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A number of psychological factors influence late life suicide, including dysfunctional family and family history of suicide; relational problems throughout life; history of drinking; numerous losses in middle and late life such as the loss of power and control, loss of spouse, and loss of work role; and increasing mental health problems in late life. Depression, the most common mental disorder in later life, is a major precipitating factor in suicide. Alcoholism is another major precipitating factor in late-life suicide. Approximately one-third of all suicides are alcoholics. Many of the same factors which contribute to depression also increase the risk of alcoholism and/or suicide. Loss, stress, loneliness, low self-esteem, and feelings of anxiety, rejection, helplessness, and hopelessness characterize late life alcoholism and depression. Alcoholism, depression, and suicide form a deadly triangle. Family, caregivers, and practitioners need to be aware of the deadly relationship between alcoholism, depression, and suicide in older adults.
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PMID:Psychological factors in late-life suicide. 193 92

In this article, general characteristics of suicide in the elderly are discussed. They have the highest suicide rate of any age group, are more determined to die, use "harder" methods, and seem less prone to communicate their suicidal intentions. Furthermore, it seems from recent research that the attitude toward suicide becomes more negative (i.e. no probability of suicide committed by oneself) with increasing age, but at the age of 55 men's attitudes remain negative whereas women's become positive. Approximately at the age of 65 we can see the reverse. The particular factors affecting suicide in old age, such as retirement, relocation, social support, bereavement, depression, hopelessness, mental disorders, and alcohol abuse are described. Physical illness, especially attendant on depression and feelings of hopelessness, also plays an important role.
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PMID:Suicide in the elderly: general characteristics. 193 94

The suicidal behavior of a college population (N = 205) was assessed. Individuals were categorized into four groups: never suicidal, brief suicidal ideation, serious suicidal ideation, and parasuicidal. They also answered questions about why they would not choose suicide, on the Reasons For Living (RFL) Inventory. Depression, hopelessness, and social desirability scales also were presented. A significant difference existed between suicidal and nonsuicidal individuals on the RFL. Hopelessness and depression were found to be correlated significantly with suicidal behavior; social desirability was found to be high among those who were not suicidal and declined as suicidal behaviors became more severe.
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PMID:The reasons for living inventory and a college population: adolescent suicidal behaviors, beliefs, and coping skills. 193 91

Studies testing cognitive theory of depression (Beck, 1963, 1987) and defining depression as a clinical syndrome are reviewed. Many aspects of the theory's descriptive claims about depressive thinking have been substantiated empirically, including (a) increased negativity of cognitions about the self, (b) increased hopelessness, (c) specificity of themes of loss to depressive syndromes rather than psychopathology in general, and (d) mood-congruent recall. Evidence that depressive thinking is especially inaccurate or illogical, however, is weak. Fewer studies have tested the theory's causal (diathesis-stress) hypotheses, and there is no strong evidence supporting them.
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PMID:Empirical status of cognitive theory of depression. 194 67

The role of loneliness, irrational beliefs, and deficient reasons for living in predicting vulnerability to hopelessness under conditions of negative life stress was examined. Subjects (N = 178) completed the UCLA Loneliness Scale. Rational Beliefs Inventory, and the Reasons for Living Inventory at the beginning of the semester. Then, at midterm, measures of negative life stress, depression, and hopelessness were obtained from the same subjects. It was hypothesized that the vulnerability factors would interact with negative life stress to predict hopelessness, independent of depressed mood. The results of multiple regression analyses supported this hypothesis. Implications for research, prevention, and treatment are noted.
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PMID:Predicting vulnerability to hopelessness. A longitudinal analysis. 198 45

Adolescent suicide attempts are often impulsive. It has been suggested that individuals who make nonimpulsive (premeditated) attempts have greater suicidal intent and are more hopeless than the impulsive attempters. Eighty-six adolescent suicide attempters were categorized according to the degree of premeditation of their attempt, as measured by two items of the Suicide Intent Scale. Sex, age, method of attempt, and the number of prior attempts were not useful discriminators between these groups. The nonimpulsive attempters were significantly more depressed and more hopeless than the impulsive attempters, as measured by several standardized scales. Measures of depression, hopelessness, and suicidal ideation were highly correlated in both groups. Anger turned inward and hopelessness were strongly correlated only in the premeditated group, suggesting that the nonimpulsive attempter's distress may bear a strong relationship to self anger.
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PMID:The correlates of planning in adolescent suicide attempts. 200 70

