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Dyadic process and dynamics of caregiving and receiving in suicide recovery among Filipino college-aged students and their families
Abstract
With the increasing incidence of suicidality among the youth, identifying effective care and support that family members provide is essential. Despite numerous studies on the link between suicide mitigation and caregiving, the dyadic process and dynamics of family members supporting youth at risk have been scarcely explored. This study utilizes grounded theory to explore the actions, interactions, and processes involved in caregiving and receiving between five pairs of Filipino family caregivers and college-aged care receivers who recovered from suicidality. The study gave rise to a seven-phase model that characterizes the dynamic dyadic interactions between the family caregiver and the youth care receiver. This is summarized in the acronym C2 A2 R2 E, which means calling-on, contemplating, accepting, allowing, responding, reciprocating, and empowering. This model highlights the processes and dynamics of care within families, which may be useful in paving the way for families and mental health professionals to foster more effective support in mitigating suicidality among youth at risk.
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i s Th a i se A. Ci m e n e 1 *, M ib zar L. Bu k o 1 a n d Ian M ark Q. Na cay a 2 1 C en te r fo r I n c lu siv e D ev elo p m en t S tu d i es (CI DS) , Un iv er s ity o f S cie n ce an d T ech n o lo g y o f So u th ern Ph i lip p in e s (UST P) , C.M. Re cto Av en u e, Lap a san , Cag ay a n d e Oro C i ty 9 0 0 0 , Ph i lip p in e s 2 C ity Go v er n m en t o f Ca g ay an d e Or o , Ph i lip p in es ARTICLE INFO ABSTRACT The study aimed to find out the common causes of suicide in relation to socio-demographic factors in Cagayan de Oro (CDO), Philippines. Only secondary data were gathered which were already publicly published. Results revealed that the common causes of suicide were depression, family problem, financial problem, work pressure and the COVID-19 pandemic. The socio-demographic factors were age, sex, location, civil status and economic status (with or without employment). The highest percentage (37.18%) was due to depression followed by family problem (21.79%). The most number of suicide cases was found among males (82.05%) as compared to females (15.38%) and lesbian, gay, bisexual and transgender (LGBT) (2.56%). A total of 78.20% of cases came from urban part while only 21.80% were from rural area. Results revealed that the socio-demographic factors significantly predict the causes of suicide (p = .053). Among the factors, only the location had a significant coefficient (β = 1.41, p = .22) which indicated that the propensity of suicide cases were mostly at urban areas. The regression analysis identified were age, sex, location, and civil status as predictors of completed suicide cases. In conclusion, depression was the most common cause of suicide particularly among single individuals in the urban area.
The alarmingly increasing prevalence rate of suicide makes it a major public health concern worldwide. Nevertheless, suicidality is preventable and manageable given the continuous efforts to fully understand it. This grounded study examined the process of suicide recovery among a selection of Filipino youth aged 15 to 27. Twenty-five survivors of suicide attempts were purposively selected and went through in-depth interviews. Emerging categories were monitored until all new data fitted into existing categories and no new data surfaced from further theoretical sampling, indicating theoretical saturation. Theoretical triangulation aided in making the findings comprehensive. Peer debriefing and member validation were conscientiously employed to yield a substantive theory called the Inflorescence Model of Suicide Recovery. This model likened suicide recovery to the processes that a flowering plant goes through. It elucidates the phases of suicide recovery: (1) immersion: the acknowledgment of brokenness and vulnerabilities; (2) germination: the process of splitting off the seed coat of emotional pains; (3) emersion: the sprouting from the soil; (4) entrenchment: the process of rooting deeper; and (5) inflorescence: the flourishing and sustaining of suicide recovery. The Inflorescence Model of Suicide Recovery can contribute to the development of recovery-focused psychological intervention and management strategies for youths suffering from suicidality.
Current studies show that the Christian faith is still robust in Philippine society and culture despite the global health crisis. This study investigates how select Filipino Christian youths intuited God’s benevolent love in the time of “social distancing” and how their experience of God’s benevolence helped them to carry on despite the COVID-19 pandemic. The authors administered open-ended survey questions about God’s love to select Filipino Christian youths. The responses were analyzed using thematic analysis and categorizations. Using contextual analysis, the researchers critically reflected upon the respondents’ notions of God’s love and religious experiences from the two poles of Filipino culture and Judeo-Christian tradition. According to select Filipino Christian youths, God is present and faithful. God’s “kagandahang-loob” (benevolent love) for human persons is evinced in the care and kindness of family members and neighbors. God also enables human persons to prevail over challenges in life, such as the COVID-19 pandemic. Moreover, God is the ultimate source of Christian hope. This hope is firmly anchored in Jesus Christ and the Church. Furthermore, God is forgiving and merciful. He continues to bless and give graces to human persons despite their sinfulness. These contemporary conceptualizations of God’s perfect interior goodness helped the select Filipino Christian youths cope with the COVID-19 pandemic.
