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  • 1. Bille-Brahe, U
    et al.
    Andersen, K
    Wasserman, D
    Schmidtke, A
    Bjerke, T
    Crepet, P
    De Leo, D
    Haring, C
    Hawton, K
    Kerkhof, A
    Lönnqvist, J
    Michel, K
    Phillippe, A
    Querejeta, I
    Salander Renberg, Ellinor
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Temesváry, B
    The WHO-EURO Multicentre Study: risk of parasuicide and the comparability of the areas under study.1996In: Crisis, ISSN 0227-5910, E-ISSN 2151-2396, Vol. 17, no 1, p. 32-42Article in journal (Refereed)
    Abstract [en]

    The 15 areas under study in the WHO/Euro Multicentre Study on Parasuicide vary considerably with regard to socio-economic factors, culture, life-styles, etc. In this paper, the authors discuss whether the traditional high risk factors for suicidal behavior (such as unemployment, abuse, divorce, etc.) take on different weights depending on local societal and cultural settings. Results from analyzing covariations between various background factors characteristic of the different areas under study and the frequency of attempted suicide showed weak or insignificant correlations, indicating that high-risk factors can only be identified from international pooled data with great care.

  • 2. Bille-Brahe, U
    et al.
    Kerkhof, A
    De Leo, D
    Schmidtke, A
    Crepet, P
    Lönnqvist, J
    Michel, K
    Salander Renberg, Ellinor
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Stiles, T C
    Wasserman, D
    Egebo, H
    A repetition-prediction study on European parasuicide populations. Part II of the WHO/Euro Multicentre Study on Parasuicide in cooperation with the EC Concerted Action on Attempted Suicide.1996In: Crisis, ISSN 0227-5910, E-ISSN 2151-2396, Vol. 17, no 1, p. 22-31Article in journal (Refereed)
    Abstract [en]

    One of the aims of the inter-European study on parasuicide, which was initiated by WHO/Euro in the mid-1980s, was to try and identify social and personal characteristics predictive of future suicidal behavior. A follow-up interview study (the Repetition-Prediction Study) was designed, and so far 1145 interviews have been carried out at nine research centers, representing seven European countries. The study and the instrument used (the European Parasuicide Study Interview Schedules, EPSIS I and II) are described here. Some basic characteristics of the material from the various centers are presented and compared, and the representativeness of the samples are discussed. There were differences between the centers in several respects. Results from analyses based on pooled data have to be treated with some caution because of the possible lack of representativeness.

  • 3.
    Holm, Anne Lise
    et al.
    Centre for Women’s, Family and Child Health, Faculty of Health Sciences, Buskerud and Vestfold University College, Kongsberg.
    Lyberg, Anne
    Centre for Women’s, Family and Child Health, Faculty of Health Sciences, Buskerud and Vestfold University College, Kongsberg.
    Berggren, Ingela
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, undergraduate level. Centre for Women’s, Family and Child Health, Faculty of Health Sciences, Buskerud and Vestfold University College, Kongsberg.
    Cutcliffe, John
    School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa .
    Severinsson, Elisabeth
    Centre for Women’s, Family and Child Health, Faculty of Health Sciences, Buskerud and Vestfold University College, Kongsberg.
    Shadows from the past: The situated meaning of being suicidal among depressed older people living in the community2014In: Crisis, ISSN 0227-5910, E-ISSN 2151-2396, Vol. 35, no 4, p. 253-260Article in journal (Refereed)
    Abstract [en]

    Background: Most depressed older people in a suicidal state have mixed feelings, where the wish to live and the wish to die wage a battle. Aims: To explore and describe depressed older people’s experiences of being suicidal and their search for meaning. Method: Data were collected from 29 participants resident in the Rogaland and Vestfold districts of Norway, by means of individual interviews, after which a thematic analysis was performed. Results: For the participants in this study, the lived experiences of the situated meaning of survival after being suicidal comprised a main theme—”shadows from the past”—and two themes—”feeling that something inside is broken” and ”a struggle to catch the light.” Conclusion: Mental health-care professionals might be able to reduce the risk of suicide and perturbation by helping depressed older people to explore, resolve, and ultimately come to terms with their unresolved historical issues. Additional valuable strategies in primary care settings include encountering patients frequently, monitoring adherence to care plans, and providing support to address the source of emotional pain and distress. 

