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PURPOSE: Psychache significantly contributes to the suicidal process. However, the transition from pre-suicidal suffering to a suicide crisis remains one of the least explored stages in suicidology. METHODS: We retrospectively explored experience of pre-suicidal suffering through semi-structured, in-depth interviews with 12 individuals recruited from the Vilnius City Mental Health Center, Lithuania. Interpretative phenomenological analysis was employed to identify recurring patterns. RESULTS: Nine primary group experiential themes emerged: Certain adverse life events occurring during the suicidal process were not immediately perceived as connected; Complex traumatic events laid the groundwork for a profound sense of lack; A compensatory mechanism balanced the experience of profound lack; Exhaustion ensued from efforts to sustain the compensatory mechanism; The main trigger directly challenged the compensatory mechanism; The affective state followed the experience of the main triggering event; Dissociation served to isolate psychache; Thoughts of suicide experienced as automatic; Suicide was perceived as a means to end suffering. CONCLUSION: The findings suggest that the suicidal process unfolds over an extended period of suffering, culminating in a crisis to alleviate unbearable psychological pain. In clinical practice, identifying the main triggering event discussed in this study can be pivotal in understanding the essence of suffering characterized by profound lacking and developed compensatory mechanisms.
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Estresse Psicológico , Ideação Suicida , Tentativa de Suicídio , Sobreviventes , Humanos , Masculino , Feminino , Tentativa de Suicídio/psicologia , Adulto , Pessoa de Meia-Idade , Sobreviventes/psicologia , Estudos Retrospectivos , Estresse Psicológico/psicologia , Lituânia , Pesquisa Qualitativa , Adulto Jovem , Acontecimentos que Mudam a VidaRESUMO
The aim of this study was to investigate the relationship between suicide risk, alcohol consumption, and attitudes towards professional psychological help among Lithuanian general population men, conscripts, and regular active duty (AD) soldiers. In total, 1195 Lithuanian adult males participated in the study: 445 men from the general population, 490 conscripts, and 260 regular AD soldiers from the Lithuanian Armed Forces. The study's measures included: general suicide risk, alcohol consumption levels, frequency of using alcohol as a means to suppress difficult thoughts and feelings, and attitudes toward psychological help. Both military samples showed significantly lower suicide risk than men from the general population. Alcohol use as a means to suppress difficult thoughts and feelings was the most significant predictor of suicide risk and a significant mediator between alcohol consumption and suicide risk in all study groups. Another significant suicide risk predictor and mediator between alcohol consumption and suicide risk-i.e., the value of seeking psychological treatment-was found only in the conscript sample. Results of the current study suggest that there is an opportunity for intervention aimed at the attitudes toward seeking professional psychological help for conscripts. However, that might not be the case for regular AD soldiers, nor the general population of Lithuanian men.
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Militares , Suicídio , Adulto , Masculino , Humanos , Militares/psicologia , Lituânia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Suicídio/psicologia , Consumo de Bebidas AlcoólicasRESUMO
Background: Along with other suicide risk factors, masculinity has been analyzed as an important subject for suicidal behavior in men. This study examines masculinity as a gender self-confidence which is the intensity of an individual's belief that he meets his standards for masculinity. We use Hoffman and her colleague's concept, which provides two theoretical constructs as elements of gender self-confidence: gender self-definition and gender self-acceptance. Gender self-definition relates to how salient masculinity is in one's identity; gender self-acceptance relates to how positively one views his masculinity. Methods: The quantitative research approach was applied in the study. The survey with a nonprobability quota sampling design was implemented to collect the data. The sample consisted of 562 Lithuanian men from various age groups and regions. The age of participants varied from 18 to 92 years (M = 42.99, SD = 17.18); 40.9% of men were from cities, 28.1% from towns, and 30.8% from rural locations. We used the Hoffman Gender Scale to measure gender self-definition and gender self-acceptance. Suicide risk was estimated with the Suicide Behavior Questionnaire-Revised. Patient Health Questionnaire-2 was used to measure depression symptoms as a controlled variable. Statistical analysis of regression and moderation was used to test the hypothesis. Results: Higher gender self-definition and higher gender self-acceptance were associated with lower suicide risk. The moderation analysis showed that in men with relatively low gender self-definition, the effect of gender self-acceptance on suicidality was larger than in men with high or moderate gender self-definition. Discussion: We conclude that a stronger gender self-confidence is an important protective factor in male suicide risk. Both, a smaller part of masculinity in one's identity and a negative view of one's masculinity have a cumulative effect on increased suicide risk. The findings have been discussed in accordance with the theories that explain suicidal behavior through the lenses of self-concept.