Caring for a family member with a serious mental illness often has an impact on the quality of life (QoL) of caregivers. This could have negative repercussions on their caring skills and thus affect the care provided to that individual. The aim of this paper is to identify current evidence on QoL factors affecting relatives of individuals suffering from serious mental illness. A systematic review related to the research question was conducted in six databases by two independent reviewers. The QoL factors of relatives include sociodemographic, contextual, psychological, physical, and patient factors. The findings are consistent with the results of previous research. Mental health professionals may support a family with a member diagnosed with a serious mental illness by enhancing their education about QoL factors, which would trigger and promote protective factors so that family members could assess and act on them on an ongoing basis.
This work is a descriptive study of the factors affecting the 2016-2017 suicide phenomenon in Cebu City, Philippines, based on the responses of the victims' significant others. Despite the surge of suicide cases in the country (there is an increasing rate since 1992), however, to date, there are not so many scholarly researches and comprehensive studies done on the subject. Given that suicide remains a serious public concern across the globe, and even more so in the Philippines, we strongly believe that discovering the factors why suicide cases happen is not only relevant and important but also very much necessary and called for, especially that there is almost a never-ending new addition to suicide statistics in many places. It is in the light of this present necessity that this study examined what triggered the suicide phenomenon in Cebu City based on: a) the occasion of the suicide; b) the social location of the suicide; and c) the reasons for the commission of the suicide according to: c1) sociocultural factors and c2) psychological factors. This study employed guided interview with the suicide victims' significant others-persons related to the victims themselves either by affinity or consanguinity. The results revealed that the 2016-2017 suicide trend in Cebu City was more a phenomenon among males who were between 25-40 years old, married or cohabiting, graduates of secondary education, unemployed, and Catholics. The results further indicated that social factors and psychological factors played a significant role in the victims' commission of suicide based on the responses of their significant others.
Religion is recognized as an influential social institution in the Philippines, yet religiosity and spirituality are rarely studied in the context of Filipino family and parent–child relationships. We examine the direct associations of religiosity and spirituality with the psychological well-being and parenting behaviors of 115 mothers and 83 fathers residing in urban neighborhoods in the Philippines. Participants completed orally administered questionnaires on engagement in religious activities, spiritual beliefs, hope, psychological distress, warmth, and harsh parenting. Analyses using structural equation modeling showed that engagement in religious activities was significantly associated with the higher levels of hope and less frequent harsh parenting. In addition, parental warmth had a stronger positive association with spiritual beliefs than with engagement in religious activities. Neither religious activity engagement nor spiritual beliefs were significantly associated with psychological distress. We discuss shared and distinct aspects of religiosity and spirituality that may explain their associations with positive parenting outcomes, and highlight the potential benefits of spiritual beliefs and experiences within the Filipino family context.
Using four datasets obtained from the World Health Organization’s Global School-based Student Health Surveys (GSHS) for the Philippines (2003, 2007, 2011, 2015) that involved high school students from private and public educational institutions in the country, the study aimed to discover the significant risk and protective factors of suicide ideation, suicide planning, and suicide attempts among the population under study. Results of the study identified several significant predictors of suicide risk from the four timeframes with two factors emerging as the most salient: (1) lack of sleep and (2) number of close friends emerging as the most salient push and pull factors of suicide respectively. This finding highlights the need for greater integration with one’s peer groups during a person’s life in secondary education and brings to fore the necessity to rethink the amount of activities that high school students engage in at the expense of their sleeping hours. The implications of the results of the study, particularly of the two most salient predictors of suicide, are discussed in the paper.
The increasing number of adolescents at risk of non-suicidal self-injurious (NSSI) behaviors has caused concern among mental health professionals and researchers. Prior studies have revealed the classification, pervasiveness, correlates, forms, and functions of NSSI; however, the behavioral dynamics are still unexplored. In order to bridge this knowledge gap, a sequential-explanatory study was conducted to illustrate, describe, and understand the behavioral dynamics of Filipino adolescents at risk of NSSI. Fifty-one participants completed a battery of psychological tests to measure personality traits and five were interviewed. Results revealed that adolescents at risk for NSSI exhibited high levels of neuroticism and openness to experience but low levels of extraversion and conscientiousness. Borderline personality traits were also common among adolescents with NSSI as evidenced by high levels of impulsivity, affective instability, abandonment, and emptiness, but low levels of interpersonal relationships, and self-image. A model fit further signified that only neuroticism and borderline personality traits moderately influence NSSI. Additionally, from the rich and detailed interpretation of the interviews gathered in this study, an interesting description of behavior was identified which includes (a) disturbed, (b) diverted and (c) devitalized behavior. A descriptive circuitry model emerged illustrating the behavioral dynamics of adolescents engaging with NSSI as a product of the intersection of personality and behavior.
The prominence of mental health advocacies in mainstream media and public discourse in
recent years brings to fore the social problem of suicide in the Philippines, necessitating an attempt to bring
a greater understanding of suicide to the discussion. This study made use of a nationally-representative
sample of Filipino youth with ages ranging from 15 to 27 to determine the individual- and community-level
factors that predict the risk of engaging in a suicide attempt among Filipino young suicide ideators. Data
were analyzed using binary logistic regression as the main statistical instrument, and a composite
theoretical framework borne from Hirschi’s Social Bonds Theory of Deviance and Agnew’s Social Strain
theory of Deviance served as the theoretical framework that guided the study. The study found ten different
variables to be significantly predictive of suicide attempt among suicide ideators at 95% level of confidence.
