

associated with thwarted or unfulfilled
needs, feelings of hopelessness and helplessness,
ambivalent conflicts between survival and
unbearable stress, a narrowing of perceived
options, and a need to escape

suicide

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suicide may be?

The culmination of self-destructive urges that have
resulted from the client’s internalizing his or her anger
* A desperate act by which to escape a perceived
intolerable psychological state or life situation
* The client may be asking for help by attempting
suicide, seeking attention, or attempting to
manipulate someone with suicidal behavior

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Various theories have been proposed to explain possible factors that
influence suicidal behavior

etiology

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what are the genetic and biologic theories?

Genetic Markers
2. Endocrine Basis
3. Relationship of Neurochemical Binding Sites
4. Protein Kinase C Abnormality
5. Familial Suicidal Behavior
6. Twin and Adoption Studies

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what are psychological theories?

Theory of Self
2. Theory of Parasuicidal Behavior
3. Other Psychological Factors

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DNA analysis
* Serotonin receptors did not normalize after depression was
treated
* Findings suggest biologic predisposition to suicide thoughts
(receptor gene associated with major depression)

genetic markers

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Hyperarousal of the hypothalamic-pituitary-adrenal axis - affects
the ability for the brain to modulate stress states
* Disturbances in the regulation of anxiety and aggression due to
increased levels of cortisol placed the participants at an
increased risk for suicide

endocrine basis

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Relationship between:
* Serotonin and Postsynaptic frontal cortices binding sites
* Increase binding sites decreases the availability of serotonin for
regulation of aggression

relationship of neurochemical binding sites

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Enzyme present in body
* Postmortem studies of brains of teenagers who have committed
suicide show decrease in levels of Protein Kinase C

protein kinase C abnormality

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Suicide is familial – studies show, however risk factors are unclear
from parent to child

familial suicide behaviour

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Suicide among identical twins higher (11.3%) than suicide in
fraternal twins (1.8%)
* Adoptees that attempt suicide have more biological relatives
who had committed suicide than members of a control group

twin and adoption studies

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identified society as an influencing factor in suicide rates

sociologic theory

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what are the 4 categories based on the degree of an individuals socialization?

Egoistic Suicide
* Altruistic Suicide
* Anomic Suicide (alienated from society)
* Fatalistic Suicide

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Internal view of personal existence is called “the self”
* Basic motivation for behaviour
* Healthy individuals have assimilation/incorporate new ideas and
expulsion/throw out old ideas

theory of seld

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Individuals who engage in self-inflicted injury or mutilation but
usually do not wish to die
* Known as self inflicted behaviour (SIB)

theory of parasuicidal behaviour

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Believed suicide was a result of anger turned inward

psychological theories

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A reunion wish or fantasy
* A way to end one’s feelings of hopelessness and helplessness
* A cry for help
* An attempt to “save face” or seek a release to a better life

other psychological factors

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what are the risk factors of suicide?

Psychiatric disorders
 Alcohol or substance use
 Suicidal ideation with intent; a plan; hx of previous attempts
 Family hx of suicide
 Hx of maltreatment
 Recent stressful life event
 Hopelessness/helplessness
 Lack of social support

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Low serotonin levels are related to depressed mood
 Low cerebrospinal fluid 5-hydroxyindoleacetic acid is a
promising biological predictor of suicidal behavior

biological factors

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aggression turned inward

Freud

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wish to kill (wish to be killed or wish to die)

Menninger

central emotional factor is hopelessness

Aaron Beck

combination of suicidal fantasies and significant loss

recent theories

what are psychosocial factors?