  • 4.
    Idenfors, Hans
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Kullgren, Gunnar
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Renberg, Ellinor Salander
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Professional Care as an Option Prior to Self-Harm A Qualitative Study Exploring Young People's Experiences2015In: Crisis, ISSN 0227-5910, E-ISSN 2151-2396, Vol. 36, no 3, p. 179-186Article in journal (Refereed)
    Abstract [en]

    Background: Deliberate self-harm (DSH) is a growing problem among young people and is a major risk factor for suicide. Young adults experiencing mental distress and suicidal ideation are reluctant to seek help, requiring new strategies to reach this group. Aims: The present study explored young people's views of professional care before first contact for DSH, and factors that influenced the establishing of contact. Method: Interviews with 10 young individuals, shortly after they had harmed themselves, were analyzed using qualitative content analysis. Results: The participants emphasized the importance of receiving more knowledge on where to turn, having different help-seeking options, and receiving immediate help. Family and friends were vital for support and making health care contact. The quality of the professional contact was stressed. Several reasons for not communicating distress were mentioned. Two themes were identified: "A need for a more flexible, available and varied health care" and "A struggle to be independent and yet being in need of reliable support." Conclusion: These findings suggest that easy and direct access to professional help is a decisive factor for young people experiencing psychological problems and that health services must find new ways of communicating information on seeking mental health help.

  • 5. Knizek, Birthe Loa
    et al.
    Hjelmeland, Heidi
    Skruibis, Paulius
    Fartacek, Reinhold
    Fekete, Sandor
    Gailiene, Danute
    Osvath, Peter
    Salander Renberg, Ellinor
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Rohrer, Rudolf R
    County council politicians' attitudes toward suicide and suicide prevention: a qualitative cross-cultural study.2008In: Crisis, ISSN 0227-5910, E-ISSN 2151-2396, Vol. 29, no 3, p. 123-30Article in journal (Refereed)
    Abstract [en]

    The purpose of the present study was to compare county council politicians' attitudes toward suicide and suicide prevention in five European countries. A questionnaire was distributed and here the responses to the open-ended questions are analyzed qualitatively. Considerable differences were found in what the politicians in the five countries believed to be the most important causes of suicide and how suicide can be prevented. There were also differences in to what degree the politicians revealed a judgmental attitude toward suicide, which seemed to be related to the magnitude of the problem in the respective countries. A certain implicit inconsistency in the logic directing the politicians' responses was found when their views on causes to suicide and suicide prevention strategies were compared. The responses indicate a need for increased consciousness and knowledge about suicide and suicide prevention among politicians in all the five countries. This is important since they are responsible for initiating and funding suicide preventive efforts.

  • 6. Krysinska, Karolina
    et al.
    Westerlund, Michael
    Stockholm University, Faculty of Humanities, Department of Media Studies.
    Niederkrotenthaler, Thomas
    Andriessen, Karl
    Carli, Vladimir
    Hadlaczky, Gergö
    Till, Benedikt
    Wasserman, Danuta
    A Mapping Study on the Internet and Suicide2017In: Crisis, ISSN 0227-5910, E-ISSN 2151-2396, Vol. 38, no 4, p. 217-226Article in journal (Refereed)
    Abstract [en]

    Background: Since the mid-1990s concerns have been raised regarding the possible links between suicide and the Internet, especially among adolescents and young adults. Aims: To identify the nature and extent of the scientific publications, especially original research studies, on suicide and the Internet, and to investigate how the field has developed over time. In particular, this mapping study looks at types of publications, topic areas, focus of original research papers, and suicide-related variables of interest in publications. Method: A search of three major databases (PubMED, PsycINFO, and Sociological Abstracts) was conducted to identify papers published until the end of January 2015. Results: The study identified 237 publications on suicide and the Internet published from 1997 to the end of January 2015. These included 122 original research papers. The three most frequent topic areas covered in publications were searching for information on suicide, online interventions, and online suicide-related behaviors. The online mediums most frequently studied were online forums/message boards, search engines, intervention and information websites, and social media. Limitations: The mapping study did not include an analysis of results of research studies and did not assess their quality. Conclusion: The field is rapidly evolving, as seen in the recent increase in the number of publications. However, there are gaps in terms of the countries where research is conducted and the coverage of topics.