Most notable of these ten predictors are (1) relationship with one’s father, (2) exposure to other suicidal
individuals, and (3) counselling. The implications of these findings to the current Philippine response to
the social problem of suicide are discussed in the study.
Objective:
To present the validation of a theoretical model through conversation circles in a qualitative research guided by the Grounded Theory.
Method:
Study carried out from a thesis developed in a reference hospital in the south region of Brazil. Two conversation circles happened, with participation of representatives of the “Training Prism”, in the months of October and November, 2016.
Results:
The conversation circle enabled an in depth dialogic approach of the subject of research, broadening the vision on the phenomenon and on the research. The circle also mobilized thinking as it highlighted the subjectivity of individuals, expanding the group’s ability of understanding and assisting in the validation process of a theoretical model.
Conclusion:
The conversation circle emerges as a powerful strategy for the development of qualitative research in nursing, more specifically in the validation step of the Grounded Theory.
Objective: To evaluate the efficacy of Attachment-based Family Therapy (ABFT) compared to a Family Enhanced Non-Directive Supportive Therapy (FE-NST) for reducing adolescents’ suicide ideation and depressive symptoms. Method: A randomized controlled trial of 129 suicidal adolescents, between the ages of 12 to 18, 49% of whom were African-American, were randomized to ABFT (N = 66) or FE-NST (N = 63) for 16 weeks of treatment. Assessments occurred at baseline, 4, 8, 12, and 16 weeks. Trajectory of change and clinical recovery were calculated for suicidal ideation and depressive symptoms. Results: There was no significant between-group difference in the rate of change in self-reported ideation (SIQ-JR) (F (1, 127) = 1.81, p = 0.18). Similar results were found for depressive symptoms. However, adolescents within the ABFT condition showed significant reductions in suicide ideation (t (127) = 12.61, p < .0001) with an effect size of d = 2.24. Adolescents in the FE-NST condition experienced a similar significant reduction (t (127) = 10.88, p < .0001) with an effect size of d = 1.93. Response rates (i.e. 50% or more reduction in suicide ideation symptoms from baseline) at post-treatment were 69.1% for ABFT versus 62.3% for FE-NST. Conclusion: Contrary to expectations, ABFT did not perform better than FE-NST. Both treatments produced substantial reductions in suicidal ideation and depressive symptoms that were comparable to those reported in other treatment studies of more intensive, longer, multicomponent therapies. The equivalent outcomes may be attributed to factors that include common treatment elements, different active mechanisms, or regression to the mean. Future studies will explore long-term follow up outcomes, secondary outcomes and potential treatment moderators and mediators.
Objective: This study aims to examine the provision of assistance among older persons in the Philippines who experience difficulty with activities of daily living (ADLs) or instrumental activities of daily living (IADLs). Method: Data for this research are drawn from the 2007 Philippine Study on Aging (PSOA). Cross-tabulations and regression analyses are used to identify who provides assistance to older Filipinos. Results: The study shows that the Filipino family, particularly spouse and daughters, plays an important role in providing assistance to older Filipinos who need help in carrying out functional activities. This provision of caregiving, however, follows a gendered pattern. Specifically, the spouse provides assistance to older men, whereas daughters provide assistance to older women. Grandchildren and noncoresident family members, to some extent, are also active in providing care to older Filipinos. Discussion: The Filipino family remains faithful to its filial duty toward older persons, but who provides care and the way it is provided are likely to change due to the demographic changes and values shifts that have swept the country.
Background
As with most of the chronic illnesses, the changes and consequences brought on by bipolar disorder (BD) are not exclusive to the patient and often spread to those around them, especially for direct caregivers of these patients. It is known that there is a significant emotional and physical toll among persons who coexist daily with those who suffer from this disorder.
Objective
Aware of the importance of the role played by informal caregivers (especially the family) in the stability and evolution of patients with bipolar disorder, this study seeks to explore the perception that family members responsible for bipolar persons have of themselves as caregivers of these patients.
Method
This is a qualitative study using a phenomenological design, for which the technique of focused or semi-structured interviews was employed. Ten caregivers of people with diagnosis of BD agreed to participate.
Results
Within the family, it is a single individual who has the role of caregiver. Experiences and meanings that are generated into the nucleus of the patient–caregiver relationship are full of ambivalence and involve many aspects worthy of analysing, such as the development of identities, the feminization of patient care, the process of therapeutic decision-making and the evolution of the disease.
Conclusions
It is necessary to integrate evaluation and attention for patients’ caregivers, recognizing them as individuals and elucidating their constructed meanings and the dynamics established in their relationship with patients. In this way, there would be a more integrative clinical approach of the patient–caregiver relationship, considering not only the necessary pharmacological treatments but also accompanying both patient and family, along the path they travel as they experience BD.