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The aim of the current study is to analyze how relatives understand in retrospect the suicide risk of their next of kin who died by suicide. We interviewed 103 adult relatives who lost their significant others to suicide, using qualitative content analysis to explore the data. Participants expressed difficulties understanding suicide risk by identifying personal traits incompatible with suicide, reasons to doubt the risk, life oriented actions, the situation seemed better than it was, or that the loved one denied suicide risk; only a few recognized suicide risk. Prevalent myths about suicide and denial are possible explanations for these findings.
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Família , Suicídio , Adulto , HumanosRESUMO
BACKGROUND: Studies show that people bereaved by suicide often feel a strong need for professional help. It is hypothesized that aspects related to suicide bereavement, such as stigmatization, shame or guilt, hinder help-seeking process of the bereaved. However, little is known about help-seeking behaviors of people who has lost someone due to suicide. AIMS: This study was conducted to attain a better understanding of the contributing factors, including the specific features of grief following suicide, to help-seeking behaviors of the bereaved by suicide. METHODS: The sample consisted of 82 adults bereaved by suicide (64 female; average age 37.79, SD = 14.33). Instruments assessing stigmatization, shame, guilt levels, well-being, tendency to disclose emotional distress and attitudes toward seeking professional psychological help were used. The participants were also asked an open-ended question what professional help-seeking barriers they had encountered. Comparisons between the groups, logistic regression analysis and thematic analysis of the qualitative data were performed. RESULTS: The findings revealed that bereaved participants who sought professional psychological help reported experiencing stigmatization and feeling guilty after the loss significantly more often. Also the results showed that attitudes toward mental health specialists had the highest prognostic value in predicting help-seeking behaviors of the bereaved. The participants themselves identified the gaps in the health care system as main barriers to seeking help. CONCLUSION: The results challenge previously spread notion that stigmatization, guilt and shame after suicide can act only as help-seeking barriers.
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The research into the phenomenon of cultural trauma is growing as the effects of historical transformations are recognized and analysed. The concept of cultural trauma and the analytic concept of the cultural complex is a suitable theoretical approach for this research. The Lithuanian experience of cultural trauma after the historical shifts indicates the importance of the interplay between societal and individual factors in coping with trauma. Academic psychotraumatological studies carried out at Vilnius University indicate a stronger traumatic experience by people who are survivors of direct political repression and even intergenerational transmission of trauma, but this group also seems to demonstrate an intergenerational transmission of resilience. Paradoxically, from a long-term perspective, the victims of direct repression seem to have suffered less than the people who accommodated to the regime, and this applies also to their offspring. Analysis in terms of overcoming cultural trauma indicates that society is gradually integrating historic traumatic experiences, although a healthy cultural identity has not yet been restored.
La recherche sur le phénomène du traumatisme culturel se développe alors que les effets des transformations historiques sont reconnues et analysées. Le concept de traumatisme culturel et le concept analytique du complexe culturel donnent un cadre théorique utile pour ce domaine d'études. L'expérience lithuanienne de traumatisme culturel après les changements historiques montre l'importance de l'interaction entre les facteurs sociétaux et individuels pour se débrouiller du traumatisme. Des études en psychotraumatologie faites à l'université de Vilnius montrent une expérience traumatique plus forte chez les personnes qui ont survécu à une répression politique directe, et même une transmission intergénérationnelle du traumatisme. Mais ces chercheurs semblent aussi pouvoir montrer une transmission intergénérationnelle de la résilience. De manière paradoxale, sur le long terme, les victimes d'une répression directe semblent avoir moins souffert que les personnes qui se sont adaptées au régime, et ceci s'applique également à leurs descendants. L'analyse s'occupant de surmonter le traumatisme culturel montre que la société procède peu à peu à l'intégration des expériences historiques traumatiques, bien qu'une identité culturelle saine n'ait pas encore été restaurée.
