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Understanding the transition from suicidal thoughts to suicidal attempts

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If you have a question about this talk, please contact Rory O’Connor.

Please note that no registration is required for this event, and that parking is limited.

For our November C2:AD talk, we are delighted to be hosting:

Rory O’Connor (University of Glasgow)

Understanding the transition from suicidal thoughts to suicidal attempts

Background: Suicide and self-harm are major public health concerns with complex aetiologies which encompass a multifaceted array of risk and protective factors. There is growing recognition that we need to move beyond psychiatric categories to further our understanding of the pathways to both. Although there have been many advances in our understanding of suicide risk, our ability to predict suicidal behaviour remains no better than chance. New approaches to predicting suicidal behaviour focus on distinguishing between those who think about suicide and those who attempt suicide.

Methods: Although a comprehensive understanding of these determinants of suicidality requires an appreciation of biological, psychological and social perspectives, the focus in this presentation is primarily on the psychological determinants of self-harm and suicide. The Integrated Motivational–Volitional (IMV) Model of Suicidal Behaviour (O’Connor, 2011; O’Connor & Kirtley, 2018) provides a framework in which to understand suicide and self-harm. This tripartite model maps the relationship between background factors and trigger events, and the development of suicidal ideation/intent through to suicidal behaviour. Findings: We propose that defeat and entrapment drive the emergence of suicidal ideation and that a group of factors, entitled volitional moderators, govern the transition from suicidal ideation to suicidal behaviour. According to the IMV model, volitional moderators include access to the means of suicide, exposure to suicidal behaviour, capability for suicide (fearlessness about death and increased physical pain tolerance), planning, impulsivity, mental imagery and past suicidal behaviour. I will present a selection of empirical studies derived from the IMV model to illustrate how psychological factors increase suicide risk and what can be done to ameliorate such risk.

Discussion: The IMV model identifies 8 key pillars that govern the transition from suicidal thoughts to suicide attempts. Clinical interventions need to target the volitional phase factors to reduce the likelihood that suicidal thoughts are acted upon. The implications for the prevention of self-harm and suicide will also be discussed.

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