The aim of this paper is to provide a discussion that is broad in both depth and breadth, about the concept of data saturation in Grounded Theory. It is expected that this knowledge will provide a helpful resource for (a) the novice researcher using a Grounded Theory approach, or for (b) graduate students currently enrolled in a qualitative research course, and for (c) instructors who teach or supervise qualitative research projects. The following topics are discussed in this paper: (1) definition of data saturation in Grounded Theory (GT); (2) factors pertaining to data saturation; (3) factors that hinder data saturation; (4) the relationship between theoretical sampling and data saturation; (5) the relationship between constant comparative and data saturation; and (6) illustrative examples of strategies used during data collection to maximize the components of rigor that Yonge and Stewin (1988) described as Credibility, Transferability or Fittingness, Dependability or Auditability, and Confirmability. © 2018: Khaldoun M. Aldiabat, Carole-Lynne Le Navenec, and Nova Southeastern University.
Objective
This study examined national trends in the prevalence of suicidal ideation and behavior among young adults and receipt of mental health care among suicidal young adults.
Method
We examined restricted data from 145,800 persons aged 18-25 who participated in the 2009-2015 National Surveys on Drug Use and Health. Descriptive analyses and bivariable and multivariable logistic regressions were applied.
Results
Among US young adults during 2009-2015, the 12-month prevalence of suicidal ideation increased from 6.1% to 8.3%, the 12-month prevalence of suicide plan increased from 2.0% to 2.7%, and 12-month prevalence of suicide attempt increased from 1.1% to 1.6%. After adjusting for personal factors and changes in residing county’s population characteristics, we found upward trends in suicidal ideation among non-Hispanic whites and Hispanics, an upward trend in suicide plan among young adults overall, and an upward trend in suicide attempt among those without major depressive episodes (MDE). Among young adults with MDE, the prevalence of suicide attempt remained high and unchanged. During 2009-2015, trends in receipt of mental health care remained unchanged among most suicidal young adults and declined slightly among uninsured suicidal young adults. The annual average prevalence of receipt of mental health care was 36.2% among suicidal young adults.
Conclusion
During 2009-2015, suicidal ideation, suicide plan, and suicide attempt increased among young adults overall, but receipt of mental health care among suicidal young adults did not increase. Our results suggest that effective efforts are needed for suicide prevention and promotion of mental health care among young adults.
Over the past decade, the interpersonal theory of suicide has contributed to substantial advances in the scientific and clinical understanding of suicide and related conditions. The interpersonal theory of suicide posits that suicidal desire emerges when individuals experience intractable feelings of perceived burdensomeness and thwarted belongingness and near-lethal or lethal suicidal behavior occurs in the presence of suicidal desire and capability for suicide. A growing number of studies have tested these posited pathways in various samples; however, these findings have yet to be evaluated meta-analytically. This paper aimed to (a) conduct a systematic review of the unpublished and published, peer-reviewed literature examining the relationship between interpersonal theory constructs and suicidal thoughts and behaviors, (b) conduct meta-analyses testing the interpersonal theory hypotheses, and (c) evaluate the influence of various moderators on these relationships. Four electronic bibliographic databases were searched through the end of March, 2016: PubMed, Medline, PsycINFO, and Web of Science. Hypothesis-driven meta-analyses using random effects models were conducted using 122 distinct unpublished and published samples. Findings supported the interpersonal theory: the interaction between thwarted belongingness and perceived burdensomeness was significantly associated with suicidal ideation; and the interaction between thwarted belongingness, perceived burdensomeness, and capability for suicide was significantly related to a greater number of prior suicide attempts. However, effect sizes for these interactions were modest. Alternative configurations of theory variables were similarly useful for predicting suicide risk as theory-consistent pathways. We conclude with limitations and recommendations for the interpersonal theory as a framework for understanding the suicidal spectrum.
The current paper presents recommendations from the Task Force on Resources for the Publication of Qualitative Research of the Society for Qualitative Inquiry in Psychology, a section of Division 5 of the American Psychological Association. This initiative was a response to concerns by authors that reviews of qualitative research articles frequently utilize inflexible sets of procedures and provide contradictory feedback when evaluating acceptability. In response, the Task Force proposes the concept of methodological integrity and recommends its evaluation via its two composite processes: (a) fidelity to the subject matter, which is the process by which researchers develop and maintain allegiance to the phenomenon under study as it is conceived within their tradition of inquiry, and (b) utility in achieving research goals, which is the process by which researchers select procedures to generate insightful findings that usefully answer their research questions. Questions that guide the evaluation of these processes, example principles, and a flowchart are provided to help authors and reviewers in the process of both research design and review. The consideration of methodological integrity examines whether the implementation of fidelity and utility function coherently together. Researchers and reviewers also examine whether methods further the research goals, are consistent with researchers’ approaches to inquiry, and are tailored to the characteristics of the subject matter and investigators. This approach to evaluation encourages researchers and reviewers to shift from using standardized and decontextualized procedures as criteria for rigor toward assessing the underlying methodological bases for trustworthiness as they function within research projects.
The trustworthiness of results is the bedrock of high quality qualitative research. Member checking, also known as participant or respondent validation, is a technique for exploring the credibility of results. Data or results are returned to participants to check for accuracy and resonance with their experiences. Member checking is often mentioned as one in a list of validation techniques. This simplistic reporting might not acknowledge the value of using the method, nor its juxtaposition with the interpretative stance of qualitative research. In this commentary, we critique how member checking has been used in published research, before describing and evaluating an innovative in-depth member checking technique, Synthesized Member Checking. The method was used in a study with patients diagnosed with melanoma. Synthesized Member Checking addresses the co-constructed nature of knowledge by providing participants with the opportunity to engage with, and add to, interview and interpreted data, several months after their semi-structured interview.
