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Hennings J. Das Verstärkermodell der Suizidalität: Chronische Suizidalität bei der Borderline-Persönlichkeitsstörung verstehen und behandeln. Verhaltenstherapie 2021. [DOI: 10.1159/000518239] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Trotz großer Fortschritte in der evidenzbasierten Psychotherapie wird unser Versorgungssystem durch chronisch suizidale Patienten mit einer Borderline-Persönlichkeitsstörung (BPS) weiterhin stark herausgefordert. Die BPS ist mit einem hohen Suizidrisiko von 5–10% sowie einem hohen Selbstverletzungsrisiko von bis zu 80% behaftet. Therapeuten wie Angehörige fühlen sich oft überfordert und hilflos, wenn sie mit der Suizidalität der Patienten konfrontiert sind. Immer wieder kommt es so zu Therapieabbrüchen, Vorstellungen in Notaufnahmen oder akut-psychiatrischen Einweisungen. Bei der nichtsuizidalen Selbstverletzung (NSSV) – einem Verhaltensmuster, das gehäuft zusammen mit chronischer Suizidalität bei BPS auftritt – tragen Verstärkermechanismen (z.B. Nachlassen von Anspannung) dazu bei, dass sich Borderline-Patienten trotz längerfristig unangenehmen Folgen immer wieder selbst verletzen. Die Motive für NSSV und suizidales Verhalten können sehr unterschiedlich sein. Es spricht jedoch einiges dafür, dass die zugrunde liegenden Mechanismen ähnlich sind und sich hieraus wichtige therapeutische Interventionsmöglichkeiten ableiten lassen. In dieser Übersichtsarbeit werden die Hintergründe und Unterschiede von NSSV, Suizidideationen sowie Suizidversuchen bei chronisch suizidalen Borderline-Patienten dargestellt. Neuere Erkenntnisse der modernen Neuro- und Verhaltenswissenschaft werden in ein Verstärkermodell der Suizidalität integriert, von dem verhaltenstherapeutische Interventionen abgeleitet werden, die Therapeuten in ihrer Arbeit mit chronisch suizidalen Patienten unterstützen können.
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Hennings JM. Function and Psychotherapy of Chronic Suicidality in Borderline Personality Disorder: Using the Reinforcement Model of Suicidality. Front Psychiatry 2020; 11:199. [PMID: 32256412 PMCID: PMC7093558 DOI: 10.3389/fpsyt.2020.00199] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 03/02/2020] [Indexed: 12/12/2022] Open
Abstract
Although great advancements in evidence-based therapies, chronic suicidal patients with borderline personality disorder (BPD) still challenge our mental health system. While BPD patients continue suffering from distress and aversive emotions, therapists and relatives feel often stunned and helpless when confronted with suicidality resulting in interruption of therapies, repeated presentations to emergency rooms and referrals to hospitals. Reviewing the current knowledge of the functions and background of non-suicidal self-injury, we learned that reinforcement mechanisms play an important role to understand why individuals act in deliberate self-mutilation. While individual motives for non-suicidal self-injury and suicidal behavior including suicidal ideations can differ, the principle mechanisms appear to be transferrable. Elucidating the individual motives and function of suicidal behavior is an important therapeutic step, giving us access to very central maladaptive schemes and false believes that we need to address in order to reduce chronic suicidality in BPD patients. This Perspective article aims to give a better idea of what is behind and what are the differences between non-suicidal self-injury, suicidal ideations and suicide attempts. It further integrates recent developments of behavioral science in a reinforcement model of suicidality that can provide therapists a practical armamentarium in their work with chronic suicidal clients.
