SI & NSSI (329 E1)

Question 1

suicidal ideation

Answer 1

thinking about death, including the wish to be dead, considering methods of accomplishing death, and formulating plans to carry the act out

Question 2

suicidal behavior

Answer 2

acts associated w/ suicidal intent

Question 3

suicidal attempt

Answer 3

engaging in potentially injurious behavior w/ the intention of death

Question 4

interrupted self directed: by other

Answer 4

a person takes steps to injure self but stopped by another person prior to fatal injury occurring, at any point during the behavior or thought of suicide

Question 5

interrupted self directed: by self

Answer 5

a person takes steps to injure self but stops prior to fatal injury

Question 6

suicide/death by suicide

Answer 6

death caused by self directed injurious behavior w/ the intent to die as a result of the behavior

Question 7

suicide survivors

Answer 7

the circle of survivors of a person who has died by suicide

Question 8

postvention

Answer 8

providing mental healthcare and support to survivors or if a patient dies by suicide. Family, friends and healthcare workers are in need postvention, including support, understanding and possibly including referrals for psychiatric treatment

Question 9

risk factor of suicide

Answer 9

• condition or circumstances that may elevate an individual’s risk for suicide
• may encompass biological, psychological or social factors in the individual, family and environment
• may be modifiable or non modifiable

Question 10

warning signs of suicide definition

Answer 10

an individual or group of behavioral or emotional clues or changes that may indicate a person is contemplating suicide or at immediate risk for suicide

Question 11

protective factors for suicide

Answer 11

factors that may reduce the risk for suicidal ideation, suicide attempt or death by suicide

Question 12

cluster suicides

Answer 12

clusters occur close together in time and space than would normally be expected in a given community; sometimes referred to as contagion suicides or copycat suicides

Question 13

research indicates an increase in suicides by when

Answer 13

• stories about suicides increase
• a story is reported at length
• story placed on front page or beginning of broadcast
• person broadly known and story/news of suicide spreads
• headline is particularly dramatic

Question 14

unacceptable terms related to suicide

Answer 14

• completed suicide/committed suicide
• successful suicide
• failed suicide attempt
• non fatal suicide attempt
• suicidal gesture
• suicidality

Question 15

suicide behavior disorder criteria (DSM-5)

Answer 15

• attempt within last 24 months
• it could not be better identified as NSSI
• attempt was not initiated in altered mental state such as delirium or confusion
• attempt was not undertaken for a religious or political objective

Question 16

what can be done to prevent suicide

Answer 16

• know the risks and warning signs
• screen individuals for suicide risk & ask directly if they are thinking about it
• ID protective factors, develop safety plan & reduce lethal means
• provide individuals w/ resources for suicide prevention
• create community based systems to respond to suicide risk

Question 17

warning signs of suicide

Answer 17

• expressing hopelessness / worthlessness
• talking about being a burden
• preoccupation w/ death/lack of cocern about personal safety
• talking about feeling trapped or in unbearable pain
• inc substance use
• anger, irritability, resentment
• being isolated / withdrawing
• giving away prized possessions or pets
• looking for lethal means

Question 18

does screening prevent suicide

Answer 18

not without action

Question 19

if a patient screens positive on the C-SSRS

Answer 19

they need to be re screened at continuous intervals (at least every 8 hrs)

Question 20

covert statements examples

Answer 20

“it is okay now, soon everything will be fine”
“i wont be a problem much longer”
“nothing feels good to me again and probably never will”

Question 21

based on screening, if a patient has a plan they are automatically considered

Answer 21

high risk of suicide

Question 22

what is NSSI

Answer 22

deliberate and direct attempts to inflect painful injuries to the surface of the body without intending to die (commonly to the frontal area of thighs & dorsal side of forearm)
ex: cutting, burning, scraping, biting, hitting

Question 23

diagnostic features of NSSI

Answer 23

• a desire to feel relief from negative thoughts or feelings such as anxiety, anger and distress
• negative self thoughts is common
• most often done w/ intent to either alleviate psychic pain or numbness
• may injure to achieve short but intense state of euphoria during or after the injury act
• may have impaired interpersonal relationships as the impetus for self injury
• to be considered significant, typically last at least a year & happen repeatedly
• majority do not seek help

Question 24

epidemiology of NSSI

Answer 24

• lifetime prevalence is difficult to accurately determine
• female to male ratio is 3-4:1
• estimated that 13-23% of adolescents engage in NSSI
• global problem that peaks between 20-29 yrs of age

Question 25

comorbidity of NSSI

Answer 25

- depression - anxiety - eating disorders - substance use disorders - borderline personality disorder

Question 26

NSSI risk factors: biological

Answer 26

investigating the neurobiological mechanisms behind this disorder. Although inconclusive, the neurotransmitter, serotonin, dopamine & norepi may play a role in the mediation of NSSI

Question 27

NSSI risk factors: cognitive

Answer 27

NSSI may be a form of self punishment as a way to make up for acts that possibly caused harm or distress to other

Question 28

NSSI risk factors: environmental

Answer 28

researchers are investigating cultural differences

Question 29

NSSI risk factors: societal

Answer 29

NSSI may be considered a social phenomenon, people often learn about NSSI from peers engaging in this behavior

Question 30

how to take action if pt has NSSI

Answer 30

- establish therapeutic relationship - caring for wounds/injuries - psychotherapeutic interventions include learning healthy coping mechanisms - CBT - DBT - group therapy - psychopharmacology

Question 31

overt statement examples

Answer 31

"i can't take it anymore" "life isn't worth living" "i wish i was dead"