  • 7.
    Music, Emina
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Salander Renberg, Ellinor
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Suicide in Bosnia and Herzegovina and the City of Sarajevo With Special Reference to Ethnicity2014In: Crisis, ISSN 0227-5910, E-ISSN 2151-2396, Vol. 35, no 1, p. 42-50Article in journal (Refereed)
    Abstract [en]

    Background: Besides the war experience (1992-1995), Bosnia and Herzegovina (BiH) constitutes an interesting area for studies on suicidal behavior from an ethnic and religious perspective with its mixed ethnic population of Bosniaks, Serbs, and Croats. Aims: The study investigates suicide in BiH and the capital city of Sarajevo before (1985-1991) and after the war (1998-2006), with special reference to gender and ethnicity. Method: Official suicide data were gathered for the two periods with regard to gender, ethnicity, and suicide methods used. Results: No differences in suicide rates were found in BiH and Sarajevo before and after the war. The male-to-female suicide rate ratio in BiH was significantly higher after the war than before the war, with an opposite tendency seen in Sarajevo. Before and after the war, the highest and stable suicide rates were among Serbs in BiH. In Sarajevo the highest suicide rates were found among Croats after the war. Hanging was the most common suicide method used, both before and after the war, while firearms were more commonly used after the war. Poisoning was a rarely used method in both periods. Conclusion: The stable suicide rates in BiH over the pre- and postwar periods indicate no evident influence of the Bosnian war on the postwar level of suicide rates, except for women in Sarajevo. Beside this exception, the findings indicate a long-established underlying pattern in suicide rates that was not immediately changed, even by war. The study supports earlier findings that the accessibility of means influences the choice of suicide method used.

  • 8.
    Mäkinen, Ilkka Henrik
    Södertörn University College, Avdelning 4, Sociology. Södertörn University College, Department of Society and History, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Suicide in the New Millennium: Some Sociological Speculations2002In: Crisis, ISSN 0227-5910, E-ISSN 2151-2396, Vol. 23, no 2, p. 91-92Article in journal (Refereed)
  • 9. Mäkinen, Ilkka Henrik
    Suicide-Related Crimes in Contemporary European Criminal Laws1997In: Crisis, ISSN 0227-5910, E-ISSN 2151-2396, Vol. 18, no 1, p. 35-47Article in journal (Refereed)
    Abstract [en]

    Describes suicide-related penal legislation in contemporary Europe, and analyzes and relates the results to cultural attitudes toward suicide and to national suicide rates. Data were obtained from 42 legal entities. Of these, 34 have penal regulations which—according to definition—chiefly and directly deal with suicide. There are 3 main types of act: aiding suicide, abetting suicide, and driving to suicide. The laws vary considerably with regard to which acts are sanctioned, how severely they are punished, and whether any special circumstances (e.g., the motive) can make the crime more serious. Various ideologies have inspired legislation, including religions, the euthanasia movement, and suicide prevention. There are some cases in which neighboring legal systems have clearly influenced laws on the topic. However, the process seems mostly to have been a national affair, resulting in large discrepancies between European legal systems. The laws seem to reflect public opinions: countries which punish the crimes harder have significantly less permissive cultural attitudes toward suicide. The cultural and normative elements of society seem to be connected with its suicide mortality.

  • 10. Nielsen, A S
    et al.
    Bille-Brahe, U
    Hjelmeland, H
    Jensen, B
    Ostamo, A
    Salander Renberg, Ellinor
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Wasserman, D
    Alcohol problems among suicide attempters in the Nordic countries.1996In: Crisis, ISSN 0227-5910, E-ISSN 2151-2396, Vol. 17, no 4, p. 157-66Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to see whether and how the number of suicide attempters with alcohol problems and their drinking habits differ between the Nordic areas under study. Problem-drinkers were defined as persons who themselves felt that they had an alcohol problem. The analyses were based on data collected at five Nordic research centers participating in the WHO/Euro Multicentre Study on Parasuicide, namely: Helsinki (Finland); Umeå and Stockholm (Sweden); Słr-Trłndelag (Norway); and Odense (Denmark). The results showed that the frequency of problem-drinking among suicide attempters differed markedly between the areas under study; the Finnish male and the Danish female suicide attempters included the highest proportions of self-identified problem-drinkers. The pattern of drinking among the suicide attempters also differed between the areas. The analyses indicate that the point when alcohol becomes a problem to somebody, especially to a degree that it increases the risk of suicidal behavior, not only depends on how much and how often the person drinks alcohol; the prevailing drinking pattern, the attitudes towards drinking alcohol, and the level of social control are also important factors to take into consideration when relations between alcohol and suicidal behavior are under study.