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Affiliation(s)
- Johannes M. Hennings
- Department of Dialectical Behavioral Therapy, kbo-Isar-Amper-Klinikum Munich-East, Munich, Germany
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van den Hondel KE, Punt P, Dorn T, Ceelen M, Reijnders U. The rise of suicides using a deadly dose of barbiturates in Amsterdam and Rotterdam, the Netherlands, between 2006 and 2017. J Forensic Leg Med 2020; 70:101916. [DOI: 10.1016/j.jflm.2020.101916] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 01/17/2020] [Accepted: 01/19/2020] [Indexed: 11/23/2022]
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Tran US, Andel R, Niederkrotenthaler T, Till B, Ajdacic-Gross V, Voracek M. Low validity of Google Trends for behavioral forecasting of national suicide rates. PLoS One 2017; 12:e0183149. [PMID: 28813490 PMCID: PMC5558943 DOI: 10.1371/journal.pone.0183149] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 07/30/2017] [Indexed: 11/18/2022] Open
Abstract
Recent research suggests that search volumes of the most popular search engine worldwide, Google, provided via Google Trends, could be associated with national suicide rates in the USA, UK, and some Asian countries. However, search volumes have mostly been studied in an ad hoc fashion, without controls for spurious associations. This study evaluated the validity and utility of Google Trends search volumes for behavioral forecasting of suicide rates in the USA, Germany, Austria, and Switzerland. Suicide-related search terms were systematically collected and respective Google Trends search volumes evaluated for availability. Time spans covered 2004 to 2010 (USA, Switzerland) and 2004 to 2012 (Germany, Austria). Temporal associations of search volumes and suicide rates were investigated with time-series analyses that rigorously controlled for spurious associations. The number and reliability of analyzable search volume data increased with country size. Search volumes showed various temporal associations with suicide rates. However, associations differed both across and within countries and mostly followed no discernable patterns. The total number of significant associations roughly matched the number of expected Type I errors. These results suggest that the validity of Google Trends search volumes for behavioral forecasting of national suicide rates is low. The utility and validity of search volumes for the forecasting of suicide rates depend on two key assumptions ("the population that conducts searches consists mostly of individuals with suicidal ideation", "suicide-related search behavior is strongly linked with suicidal behavior"). We discuss strands of evidence that these two assumptions are likely not met. Implications for future research with Google Trends in the context of suicide research are also discussed.
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Affiliation(s)
- Ulrich S. Tran
- Department of Basic Psychological Research and Research Methods, School of Psychology, University of Vienna, Vienna, Austria
- Wiener Werkstaette for Suicide Research, Vienna, Austria
| | - Rita Andel
- Department of Basic Psychological Research and Research Methods, School of Psychology, University of Vienna, Vienna, Austria
- Wiener Werkstaette for Suicide Research, Vienna, Austria
| | - Thomas Niederkrotenthaler
- Wiener Werkstaette for Suicide Research, Vienna, Austria
- Suicide Research Unit, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Benedikt Till
- Wiener Werkstaette for Suicide Research, Vienna, Austria
- Suicide Research Unit, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | | | - Martin Voracek
- Department of Basic Psychological Research and Research Methods, School of Psychology, University of Vienna, Vienna, Austria
- Wiener Werkstaette for Suicide Research, Vienna, Austria
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Scheidemann JH, Petermann F, Schipper M. Are Deficits in Social Cognition Linked to Autobiographical Memory in Patients with Alzheimer’s Disease? Zeitschrift für Neuropsychologie 2016. [DOI: 10.1024/1016-264x/a000187] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract. We investigated theory of mind (ToM) deficits in Alzheimer‘s disease (AD) and its possible connection to autobiographical memory (ABM). Patients and matched controls were evaluated and compared using a video-based ToM test, an autobiographical fluency task, and a neuropsychological test battery. We found that ToM deficits were positively associated with semantic ABM in the clinical group, whereas a positive relationship appeared between ToM and episodic ABM in controls. We hypothesize that this reflects the course of the disease as well as that semantic ABM is used for ToM processing, being still accessible in AD. Furthermore, we assume that it is also less efficient, which in turn leads to a specific deficit profile of social cognition.
