Understanding Suicide: Ian Hussey ! PhD student ! Dept of Psychology - - PowerPoint PPT Presentation

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Understanding Suicide: Ian Hussey ! PhD student ! Dept of Psychology - - PowerPoint PPT Presentation

Oct 29, 2023 476 likes •859 views

Understanding Suicide: Ian Hussey ! PhD student ! Dept of Psychology ! (very little) ! Progress to Date 5pm Monday 24th March ! Teaching Lab Suicide is unique to language-able humans This fact is rarely recognised, nor have its implications

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Understanding Suicide: Progress to Date

Ian Hussey! PhD student! Dept of Psychology!

!

5pm Monday 24th March! Teaching Lab

(very little)

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01

Suicide is unique to language-able humans

This fact is rarely recognised, nor have its implications been realised

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Scale of the problem

1 in 55 deaths 1.8% of all deaths

!

Too many scales: I’ll use 2010 statistics and US Dollars

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Who

(National Office of Suicide Prevention, 2013)

82% male in 2010

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Who

(National Office of Suicide Prevention, 2013)

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Who

(National Office of Suicide Prevention, 2013)

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Health Spending Benchmarks: $/QALY

…Except governments, of course $50,000/QUALY is the international benchmark

$61,294 per QUALY

(Lee, Chertow & Zenios, 2009)

No one can put a dollar value on human life

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Money to be spent on prevention & treatment $0 $20,000 $40,000 $60,000 $80,000 +50 years +10 years +1 year +1 month +1 week

Health Spending Benchmarks: $/QALY

Rationale spending model assumes a flat curve

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Money to be spent on prevention & treatment $0 $20,000 $40,000 $60,000 $80,000 +50 years +10 years +1 year +1 month +1 week

Health Spending Benchmarks: $/QALY

Rationale spending model assumes a flat curve

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SLIDE 10

Price of a Death by Suicide in Ireland

(National Office of Suicide Prevention, 2013; HSE, 2004)

Suicide is unbelievably expensive in terms of $/QUALYs Per marginal suicide:

$0 $500,000 $1,000,000 $1,500,000 $2,000,000 $2,500,000 Rational spending on suicide Cost to Irish economy NOSP budget

€10,700 $2,425,000 $2,022,702

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01

Where’s the science?

Suicide as a scientific question

“You can also collect butterflies and make many observations. If you like butterflies, that’s fine; but such work must not be confounded with research, which is concerned to discover explanatory principles of some depth and fails if it does not do so” !

!

(Chomsky, 1979; see also Barnes-Holmes, Hussey, McEnteggart, Barnes-Holmes & Foody, in press)

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01

Where’s the science?

Suicide as a scientific question

“You can also collect butterflies and make many observations. If you like butterflies, that’s fine; but such work must not be confounded with research, which is concerned to discover explanatory principles of some depth and fails if it does not do so” !

!

(Chomsky, 1979; see also Barnes-Holmes, Hussey, McEnteggart, Barnes-Holmes & Foody, in press)

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01

Where’s the science?

Suicide as an epidemiological question

The current state of suicidology is to treat it like a disease.!

!

Study how it spreads, and what techniques are best curb this spread!

!

When formulated as an epidemiological question, we require health & social policy answers

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01

!

  • What works: !

!

  • Physical barriers!
  • Railings at railway stations!
  • Purchasing limits on over the counter drugs!

!

  • Information barriers - journalistic guidelines

Health & Social Policy

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01

Where’s the psychology???

!

1000s of published papers:!

  • Short term risk assessment!
  • Long term risk factor research!
  • Meditational analysis!
  • Scale development

Psychology is concerned with measurement and treatment:!

  • Does/will this person have ‘it’?!
  • How do we change ‘it’?
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01

Where’s the psychology???

!

1000s of published papers:!

  • Short term risk assessment!
  • Long term risk factor research!
  • Meditational analysis!
  • Scale development

Psychology is concerned with measurement and treatment:!

