Tag: Suicide

Responding to Criticism on my notion of loneliness

October 13th, 2016
By: Curtis Peterson ©

Recently I have been criticized for my views on loneliness, even though these views are deeply seated in current research on the topic of loneliness. I would like to respond to some of the criticisms I have received. For this blog, I want to take on one of the most salient criticisms I have received

Criticism 1: Loneliness is not a product of an individual’s social world, but rather a disposition of a person and psychological disorders.

This criticism mostly comes from individuals who work in the mental health field, and work with individuals who report being extremely lonely. In this view, many of the individuals who are upset with my notion that loneliness is deeply seated within one’s social experiences, claim that loneliness is part of one’s psychological disorder and therefore should be treated on the individual level.

However, there are fundemental problems with this argument. The first comes from science dating back to the 1940s and is supported by current research, and that is loneliness is not a symptom of psychological disorders, but are a consequence of the social allienation most individuals with psychological disorders experience.

There is only one exception to this rule, and that is for individuals who experience depression. But, loneliness, when someone is in a bout of depression, is qualitatively different than the normative loneliness that everyone experiences. Loneliness during depression drives us away from seeking social and emotional connections, while normative loneliness drives us to seek out a social and emotional connection to alleviate the negative emotional state associated with the experience of loneliness. For me, there is another very important reason to separate loneliness from depression, and that comes from recent research conducted with individuals who have made serious suicide attempts and individuals who display suicidal thoughts. According to this research, individuals who are diagnosed with depression seem to only have suicidal ideation and attempts when they also score high on scales of normative loneliness – such as the UCLA Loneliness Scale. This is important because it provides a window into what drives individuals who are experiencing depression and when they are at risk for suicidal thoughts and attempts.

The second fundamental problem with loneliness only being a feature of psychological disorders that are self-driven is that everyone can experience loneliness regardless of their mental state. In fact, loneliness is a fact of being human. One reason that some individuals may argue that it is not is we all have varying degrees of the need to have social and emotional connections with other individuals. Indeed, most of the individuals that disagree with me have very low needs for social and emotional relationships. Loneliness and social connection as a drive system are very much like our system for hunger and thirst. Some individuals need for more food intake – and make sure they get three meals a day -and some individuals only have the desire to eat maybe once during the day. Loneliness is the same way, some individuals need a constant stream of socialization and emotional connection, whereas others need very little. Unfortunately the high-level person – especially in American culture – are considered needy, dependent, and weak – whereas individuals who have very little need are seen as strong and independent. While I would argue that being at either extreme can lead to dysfunction – just like too much food can lead to obesity, and too little food can lead to anorexia – the assumption that low social need people are stronger than high need individuals is just empirically false. There is no evidence in the empirical literature to suggest that individuals differ on how “strong” and “independent” they are based on their need for social and emotional connections.

My main goal for refuting the claim that loneliness is a feature of one’s disposition is in our modern world individuals are becoming more and more disconnected from each other. Evidence indicates that loneliness and the negative physical and psychological consequences of continued chronic loneliness are on the increase especially among at risk populations such as teens, elderly, and individuals who are members of stigmatized groups. Therefore, loneliness as an increasing epidemic in our society needs to be addressed on the social and cultural level, and we should let go of old unsupported notions that loneliness is a feature of one’s disposition. I make this plea that we should look at loneliness as a disease of society because the only long-term solution and “cure” for loneliness are for one to meet their social and emotional connections with others, through engaging in their social life.
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The Relationship between Drugs and Alcohol Use and Suicidal Idealization and Attempts of Montanan Adolescence

May 1st, 2016
Authors: April Kortz, Alex Holter, and Aundrea Edwards

Helena College University of Montana

Abstract

Suicidal ideation and attempts start emerging in adolescents and can be increased by the use of illicit drugs and/or alcohol. Montana adolescents participate in a survey, YRBSS, every other year that helps monitor mental health status, drug use, alcohol use, and other items. The researchers used the YRBSS data from 1999 to 2013 to look for a link between alcohol use, drug use, suicidal ideation and attempts. The data showed that students who answered yes to feeling hopeless were more likely to have had used drugs or drank alcohol on school property within 30 days, these students were more likely to answer to having attempted suicide within the last 12 months. This research shows more research is needed to look at the relationship between suicidal ideation/attempts and drugs/alcohol in Montana youth.