Mientras los efectos sobre las transformaciones históricas y sociales están siendo reconocidas y analizadas, la investigación sobre el fenómeno del trauma cultural está creciendo. El concepto de trauma cultural y el concepto analítico de complejo cultural es un abordaje teórico apropiado para dicha investigación. La experiencia Lituana de trauma cultural luego de los cambios históricos da cuenta de la importancia del inter-juego entre factores individuales y sociales para hacer frente al trauma. Estudios académicos psico-traumatológicos llevados a cabo e la Universidad de Vilnius indican la presencia de experiencias traumáticas más intensas en las personas sobrevivientes de una represión política directa, y también de la transmisión intergeneracional del trauma, pero este grupo, también pareciera demostrar la transmisión intergeneracional de resiliencia. Paradójicamente, desde una perspectiva a largo plazo, las víctimas de represión directa parecieran haber sufrido menos que quienes se acomodaron al régimen, y esto aplica también a los descendientes. El análisis, en términos de sobreponerse al trauma cultural indica que la sociedad está gradualmente integrando las experiencias traumáticas de la historia, aunque una identidad cultural saludable todavía no ha podido ser restaurada.
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Adaptação Psicológica , Cultura , Política , Trauma Psicológico , Resiliência Psicológica , Humanos , LituâniaRESUMO
Little is known about intergeneration effects on mental health in the families of survivors of political oppression of communist regime in Central and Eastern Europe. We aimed to explore post-traumatic stress in the second generation of the Lithuanian survivors of political violence, and analyze links between parental and adult offsprings' sense of coherence in the families exposed to political violence during the oppressive communist regime in Lithuania. A total of 110 matched pairs of communist regime political violence survivors (mean age = 73.22 years) and their adult offspring (mean age = 44.65 years) participated in this study. Life-time traumatic experiences and sense of coherence were measured in both parents and their offspring. Post-traumatic stress symptoms were assessed in the second generation of survivors. We found a high vulnerability in the second generation of the Lithuanian families of political violence survivors, with a 29% of probable PTSD in the second generation based on self-report measures. A significant positive correlation between parental and adult offsprings' sense of coherence was found. Post-traumatic stress symptoms were associated negatively with a sense of coherence in the second generation. Our study indicates the links between parental and the second generation's sense of coherence in the families of survivors of political violence. The study raises broader questions about the intergenerational aspects of resilience. Further studies are needed to explore the links between parental and child sense of coherence in other samples.
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The study aimed to understand the tendencies of help seeking before a suicide attempt in Lithuania. An analysis of interviews with 21 Lithuanian adults demonstrated strong avoidance of seeking help. The main reasons for avoidance included a lack of trust in other people, thinking that one must solve problems independently without sharing them, avoiding troubling others, and a belief that showing genuine emotions is a sign of weakness. These findings may contribute to suicide prevention by more deeply understanding the barriers to help seeking among high suicide risk groups, particularly in countries with a traumatic historical experience.
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Acessibilidade aos Serviços de Saúde , Comportamento de Busca de Ajuda , Tentativa de Suicídio/prevenção & controle , Tentativa de Suicídio/psicologia , Adaptação Psicológica , Adolescente , Adulto , Feminino , Humanos , Lituânia , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
The purpose of the present study was to compare county council politicians' attitudes toward suicide and suicide prevention in five European countries. A questionnaire was distributed and here the responses to the open-ended questions are analyzed qualitatively. Considerable differences were found in what the politicians in the five countries believed to be the most important causes of suicide and how suicide can be prevented. There were also differences in to what degree the politicians revealed a judgmental attitude toward suicide, which seemed to be related to the magnitude of the problem in the respective countries. A certain implicit inconsistency in the logic directing the politicians' responses was found when their views on causes to suicide and suicide prevention strategies were compared. The responses indicate a need for increased consciousness and knowledge about suicide and suicide prevention among politicians in all the five countries. This is important since they are responsible for initiating and funding suicide preventive efforts.
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Atitude , Governo Local , Política , Prevenção do Suicídio , Áustria/epidemiologia , Comparação Transcultural , Humanos , Hungria/epidemiologia , Lituânia/epidemiologia , Noruega/epidemiologia , Suicídio/estatística & dados numéricos , Inquéritos e Questionários , Suécia/epidemiologiaRESUMO
Lithuania, among other Eastern European countries, has the highest suicide rates in the world. While the mid 1980's experienced a sharp decline in suicidality, the year of 1991 began a new increase in suicide rates, reaching an estimated 44.7 per 100,000 persons in the year of 2002. The ratio of male to female rates was 4.5 to 6.1 in the years of 1990 to 2002. The suicide mortality of rural inhabitants, especially men, has been growing even more intensely, occurring twice as often as among their urban counterparts. When looking at the age factor, the highest suicide risk is for middle-aged men. Among the males aged 45 to 54 years suicide rates reach 154.6. The most common method of suicide remains hanging, both for males and females. The underlying reasons of the suicide spread in Lithuania are multi determined.