Suicidal Behavior Including Attempted Suicide Completed And Successful Suicide

About 80% of borderlines have suicidal behaviors and 4-9% actually commits suicide (NIMH). A very dangerous feature of BPD is the very high rate of suicide and suicidal behaviors, making it very dangerous for the person who has it and the people around them. Sufferers often have parasucidal behaviors where there feign death so people they can receive attention. Borderline individuals also would cut themselves as an extreme way of asking for help. Other self-harming behaviors include cutting, burning, hitting, head banging (NIMH). Although we may see these as self-harming acts, they do not feel the same way. These behaviors are often used to control their mood swings, or just to show how much pain they feel because they don’t know how to express it in any other way. Patients might accidently kill themselves while attempting suicide or harmful acts. Borderlines often use emotional blackmail where they

hospitals, psychiatric hospitals, and hospitals claiming “other specialty”. The criteria for the study were previous suicide attempts, drug abuse, and being admitted to a hospital for suicidality. Whether or not the hospitals conducted a mental health assessment was not a requirement for participation in the study, but this factor was considered.

Suicide was seen as a just way to die if one was faced with unendurable suffering - be it physical or emotional”. Throughout time, suicide has been viewed and dealt with in countless ways. Recently in America, the problem has grown increasingly. In the past decade, suicide rates have been on the incline; especially among men. According to the New York Times (2013), “From 1999 to 2010, the suicide rate among Americans ages 35 to 64 rose by nearly 30 percent… The suicide rate for middle-aged men was 27.3 deaths per 100,000, while for women it was 8.1 deaths per 100,000”. A 30 percent increase with an average of 19 more male suicides than female suicides is certainly an issue for both genders, and an epidemic for men. The American Foundation for Suicide Prevention (n.d.), found that in 2010, 38,364 suicides were reported, with 78.9% being men. The economic recession, unemployment, and various other factors are speculated to be responsible for this incline in male suicide. As of 2010, an estimated 30,308 men ended their own lives, and it seems as if there is a great risk of that number increasing each year.

Borderline personality disorder is defined in its most simplest sense as being a mental health disorder that generates significant emotional instability. [1] In sufferers it generates a wide range of symptoms typically characterised into three groups; Problems regulating emotions and thoughts; impulsive behaviour without thinking of the consequences of actions; and lastly unstable relationships. Evaluating the most effective treatment(s) for BPD remains a target for mental health services as the disorder is associated with self harm and suicide attempts, with suicide attempts recorded in 69-80% of patients. [2]

Diana Miller is a deeply troubled young woman who has on numerous occasions been hospitalized in psychiatric institutions for severe abnormal behaviour. Following a serious suicide attempt and seventh hospitalization, Diana was given a diagnosis of major depressive disorder and a borderline personality disorder (BPD). The purpose of this essay is to elucidate the diagnostic accuracy of Diana’s disorders via the analysis of diagnostic features, sociocultural factors, and treatment interventions.

In 2014, suicide was the tenth leading cause of death overall in the United States. According to the National Institute of Mental Health (NIMH, 2015), there were twice as many suicides than there were homicides. Suicidal ideation (SI), defined as an individual thinking about, considering, or planning their suicide, is established before the act of committing suicide. Research suggests that adverse childhood experiences (CDC, 2015) will put an individual at risk for developing a mental illness that could result in SI and suicide attempt (SA). It is important for the psychiatric mental health nurse practitioner (PMHNP) to recognize the signs of SI and SA while assessing their client.

There is at least 113 suicides each day or 1 every 13 minutes. Suicide among males is the seventh leading cause of death and the fourteenth leading cause in females. Most suicides are with a firearm and are carried out with a “ Saturday night special”. (Dilaura,Cynthia DiLaura) “More than 90 percent of suicide attempts with a gun are fatal. “ (Brady Campaign) There are a number of reasons why suicide occurs. Stress is the number one cause among our youth, bullies, peer pressure, depression, and abuse. 41,100 people committed suicide in the United States in 2013. Our young teens today does not take time to look deeper into there problem and to seek out a better solution. They are looking for a quick fix but not realizing once the trigger is pulled the result is final with no turning back. Most people who has attempted suicide is more likely to try a second attempt and most have an underlying mental illness. There is many warming that someone may be in a suicide crisis. We most learn how to see things through their eyes. No matter what one is facing in life or the difficult that lie ahead of them Nothing is worth taken your own

3)Christina L. Boisseaua, Shirley Yen,John C. Markowitz,Carlos M.Grilo et al did a longitudinal study to identify characteristics that differentiate multiple suicide attempters from single attempters in people who suffered from personality disorders and depression.431 people participated from july 1996 to june 2008.Suicide attempts were assessed with a follow up evaluation at 6 and 12 months and then yearly through 10 years.21% of participants attempted