The Relationship between Drug and Alcohol Use and Suicidal Idealization and Attempts of Montanan Adolescence

The transition from childhood into adulthood represents a phase of biological and psychological development otherwise known as adolescence. Suicidal ideations and other suicidal thoughts first emerge as a major public health problem during adolescence. Judge and Billick (2004), reviewed the available suicide data for the United States and found that, during 2001, 4,382 U.S. youths between the ages of 15 and 24 completed suicide. Adolescents are faced with new and unexpected developmental changes starting in the middle school years. The frequent discrepancies in this process render some adolescents particularly vulnerable to periods of marked psychological pain and distress (Pfeffer, 1997).

The relationship between suicidal ideation/attempts and substance use have started to become an increasing interest for researchers. Zhang and Wu (2014) looked at four waves of public-use Add Health data to look into the association. They looked into past-year drug use (including alcohol and other drugs) in relation to past-year suicidal ideation. After they received the data, Zhang and Wu (2014) created fixed effects models with lagged dependent variable to test for unidirectional associations between substance use and suicidal ideation. Non-recursive models with feedback loops were also conducted to examine reciprocal relations between suicidal ideation and each substance that could have been used. Once the information was adjusted for the time-invariant effects and lagged effects of dependent variables, the associations from substance use to suicidal ideation were consistently significant. The use of cigarettes or alcohol increased the risk of suicidal ideation, while suicidal ideation was not associated with cigarette or alcohol use. The same held true for other substances used (Zhang and Wu, 2014).

A particular high risk factor for suicide attempts among adolescents is within 12 months after being discharged from a treatment facility. Czyz and King (2015) completed a longitudinal study of adolescents with suicidal ideation and how hospitalization affected the chance of re-hospitalizations or suicidal attempts. The 376 participants, ranging in ages 13-17 and sex, were assessed at hospitalization as well as 3, 6, and 12 months after discharge. Trajectory groups, and predictors, were identified by Czyz and King (2015) by using latent class growth modeling. Logistic regression was used to examine associations between trajectory groups and their likelihood of suicide attempts and re-hospitalization. The research found that adolescents in the chronically elevated ideation group had a 2.29 and 4.15 greater odds of attempting suicide and 3.23 and 11.20 greater odds of re-hospitalization. Hopelessness was associated with persisting suicidal ideation (Czyz and King, 2015). Their results suggest that suicidal ideation severity at their original hospitalization may not be an adequate marker for subsequent crises.

Psychoactive substance use disorder (PSUD) has also been researched in its relation among suicidal adolescents who have been hospitalized. Mean et. al (2005) conducted a study on 186 adolescents monitoring for substance intoxication at the moment of the attempt and the association PSUD at baseline and either occurrence of suicide or repetition of suicide attempt(s). 148 participants were traced again after 6 or 18 months for evaluations. The research found that 39.2% of the subjects were found to have a PSUD. A significantly higher proportion was intoxicated at the time of their attempt than those without PSUD. During the course of tracing the 148 participants, it was found that two had completed suicide and 30 had repeated suicide attempts. Mean et al (2005) found that adolescents that are hospitalized for suicide attempt or ideation have a high risk of attempting suicide again as well as a higher risk of completion and is marginally associated with PSUD.

A group of chemically dependent adolescents, a group that is commonly at high risk of self-destructive behavior, were studied for suicidal ideation and attempts. Deykin and Buka (1994), interviewed 300 addicts and their families aged 15 through 19 years as well as assessed by the diagnostic interview schedule and a social history interview. Their research found that 31%-75% of the subjects reported suicidal ideation while 28%-61% reported attempting suicide, with females predominating. They found that the subjects had a higher risk of a suicide attempt when thoughts of suicide coincide with morbid ideation that has been existing for an extended duration. Substance abuse treatment requires an assessment of suicidal potential as well as counseling for those in the high risk category, paying special attention to male subjects who have been exposed to abuse.

The association between suicidal ideation/attempts and different types/number of substances are unclear. Wong, Zhou, Goebert and Hishinuma (2012) examined data from the Youth Risk Behavior Survey (YRBS) from 2001 to 2009 which included 73,183 high school students. Their research examined the association between lifetime use of ten common substances of abuse (alcohol, cocaine, ecstasy, hallucinogens, heroin, inhalants, marijuana, methamphetamines, steroids and tobacco) and four different measures of suicidality they had over the past year (suicidal ideation, suicide plan, suicide attempt, and severe suicide attempt requiring medical attention). The logistic regression analyses of the data controlled for potential confounders in the data: socio-demographic variables, interpersonal violence, sexual intercourse and symptoms of depression and eating disorder. Wong, Zhou, Goebert, and Hishinuma’s (2012) results showed that adolescents that reported a history of heroin use had the strongest association with suicidal ideation, suicide planning, and suicide attempts including severe attempts. Each of the ten substances and the four measures of suicidality remained significant with multivariate analysis (p<0.05). Their research shows that there is a strong risk factor for suicidal thoughts and behaviors among American high school students with substance abuse. The relationship between them increases with particular illicit drugs and higher number of substances.

