大学生自杀现象引发的生命教育的思考

大学生自杀现象屡见不鲜,大学生生命意识的淡薄,高校生命教育的缺失是大学生自杀很重要的因素.着重介绍了生命教育的内涵、发展沿革,大学教育中实施生命教育的意义和紧迫性,以及高校(包括医学院校)对如何实施生命教育作了一些思考.     

大学生自杀现象的心理分析和干预

大学生的自杀已成为社会、教育和行政管理部门越来越关注的话题,对大学生自杀现象的心理进行了分析,结合工作实际,提出了一些心理干预的措施。     

The descent into suicide

Suicidal breakdown requires attention both to attack upon the self (ego) as aggressive forces are unleashed against it by the superego, but also to the phases of self-breakup (ego regression) that follow. Less attention has been directed to ego-regression in suicide than to superego-directed assault on the ego in the psychoanalytic literature; this paper directs attention to the phenomena of ego failure and disarticulation of the self-representation. Clinical study of suicidal patients shows four aspects of suicidal collapse as ego loosens: affective flooding, desperate maneuvering to counter the resulting mental emergency, loss of control as the self begins to disintegrate, and grandiose magical scheming for mental survival as the self-representation splits up and body jettison becomes plausible. These phenomena are discussed theoretically in terms of failed affect regulation, ego helplessness, narcissistic surrender, breakdown of the representational world, and loss of reality testing.     

A Psychobiographical Analysis of Faith, Hope, and Despair in Suicide

This paper presents a psychobiographical analysis of a young woman who committed suicide over 50 years ago. Among the documents analyzed are her letters, a high-school diary, creative writing, college newspaper book reviews, and academic papers. Using both an Eriksonian and object-relational theoretical framework, the roles of faith, hope, and despair in suicide—and the ways in which these were represented in the young woman's self-system—are analyzed. Although she possessed strong elements of both faith and hope, along with a will to implement them in a purposeful manner, she was prone to the defense mechanisms of splitting, devaluation, and dissociation, which led to an inability to create an abiding sense of self that may have prevented her descent to despair. Among other issues discussed in the article are the usefulness of psychobiography as a method of studying suicide and both the benefits and limitations of spiritual faith in countering depression and suicide.     

Dialectical Behavior Therapy Is Effective for the Treatment of Suicidal Behavior: A Meta-Analysis

Dialectical Behavior Therapy (DBT) prioritizes suicidal behavior and other self-directed violence as the primary treatment targets, and has been demonstrated to reduce self-directed violence in clinical trials. This paper synthesizes findings from controlled trials that assessed self-directed violence and suicidality, including suicide attempts, non-suicidal self-injury (NSSI), suicidal ideation, and accessing psychiatric crisis services. Eighteen controlled trials of DBT were identified. Random effects meta-analyses demonstrated that DBT reduced self-directed violence (d = -.324, 95% CI = -.471 to -.176), and reduced frequency of psychiatric crisis services (d = -.379, 95% CI = -.581 to -.176). There was not a significant pooled effect of DBT with regard to suicidal ideation (d = -.229, 95% CI = -.473 to .016). Our findings may reflect the prioritization of behavior over thoughts within DBT, and offer implications for clinical practice and future research concerning the implementation of DBT for acute suicidality.     

Association between substance use disorders and self- and other-directed aggression: An integrated model approach

Our study's objective is to determine whether substance use disorders’ association with aggression differs according to the type of substance and/or the form of aggression, within the same population. We used data from the National Survey on Drug Use and Health across 2008–2014, with a pooled sample of 270,227 adult respondents. We used regression models to estimate the odds ratios for those having alcohol and/or drug use disorder(s) perpetrating (a) each form of aggression compared with no aggression and (b) other-directed compared with self-directed aggression. Alcohol use disorder alone and drug use disorder(s) alone were both associated with significantly increased odds of committing self-directed, other-directed, and combined aggression. Individuals with drug use disorder(s) alone were more likely to commit other-directed than self-directed aggression (adjusted odds ratio = 1.46, 95% CI = 1.04–2.05). Individuals with alcohol use disorder alone were not likely to commit one over the other (adjusted odds ratio = 1.20, 95% CI = 0.90–1.61). In conclusion, the integrated model of aggression based on the stress–diathesis model is a relevant framework to study risk factors for aggression. Further research is needed to identify longitudinal predictors of directionality of aggression.     

Suicide Intervention Training for K–12 Schools: A Quasi‐Experimental Study on ASIST

This quasi‐experimental study investigated differences between 104 school personnel who received a standardized suicide awareness and prevention training (i.e., Applied Suicide Intervention Skills Training) and 45 control group participants. Pre‐ and posttraining data included experimental and control group participants' (a) suicide intervention skills; (b) attitudes toward suicide; (c) knowledge of suicide; and (d) comfort, competence, and confidence in responding to individuals at risk of suicide. Results indicated a significant positive effect for training on all measures. Implications for training of school personnel and future research are discussed.     

The Reasons to Go On Living Project: stories of recovery after a suicide attempt

Qualitative research in suicidology has become increasingly common in the literature. Lakeman and FitzGerald (2008) conducted a review of qualitative works specifically on suicide and recovery. Five interconnected themes—suffering/psychache, struggle, connection, turning points, and suicide and coping—were identified. The Reasons to Go On Living Project (RTGOL) project was a web-based narrative research project that sought to understand the transition from making a suicide attempt to choosing life. This article reports the findings of a secondary analysis of the narratives. By using Lakeman and FitzGerald’s themes as a starting point, one hundred and thirteen submissions were thematically analyzed using a deductive approach. The findings are mostly consistent with the interconnected themes identified by Lakeman and FitzGerald. Moreover, subthemes were identified to better reflect the lived experience of the participants. Clinical and research implications of this project will be discussed.     

Supporting Counselors After a Client Suicide: Creative Supervision Techniques

Many professional counselors will experience the loss of a client to suicide. The effects of this loss are explored in this article. The supervisor’s role in supporting a supervisee after a client’s suicide is presented. Additionally, creative interventions that can be used by supervisors to support supervisees after the loss of a client are provided. These creative techniques are theoretically grounded within the cognitive behavioral, solution-focused, and narrative paradigms.     

Stress factors,social support,and violence in Israeli society: A quantitative analysis

In the present study violence in Israel for a period of 32 years (1950-1981) was analyzed, within a stress model according to which the probability of violence and agression as a reaction to stress will increase when social support systems fail or malfunction. Following this model, three types of variables were identified: 1. Measures of stress and social change: to the regular social stressors (i.e., inflation and unemployment), we added two measures of affluence (income per capita and rates of cars) as well as population density. 2. Measures of social support: rates of birth to unmarried mothers and marriage and divorce rates served as measures of the strength of the family. Another measure in this category was rates of psychiatric hospitalization. 3. Measures of violence: in addition to rates of homicide, robbery, and all offenses, inward directed aggression (suicide) was included in this category. At the first stage of the data analysis, Guttman's Smallest Space Analysis (SSA-1) was applied, providing a two-dimensional space diagram of the correlations between the variables. At the second stage, a multiple regression analysis was introduced. The findings indicate that the theoretical model received substantial support mainly from four stress measures (inflation, income per capita, cars, and population density) and one measure of social support (divorce). Unemployment contributed significantly (in the expected direction) only to homicide. Some theoretical implications of the findings, as well as their relevance to some developments in Israeli society are discussed, and suggestions are made for future research.