Malestar en la cultura. Suicidio: aspectos transculturales

La introducción menciona que el suicidio es un epítome del Malestar en la Cultura. Pasa revista por sectores vulnerables, grupos indígenas, intelectuales, la relación con catástrofes económicas. Cita varios de los países propensos, mencionando algunas tasas de suicidio, deteniéndose en casos de suicidios colectivos de la historia. Menciona diversos métodos suicidas, épocas propensas, tanto como la relación eutanasia-suicidio y los cambios ocurridos según edad y género. Numerosas referencias son mencionadas de acuerdo a culturas, pueblos, religiones. Compara el suicidio humano con el mundo animal y alerta sobre criterios de prevención y uso de fármacos. Dada una publicación ofrecida en Ecuador, el artículo realiza una breve referencia sobre el tema. El colofón recuerda que el suicidio es el acontecimiento humano más estremecedor

Caracterización de los procesos psicoeducativos orientados a la prevención de la conducta suicida en colegios de Bogotá.

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Estrategias de intervención desde el trabajo social frente al suicidio en la adolescencia

La presente monografía; “Estrategias de intervención desde el Trabajo Social frente al suicidio en la adolescencia” aborda, entre otras, las siguientes temáticas; definiciones y tipos desuicidio; factores que influyen en el suicidio de la adolescencia y las causas que generan este problema de salud pública. El “sujeto” central de la investigación es la adolescencia, grupo etario donde el suicidio se ha convertido en la tercera causa de muerte. La conducta suicida,también es abordada; considerando los cambios y características psicológicas que es determinante para detectarestos comportamientos y poder prevenirlos e intervenir desde diferentes perspectivas profesionales, en donde el trabajo multidisciplinario es la base de la intervención especializada. En este escenario de multidisciplinariedad la tarea del Trabajador Social es caracterizada, en la monografía, como la del profesional que dinamiza armónicamente la acción de los profesionales involucrados, apoyándose en lopsicoeducativo y en la definición del escenario social. Finalmente se plantean estrategias y alternativas conceptuales y metodológicas, para prevenir el suicidio en la adolescencia y como intervenir con sus familias y allegados. La propuesta metodológica que se enfatiza como estrategia, para prevenir el suicidio, es el trabajo de equipo multidisciplinario,en dónde; psicólogos, médicos, psiquiatras, enfermeras, educadores, orientadores familiares y trabajadores sociales, aúnan esfuerzos para prevenir este flagelo y con la finalidad de relacionar lo conceptual y metodológico desde la práctica profesional se transcribe una entrevista a profundidad con un médico psiquiatra de uno de los hospitales de la localidad.

A different kettle of fish : mental health strategies for Australian fishers, and farmers

Despite being typically represented and managed under the same policy umbrella, fishers face different challenges than do their farming counterparts. This paper unpacks the findings of research depicting poor levels of mental health and well-being among Australian commercial wild-catch fishers. The research is considered in the context of widespread acceptance that farmers tend to exhibit worse than average mental health outcomes due, at least in part, to the environmental uncertainties of climate change. In particular it is stressed that the insecurity of fishing concessions (quota and licenses), is a key driver of chronic livelihood insecurity, resulting in reports of stress, depression and suicide. A call is made for the separation of health research in the fishing and farming industries. Importantly, the role that tenure insecurity plays in the perpetuation of poor mental health among fishers should be acknowledged and addressed so that the fishing industry can maximize the strength of its human capital.

Social connections and suicidal behaviour in young Australian adults: Evidence from a case-control study of persons aged 18-34 years in NSW, Australia

Purpose: There is evidence that social isolation is a risk factor for suicide, and that social connections are protective. Only a limited number of studies have attempted to correlate the number of social connections a person has in their life and suicidal behaviour. Method: Two population-based case-control studies of young adults (18-34 years) were conducted in New South Wales, Australia. Cases included both suicides (n=84) and attempts (n=101). Living controls selected from the general population were matched to cases by age-group and sex. Social connections was the main exposure variable (representing the number of connections a person had in their life). Suicide and attempts as outcomes were modelled separately and in combination using conditional logistic regression modelling. The analysis was adjusted for marital status, socio-economic status, and diagnosis of an affective or anxiety disorder. Results: Following adjustment for other variables, those who had 3-4 social connections had 74% lower odds of suicide deaths or attempts (OR=0.26, 95% CI 0.08, 0.84, p=0.025), and those with 5-6 connections had 89% lower odds of suicide deaths or attempts (OR=0.11 95% CI 0.03, 0.35, p<0.001), compared to those with 0-2 social connections. With the number of social connection types specified as a continuous variable, the odds ratio was 0.39 per connection (95% CI 0.27, 0.56, p<0.001). Conclusions: A greater number of social connections was significantly associated with reduced odds of suicide or attempt. This suggests that suicide prevention initiatives that promote increased social connections at an individual, familial, and wider social levels might be effective.

