Brian L. Mishara PhD  Marc Daigle PhD  Cécile Bardon PhD  François Chagnon PhD  Bogdan Balan MD  PhD  Sylvaine Raymond MA  Julie Campbell MA 《Suicide & life-threatening behavior》2016,46(5):577-587

Research since the 1960s has consistently found that lay volunteers are better at helping suicidal callers than professionals. Yet, professional degrees are increasingly becoming requirements for helpline workers. In our first study, we conducted post hoc comparisons of U.S. helplines with all professional paid staff, all lay volunteers, and a mix of both, using silent monitoring and standardized assessments of 1,431 calls. The volunteer centers more often conducted risk assessments, had more empathy, were more respectful of callers, and had significantly better call outcome ratings. A second study of five Quebec suicide prevention centers used silent monitoring to compare telephone help in 1,206 calls answered by 90 volunteers and 39 paid staff. Results indicate no significant differences between the volunteers and paid employees on outcome variables. However, volunteers and paid staff with over 140 hours of call experience had significantly better outcomes. Unlike the United States, Quebec paid employees were not required to have advanced professional degrees. We conclude from these results and previous research that there is no justification for requiring that suicide prevention helpline workers be mental health professionals. In fact, the evidence to date indicates that professionals may be less effective in providing telephone help to suicidal individuals when compared to trained lay volunteers.  相似文献   

    

Colleen Jacobson PhD  Kristen Batejan MA  Marjorie Kleinman MS  Madelyn Gould PhD  MPH 《Suicide & life-threatening behavior》2013,43(6):646-662

The motives of suicide attempts among a community sample of 99 U.S. high school students were explored. Participants completed an in‐depth computer‐assisted self interview about their most recent attempts as well as additional psychosocial measures. Results indicated that nearly 75% of the adolescents engaged in suicide attempts for reasons other than killing themselves and that depressive symptoms and premeditation prior to the attempt were significantly associated with increased risk for engaging in the attempts with death as a clear motive. Linking motive for an attempt (death, interpersonal communication, emotion regulation) and treatment approach may improve prevention of subsequent attempts and completed suicides.  相似文献   

    

Madelyn S. Gould PhD  MPH  Wendi Cross PhD  Anthony R. Pisani PhD  Jimmie Lou Munfakh BA  Marjorie Kleinman MS 《Suicide & life-threatening behavior》2013,43(6):676-691

We examined the impact of the implementation of Applied Suicide Intervention Skills Training (ASIST) across the National Suicide Prevention Lifeline's national network of crisis hotlines. Data were derived from 1,507 monitored calls from 1,410 suicidal individuals to 17 Lifeline centers in 2008–2009. Callers were significantly more likely to feel less depressed, less suicidal, less overwhelmed, and more hopeful by the end of calls handled by ASIST‐trained counselors. Few significant changes in ASIST‐trained counselors' interventions emerged; however, improvements in callers' outcomes were linked to ASIST‐related counselor interventions, including exploring reasons for living and informal support contacts. ASIST training did not yield more comprehensive suicide risk assessments.  相似文献   

    

Alison M. Lake MA  Suganthi Kandasamy MPH  Marjorie Kleinman MS  Madelyn S. Gould PhD  MPH 《Suicide & life-threatening behavior》2013,43(6):692-703

We examined teenagers' attitudes about the role of mental illness in suicidal behavior and the relationship between these attitudes and suicide risk. Serious suicidal ideation or behavior and associated risk factors (gender, depression, substance problems, and first‐hand experience with a suicidal peer) were assessed in 2,419 students at six New York high schools. Less than one fifth of students thought that mental illness was a major contributor to suicide. Suicidal adolescents and those at risk were less likely than their nonsuicidal and low‐risk counterparts to associate suicide with mental illness. Our findings contribute to the debate over whether accepting attitudes toward suicide increase suicide risk.  相似文献   

    

Lindsay A. Taliaferro PhD  MPH  Jennifer J. Muehlenkamp PhD  Joel Hetler PhD  LP  Glenace Edwall PhD  PsyD  Catherine Wright MS  LPCC  Anne Edwards MD  Iris W. Borowsky MD  PhD 《Suicide & life-threatening behavior》2013,43(3):250-261