The goal of this study was to examine these two values (utang na loob and gratitude) in terms of how they are understood by Filipinos and how they are manifested in the hope of delineating meanings and establishing links between the two construct. Using qualitative responses of Filipino respondents regarding their conception of utang na loob and gratitude, the following descriptions were identified: pagkilala (acknowledgement), pagtutumbas (reciprocity), and panlipunang gampanin (social responsibility) as conceptual meanings for utang na loob; and pasasalamat (thankfulness) and pagtutumbas (reciprocity) for gratitude. Reciprocity being found to be shared by two concepts was also analyzed and contextualized.
Failure to reach data saturation has an impact on the quality of the research conducted and hampers content validity. The aim of a study should include what determines when data saturation is achieved, for a small study will reach saturation more rapidly than a larger study. Data saturation is reached when there is enough information to replicate the study when the ability to obtain additional new information has been attained, and when further coding is no longer feasible. The following article critiques two qualitative studies for data saturation: Wolcott (2004) and Landau and Drori (2008). Failure to reach data saturation has a negative impact on the validity on one’s research. The intended audience is novice student researchers. © 2015: Patricia I. Fusch, Lawrence R. Ness, and Nova Southeastern University.
Limited research exists that examines the contribution of family factors to the development and treatment of suicide. Although suicidal behavior occurs within an individual, the context in which it occurs can add necessary insights for understanding and preventing suicide. In this article, the existing literature on the family’s psychosocial role in the development of suicidal behavior is reviewed. Additionally, a review of the limited research on the family’s role in treatment following a suicidal action is provided. Finally, several directions for future research and clinical work are discussed to enhance our understanding of the family’s role in preventing suicide.
Background
Despite the strong influence of culture on family involvement in disease management, few studies have examined how immigrant families care for persons with mental illness. The purpose of this study was to examine how immigrant families organize their world to care for a mentally ill person in the United States. The current analysis focused on how Confucian notions of filial piety and parental obligation shape caregiving in Korean immigrant families.
Methods
Participants in this interpretive phenomenological study were comprised of six Korean immigrant women caring for a family member with mental illness. Participants provided narratives that illustrate challenges and opportunities in caring for their mentally ill family member.
Results
Three family caregiving patterns were discerned. Insulating from the outside world describes a family’s effort to accept a member's illness and to manage it within the family. Prioritizing education over well-being concerns parental commitment to the Confucian priority of educating one’s children. Reciprocating the sacrifice describes how a family adapts and enacts filial piety.
Conclusion
The findings of this study warrant further study to examine the influence of Confucianism among Korean American families. The three patterns of caregiving are strongly aligned with Confucian notion of family and family engagement. These patterns may help health providers to anticipate the needs of and provide individualized, culturally appropriate mental health care for patients with mental illness and their families of Korean origin.
The purpose of the present chapter is to provide a comprehensive framework for understanding caregiving as a behavioral system in its own right—that is, as an organized set of behaviors guided by a representation of the current parent-child relationship (George & Solomon, 1989, 1996; Solomon & George, 1996, 2000). A unique contribution of this chapter is to emphasize the importance for the parent of making a shift away from seeking protection and proximate care from attachment figures (the function and goal of attachment for the child) to providing protection, comfort, and care for a child (the function and proximate goal for the parent). This shift is fundamental to understanding the meaning of and motivation underlying critical aspects of parental behavior, cultural differences in providing care, the development of the child's quality of attachment, and the mechanisms of intergenerational transmission. The first section of this chapter outlines the components of a behavioral systems approach to caregiving. We next describe the caregiving system in relation to interactions and competition among behavioral systems. This discussion leads us to define the construct of "flexible care." We next discuss what little is known about the ontogeny of a mother's caregiving system, including potential influences in childhood, adolescence, and the transition to parenthood (pregnancy and childbirth). The final major section discusses representational models of caregiving. The predominant focus of caregiving researchers to date has been on describing the representational mechanisms that underlie maternal sensitivity. We complete our caregiving model by contrasting these approaches with our own, which defines caregiving representation in terms of flexibility and of organizing and disorganizing forms of defensive exclusion. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Using qualitative data collected from adolescent Latinas and their parents, this article describes ways in which family relationships are organized within low-income Latino families (n = 24) with and without a daughter who attempted suicide. Based on a family-level analysis approach, we present a framework that categorizes relationships as reciprocal, asymmetrical, or detached. Clear differences are identified: Families of nonattempters primarily cluster in reciprocal families, whereas families with an adolescent suicide attempter exhibit characteristics of asymmetrical or detached families. Our results highlight the need for detailed clinical attention to family communication patterns, especially in Latino families. Clinicians may reduce the likelihood of an attempt or repeated attempts by raising mutual, reciprocal exchanges of words and support between parents and daughter.
