A psychodynamic approach to suicide prevention

This paper sets forth a new theoretical approach to understanding the psychological etiology of suicide. The theory is demonstrated by an in-depth clinical case example, and its implications for the management of the suicidal candidate in his acute interim and long-term care are described. The theory assumes that the primary motivation to suicide comes from a clinically characteristic, unremitting psychological pain. The role of the suicidal prevention center is discussed with specific emphasis on the quality of the engagement between a center staff person and the suicidal patient. A future course for suicide centers is suggested based on the theory .Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/44296/1/10597_2005_Article_BF01411076.pd

(Re)Moralizing the suicide debate

Contemporary approaches to the study of suicide tend to examine suicide as a medical or public health problem rather than a moral problem, avoiding the kinds of judgements that have historically characterised discussions of the phenomenon. But morality entails more than judgement about action or behaviour, and our understanding of suicide can be enhanced by attending to its cultural, social, and linguistic connotations. In this work, I offer a theoretical reconstruction of suicide as a form of moral experience that delineates five distinct, yet interrelated domains of understanding – the temporal, the relational, the existential, the ontological, and the linguistic. Attention to each of these domains, I argue, not only enriches our understanding of the moral realm, but provides a heuristic for examining the moral traditions and practices which constitute contemporary understandings of suicide. Keywords: Suicide; philosophy; social values; humanitie

Suicide risk in schizophrenia: learning from the past to change the future

Suicide is a major cause of death among patients with schizophrenia. Research indicates that at least 5–13% of schizophrenic patients die by suicide, and it is likely that the higher end of range is the most accurate estimate. There is almost total agreement that the schizophrenic patient who is more likely to commit suicide is young, male, white and never married, with good premorbid function, post-psychotic depression and a history of substance abuse and suicide attempts. Hopelessness, social isolation, hospitalization, deteriorating health after a high level of premorbid functioning, recent loss or rejection, limited external support, and family stress or instability are risk factors for suicide in patients with schizophrenia. Suicidal schizophrenics usually fear further mental deterioration, and they experience either excessive treatment dependence or loss of faith in treatment. Awareness of illness has been reported as a major issue among suicidal schizophrenic patients, yet some researchers argue that insight into the illness does not increase suicide risk. Protective factors play also an important role in assessing suicide risk and should also be carefully evaluated. The neurobiological perspective offers a new approach for understanding self-destructive behavior among patients with schizophrenia and may improve the accuracy of screening schizophrenics for suicide. Although, there is general consensus on the risk factors, accurate knowledge as well as early recognition of patients at risk is still lacking in everyday clinical practice. Better knowledge may help clinicians and caretakers to implement preventive measures. This review paper is the results of a joint effort between researchers in the field of suicide in schizophrenia. Each expert provided a brief essay on one specific aspect of the problem. This is the first attempt to present a consensus report as well as the development of a set of guidelines for reducing suicide risk among schizophenia patients

Psychology and aggression

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68264/2/10.1177_002200275900300301.pd

selbstmord in zwei grossstaedten: ein sozio-kultureller vergleich

summary (abridged): during 1965-67 fifty consecutive cases of completed suicide were investigated in vienna and los angeles by identical methods, and the results compared. data were obtained by means of intensive semi-structured interviews with the nearest surviving relative. the interview related to the external circumstances of the suicide act, overt and covert warnings given of suicidal intent on the part of the deceased, the reactions of others to such forewarning, presumed motives, and theseriousness of the attempt. beside the immediate circumstances, family history, childhood and adolescence, physical and mental health, marital adjustment, social and leisure activities, occupational and financial status and housing were investigated. moreover, for a number of comparisons data from 44 additional suicides from los angeles and 99 various from vienna were available, those being cases where for various reasons partial data only could be secured. differences found between the two local samples were in part due to the differing age and sex compositions of the populations from which the samples were drawn, a case in point being the preponderance of elderly female suicides in the vienna group. in part, however, there seem to exist genuine differences in the sources of stress due to cultural specifics. (...)

Selbstmord in zwei Grosstädten. Ein sozio-kultureller Vergleich

During 1965-67 fifty consecutive cases of completed suicide were investigated in vienna and los angeles by identical methods, and the results compared. data were obtained by means of intensive semi-structured interviews with the nearest surviving relative. the interview related to the external circumstances of the suicide act, overt and covert warnings given of suicidal intent on the part of the deceased, the reactions of others to such forewarning, presumed motives, and theseriousness of the attempt. beside the immediate circumstances, family history, childhood and adolescence, physical and mental health, marital adjustment, social and leisure activities, occupational and financial status and housing were investigated. moreover, for a number of comparisons data from 44 additional suicides from los angeles and 99 various from vienna were available, those being cases where for various reasons partial data only could be secured. differences found between the two local samples were in part due to the differing age and sex compositions of the populations from which the samples were drawn, a case in point being the preponderance of elderly female suicides in the vienna group. in part, however, there seem to exist genuine differences in the sources of stress due to cultural specifics. (...)