  • Does/will this person have ‘it’?!
  • How do we change ‘it’?
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Measurement

Scales M e d i a t i

  • n
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Why is measurement so difficult?

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!

  • “Proxy” behaviours!
  • When our behaviour of interest is hard to study we look at other behaviours that

predict it! ! ! ! ! ! ! !

  • “Mediation” analyses: variable

Y explains relationship between variables X and Z!

  • “Just as correlation does not equal causation, mediation does not equal

mechanism” (Nock, 2007, p. 5)

Rate of “Completed” suicide 1.8%

Previous attempts 2 - 7% Intent ?? Planning 3 - 30% Ideation 8 - 50%

Why is measurement so difficult?

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‘Implicit’ Measures

!

  • We need a functional analysis of human language within suicide!

!

  • Used in thousands of published studies !

!

  • Used to study most DSM IV categories (Roefs et al., 2011)
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‘Implicit’ Measures

  • 250

500 750 1000 1250 1500

TRUE FALSE

milliseconds

“My Death is distressing” Tiny reaction time differences

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‘Implicit’ Measures

!

  • Nock (2010):!

!

  • Individuals attending A&E clinical for self-harm!

!

  • IAT predicted future suicidal behaviour within 6 months far

better than traditional measures or clinician assessment

  • Randall & Nock (2013):!

!

  • Integrative model (IAT + questionnaires) that had either 90%

specificity or 90% sensitivity

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IRAP vs IAT

IAT: Self-Death/Others-Life

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IRAP vs IAT

Self - Life Self - Death Others - Death Others - Life

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! ! ! ! ! ! ! ! ! ! !

  • Theories of suicide emphasise role of complex propositions and

evaluations (e.g. Joiner et al., Williams et al., Abramson et al.)

IRAP vs IAT

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Hussey & Barnes-Holmes (Individuals attending St Patricks with suicidal ideation) 0.00 0.10 0.20 0.30 0.40 0.50

0.43

Implicit Death - Positive Attitudes

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Hussey, Barnes-Holmes & Gallagher 0.00 0.10 0.20 0.30 0.40 0.50

0.39

Implicit Death - Positive Attitudes

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Hussey, Barnes-Holmes & Dennehy I 0.00 0.10 0.20 0.30 0.40 0.50

0.20

Implicit Death - Positive Attitudes

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Hussey, Barnes-Holmes & Dennehy II 0.00 0.10 0.20 0.30 0.40 0.50

0.23

Implicit Death - Positive Attitudes

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Hussey, Barnes-Holmes & Fawcett I 0.00 0.10 0.20 0.30 0.40 0.50

0.38

Implicit Death - Positive Attitudes

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Hussey, Barnes-Holmes & Fawcett II 0.00 0.10 0.20 0.30 0.40 0.50

0.17

Implicit Death - Positive Attitudes

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Hussey, Barnes-Holmes & Cahill 0.00 0.10 0.20 0.30 0.40 0.50

0.33

Implicit Death - Positive Attitudes

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Hussey, Barnes-Holmes & Fawcett (Post Mortality Salience Induction) 0.00 0.10 0.20 0.30 0.40 0.50

0.33

Not Attributable to Mortality Salience

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Hussey, Barnes-Holmes & Dennehy (Post Mortality Salience Induction) 0.00 0.10 0.20 0.30 0.40 0.50

0.30

Not Attributable to Mortality Salience

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01

Attitudes to death & suicide are not what we assume

!

  • Contemplating the reinforcing properties of suicidal

ideation is a very recent idea ! !

  • e.g. Williams et al., 2007!

!

  • This coincides with a gradual reorientation towards

behavioural and functional psychology!

!

  • Need to focus on ‘suicidality’ as a form of suffering to be

relieved, not just because it is a risk factor for suicidal acts

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Understanding Suicide: Progress to Date

Help & Support:! Aware.ie! Samaritans.ie! Pieta.ie! Console.ie! PleaseTalk.ie

(very little)