This study determined the effect of Cognitive Behavioral Therapy (CBT) group counseling on the psychological well-being of self-harming emerging adults. It utilized the pretest-posttest control group design. The Self-Harm Inventory (SHI) was used to determine self-harming emerging adults. There were no significant relationships among the socio-demographic variables and the level of severity of self-harm of 30 college students. The intervention was a four session CBT group counseling. The Depression, Anxiety, and Stress Scale – 21 (DASS-21) was used to measure psychological well-being. There were eight participants in the experimental group and nine participants in the control group. The results of the study revealed significant differences in the psychological well-being of the experimental group and the control group after the intervention. The findings suggest implications in school guidance and counseling programs to address the mental health issues of emerging adults.
This study sought to understand the experiences of intergenerational caregiving among urban poor women belonging to the Sandwich Generation that is individuals who care for both their children and aging parents. Guided by Interpretative Phenomenological Analysis, we explored the experiences of eight Filipina mothers. Results revealed how societal/cultural expectations contributed to their willingness to accept the responsibility to be intergenerational caregivers, and how socioeconomic conditions influenced the existence of this care cycle. Findings point to how financial, material and policy support from government and workplaces may enable better provision of care for the parents and children of urban poor Filipino women as well as allow for self-care. Reframing traditional gender roles especially in child-rearing as well as discouraging culturally-shaped practices that engender the continuation of the care cycle through education may help in addressing the structurally enabled challenges experienced by women in the Sandwich Generation.
A growing number of adolescents who engage in non-suicidal self-injury (NSSI) have been reported worldwide. Despite numerous investigations about NSSI, this self-harming behavioral process mostly found among adolescents has not been examined much in non-western countries like the Philippines. This grounded theory study purports to investigate and understand the dynamic process of deliberate self-harm among 20 Filipino adolescents performing non-suicidal self-injury. Field texts were analyzed using repertory grid and with-in and cross-case analysis. Thick description of data and saturation, prolonged engagement, member checking technique, triangulation, theoretical sampling, bracketing, peer debriefers, self-reflective journals, and audit trails were likewise employed to ensure trustworthiness of findings. Results of the individual interviews conducted were able to explain the phenomenon and a four-phased process surfaced to characterize non-suicidal self-injury. The R.I.S.E. of the Phoenix illustrates how Filipino adolescents experience engaging with non-suicidal self-injury in four phases: (1) ruining, (2) impassing, (3) separating, and (4) emerging. Considering this process may equip psychological health personnel with the knowledge on relevant interventions in providing comprehensive support to Filipino adolescent self-harmers.
Attachment-based family therapy (ABFT; G. S. Diamond et al., 2014) is an empirically supported treatment designed to capitalize on the innate, biologically based, caregiving instinct and adolescent need for attachment security. This therapy is grounded in attachment and emotional processing theory and provides an interpersonal, process-oriented, trauma-informed approach to treating adolescents struggling with suicide and associated problems such as depression and trauma. ABFT offers a clear structure and road map to help therapists quickly address the attachment ruptures that lie at the core of family conflict, which can fuel adolescent distress. Several clinical trials and process studies have demonstrated empirical support for the model and its proposed mechanisms of change. In this paper, we provide an overview of the theories underlying the model, the clinical strategies that guide the treatment, the outcome research that demonstrates efficacy, and the process research that explores the proposed mechanisms of change.
Families and carers can play an important role in helping prevent suicide. Unfortunately, silence and secrecy within the family environment have sometimes prevented family members from intervening to potentially change the course of suicide intent. This article describes a family‐oriented assessment process that can facilitate family‐involvement in care. Suicide risk assessment requires a skilled interview with the individual patient to determine accurately suicidal intent. However, family members provide a vital source of collateral information for assessing risk and the relational support needed to diminish risk. Strength‐based strategies for intervening with patients and family members to help prevent suicide are described.
Objective. To determine the prevalence and possible risk factors associated with nonsuicidal self-injury (NSSI) and suicide attempt among young adult university students. Methods. A cross-sectional study involving six colleges from a university in Manila, from which randomization through a computer-generated random number was done. Data were obtained through self-administered questionnaires. Descriptive analysis and logistic regression were done to evaluate the data. Results. A total of 225 students participated in the study (mean age of 20.33 years). Majority were females (60.44%). Ideations of self-harm were reported in 49.33%. NSSI and suicide attempts were reported at 26.22% and 14.67%, respectively. In general, self-harm (NSSI and/or suicidal attempt) was reported at 33.78%, while 7.11% of the respondents reported both NSSI and suicidal attempt in the past. Furthermore, 2-3 out of 10 students who engaged in NSSI would have a suicide attempt. Associated factors of NSSI and suicide attempt were age, female gender, gender orientation, parental civil status, employment, economic standing, and psychopathology which support the findings cited in literature. Conclusion. The high prevalence of self-harm NSSI and/or suicidal attempt (33.78%) and the finding that NSSI was a gateway for suicidal attempt and that 2-3 out of ten who engaged in NSSI would have a suicide attempt underscores the need to develop an early intervention upon detecting self-harming behaviors and a preventive program for the progression of NSSI to suicide attempts.