  • 11.
    Omerov, Pernilla
    et al.
    Karolinska institutet.
    Steineck, Gunnar
    Karolinska institutet; Sahlgrenska akademin Göteborgs universitet.
    Runeson, Bo
    Karolinska institutet.
    Christensson, Anna
    Karolinska institutet.
    Kreicbergs, Ulrika
    Sophiahemmet Högskola, Karolinska institutet.
    Pettersén, Rossana
    Karolinska institutet.
    Rubenson, Birgitta
    Karolinska institutet.
    Skoogh, Johanna
    Sahlgrenska akademin Göteborgs universitet.
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Nyberg, Ullakarin
    Karolinska institutet.
    Preparatory studies to a population-based survey of suicide-bereaved parents in Sweden2013In: Crisis, ISSN 0227-5910, E-ISSN 2151-2396, Vol. 34, no 3, p. 200-210Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: There is a need for evidence-based guidelines on how professionals should act following a suicide. In an effort to provide empiric knowledge, we designed a nationwide population-based study including suicide-bereaved parents.

    AIM: To describe the process from creating hypotheses through interviews to the development of a population-based questionnaire.

    METHOD: We used interviews, qualitative analysis and various means of validation to create a study-specific questionnaire to be used in a nonselected nationwide population of suicide-bereaved parents and a control population of nonbereaved (N = 2:1). The Swedish Register of Causes of Death and the Multigeneration Register were used to identify eligible individuals. All presumptive participants received a letter of invitation followed by a personal contact.

    RESULTS: We developed a questionnaire covering the participants' perception of participation, their daily living, psychological morbidity, professional actions, and other experiences in immediate connection to the time before and after the suicide. Almost three out of four parents (bereaved = 666, nonbereaved = 377) responded to the questionnaire.

    CONCLUSIONS: By involving parents early in the research process we were able to create a questionnaire that generated a high participation rate in a nationwide population-based study that might help us to answer our hypotheses about bereavement after suicide.

  • 12. Omerov, Pernilla
    et al.
    Steineck, Gunnar
    Runeson, Bo
    Christensson, Anna
    Kreicbergs, Ulrika
    Sophiahemmet University.
    Pettersén, Rossana
    Rubenson, Birgitta
    Skoogh, Johanna
    Rådestad, Ingela
    Sophiahemmet University.
    Nyberg, Ullakarin
    Preparatory studies to a population-based survey of suicide-bereaved parents in Sweden2013In: Crisis, ISSN 0227-5910, E-ISSN 2151-2396, Vol. 34, no 3, p. 200-10Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: There is a need for evidence-based guidelines on how professionals should act following a suicide. In an effort to provide empiric knowledge, we designed a nationwide population-based study including suicide-bereaved parents.

    AIM: To describe the process from creating hypotheses through interviews to the development of a population-based questionnaire.

    METHOD: We used interviews, qualitative analysis and various means of validation to create a study-specific questionnaire to be used in a nonselected nationwide population of suicide-bereaved parents and a control population of nonbereaved (N = 2:1). The Swedish Register of Causes of Death and the Multigeneration Register were used to identify eligible individuals. All presumptive participants received a letter of invitation followed by a personal contact.

    RESULTS: We developed a questionnaire covering the participants' perception of participation, their daily living, psychological morbidity, professional actions, and other experiences in immediate connection to the time before and after the suicide. Almost three out of four parents (bereaved = 666, nonbereaved = 377) responded to the questionnaire.

    CONCLUSIONS: By involving parents early in the research process we were able to create a questionnaire that generated a high participation rate in a nationwide population-based study that might help us to answer our hypotheses about bereavement after suicide.

  • 13.
    Pettersen, Rossana
    et al.
    Karolinska institutet.
    Omerov, Pernilla
    Karolinska institutet.
    Steineck, Gunnar
    Karolinska sjukhuset, Göteborgs universitet.
    Titelman, David
    Karolinska institutet.
    Dyregrov, Atle
    Norge.
    Nyberg, Tommy
    Karolinska institutet.
    Nyberg, Ullakarin
    Karolinska institutet.
    Lack of Trust in the Health-Care System After Losing a Child to Suicide: A Nationwide Population Survey2015In: Crisis, ISSN 0227-5910, E-ISSN 2151-2396, Vol. 36, no 3, p. 161-172Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Lack of trust in the health-care system after losing a child to suicide may prevent bereaved parents from seeking professional treatment when needed, thus diminishing their chances of recovery.

    AIMS: This is the first large study to aim at evaluating the incidence of lack of trust in the health-care system and associated variables in suicide-bereaved parents.

    METHOD: This nationwide population-based survey included 569 parents who lost a child to suicide 2-5 years earlier and a matched comparison group of 326 nonbereaved parents. Using a study-specific questionnaire, we asked bereaved and nonbereaved parents if they trusted the health-care system and measured psychological and background variables.