Bipolar disorder

Bipolar disorder is a recurrent chronic disorder characterised by fluctuations in mood state and energy. It affects more than 1% of the world's population irrespective of nationality, ethnic origin, or socioeconomic status. Bipolar disorder is one of the main causes of disability among young people, leading to cognitive and functional impairment and raised mortality, particularly death by suicide. A high prevalence of psychiatric and medical comorbidities is typical in affected individuals. Accurate diagnosis of bipolar disorder is difficult in clinical practice because onset is most commonly a depressive episode and looks similar to unipolar depression. Moreover, there are currently no valid biomarkers for the disorder. Therefore, the role of clinical assessment remains key. Detection of hypomanic periods and longitudinal assessment are crucial to differentiate bipolar disorder from other conditions. Current knowledge of the evolving pharmacological and psychological strategies in bipolar disorder is of utmost importance.

The treatment of suicidality in adolescents by psychosocial interventions for depression: a systematic literature review

OBJECTIVE: Given depression is a significant risk factor for suicidal behaviour, it is possible that interventions for depression may also reduce the risk of suicide in adolescents. The purpose of this literature review is to determine whether psychological interventions aimed to prevent and/or treat depression in adolescents can also reduce suicidality. METHODS: We conducted a systematic review of psychological interventions aimed to prevent and/or treat depression in adolescents in which outcomes for suicidality were reported, using five databases: PsycINFO, Embase, Medline, CINAHL and Scopus. Study quality was assessed using the Cochrane Collaboration's tool for assessing risk of bias. RESULTS: A total of 35 articles pertaining to 12 treatment trials, two selective prevention trials and two universal prevention trials met inclusion criteria. No studies were identified that used a no-treatment control. In both intervention and active control groups, suicidality decreased over time; however, most structured psychological depression treatment interventions did not outperform pharmaceutical or treatment as usual control groups. Depression prevention studies demonstrated small but statistically significant reductions in suicidality. LIMITATIONS: Analysis of study quality suggested that at least 10 of the 16 studies have a high risk of bias. Conclusive comparisons across studies are problematic due to differences in measures, interventions, population differences and control groups used. CONCLUSIONS: It is unclear whether psychological treatments are more effective than no treatment since no study has used a no-treatment control group. There is evidence to suggest that Cognitive Behavioural Therapy interventions produce pre-post reductions in suicidality with moderate effect sizes and are at least as efficacious as pharmacotherapy in reducing suicidality; however, it is unclear whether these effects are sustained. There are several trials showing promising evidence for family-based and interpersonal therapies, with large pre-post effect sizes, and further evaluation with improved methodology is required. Depression prevention interventions show promising short-term effects.

South Road

SOUTH ROAD, a novel told in third-person limited, follows Adrienne Harris as she navigates the trials of her coming-of-age summer and then must deal with the aftermath. 1997: seventeen-year-old Adrienne Harris wants nothing more than to flee her eccentric grandmother’s rule and leave Harbor Point and never look back. When she meets her new neighbors, Adrienne knows her life will never be the same. Adrienne quickly falls in love with the charismatic Quinn Merritt. They decide to keep their relationship a secret since both families disapprove. This secret starts a chain reaction that seemingly leads to the suicide of the troubled and poetic Lucas Merritt. The summer culminates with Adrienne running away, pregnant and heartbroken. 2011: thirty-one-year-old Adrienne is an out of work line cook and single mother. The story opens as Adrienne reluctantly returns home to Harbor Point to care for her ailing grandmother. Once home, Adrienne has to confront the things that haunt her—the summer she met and lost both Merritt brothers, and also her dysfunctional relationship with her grandmother—in order to heal and repair her own life and her relationship with her daughter. In the end, Adrienne discovers many truths that alter her perception of her past in Harbor Point. Adrienne is finally able to move forward and start to build a life for her and her daughter. Harbor Point, the last place in the world Adrienne Harris wanted to be, turns out to be the only place she wants to call home.

