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Title: A study of psychological protective factors and psychological processes in those who are acutely suicidal
Author: Davies, Charlotte
Awarding Body: Cardiff University
Current Institution: Cardiff University
Date of Award: 2020
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Suicide is a global health problem with many people dying by suicide each year. Much research has been conducted on the various risk and protective factors which both increase and decrease the likelihood of both suicidal thoughts and attempts. However, more research is needed to understand the psychological processes involved in suicide. This thesis explored the psychological components of suicidal thoughts and behaviours in adults who are acutely suicidal. This was done by firstly systematically reviewing the protective factors in those who were admitted to hospital following a suicide attempt or for suicidal thoughts. Secondly, this was done by conducting a Grounded Theory with eleven acutely suicidal individuals with an aim to understand the process linking suicidal thoughts to suicide attempts. The aim of the systematic review was to identify the psychological factors which protect acutely suicidal individuals from suicidal thoughts and behaviours. Fifteen papers were identified which looked at a range of different factors in very different populations of suicidal individuals. The review found that when suicidal individuals feel more able to cope with suicidal thoughts or urges, then this protects them from further suicide attempts. Also, if a suicidal individual perceives themselves as someone who is able to achieve things in their life, then this will also protect them from suicidal thoughts and behaviours. This may be protective even when someone does not perceive themselves to have others to support them and when they do not feel able to obtain resources in their life. In addition, suicidal individuals may be protected from suicidal thoughts and behaviours when they have meaning in life and can think positively about the future. Feeling trapped has been found to increase the risk of suicide, though, when someone feels positively about the future, even if they are feeling trapped, they will be less suicidal. However, this review does have its limitations. Many studies were in very specific populations i.e. the military, veterans and African American women who had experienced domestic violence. Additionally, some of the studies used cross-sectional data (studying people at one time point) rather than longitudinal (over time). This does not provide information about factors which may protect someone from a further attempt. Further research would benefit from exploring whether suicidal individuals improve over time when these protective factors are present. Implications for those working with suicidal individuals (i.e. crisis teams, inpatient wards and community mental health teams) are that protective factors should be routinely assessed. Questions that can be asked are: what someone’s reasons to live are; what coping they have for the suicidal thoughts and behaviours; what meaning they have in life and how supported they feel by those around them. The aim of the empirical paper was to identify any psychological processes linking thoughts about suicide to attempting suicide. Eleven participants were interviewed whilst they were either under the care of the crisis team or the inpatient ward. The results of this study showed that there were nine categories that emerged from the data as central to this process. The participants spoke of thoughts of events from their past which were intensifying and impacting on their present. They found these thoughts hard to deal with it and described it with words such as ‘despair’ and ‘pain’. Each individual then thought about ways to block out this intensity, which was often unsuccessful. This often served to increase the building pressure even further. Participants came to think of suicide as something positive as it would bring an end to their pain and despair, solve their problems and stop them from affecting, and being a burden to, those around them. They began to weigh the options that they had. For those who made the decision, their focus then narrowed on suicide and this became the only option. Once this focus was narrowed, they attempted to end their lives. For those who chose not to, they were found to still hold some hope, whereas those who attempted were completely devoid of hope. This study highlights the importance of various psychological processes which may be considered when mental health professionals assess the risk in someone who presents to hospital or to their GP with suicidal thoughts and/or an attempt. This means that mental health professionals could ask about their views on what death would bring them, whether they are feeling ‘numb’ or ‘shut off’ and whether they feel in control of their lives. Some brief psychological interventions may be useful in addressing these processes within mental health services. These interventions should focus on moving people towards acceptance. Further research is needed to see whether these processes are found in other patient samples.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Clin.Psy.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: BF Psychology