Freud
Menninger
Aaron Beck
Recent theories

Cultural safety  “Pain is pain . . . in any cultural group” (Leong & Leach, 2008)  Cultural contexts and conditions

cultural factors

what are the factors influencing suicide rates?

religious beliefs family values attitude toward deaht

what are the verbal suicidal cues?

talking about death  making comments that significant others would be better off without them  asking questions about lethal dosages of drugs

what are the behavioural suicidal cues?

writing forlorn love notes  directing angry messages at others  giving away personal items  taking out a large life insurance policy

what are the situational suicidal cues?

escribe events or situations that present themselves either around or within the person  unexpected death of a loved one, divorce, job loss

what is the nursing process?

assessment nursing diagnoses outcome identification planning interventions implementation evaluation

Suicide is considered more preventable than any other cause of death. The “suicide lexicon” is commonly used to describe the range of suicide thoughts and behavior during assessment Assessment of suicide risk is an ongoing process  Regard all behaviors and comments about suicide seriously  Review medical records  Demonstrate accepting attitude

assessment

what are the 10 major risk factors to assess suicidal potential>

Sex (male) 6. Rational thinking loss 2. Age 25 to 44 7. Social supports lacking or 65+ years or recent loss 3. Depression 8. Organized plan 4. Previous attempt 9. No spouse 5. Ethanol use 10. Sickness

what is the application of the nursing process?

nursing diagnosis outcomes identification implementation

what are the levels of intervention?

primary secondary tertiary

activities that provide support, information, and education to prevent suicide

primary

treatment of the actual suicidal crisis

secondary

interventions with a circle of survivors left by individuals who completed suicide to reduce the traumatic aftereffects

tertiary

what are the planning interventions?

Establish a safe environment  Assist the client in meeting basic needs  Administer and monitor prescribed medications  Assist with interactive therapies  Provide client and family education  Provide continuum of care

what are the advanced-practice interventions?

Psychotherapy Psychobiological interventions Clinical supervision Consultation

of the client’s progress is an ongoing process – mood may fluctuate quickly and unpredictably. Reassessment of information obtained from the client, family, or significant others regarding Client’s mood, affect, and behavior Plan of care Continuum of care

evaluation

Characterized by self-harming behaviour with no intent to die  Also commonly known as self-injurious behaviour, self- mutilation, parasuicide, deliberate self-harm, self-abuse, and self-inflicted violence  Behaviour most commonly consists of cutting, burning, scraping or scratching skin, biting, hitting, skin or hair picking, and interfering with wound healing

non-suicidal self injury

Children, youth and young adults can text ‘TALK’ to 686868 to a trained volunteer Crisis Responder who will help with any issues – big or small. The service is free, confidential, and available 24/7

crisis text line

if you feel like you are unable to cope, are thinking about suicide or if you are unsure where to turn for help. The Mental Health Crisis Line is a free, confidential service for individuals, family and friends. The crisis line is province-wide, 24 hours a day. Phone (709) 737-4668 / 1-888-737-4668

mental health crisis line

offers free telephone and texting support to children and youth, 24/7 in French and English. Youth can be anonymous and will receive professional counselling, information and referrals. Call 1-800-668- 6868, visit KidsHelpPhone.ca for online resources or download the Always There App

kids help phone

a peer support service run by and for 2SLGBTQIA+ people in Newfoundland and Labrador. If you need someone to talk to, call us and we will do our best to support you and provide you resources

2SLGBTQIA+ warm line

an information and referral service that connects Newfoundlanders and Labradoreans to critical human, social, community, and government supports. The service is available in 170 different languages, 24/7, 365 days a year and is 100% free and confidential service to all users

211

HealthLine is a free, confidential, 24 hour telephone line, staffed by experienced registered nurses in our province who can offer health advice, information and connect you to resources and local services.

811

a new way to connect with guidance and supports for mental health and addictions in Newfoundland and Labrador. Easily accessible, from a computer, tablet or a phone, one can instantly access content that can provide advice, inspiration, assurance, or direction for finding additional supports. Offers self-help resources, links to local services, and allows the user to share their own personal stories

bridgethegapp.ca

comprised of mental health and addictions clinicians and police officers who are trained to respond together to mental health and addictions-related calls for service. The purpose of these teams is to deliver crisis intervention services directly to people in the community, thereby helping divert individuals from emergency departments and the criminal justice system

mobile crisis response team

a mental health and addictions walk-in service. Counsellors offer single-session therapy services. Some examples of what could be discussed with a counsellor are: depression, anxiety, bullying, coping, grief/loss, addictions, relationship issues and/or stress. Doorways is not an emergency service

doorways