A relação entre comportamentos auto lesivos e os comportamentos suicidários e o impacto do funcionamento familiar

Dissertação de Mestrado apresentada no ISPA- Instituto Universitário para obtenção de grau de Mestre na especialidade de Psicologia Clínica

Risk of repeated self-harm and associated factors in children, adolescents and young adults

Background: Repeated self-harm represents the single strongest risk factor for suicide. To date no study with full national coverage has examined the pattern of hospital repeated presentations due to self-harm among young people. Methods: Data on consecutive self-harm presentations were obtained from the National Self-Harm Registry Ireland. Socio-demographic and behavioural characteristics of individuals aged 10–29 years who presented with self-harm to emergency departments in Ireland (2007–2014) were analysed. Risk of long-term repetition was assessed using survival analysis and time differences between the order of presentations using generalised estimating equation analysis. Results: The total sample comprised 28,700 individuals involving 42,642 presentations. Intentional drug overdose was the most prevalent method (57.9%). Repetition of self-harm occurred in 19.2% of individuals during the first year following a first presentation, of whom the majority (62.7%) engaged in one repeated act. Overall, the risk of repeated self-harm was similar between males and females. However, in the 20–24-year-old age group males were at higher risk than females. Those who used self-cutting were at higher risk for repetition than those who used intentional drug overdose, particularly among females. Age was associated with repetition only among females, in particular adolescents (15–19 years old) were at higher risk than young emerging adults (20–24 years old). Repeated self-harm risk increased significantly with the number of previous self-harm episodes. Time differences between first self-harm presentations were detected. Time between second and third presentation increased compared to time between first and second presentation among low frequency repeaters (patients with 3 presentations only within 1 year following a first presentation). The same time period decreased among high frequency repeaters (patients with at least 4 to more than 30 presentations). Conclusion: Young people with the highest risk for repeated self-harm were 15–19-year-old females and 20–24-year-old males. Self-cutting was the method associated with the highest risk of self-harm repetition. Time between first self-harm presentations represents an indicator of subsequent repetition. To prevent risk of repeated self-harm in young people, all individuals presenting at emergency departments due to self-harm should be provided with a risk assessment including psychosocial characteristics, history of self-harm and time between first presentations.

Yoga and loss: an autoethnographical exploration of grief, mind, and body

The author explores her experience of yoga as a therapeutic tool in recovering from the impact of losing a close friend to suicide. The benefits of yoga include improved emotional self-regulation, a more positive relationship with self, and the emergence of a new personal physical reality. An autoethnographical approach permits a necessarily ambiguous and messy in-depth exploration of yoga as a resource for well-being. Nevertheless, it is hoped that it will serve as a means of promoting further study into the role of cultural resources, particularly body-based practices, as means of coming to terms with traumatic loss.

Staying healthy: industry organisations’ influence on behaviours and services used by fishers

This study emerged in response to a previous report that used a strength-based approach to identify best-practice good-health behaviours in a number of farming and fishing communities, titled Staying Healthy: Behaviours and services used by farmers and fishers. This earlier report found there was a need for specific attention to the physical and particularly the mental health of those in the Australian commercial fishing industry. This included a better understanding of the issues, logistical and social barriers to good-health practices, and avenues of health communication and treatment. The 2013 Staying Healthy study echoed the Rural Industries Research and Development Corporation (RIRDC) research and development Plan for 2008-2012, Collaborative Partnership for Farming and Fishing Health and Safety, which advocated research into health, well-being and resilience in rural primary industries. These reports are coupled with widespread anecdotal accounts describing very poor physical and mental health within the fishing industry, including accounts of suicide and attempted suicide. As a contributor to a body of scholarly research, this study is supported by other literature, which is addressed, below. In this short section we introduce research that is most relevant to appreciating the findings of this study on fisher health and well-being.

Action en santé mentale au travail et syndicalisme québécois : l’expérience de représentants syndicaux