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Affiliation(s)
| | - Franz Petermann
- Center for Clinical Psychology and Rehabilitation, University of Bremen
| | - Marc Schipper
- Center for Clinical Psychology and Rehabilitation, University of Bremen
- Department of Prevention and Health Promotion, APOLLON University of Applied Sciences Bremen
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Müller N, Baumeister S, Dziobek I, Banaschewski T, Poustka L. Validation of the Movie for the Assessment of Social Cognition in Adolescents with ASD: Fixation Duration and Pupil Dilation as Predictors of Performance. J Autism Dev Disord 2016; 46:2831-44. [DOI: 10.1007/s10803-016-2828-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Affiliation(s)
- Keith Harris
- The University of Queensland, School of Psychology, St Lucia, Queensland, Australia
| | - John McLean
- The University of Queensland, School of Psychology, St Lucia, Queensland, Australia
| | - Jeanie Sheffield
- The University of Queensland, School of Psychology, St Lucia, Queensland, Australia
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Schneider B, Fritze J, Georgi K, Grebner K. [Do individuals with substance use disorders find information for crisis intervention and suicide prevention resources on the Internet?]. Nervenarzt 2012; 82:859-65. [PMID: 20383485 DOI: 10.1007/s00115-010-2974-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND OBJECTIVE Suicidality is an important issue for substance-dependent people. The few studies about Internet searches have provided ambiguous results regarding help and support using suicide-related terms. MATERIAL AND METHODS Five popular search engines and several substance use- and suicide-related German search terms were used; the search results were classified as being pro-suicide, anti-suicide, suicide-neutral, websites not associated with suicide or "page could not be loaded". RESULTS The majority of identified websites was not associated with suicide at all, whereas websites offering help and support were less frequent. Using suicide-associated search terms (such as "Selbsttötung") almost half of all web pages were help sites. Websites with instructions for committing suicide were very rarely found. CONCLUSIONS In view of the difficulties for substance abusers to get immediate and adequate information about help and support in a suicidal crisis via the Internet, it is urgently necessary to extend fast available help sites on the Internet.
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Affiliation(s)
- B Schneider
- Zentrum der Psychiatrie, Klinik für Psychiatrie, Psychosomatik und Psychotherapie, Goethe-Universität, Heinrich-Hoffmann-Straße 10, 60528, Frankfurt am Main, Deutschland.
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Abstract
Background: The Internet is commonly used to advertise and sell medications and dietary supplements directly to consumers. Prescriptions are often not needed, and consumers may engage in unmonitored and risky health practices. No systematic attempt has been made to evaluate reported cases of adverse events following such purchases. Objective: To systematically identify and examine reported cases of adverse events associated with the purchase of medications and dietary supplements from the Internet. Methods: MEDLINE (1990-June 2009), EMBASE (1990-June 2009), IBIDS (to June 2009), TOXNET (to June 2009), bibliographies of identified articles, and Web sites of relevant health ministries and professional associations in the US and Canada were reviewed to identify eligible articles that describe adverse events associated with the purchase of medications or dietary supplements from the Internet. Results: Thirty-two reports of 41 cases of adverse consequences of pharmaceutical products (n = 31) or dietary supplements (n = 10) were identified. Purchases were made by people in the 30- to 50-year-old age group in 36% of cases. Prescription medications were implicated in 27% of cases and narcotic and controlled drugs were implicated in 49% of cases. Drug abuse was responsible for harm in 73% of cases, whereas adverse drug reactions occurred in 27% of cases. Nine (22%) patients died as a result of adverse consequences following such purchases. The remaining patients suffered serious adverse events such as seizures, liver damage, and hallucinations. Conclusions: An unexpectedly large number of case reports were identified from the literature; however, these reports do not fully illustrate the magnitude of the problem. Life-endangering adverse consequences signify a need for increased regulation and control of Internet Web sites and a need for healthcare provider involvement. Pharmacists should know where their patients obtain medications, how to verify the validity of the sources of prescriptions, and how to report adverse consequences.
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Affiliation(s)
- Della Kwan
- DELLA KWAN BScPhm MSc, Graduate Student, Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Joseph Beyene
- JOSEPH BEYENE MSc PhD, Associate Professor, Research Institute of the Hospital for Sick Children, Dalla Lana School of Public Health, University of Toronto
| | - Prakesh S Shah
- PRAKESH S SHAH MSc MBBS MD DCH MRCP MRCPCH FRCPC, Associate Professor, Department of Paediatrics and Department of Health Policy, Management and Evaluation, Mount Sinai Hospital and University of Toronto
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Strubel T, Birkhofer A, Eyer F, Werber K, Förstl H. Suizidversuch durch Schlangenbiss: Kasuistik und Literaturübersicht. Nervenarzt 2008; 79:604-6. [DOI: 10.1007/s00115-008-2431-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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