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      The Stigma of Suicide Scale : Psychometric Properties and Correlates of the Stigma of Suicide

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          Abstract

          Background: There are presently no validated scales to adequately measure the stigma of suicide in the community. The Stigma of Suicide Scale (SOSS) is a new scale containing 58 descriptors of a “typical” person who completes suicide. Aims: To validate the SOSS as a tool for assessing stigma toward suicide, to examine the scale’s factor structure, and to assess correlates of stigmatizing attitudes. Method: In March 2010, 676 staff and students at the Australian National University completed the scale in an online survey. The construct validity of the SOSS was assessed by comparing its factors with factors extracted from the Suicide Opinion Questionnaire (SOQ). Results: Three factors were identified: stigma, isolation/depression, and glorification/normalization. Each factor had high internal consistency and strong concurrent validity with the Suicide Opinion Questionnaire. More than 25% of respondents agreed that people who suicided were “weak,” “reckless,” or “selfish.” Respondents who were female, who had a psychology degree, or who spoke only English at home were less stigmatizing. A 16-item version of the scale also demonstrated robust psychometric properties. Conclusions: The SOSS is the first attitudes scale designed to directly measure the stigma of suicide in the community. Results suggest that psychoeducation may successfully reduce stigma.

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          Contact With Mental Health and Primary Care Providers Before Suicide: A Review of the Evidence

          Objective This study examined rates of contact with primary care and mental health care professionals by individuals before they died by suicide. Method The authors reviewed 40 studies for which there was information available on rates of health care contact and examined age and gender differences among the subjects. Results Contact with primary care providers in the time leading up to suicide is common. While three of four suicide victims had contact with primary care providers within the year of suicide, approximately one-third of the suicide victims had contact with mental health services. About one in five suicide victims had contact with mental health services within a month before their suicide. On average, 45% of suicide victims had contact with primary care providers within 1 month of suicide. Older adults had higher rates of contact with primary care providers within 1 month of suicide than younger adults. Conclusions While it is not known to what degree contact with mental health care and primary care providers can prevent suicide, the majority of individuals who die by suicide do make contact with primary care providers, particularly older adults. Given that this pattern is consistent with overall health-service-seeking, alternate approaches to suicide-prevention efforts may be needed for those less likely to be seen in primary care or mental health specialty care, specifically young men.
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            Twelve-month prevalence of and risk factors for suicide attempts in the World Health Organization World Mental Health Surveys.

            Although suicide is a leading cause of death worldwide, clinicians and researchers lack a data-driven method to assess the risk of suicide attempts. This study reports the results of an analysis of a large cross-national epidemiologic survey database that estimates the 12-month prevalence of suicidal behaviors, identifies risk factors for suicide attempts, and combines these factors to create a risk index for 12-month suicide attempts separately for developed and developing countries. Data come from the World Health Organization (WHO) World Mental Health (WMH) Surveys (conducted 2001-2007), in which 108,705 adults from 21 countries were interviewed using the WHO Composite International Diagnostic Interview. The survey assessed suicidal behaviors and potential risk factors across multiple domains, including sociodemographic characteristics, parent psychopathology, childhood adversities, DSM-IV disorders, and history of suicidal behavior. Twelve-month prevalence estimates of suicide ideation, plans, and attempts are 2.0%, 0.6%, and 0.3%, respectively, for developed countries and 2.1%, 0.7%, and 0.4%, respectively, for developing countries. Risk factors for suicidal behaviors in both developed and developing countries include female sex, younger age, lower education and income, unmarried status, unemployment, parent psychopathology, childhood adversities, and presence of diverse 12-month DSM-IV mental disorders. Combining risk factors from multiple domains produced risk indices that accurately predicted 12-month suicide attempts in both developed and developing countries (area under the receiver operating characteristic curve = 0.74-0.80). Suicidal behaviors occur at similar rates in both developed and developing countries. Risk indices assessing multiple domains can predict suicide attempts with fairly good accuracy and may be useful in aiding clinicians in the prediction of these behaviors. © Copyright 2010 Physicians Postgraduate Press, Inc.
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              Lessons from social psychology on discrediting psychiatric stigma.

              Advocacy, government, and public-service groups rely on a variety of strategies to diminish the impact of stigma on persons with severe mental illness. These strategies include protest, education, and promoting contact between the general public and persons with these disorders. The authors argue that social psychological research on ethnic minority and other group stereotypes should be considered when implementing these strategies. Such research indicates that (a) attempts to suppress stereotypes through protest can result in a rebound effect; (b) education programs may be limited because many stereotypes are resilient to change; and (c) contact is enhanced by a variety of factors, including equal status, cooperative interaction, and institutional support. Future directions for research and practice to reduce stigma toward persons with severe mental illness are discussed.
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                Author and article information

                Journal
                cri
                Crisis
                The Journal of Crisis Intervention and Suicide Prevention
                Hogrefe Publishing
                0227-5910
                2151-2396
                August 3, 2012
                2013
                : 34
                : 1
                : 13-21
                Affiliations
                [ 1 ] Centre for Mental Health Research, The Australian National University, Canberra, Australia
                [ 2 ] Black Dog Institute, University of New South Wales, Sydney, Australia
                Author notes
                Philip J. Batterham, Centre for Mental Health Research, Building 63, Eggleston Road, The Australian National University, Canberra ACT 0200, Australia +61 2 61252741 +61 2 61250733 philip.batterham@ 123456anu.edu.au
                Article
                cri_34_1_13
                10.1027/0227-5910/a000156
                22846447
                c1035093-dfec-4119-8f92-cb4f50f66b26
                Copyright @ 2012
                History
                : August 8, 2011
                : February 19, 2012
                : February 22, 2012
                Categories
                Research Trends

                Emergency medicine & Trauma,Psychology,Health & Social care,Clinical Psychology & Psychiatry,Public health
                attitudes,risk factors,scale validation,suicide,stigma

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