Although most individuals who experience suicidal thoughts will never attempt suicide and the majority of those who survive a suicide attempt will neither re-attempt nor die by suicide, little is known about salutary outcomes among previously suicidal individuals. The present study examined levels of happiness and meaning in life among 997 U.S. military personnel, of whom 23% had experienced suicide ideation and 4% had made a suicide attempt during their lives. Happiness and meaning in life were significantly reduced among participants with a history of suicidal thoughts and/or behaviors. Happiness and meaning in life were significantly higher among those participants whose last suicidal thought was further in the past. In less than one year after their last suicidal thought, the majority of previously suicidal participants reported average to above average happiness and meaning in life.
Suicide remains an important public health issue across the globe. Until recently the medically dominated field of suicide prevention has neglected first-hand accounts of suicidal thoughts and behaviors from those who have survived prior suicide attempts. This qualitative research provides insight into the experience of suicide attempt, highlighting difficulties with disclosure of suicidal thinking prior to, and after, suicide attempts. Semi-structured interviews were undertaken with 31 adult suicide attempt survivors. The focus of the interviews was to explore their experience of suicide attempt and recovery. This paper reports on the complexity involved in disclosing suicidal thoughts or behavior prior to, at the time, or post attempt; the role that help seeking has when someone is acutely suicidal; and the challenges people have in finding their voice at these critical junctures. These factors are both inter- and intra-personal, and are influenced by stigma and lack of understanding of the suicidal state.
This review updates previous similar papers published in JFT in 2000, 2009 and 2014. It presents evidence from meta‐analyses, systematic literature reviews, narrative literature reviews and controlled trials for the effectiveness of systemic interventions for families of children and adolescents with common mental health problems and other difficulties. In this context, systemic interventions include both family therapy and other family‐based approaches such as parent training, or parent implemented behavioural programmes. The evidence supports the effectiveness of systemic interventions either alone or as part of multimodal programmes for sleep, feeding and attachment problems in infancy; recovery from child abuse and neglect; conduct problems, emotional problems, eating disorders, somatic problems, and first episode psychosis.
Despite the importance of both members of the adult patient–care partner dyad, a majority of research on illness management is focused on the patient or the care partner. The basic principle of the Theory of Dyadic Illness Management is that illness management is a dyadic phenomenon; the theory focuses extensively on the dyad as an interdependent team. The way dyads appraise illness as a unit influences the ways in which they engage in behaviors to manage illness together in a recursive fashion that influences dyadic health. Optimizing the health of both members of the dyad is a goal of the theory. In turn, the health of the dyad can feedback to influence how they appraise and manage illness together. Finally, dyadic illness management is an inherently variable process that is influenced by several contextual factors. Supportive evidence and implications for practice and future research are presented.
Aims and objectives:
The aim of this study was to explore the factors predicting suicide recovery and to provide guidance for healthcare professionals when caring for individuals who have attempted suicide.
Background:
The high rate of suicide is a global health problem. Suicide prevention has become an important issue in contemporary mental health. Most suicide research has focused on suicidal prevention and care. There is a lack of research on the factors predicting suicidal recovery DESIGN: A cross-sectional design was adopted.
Methods:
A correlational study with a purposive sample of 160 individuals from a suicide prevention centre in southern Taiwan was conducted. The questionnaires included the Brief Symptom Rating Scale (BSRS-5), Suicidal Recovery Assessment Scale (SRAS), and Beck Hopelessness Scale (BHS). Descriptive statistics and linear regressions were used for the analysis.
Results:
The mean age of the participants was 40.2 years. Many participants were striving to make changes to create a more stable and fulfilling life, had an improved recovery from suicide, and had a good ability to adapt or solve problems. The linear regression showed that the BHS scores (ß =- .551, p < .001) and BSRS-5(ß =- .218, p= .003) and past suicidal behaviour (ß =- .145, p =.008) were significant predictors of individuals' recovery from suicide. They accounted for 57.1% of the variance.
Conclusions:
Suicidal individuals who have a lower level of hopelessness, a better ability to cope with their mental condition, and fewer past suicidal behaviours may better recover from suicide attempts. This article is protected by copyright. All rights reserved.
Suicide attempt survivors' interpretations of reactions to attempts are understudied, yet could inform prevention efforts concerning subsequent attempts. Interviews with 40 attempt survivors about family and friend reactions were analyzed using interpretive phenomenological techniques. Three distinct patterns emerged as follows: (a) Stigmatizing statements and emphasis on reactor's feelings were interpreted as signs that attempt survivors were a burden to others, (b) avoidant reactions and excessive monitoring were interpreted as cues that suicidal behavior must remain hidden to not be a burden, and (c) asking questions and projecting strength were interpreted as signs that attempt survivors belonged and were not a burden. These findings highlight the importance of working with family and friends to encourage reactions that reduce the risk of future attempts.