The relationship between suicidal ideation and attempts to use of illegal substances among adolescents is one that has been researched using different methods. The YRBS survey provides some insight into adolescents that otherwise could be missed during regular interviews. Using YRBS data, this study will aim to provide information on Montana students, in High school age, and how suicidal ideation/attempts relate to substance use (i.e. drugs and alcohol).

Methods

The data for this study was reviewed to determine if there is relationship between drug and alcohol use and suicidal idealization or suicide attempts in Montana adolescence. High school students in Montana were surveyed during school hours. The students were administered surveys in which participation was completely voluntary. Their responses were recorded according to the students’ prevalence of a given behavior. This survey is the Youth Risk Behavioral Surveillance System (YRBSS) and the data is evaluated by the Centers for Disease Control and Prevention. With the data from the YRBSS the CDC is able to determine the prevalence of the behaviors among adolescents in Montana as well as in other states. The data collection that we obtained occurred on odd numbered years starting in 1999 and ending in 2007. The data studied included the whole state of Montana high school students. This study looked at the data that included adolescents who used drugs, specifically marijuana and cocaine, and/or alcohol in school in the last 30 days. This study also looked at students that struggled with emotional feelings that included feeling sad or hopeless for more than 2 weeks in the past 12 months, or had thoughts of suicide and/or suicide attempts in the last 12 months.

Results

After analyzing the data through SPSS, there was significant data for specific items that were investigated. First, a relationship was found between alcohol use in the last 30 days on school property and whether or not the respondents answered yes or no to the question of feeling sad or hopeless for more than 2 weeks in the past 12 months. These results are shown by F (11, 19966) =28.632, p<.001, Ƞ²=.016. This indicates that the overall means for yes are significantly higher than the overall means of no (see Table 1). As Figure 1 indicates, the difference between answering yes or no to feeling sad or hopeless for more than 2 weeks in the past 12 months cannot be explained by years because the issue of using alcohol in school in the last 30 days was there before 1999 and will be there after 2013. The data is significant, but it only explains .016 of the variance of the difference between the yes and no lines as explained by alcohol.

Second, a relationship was also found between marijuana use in the last 30 days on school property and whether or not the respondents answered yes or no to the question of feeling sad or hopeless for more than 2 weeks in the past 12 months. These results are shown by F (11, 19980) =23.176, p<.001, Ƞ²=.013. This indicates that the overall means for yes are significantly higher than the overall means of no (see Table 2). As Figure 2 indicates, the difference between answering yes or no to feeling sad or hopeless for more than 2 weeks in the past 12 months cannot be explained by years because the issue of using marijuana in school in the last 30 days was there before 1999 and will be there after 2013. The data is significant, but it only explains .013 of the variance of the difference between the yes and no lines as explained by marijuana.

The next relationship found, was between cocaine use in the last 30 days and whether or not the respondents answered yes or no to the question of feeling sad or hopeless for more than 2 weeks in the past 12 months. These results are shown by F (9, 15208) =28.245, p<.001, Ƞ²=.016. This indicates that the overall means for yes are significantly higher than the overall means of no (see Table 3). As Figure 3 indicates, the difference between answering yes or no to feeling sad or hopeless for more than two weeks in the past 12 months cannot be explained by years because the issue of using cocaine in the last 30 days was there before 1999 and will be there after 2007. The data is significant, but it only explains .016 of the variance of the difference between the yes and no lines as explained by cocaine.