Primary care providers were surveyed to determine how prepared they feel to address nonsuicidal self‐injury (NSSI) among adolescents, their interest in training on NSSI, and factors associated with routinely asking about NSSI when providing health supervision. Participants included family medicine physicians (n = 260), pediatricians (n = 127), family nurse practitioners (n = 96), and pediatric nurse practitioners (n = 54). Almost 50% felt unprepared to address NSSI, and over 70% wanted training in this area. Overall, relative to other areas of mental health care, clinicians felt least prepared to address and wanted more training on NSSI. Just 27% reported they routinely inquired about NSSI during health supervision. Factors associated with routinely asking about NSSI were identifying as female (OR = 2.37; 95% CI = 1.25–4.49), feeling better prepared to address NSSI (OR = 1.51; 95% CI = 1.04–2.20), and more frequently using a psychosocial interview to identify adolescents in distress (OR = 1.23; 95% CI = 1.02–1.48). Teaching clinicians to assess NSSI within a psychosocial interview may increase screening for and identification of the behavior among adolescents in primary care.  相似文献   

    

Kristy K. Ward MD  Angelica M. Roncancio PhD  Steven C. Plaxe MD 《Suicide & life-threatening behavior》2013,43(1):109-115

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Melanie L. Straiton PhD  Heidi Hjelmeland PhD  Tine K. Grimholt MS  Gudrun Dieserud PhD 《Suicide & life-threatening behavior》2013,43(2):161-173

A total of thirty‐two women admitted to a general hospital for medical treatment after self‐harming completed measures of conventional positive and negative masculinity and femininity. Comparisons were made with two control groups with no self‐harm history; 33 women receiving psychiatric outpatient treatment and a nonclinical sample of 206 women. Multinomial logistic regression analyses showed that those with lower scores on Instrumentality and Unmitigated Agency (positive and negative masculinity) and higher scores on Insecurity (negative femininity) had greater odds of self‐harming. Relationships were weaker after accounting for generalized self‐efficacy. Results are discussed in relation to previous findings and suggestions for prevention are made.  相似文献   

    

S. Janet Kuramoto PhD  MHS  Holly C. Wilcox PhD  Carl A. Latkin PhD 《Suicide & life-threatening behavior》2013,43(4):366-378

Social network density, as measured by the extent to which network members know each other, was examined to determine whether it is associated with suicide‐related ideation and plan approximately 3 years later. Eight hundred and nineteen African Americans were interviewed at Wave 1 (1997–1999) and Wave 4 (2001–2003) of the Self‐Help In Eliminating Life‐Threatening Diseases (SHIELD) study, a HIV preventive intervention study in Baltimore, MD. Multinomial logistic regression models were used to compare risks of suicide‐related ideation and plan at Wave 4 by Wave 1 density. Even after adjusting for baseline sociodemographic characteristics and depressive symptoms, individuals with a lower level of density were three times more likely to report suicide‐related ideation and plan in the past year at Wave 4. The findings reinforce the importance of social integration among inner‐city African Americans from a social network perspective. Future research should examine the mechanisms associated with this relationship and other social network constructs.  相似文献   

    

Philip J. Batterham PhD  Alison L. Calear PhD  Helen Christensen PhD 《Suicide & life-threatening behavior》2013,43(4):406-417

Public knowledge and attitudes toward suicide may influence help‐seeking for suicidality. This study aimed to identify correlates of suicide attitudes and knowledge. Australian adults were invited to complete an online survey, with 1,286 responders. Less exposure to suicide, older age, male gender, less education, and culturally diverse backgrounds were associated with poorer knowledge; while younger age, male gender, and culturally diverse backgrounds were associated with more stigmatizing attitudes toward people who die by suicide. The results suggest suicide literacy and stigma reduction programs would benefit community members, particularly males and individuals from culturally diverse backgrounds.  相似文献   

    

Paul N. Pfeiffer MD  Hyungjin M. Kim ScD  Dara Ganoczy MPH  Kara Zivin PhD  Marcia Valenstein MD 《Suicide & life-threatening behavior》2013,43(4):356-365

We evaluated whether treatment‐resistant depression (TRD) as measured by the Massachusetts General Hospital (MGH) staging method was associated with suicide in a large U.S. health system. Data from the Veterans Health Administration and the National Death Index were used to conduct a case–control study of patients newly diagnosed with depression who received antidepressant treatment between 2003 and 2006. Suicide cases (N = 499) were matched with nonsuicide controls (N = 1994). Conditional logistic regression was used to assess whether MGH stage at time of suicide (or matched date) was associated with case status, adjusting for patient demographic characteristics, comorbidity, and service use. Results indicated 11.6% of suicide cases had MGH stage 3 or greater (indicating at least two antidepressant trials) compared to 6.4% of controls (p < .001). In adjusted analyses, suicide was not significantly more likely among patients with stage 3 or greater (OR 1.52; 95% CI: 0.98, 2.37) or stages 1.5–2.5 (OR 1.19; 95% CI: 0.91, 1.55) compared to patients with stage 1 or less (<10 weeks of antidepressant medication). Staging TRD using MGH criteria is unlikely to substantially improve suicide risk assessment of depressed patients beyond existing measures contained in health system records.  相似文献