Biomedical subjects
Publications and source records attributed to Morton M Silverman.
The current article addresses the issue of warning signs for suicide, attempting to differentiate the construct from risk factors. In accordance with the characteristic features discussed, a consensus set of warning signs identified by the American Association of Suicidology working group are presented, along with a discussion of relevant clinical and research applications.
In this study we examined the effect that reading a list of warning signs for suicide has on beliefs about suicide, including the belief that one can recognize a suicidal crisis. All participants read two sets of warning signs (with only the experimental group reading the suicide warning signs) and then answered questions concerning beliefs related to three health problems. Results indicate that participants who read the suicide warning signs reported greater abilities to recognize if someone is suicidal but did not report stronger beliefs that suicidal individuals are partly to blame, nor did they report lower likelihoods of befriending suicidal individuals. Results suggest that reading the list of warning signs may be effective in increasing the public's ability to recognize suicidal crises without creating or magnifying stigmatizing beliefs about suicidal individuals.
This 2005 Louis I. Dublin Award Address explores some of the basic difficulties and controversies inherent in the development and universal acceptance of a nomenclature for suicidology. Highlighted are some of the unresolved challenges with agreeing upon a mutually exclusive set of terms to describe suicidal thoughts, intentions, motivations, and self-destructive behaviors.
The National College Health Assessment Survey (NCHA), sponsored by the American College Health Association, measured depression, suicidal ideation, and suicide attempts among 15,977 college students in the academic year 1999-2000. Similar to the National College Health Risk Behavior Survey, conducted by the Centers for Disease Control and Prevention in 1995, 9.5% of students reported that they had seriously considered attempting suicide and 1.5% of students reported that they had attempted suicide within the last school year. The NCHA findings show a relationship between suicidal behavior and depressed mood. Depressed mood, difficulties of sexual identity, and problematic relationships all increase the likelihood of vulnerability to suicidal behavior. Less than 20% of students reporting suicidal ideation or attempts were receiving treatment.
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OBJECTIVE: To encourage treatment of depression and prevention of suicide in physicians by calling for a shift in professional attitudes and institutional policies to support physicians seeking help. PARTICIPANTS: An American Foundation for Suicide Prevention planning group invited 15 experts on the subject to evaluate the state of knowledge about physician depression and suicide and barriers to treatment. The group assembled for a workshop held October 6-7, 2002, in Philadelphia, Pa. EVIDENCE: The planning group worked with each participant on a preworkshop literature review in an assigned area. Abstracts of presentations and key publications were distributed to participants before the workshop. After workshop presentations, participants were assigned to 1 of 2 breakout groups: (1) physicians in their role as patients and (2) medical institutions and professional organizations. The groups identified areas that required further research, barriers to treatment, and recommendations for reform. CONSENSUS PROCESS: This consensus statement emerged from a plenary session during which each work group presented its recommendations. The consensus statement was circulated to and approved by all participants. CONCLUSIONS: The culture of medicine accords low priority to physician mental health despite evidence of untreated mood disorders and an increased burden of suicide. Barriers to physicians' seeking help are often punitive, including discrimination in medical licensing, hospital privileges, and professional advancement. This consensus statement recommends transforming professional attitudes and changing institutional policies to encourage physicians to seek help. As barriers are removed and physicians confront depression and suicidality in their peers, they are more likely to recognize and treat these conditions in patients, including colleagues and medical students.
The concept of lethality is essential to the assessment of suicide risk; yet operational definitions of lethality for purposes of its measurement have been loose and varied. A number of scaling measures have been published in the literature, with no relative consensus on the best of these. In addition, only a few of these scales have published data on their psychometric properties. Of these, we argue that the best is the Lethality of Suicide Attempt Rating Scale (LSARS; Smith, Conroy, & Ehler, 1984). Presented here is a significantly revised and redesigned listing of drugs and chemicals and lethal ranges of ingestion (in caps, tabs, or ounces) by body weight to update that scale.
The pathology of cardiac disease includes genetic, physical, biochemical, psychological, social, and environmental vectors. Factors contributing to suicide have been identified in these same areas. Survival from an acute cardiac event requires a systematized and multisectoral response. Communities that do not have systematized response capabilities to acute cardiac events have poorer survival outcomes. Suicide prevention and control may also be responsive to an integrated community response system. This paper examines the development of a community cardiac care model, explores potential parallels for a community suicide prevention and control model, and outlines a general systems theory framework for a suicide prevention and control system.