Medical care in America is estimated to cost $2.7 trillion each year with roughly 30 percent of that cost attributed to ineffective or redundant care, approximately $800 billion (America's Health Insurance Plans, 2014; FOX, 2010). Within this section $44.6 billion is attributed to suicide treatment and medical cost (Center for Disease Control and Prevention, 2015). The CDD further estimates that with approximately 40,000 people dying of suicide annually suicide contributes to the 10th leading cause of death for Americans, narrowly being outstrode by kidney disease and influenza yet still achieving a higher overall medical cost than the ninth and eighth ranked causes of death (Keren, Zaoutis, Saddlemire, Luan, & Coffin, 2006;Webberley, 2015).

Current psychological research on personality disorders aims to identify psychological and psychopathologic dynamics latent to violent behaviors. In

Individuals with Borderline Personality Disorder do not have any or very little, emotion or feelings, they are more likely to commit suicide. Borderlines are also confused about who they are and what their place is in this world (Halgin & Whitbourne, 2010). Approximately 75 percent of Borderlines hurt themselves and 10 percent of them commit suicide, compared to only 6 percent rate for people who commit suicide in mood disorders (Cloud, 2009). Some Borderlines hurt themselves only to seek out attention from others but some end up losing their lives because of a severe wound or over dosing. These individuals are trying to find a way to escape their depression, numbness, and over exaggerated emotions and most of the time they turn to alcohol and drugs to make them feel something. Once these factors are added to the Borderline Personality Disorder, the risk of over dosing is much higher than it is for someone who does not have this disorder.

Whilst risk factors have been found for suicide, there is no factor that leads directly to it. Many people without a specific factor will commit suicide and many people with the same factor will not. { Ortigo, Westen, and Bradley 2009} investigated the idea of an underlying personality vulnerability which interacts with these risk factors. Their study found “internalizing, emotionally dysregulated, dependent, hostile-isolated and anxious somatising” personality subtypes as at risk for suicide. This study looked at 311 patients who had attempted suicide, from a list of 1201 patients who has seen the participating clinicians in the past week using the CDF and SWAP-II (CDF – Clinical Data Form, Shedler-Westen Assessment Procedure-II). This method of selection removes completed attempters from the study which may affect the results on subtypes (as a particular personality subtype may use more effective/lethal methods). It also only includes patients known to services, whilst some suicidal personalities may not see a doctor or may withhold information on previous attempts.

DBT can be considered as variant of cognitive behavioral treatment that was originally developed to treat chronically suicidal individuals diagnosed with borderline personality disorder. DBT emerged out of Marsha Linehan’s clinical experience and research who was working with women having histories of chronic suicide attempts, suicidal ideation, and non-suicidal injury in the late 1970s. These patients were receiving standard CBT which was met with drop outs, ineffectiveness of standard CBT at handling multiple problems comorbid with BPD and a non collaborative, conflicting therapist client relationship producing therapy-interfering behaviours. Marsha Linehan in collaboration with her team made several modifications to the standard CBT, which

Borderline personality disorder (BPD) is a severe Axis 2 mental illness distinguished by a common pattern of mental impulsivity, interpersonal dysfunction, disrupted self-image, and self-harming behaviours (Chanen & Kaess, 2012; Leichsenring, Leibing, Kruse, New & Leweke, 2011). Between 0.7% and 2.7% of the population suffer from BPD, and 70% of BPD sufferers are reported to be female (Bateman, & Krawitz, 2013; Coid et al., 2006; Grant et al., 2008). Whilst BPD is predominantly seen as a disorder of the female gender, it is suspected that males are grossly underrepresented as male BPD sufferers are often found in substance rehabilitation facilities as well as in the prison system (Grant et al., 2008). It is also understood that due to the often comorbid nature of BPD, its symptoms are most often exacerbated by the presence of other mental illnesses (Commonly Axis 1 disorders) such as depression, anxiety, and substance abuse (Bateman, & Krawitz, 2013).

Suicide is currently the 10th leading cause of death in the United States (Suicide and Self-Inflicted Injury, 2017). On average, 121 Americans complete suicide each day (CDC Fatal Injuries Report 2015, 2015). The American people are living longer with advances to medical care and technology, yet suicide rates continue to rise. According to the CDC, suicide rates have increased by 24% from the year 1999 to 2014 (Curtain, Warner & Hedegaard, 2016). Consequently, the suicide epidemic continues to grow with no clear path to prevention. This literature review was conducted using the Robert Morris University Library online databases. Databases accessed include PubMed…………., from the years 2000 to 2017. Overall, most the articles obtained are