Grounded theory and theoretical coding Grounded theory (GT) is a research approach in which data collection and analysis take place simultaneously. Each part informs the other, in order to construct theories of the phenomenon under study. GT provides rigorous yet flexible guidelines that begin with openly exploring and analysing inductive data and leads to developing a theory grounded in data. Induction starts with ‘study of a range of individual cases and extrapolates patterns from them to form a conceptual category’ (Charmaz, 2006: 188). Nevertheless, instead of pure induction, the underlying logic of GT actually moves between induction and abduction. Abduction means selecting or constructing a hypothesis that explains a particular empirical case or set of data better than any other candidate hypotheses, as a provisional hypothesis and a worthy candidate for further investigation. GT was originally developed by sociologists Barney Glaser and Anselm Strauss (1967), and has since then been ...
This article presents a dialogic qualitative interview design for a narrative study of six international UK university students' motivation for learning English. Based on the work of Mikhail Bakhtin, this design was developed in order to address the limitations of member-checking [Lincoln, Y. S., and E. G. Guba. 1985. Naturalistic Inquiry. Newbury Park, CA: Sage] as a means by which participants' responses to data and interpretation might be gathered. Through a personalized reflection on my design and consideration of attitudes to member-checking, I demonstrate that a more explicit co-constructedness is evident in both the design and the data generated, and I offer this design as a more collaborative, more ethical alternative to member-checking in particular, and as an approach to qualitative research interviews in general.
Family resilience has progressed through two waves and is poised for Wave 3. During Waves 1 and 2, family resilience perspectives were conceptualized, researched, and applied as a strengths-based approach focused on positive family adaptation despite significant risk using an integration of concepts from individual resilience, general systems perspectives on families, and family stress theory. For Wave 3 we advocate for increased consistency in terminology and present the Family Resilience Model (FRM) within which existing models interface with family adaptive systems (meaning systems, emotion systems, control systems, maintenance systems, and family stress-response systems). We also argue for increased focus on trajectories and cascades, and enhanced prevention, intervention, and policy. We provide a case study applying the FRM.
Background:
Suicide is a serious problem in East Asia. Yet, there is a significant lack of research on the topic, particularly using qualitative methodology.
Objectives:
This scoping review reports on findings drawn from 11 qualitative studies, providing up-to-date knowledge and understandings about suicide in East Asian populations.
Methods:
A web-based literature search was performed to identify empirical qualitative research articles addressing suicide in East Asia, published from January 2002 to December 2011.
Results:
Three themes were identified within the reviewed studies; (1) influence of cultural beliefs; (2) the role of caregivers; and (3) specific sociological contexts. These themes are interrelated rather than mutually exclusive.
Conclusion:
The findings drawn from this scoping review reveal specific as well as broad contexts where suicidal ideation and behaviours occur among East Asians. To advance understandings, future studies should focus on comparative and longitudinal research to distil prevailing trends as well as the specificities that reside among particular East Asian subgroups (i.e. gender, sexual identity and generational) as a means to developing culturally sensitive and targeted suicide prevention programs.
Research is reviewed on family risk factors for youth suicidal behaviors. Both fatal and nonfatal suicidal behaviors have been linked consistently to negative parent-child relationships (e.g., high conflict, low closeness), child maltreatment, residing with less than two biological parents, and family history of affective and antisocial disorders. Parental separation/divorces and family history of suicidal behavior and alcohol/substance abuse are more strongly associated with completed suicide than with other suicidal symptoms, but family systems problems (such as low cohesion and adaptability) and insecure parent-child attachments are more consistently associated with nonfatal suicidal symptoms than completed suicide. Future research will benefit from attending to the temporal sequencing of putative risk factors and suicidal symptoms and from greater use of observational methods and parental reports.
The author played a key role in the creation of the Mental Health Screening Form III (MHSF-III). It is noted that one must
understand who will be using a given tool, the setting it will be used, and how the information obtained from it will be used
by staff. To meet the needs of clinicians, MHSF-III was required to be short, understandable, inexpensive, and easy to use.
The tool is not meant to be diagnostic but rather one which can better screen for possible mental health problems and to effectively
refer identified cases.
Aims and objectivesThe aim of the study was to illuminate the meaning of lived experience of living as a family in the midst of chronic illness. Background
Chronic illness implies a change for both the individual and the family. In this changed situation, all family members seem to benefit from sharing experiences and receiving support. Current research highlights the individual patient's or family member's perspectives on chronic illness, but family systems nursing (FSN) studies are warranted. DesignA qualitative design with a FSN approach was chosen. Method
Repeated qualitative narrative interviews with seven families living with chronic illness were performed. A phenomenological hermeneutic analysis, inspired by Ricoeur, was used to interpret the data. ResultsThe phenomenon can be described as an ongoing movement towards well-being. The results included two themes and five sub-themes. The first theme was Co-creating a context for living with illness' with the subthemes; learning to live with the expressions of illness' and communicating the illness within and outside the family'. The second theme was Co-creating alternative ways for everyday life' with the subthemes; adapting to a new life rhythm', altering relationships' and changing roles and tasks in the family'. Conclusions
Living as a family in the midst of chronic illness can be described as an ongoing process where the family members co-create a context for living with illness. They also co-create a context for alternative ways of everyday life. Relevance to clinical practiceKnowledge about lived experience of living as a family in the midst of chronic illness can help nurses to adopt a FSN care perspective. This can increase the chances of taking advantage of the ways family members manage situations together, as well as highlight resources within the family.