A qualitative investigation into the relationships between social factors and suicidal thoughts and acts experienced by people with a bipolar disorder diagnosis

Abstract

This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting galley proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. AbstractBackground: The prevalence rate of completed suicide in bipolar disorder is estimated to be as high as 19%. Social factors or influences, such as stigmatisation and family conflict, contribute to the development of suicidal ideation in clinical and non-clinical populations. Yet, there is a lack of studies examining suicidality from a psychosocial perspective in people who experience bipolar disorder.Method: Semi-structured interviews were used to collect qualitative data from 20 participants with bipolar disorder. The interview focused on the effects of social factors upon participants" experiences of suicidality (suicidal thoughts, feelings or behaviours). A thematic analysis was used to understand the data.Results: Social or interpersonal factors which participants identified as protective against suicidality included, 'the impact of suicide on others' and, 'reflecting on positive social experiences'. Social factors which triggered suicidal thoughts included, 'negative social experiences' and, 'not being understood or acknowledged'. Social factors which worsened suicidal thoughts or facilitated suicidal behaviour were, 'feeling burdensome," and 'reinforcing negative self-appraisals'.Limitations: Some participants had not experienced suicidal thoughts for many years and were recalling experiences which had taken place over ten years ago. The accuracy and reliability of these memories must therefore be taken into consideration when interpreting the results. Conclusions:The themes help to enhance current understanding of the ways in which social factors affect suicidality in people who experience bipolar disorder. These results highlight the importance of considering the social context in which suicidality is experienced and incorporating strategies to buffer against the effects of negative social experiences in psychological interventions which target suicide risk in bipolar disorder.

Associations among Substance Use, Mental Health Disorders, and Self-Harm in a Prison Population: Examining Group Risk for Suicide Attempt

“…In many correctional settings, including the department of corrections that was the source for our data, offenders classified at the maximum level reside in single bed units (i.e., they do not share living quarters), and contact with other offenders is minimal. The association between maximum security and suicide attempts may be related to offenders experiencing a negative environment, increased stress, reinforcement of negative self-worth, and social isolation [28,30,41]. The majority of offenders classified as maximum security were tobacco smokers (64.5%) and a plurality had a diagnosis of depression (38.4), significant risk factors for suicide attempts.…”

“…In particular, depression and bipolar with anxiety disorders are strongly associated with suicidal ideation, attempts, and completion [3,20,21,22,23,24,26,29,30,31]. Individuals with SUD also have greater incidence of suicidal ideation and attempts compared to the population who do not have a problem with substances [32,33].…”

Understanding the role of sleep in suicide risk: qualitative interview study

“…Second, to minimise problems with recall, the inclusion criteria specified that participants must have had experience of suicidal thoughts or behaviours in the past year 38. For some participants, memories regarding sleep in the more distant past were often more generalised in comparison with recollections of suicidal experiences.…”

The influence of social networks in suicidal behavior

“…Suicide is a cause of death in which psychological factors are directly involved, as the individual ultimately forms a decisive intention to end their own life [1,2,3]. The suicidal downward spiral starts with ideation, which functions as an indicator of vulnerability and might lead to a suicide attempt or suicide.…”

“…[41,18] A mental health diagnosis is a strong predictor of suicidal behavior and nine out of 10 people who end their life will have experienced clinically signifi-cant mental health problems. [42,3] One potential risk factor that has received comparatively little attention is the stigma associated with mental health problems and associated experience of discrimination. [43,7] It has been suggested that the acceptance of stigmatizing beliefs about mental illness may influence levels of hopelessness.…”