Wellness Space team is going to present total of 3 abstracts (please see below) at the conference. Please join us.
Abstract #1 -Effective Strategies for Suicide Risk Assessment and Intervention: A Practical Guide Utilizing the ASQ Tool for Screening
Background:
Suicide behaviour (including suicide thoughts, plans, and history of attempts) requires specialised screening and intervention. Suicide is a primary cause of death in the young population of India (Age <39), and hence, psychologists and psychotherapists need a framework to facilitate better screening and recovery.
Objective:
The study, based on the ASQ (Ask Suicide Screening Questions) toolkit, provides a framework for all psychologists and psychotherapists for screening individuals with suicide risk for relevant interventions.
Methods:
Based on 570 personal interviews, individuals with a history of suicide thoughts, plans and actual attempts (N=65) were administered ASQ by two qualified therapists (including a psychologist), followed by the psychiatrist. The ASQ consists of four yes/no questions and takes only several seconds to administer. Screening identifies individuals that require further mental health/suicide safety assessment. In clinical settings, one of the biggest barriers to screening is managing the patients who screen positive effectively and efficiently. The results (ASQ) were tabulated to understand the implications for further treatment for emergency management or therapeutic interventions.
Given that ASQ is a validated tool, the outcome was compared between the therapists’ team and the psychiatrist to understand the agreement on the suggested outcome.
Results:
Use of ASQ provided agreement in 50 out of 65 subjects. The remaining 15 therapists preferred to seek an external (psychiatrist) perspective. The results indicated 100% agreement on high-risk subjects (i.e. therapists and psychiatrists reached the same conclusion). The findings indicate that ASQ provided a very useful and actionable framework in clinical settings for healthcare workers, including psychologists, psychiatrists, and psychotherapists. Actionable (quantitative, qualitative) insights were highlighted for further distribution and learning.
Conclusion:
ASQ is an effective tool for screening and decisions related to further therapeutic intervention. The findings should be further explored by psychotherapists/psychologists to improve the ability to screen for suicide and explore therapeutic intervention.
Key Words:
Adverse childhood experiences, Suicide Behaviour, Suicide Attempts, Childhood trauma, Self-Harm
Abstract #2: Differentiating Between Self-Harm and Suicide Behaviour: Implications for Parenting
Background:
Global evidence highlights the role of childhood trauma and several mental health and behavioural issues as a risk factor for self-harm and suicide behaviour. However, the pathways from childhood trauma to self-harm and suicide behaviours are not well-documented. Given the societal taboo about such topics, there is an opportunity to provide guidelines to help parents be more informed through actionable solutions. The study explores the drivers of self-harm and suicide behaviour and provides a framework for parents to understand and incorporate the insights into their parenting styles.
Objective:
The study explores the role of childhood trauma components in self-harm and suicide behaviour and provides a framework for parenting style for prevention and management.
Methods:
Approximately 700+ people sought assistance at the wellness centre for a range of mental health concerns. Of this group, 570 individuals completed a self-assessment using the ACE inventory, and several quantitative mental health parameters were also assessed. The interview (by two trained therapists, one of them an experienced psychologist) documented the prevalence of (a) the absence or presence of self-harm history and (b) the absence or presence of suicide behaviour (Suicide ideation, plan, history of suicide attempt). A complete timeline of ACE events was also captured. Descriptive statistics were computed using Microsoft Excel, and correlation followed by logistic regression was conducted with SPSS.
Results:
The findings provide insights into the role of ACE exposure in self-harm (Odds Ratio of 4 to 6 for very high exposure to ACE compared to no exposure) and suicide behaviour (Odds Ratio of 6 to 10 for very high exposure to ACE compared to no exposure). Specific ACEs’ (emotional neglect, peer isolation and sexual abuse) play a statistically significant role as a risk factor for the outcomes.
The study also observed a correlation between the occurrences of several ACEs (emotional neglect, physical abuse, peer isolation and sexual abuse).
Conclusion:
There is a strong dose-response relationship between adverse childhood experiences and the risk of self-harm and suicide behaviour across the lifespan. Specific ACEs (emotional neglect, sexual abuse) play a more significant role in behavioural outcomes. From a parenting style perspective, there is an opportunity to (a) understand the role of parenting, (b) understand the common and unique threads for self-harm and suicide behaviour, and (c) adopt the approach to facilitate the prevention and, if needed, seek help for the management of such issues.
Key Words:
Adverse childhood experiences, Suicide Behaviour, Suicide Attempts, Childhood trauma
Abstract #3 – Predicting suicide behaviour using childhood trauma, internalisation and externalisation parameters at a wellness centre in India
Background:
Suicide is India’s leading cause of death among adolescents and young adults. Evidence has highlighted the link between specific adverse childhood experiences (ACE), internalisation/externalisation issues and suicide behaviour. This study aims to examine the role of ACE as a predictor of suicide behaviour.
Objective:
The study aimed to understand the impact of ACE, internalisation and externalisation issues on individuals with a history of suicide behaviour.
Methods:
Approximately 719 people sought assistance at the wellness centre for a range of mental health concerns. Of this group, 570 individuals completed a self-assessment using the ACE inventory, and several quantitative mental health & behavioural (i.e. internalisation & externalisation) parameters were also assessed. The interview (by two trained therapists, one of them an experienced psychologist) documented (a) the absence of suicide ideation and (b) the presence of suicide behaviour (Suicide ideation, history of suicide attempt). During the interview, suicide attempts were distinguished from suicide ideation and self-harm. A complete timeline of ACE events was also captured along with several behavioural traits (such as irrational behaviour, relationship issues, violent behaviour, etc.). Descriptive statistics were computed using statistical analysis in SPSS (correlation and logistic regression).
Results:
The findings indicated that exposure to categories of ACEs, internalisation and externalisation directly predicted suicide behaviour. Specifically, childhood emotional neglect plays a significant role (high odds ratio) in predicting the risk of suicide behaviour.
Conclusion:
Emotional neglect (childhood) is a risk factor for the long-term risk of suicidal behaviour. Several internalisation and externalisation issues) also act as risk factors for suicide behaviour. The findings have implications for parenting and healthcare frameworks.
Future work should expand the research to more mental health centres and study the causal pathway.
Key Words:
Adverse childhood experiences, Suicide Behaviour, Suicide Attempts, Childhood trauma
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