    RESULTS: Prevalence of lack of trust in the health-care system differed between the bereaved (46.5%) and the nonbereaved parents (18.3%), giving a relative risk of 2.5 (95% CI = 2.0-3.3). After multivariable modeling, high scores of depression, living in big cities, and being single were identified as variables associated with lack of trust in suicide-bereaved parents.

    CONCLUSION: Suicide-bereaved parents show lack of trust in the health-care system. We present possible effect modifiers that may be considered in professional interventions aiming at influencing suicide-bereaved parents' level of trust.

  • 14. Vatto, Ingvild Engh
    et al.
    Lien, Lars
    DeMarinis, Valerie
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine. Centre for Psychology of Religon, Innlandet Hospital Trust, Hamar, Norway; Department of Theology, Psychology of Religion & Cultural Psychology, Uppsala University, Uppsala, Sweden.
    Haug, Sigrid Helene Kjorven
    Danbolt, Lars Johan
    Caught Between Expectations and the Practice Field Experiences of This Dilemma Among Volunteers Operating a Diaconal Crisis Line in Norway2019In: Crisis, ISSN 0227-5910, E-ISSN 2151-2396, Vol. 40, no 5, p. 340-346Article in journal (Refereed)
    Abstract [en]

    Background: Volunteer crisis tine responders are a valuable resource for suicide prevention crisis lines worldwide.

    Aim: The aim of this study was to gain a deeper understanding of how volunteers operating a diaconal crisis line in Norway experienced challenges and how these challenges were met.

    Method: A qualitative, explorative study was conducted. A total of 27 volunteers were interviewed through four focus groups. The material was analyzed using systematic text condensation.

    Results: The greatest challenge to the volunteers was the perception of a gap between their expectations and the practice field. The experience of many volunteers was that the crisis line primarily served a broad ongoing support function for loneliness or mental illness concerns, rather than a suicide prevention crisis intervention function. Limitations:The focus group design may have made the participants more reluctant to share experiences representing alternative perspectives or personally sensitive information.

    Conclusion: The findings of this study suggest that a uniform response to callers using crisis lines as a source of ongoing support is warranted and should be implemented in volunteer training programs.

  • 15.
    Vattø, Ingvild Engh
    et al.
    Innlandet Hosp Trust, Ctr Psychol Relig, Hamar, Norway; MF Norwegian Sch Theol, Oslo, Norway.
    Lien, Lars
    Innlandet Hosp Trust, Norwegian Natl Advisory Unit Concurrent Subst Abu, Hamar, Norway; Inland Norway Univ Appl Sci, Fac Social & Hlth Sci, Elverum, Norway.
    DeMarinis, Valerie
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Theology, Department of Theology, The Social Sciences of Religion, Psychology of Religions. Innlandet Hosp Trust, Ctr Psychol Relig, Hamar, Norway; Umeå Univ, Dept Publ Hlth & Clin Med, Umeå, Sweden.
    Haug, Sigrid Helene Kjorven
    Innlandet Hosp Trust, Ctr Psychol Relig, Hamar, Norway; Inland Norway Univ Appl Sci, Fac Social & Hlth Sci, Elverum, Norway.
    Danbolt, Lars Johan
    Innlandet Hosp Trust, Ctr Psychol Relig, Hamar, Norway; MF Norwegian Sch Theol, Oslo, Norway.
    Caught Between Expectations and the Practice Field Experiences of This Dilemma Among Volunteers Operating a Diaconal Crisis Line in Norway2019In: Crisis, ISSN 0227-5910, E-ISSN 2151-2396, Vol. 40, no 5, p. 340-346Article in journal (Refereed)
    Abstract [en]

    Background: Volunteer crisis line responders are a valuable resource for suicide prevention crisis lines worldwide.

    Aim: The aim of this study was to gain a deeper understanding of how volunteers operating a diaconal crisis line in Norway experienced challenges and how these challenges were met.

    Method: A qualitative, explorative study was conducted. A total of 27 volunteers were interviewed through four focus groups. The material was analyzed using systematic text condensation.

    Results: The greatest challenge to the volunteers was the perception of a gap between their expectations and the practice field. The experience of many volunteers was that the crisis line primarily served a broad ongoing support function for loneliness or mental illness concerns, rather than a suicide prevention crisis intervention function.

    Limitations: The focus group design may have made the participants more reluctant to share experiences representing alternative perspectives or personally sensitive information.

    Conclusion: The findings of this study suggest that a uniform response to callers using crisis lines as a source of ongoing support is warranted and should be implemented in volunteer training programs.

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