Depressive patients in a high-risk-group due to suicidal behavior and death by suicide. Suicide rates amount to 500 to 900 per 100,000 depressives. According to the literature mortality reaches 15% in all primary depressive patients. Of our own depressive inpatients 20% were admitted because of tentamen. About 29% of our depressive inpatients have attempted ed suicide in former history. Among suicides during psychiatric hospital treatment were significantly more patients with depression than among the entire hospital clientele and inpatients with affective psychoses especially with delusional depression were overrepresented. Hopelessness, higher scores in depression scales, feelings of guilt and worthlessness, delusions seem to differentiate between depressives with and without suicidal behavior. Treatment of these patients means psychotherapeutic measures which can be described in terms of crisis intervention, brief psychotherapy, and antidepressive medication as a treatment of the underlying depression, sometimes in combination with neuroleptics or/and tranquilizers.
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PMID:[Psychotherapeutic and psychopharmacological treatment of suicidal depressive patients]. 200 53

A longitudinal study between 1980 and 1988 of school leavers entering adulthood examined suicidal ideation 4 and 8 years after an initial battery of psychological tests. The report of suicidal ideation during their lives was significantly associated with measures of depression, self-esteem and locus of control 8 years previously. It was also associated with those measures as well as anomie, hopelessness and scores on the General Health Questionnaire 4 years previously. These associations were not as strong for subjects whose suicidal ideation had been present in the most recent 6 months, or for those who acknowledged having attempted suicide. No fewer than 40% of subjects who acknowledged suicidal ideation when examined in 1984 denied ever having had suicidal ideation during their lives when re-examined in 1988. This raises doubts about the validity of such studies. Although these findings provide data that confirm the enduring nature of suicidal ideation and its continuing morbidity, they do not give confidence that any screening of schoolchildren could actually predict those who will attempt suicide. Such studies cannot replace full clinical assessment of individual suicidal subjects.
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PMID:Suicidal ideation: its enduring nature and associated morbidity. 201 8

Specificity of cognitive change following cognitive therapy for depression was assessed in 39 depressed inpatients who completed either a standard inpatient treatment (pharmacotherapy and milieu management) or the standard treatment plus cognitive therapy. Following treatment, patients in both groups endorsed fewer dysfunctional cognitions on 2 of 4 measures of cognitive distortion. Compared with patients receiving only the standard treatment, patients also receiving cognitive therapy reported less hopelessness and fewer cognitive biases at posttreatment and 6- and 12-month follow-up assessments and fewer dysfunctional attitudes at the 6-month follow-up. Treatment effects for dysfunctional cognitions were found even though the treatment groups did not differ in depression severity, suggesting that results did not reflect state-dependent differences between treatments secondary to difference in depression.
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PMID:Cognitive therapy with depressed inpatients: specific effects on dysfunctional cognitions. 203 Jan 89

A number of conclusions can be drawn from the themes derived from the interview data. First, even though the most basic physical needs, such as food, clothing, and shelter were being met, a recurring theme from the responses of the homeless was the need for interaction with a caring person. The feeling that no one cares, a lack of self-worth, and a sense of limited control over their lives may lead to depression, hopelessness, and finally illness. The extent and effectiveness of health-seeking behaviors among this group are limited because of decreased trust, decreased motivation for self-care, and isolation from social and health care systems. Second, if health needs are to be met, services must be provided in sites where they can be accessed by the homeless. For transients, health care services may be provided most effectively through the shelters. For the SRO residents, these services could be provided through a combination of clinics in hotel lobbies and visits to rooms. Third, developing trust with the homeless includes meeting their self-perceived basic needs. What may seem like nonnursing activities, such as fixing a meal, may be important in establishing rapport with SRO residents. If a nurse assists a homeless person to meet survival needs, that person may be more willing to deal with health issues. Fourth, the population is highly heterogeneous. Each subgroup has its own identity. Most SRO residents do not want to be identified with street people, even through a portion of them move between street life and SRO life. Health care professionals need to recognize these differences, accept the life-style of each subgroup, and respect each homeless person as a unique individual. Finally, caring is the primary element necessary in providing nursing services to the homeless. Awareness and understanding of the homeless way of life will increase nurses' effectiveness in working with this ever growing population.
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PMID:Self-identified health concerns of two homeless groups. 204 11


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