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      Alcohol and Suicide in Postconflict Northern Uganda : A Qualitative Psychological Autopsy Study


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          Background: Alcohol has been noted to be an important factor in nearly 68% of the suicides in Northern Uganda, yet exactly how alcohol contributes to suicide in this region has not been studied. Aims: To determine how alcohol contributes to suicide in this region. Methods: Qualitative psychological autopsy interviews were conducted with bereaved relatives and friends of 20 suicides mainly from Internally Displaced Peoples’ camps in Northern Uganda. Data were analyzed using a modified Interpretative Phenomenological analysis (IPA). Results: Alcohol had a direct or an indirect influence on the suicide of 16 out of the 20 decedents. Directly, alcohol facilitated the suicidal process, was a means to suicide, or had an influence on the decedents’ lifestyles. Indirectly, alcohol had an influence on the suicidal process of the deceased through the drinking behavior of significant others. Conclusions: This study established that alcohol not only contributes to the suicidal process of the individuals through acute and chronic alcohol consumption, but also through victimization of those lowest in the power hierarchy by alcohol abusers higher up in the power hierarchy. Therefore, future development of suicide prevention programs should address the interrelated public health problem of alcohol abuse.

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          The gender gap in suicide and premature death or: why are men so vulnerable?

          Suicide and premature death due to coronary heart disease, violence, accidents, drug or alcohol abuse are strikingly male phenomena, particularly in the young and middle-aged groups. Rates of offending behaviour, conduct disorders, suicide and depression are even rising, and give evidence to a high gender-related vulnerability of young men. In explaining this vulnerability, the gender perspective offers an analytical tool to integrate structural and cultural factors. It is shown that traditional masculinity is a key risk factor for male vulnerability promoting maladaptive coping strategies such as emotional unexpressiveness, reluctance to seek help, or alcohol abuse. This basic male disposition is shown to increase psychosocial stress due to different societal conditions: to changes in male gender-role, to postmodern individualism and to rapid social change in Eastern Europe and Russia. Relying on empirical data and theoretical explanations, a gender model of male vulnerability is proposed. It is concluded that the gender gap in suicide and premature death can most likely be explained by perceived reduction in social role opportunities leading to social exclusion.
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            Suicidal Behavior and Alcohol Abuse

            Suicide is an escalating public health problem, and alcohol use has consistently been implicated in the precipitation of suicidal behavior. Alcohol abuse may lead to suicidality through disinhibition, impulsiveness and impaired judgment, but it may also be used as a means to ease the distress associated with committing an act of suicide. We reviewed evidence of the relationship between alcohol use and suicide through a search of MedLine and PsychInfo electronic databases. Multiple genetically-related intermediate phenotypes might influence the relationship between alcohol and suicide. Psychiatric disorders, including psychosis, mood disorders and anxiety disorders, as well as susceptibility to stress, might increase the risk of suicidal behavior, but may also have reciprocal influences with alcohol drinking patterns. Increased suicide risk may be heralded by social withdrawal, breakdown of social bonds, and social marginalization, which are common outcomes of untreated alcohol abuse and dependence. People with alcohol dependence or depression should be screened for other psychiatric symptoms and for suicidality. Programs for suicide prevention must take into account drinking habits and should reinforce healthy behavioral patterns.
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              The psychological autopsy approach to studying suicide: a review of methodological issues.

              The psychological autopsy approach to studying suicide is becoming an increasingly used research method. It presents considerable methodological problems. In order to assist future researchers in this field and to help readers assess reports of psychological autopsy studies the authors have reviewed these issues on the basis of their own experience and those of other workers. The areas covered include research design, identification of subjects, sources of information and the particular issues concerned with approaching relatives and other informants, choice and recruitment of controls, the difficulties of conducting psychological autopsy interviews with relatives, problems for interviewers, the selection of appropriate measures to obtain information, and achieving valid and reasonably reliable conclusions from diverse information sources.

                Author and article information

                The Journal of Crisis Intervention and Suicide Prevention
                Hogrefe Publishing
                February 15, 2012
                : 32
                : 2
                : 95-105
                [ 1 ] Norwegian University of Science and Technology, Trondheim, Norway
                [ 2 ] Butabika National Referral and Teaching Mental Hospital, Kampala, Uganda
                [ 3 ] Norwegian Institute of Public Health, Oslo, Norway
                [ 4 ] MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda
                Author notes
                Dorothy Kizza, Butabika National Referral and Teaching, Mental Hospital, P. O. Box 7017, Kampala, Uganda +256 774 997364 +256 414 504760 d_kizza@ 123456yahoo.com
                Self URI (journal-page): https://econtent.hogrefe.com/loi/cri
                Research Trends

                Emergency medicine & Trauma,Psychology,Health & Social care,Clinical Psychology & Psychiatry,Public health
                alcohol,suicide,psychological autopsy,postconflict Northern Uganda


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