Dans certains milieux syndicaux québécois, des initiatives porteuses destinées à prévenir les problèmes de santé mentale au travail ont vu le jour. Des représentants syndicaux pionniers ont mis en place des structures d’entraide opérantes, obtenu des jurisprudences importantes et développé des approches innovantes pour corriger ou bonifier l’organisation du travail, et ce depuis plus de trois décennies. Alors que la montée de l’idéologie néolibérale et les principes d’organisation du travail qu’elle sous-tend engendrent une intensification du travail qui fragilise la psyché des travailleurs et que le rapport de force des syndicats s’effrite, il apparaît porteur d’interroger l’expérience de ces représentants syndicaux pour mieux comprendre comment se structure l’action syndicale en santé mentale au travail. Cette thèse fait l’étude de réalisations syndicales québécoises en matière de santé mentale au travail visant à prévenir et à corriger les problèmes de détresse psychologique, d’épuisement professionnel, de harcèlement, de dépression, de violence, de suicides reliés au travail, etc. Pour ce faire, un cadre théorique mixte a été utilisé. D’une part, une perspective large a été adoptée pour comprendre les enjeux entourant les rapports humains au travail et l’action. Pour ce faire, quatre auteurs influents de la philosophie des Lumières et de la philosophie contemporaine ont été sélectionnés, soit Thomas Hobbes, Adam Smith, Karl Marx et Hannah Arendt. Dégager ces différentes perspectives du monde, de l’action et du lien social avait pour objectif de mettre en place une grille d’analyse susceptible de relier l’expérience de représentants syndicaux à ces visions du monde. Il est apparu essentiel de mieux saisir les bases idéologiques sur lesquelles ces derniers ont construit leur action pour comprendre comment elles ont influencé leur démarche singulière et collective. D’autre part, la théorie de l’expérience sociale a été retenue (Dubet, 2009; 1994) pour analyser plus finement le travail des représentant syndicaux. Celle-ci distingue trois logiques d’action complémentaires et en tension avec lesquelles doivent composer les acteurs sociaux : une logique d’intégration, une logique stratégique et logique appuyée sur la subjectivation. La coexistence de ces trois logiques signifie que l’expérience que les individus font du monde n’est pas une simple reproduction de déterminismes qui les précèdent. Les acteurs sont aussi sujets de leur expérience et capables de prendre une distance du social pour comprendre les significations de leur agir; ils s’inscrivent dans le monde dans une dialectique critique. Cette théorie apporte un éclairage permettant de dégager à la fois ce qui freine et ce qui facilite l’action individuelle et collective en matière de santé mentale au travail et de décrire comment des représentants syndicaux se mobilisent pour répondre aux nombreuses attentes des membres. Cette recherche qualitative s’est appuyée sur une méthodologie de récit de vie (Rhéaume 2008; Bertaux 2006). Vingt représentants syndicaux ont témoigné de la souffrance au travail (Dejours, 2008) vécue par leurs membres et ont présenté des actions déployées pour leur venir en aide. Les réalités décrites par les participants montrent comment certains éléments de l’organisation du travail sont associés à des expériences de domination (Martuccelli, 2004): les méfaits du productivisme et de l’hyperflexibilité, les accidents de travail, les maladies professionnelles et les situations d’horreur au travail, les rapports sociaux au travail devenus délétères et les utilisations abusives de l’appareil judiciaire. L’étude démontre aussi à quel point des initiatives portées par des représentants syndicaux contribuent à une résolution de problèmes dans une perspective d’interdépendance, de développement du pouvoir d’agir, de justice sociale et de lutte pour la dignité. Quatre catégories d’initiatives ont été retenues : l’entretien du lien social dans l’entraide au quotidien, la défense juridique et légale des membres, les clauses de convention collective et les actions sur l’organisation du travail. Enfin, la recherche dégage trois profils de représentants syndicaux : la militance qui tente de former un nous, la professionnalisation qui tente de faire reconnaitre son utilité et sa compétence, et l’entraide qui cherche à développer une action engageant le Je. Leur rencontre laisse entrevoir le développement d’une praxis syndicale qui vise à promouvoir et protéger la dignité du travail et des travailleurs.

Étude philosophique du renversement juridique canadien concernant l’aide médicale à mourir, à la lumière du débat Hart-Dworkin

Le 6 février 2015, la Cour suprême du Canada a rendu un jugement historique, unanime et anonyme. Dans l’arrêt Carter c. Canada (Procureur général), la Cour reconnaît que l’interdiction mur à mur de l’aide médicale à mourir porte atteinte aux droits constitutionnels de certaines personnes. En effet, les adultes capables devraient pouvoir demander l’aide d’un médecin pour mettre fin à leur vie s’ils respectent deux critères : consentir clairement et de façon éclairée à quitter ce monde et être affecté de problèmes de santé graves et irrémédiables leur causant des souffrances persistantes et intolérables. Or, cette décision constitue un renversement juridique, car un jugement inverse avait été rendu en 1993. En effet, vingt-deux ans auparavant, la Cour suprême avait jugé à cinq contre quatre que l’interdiction du suicide assisté était constitutionnelle. Dans l’arrêt Rodriguez c. Colombie-Britannique, la majorité avait statué que la protection du caractère sacré de la vie dans toute circonstance, tant pour les personnes vulnérables que pour les adultes capables, était une raison suffisante pour ne pas accorder de dérogation aux articles du Code criminel qui concernent le suicide assisté. Les juges majoritaires craignent alors que toute ouverture à l’aide au suicide entraine un élargissement progressif des critères d’admissibilité, ce que plusieurs appellent l’argument du « doigt dans l’engrenage ». Dans le cadre de ce mémoire, le renversement juridique Rodriguez-Carter sera analysé à la lumière du débat entre H. L. A. Hart et Ronald Dworkin. Alors que le premier défend une nouvelle version du positivisme modéré, le second offre une théorie nouvelle et innovatrice, nommée l’interprétativisme. L’objectif est simple : déterminer laquelle de ces deux théories explique le mieux le renversement juridique canadien concernant l’aide médicale à mourir. L’hypothèse initiale soutient que les deux théories pourront expliquer ledit renversement, mais que l’une le fera mieux que l’autre.