Suicide Risk Assessment Spring 2014

CBT MODEL of SUICIDE View of self, others, future Decreased problem solving Suicide Dichotomous thinking Hopelessness Cognitive rigidity PAIN Inescapable Intolerable Interminabne Attentional bias Attentional fixation Overgeneralized memory

Dynamic Risk Factors/ Warning Signs Suicidal ideation -- Passive (without a plan) vs active (with a plan) Suicidal communication Suicidal intent (wish to die) Active suicidal behaviors Availability of, access to, the means Hopelessness Active psych symptoms Treatment adherence Substance misuse Psychiatric admission and discharge Psychosocial stress Problem-solving deficits

Static and Stable Risk Factors History of self-harm Seriousness of previous suicidality (help-seeking behavior, lethality, past preparatory behaviors…) Previous hospitalizations History of mental disorder History of substance use disorder Physical disorder Exposure to models Availability of means Personality disorder/traits – Impulsivity-aggression; antisocial personality; borderline pd Childhood adversity – sexual abuse history Family history of suicide Age, gender, marital status

Future Risk Factors Access to preferred method of suicide Future service contact Future response to drug treatment Future response to psychosocial treatments Future stress

Protective Factors Social support network – two or more confidants, living with family/relatives/husband or wife Connectedness Problem solving skills Self efficacy Reasons for living Children at home Pregnancy Life satisfaction Fear of social disapproval or religious norms Fear of death, suicide, self-harm