After the suicidal ideations were compared to alcohol; marijuana; and cocaine, suicide attempts in the past 12 months where compared to the amount of alcohol consumed on school property in the last 30 days was analyzed. These results are shown by F (44, 24761) =109.949, p<.001, Ƞ²=.163. This indicates that the overall means for 5 or more times of attempting suicide as related with using alcohol in school in the last 30 days are significantly higher than the overall means of 4 or fewer times of attempting suicide as related with using alcohol in school in the last 30 days. As Figure 4 indicates, the difference between how many times a person attempted suicide in the past 12 months as related with using alcohol in school in the last 30 days cannot be explained by years because the issue was there before 1993 and will be there after 2013. The data is significant, but it only explains .163 of the variance of the difference between the amounts of times a person attempted suicide in the past 12 months as related with using alcohol in school in the last 30 days

The last comparison that was evaluated was suicide attempts in the past 12 months as it related to the amount of marijuana smoked on school property in the last 30 days. These results are shown by F (44, 24784) =59.633, p<.001, Ƞ²=.096. This indicates that the overall means for 5 or more times of attempting suicide as related with using marijuana in school in the last 30 days are significantly higher than the overall means of 4 or fewer times of attempting suicide as related with using marijuana in school in the last 30 days. As Figure 5 indicates, the difference between how many times a person attempted suicide in the past 12 months as related with using marijuana in school in the last 30 days cannot be explained by years because the issue was there before 1993 and will be there after 2013. The data is significant, but it only explains .096 of the variance of the difference between the amounts of times a person attempted suicide in the past 12 months as related with using marijuana in school in the last 30 days.

Discussion

Adolescents have substantial volume changes in gray and white matter in the brain. Gray matter is made of neuronal cell bodies, dendrites, glial cells, synapses, and capillaries. While gray matter decreases during adolescence, white matter increases. White matter increasing is due to increased myelination of axons, thus allowing better communication between brain regions. Changes begin in the posterior portion of the brain and progress to the anterior regions. These neural changes occur well into the mid-to-late 20’s.

Alcohol affects GABA (Gamma-Amino Butyric Acid, inhibits neurotransmission which clams activity) receptors making them more inhibitory. Prevents glutamate (an excitatory neurotransmitter) from exiting the cell. Alcohol also affects the Prefrontal cortex which aids in decision making, memory, and impulse control. With how alcohol affects the brain function, when an adolescents drinks they are not able to make good decisions which can lead to attempting and or completing suicide, especially if paired with feeling hopeless and sad.

In marijuana, THC mimics anandamide (the brain’s own cannabinoid receptor) by binding to the cannabinoid receptors, which then allows dopamine to stay in the synapse. Marijuana slows down body movements, helping us feel relaxed and calm. Cocaine blocks dopamine transporters leaving them trapped in the synaptic cleft which overstimulates the cell. Cocaine also affects the area of the brain controlling voluntary movements. Alcohol is the most commonly used substance among adolescents with marijuana being the second most used substance.

Montana is a state that targets Meth use, this research shows that cocaine use is higher on school property as well as marijuana use. This would be another area to research more to see if Methamphetamines are the drugs that should be targeted or if the focus should change, especially if cocaine is found to be more commonly used across the U.S.A on school property. It is also possible that cocaine may be more easily accessible to students compared to methamphetamines, which is another area that would be considered with further study.

This research has found that there is an association between alcohol consumption as well as drug use on school campuses and suicidal ideation and/or attempts. Risk seeking behavior could be related to conduct disorder or a way for students to reach out for help, more research would need to be done in this area to know for sure. Data is limited to every other year and the most recent year, 2015, is not available to view to see if the increase of drug and alcohol use is continuing. The questions asked in the YRBSS do not cover all the possibilities that could explain suicidal ideation and did not provide as much raw data. Further research should be done on Montana adolescents to help explain the increase of drug use on school property as well as its link to suicidal ideation and attempts.

References

Ansell, E. B., Laws, H. B., Roche, M. J., & Sinha, R. (2015). Effects of marijuana use on impulsivity and hostility in daily life. Drug and Alcohol Dependence, 148, 136-142. Retrieved March 21, 2016, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4330120/.

Cservenka, A., & Nagel, B. J. (2016). Neuroscience of alcohol for addiction medicine. Progress in Brain Research Neuroscience for Addiction Medicine: From Prevention to Rehabilitation – Constructs and Drugs, 223, 215-235. Retrieved March 21, 2016, from https://www.ncbi.nlm.nih.gov/pubmed/26806778.

Czyz, E. K., & King, C. A. (2013). Longitudinal trajectories of suicidal ideation and subsequent suicide attempts among adolescent inpatients. Journal of Clinical Child & Adolescent Psychology, 44(1), 181-193. Retrieved February 1, 2016.

Deykin, E. Y., & Buka, S. L. (1994). Suicidal ideation and attempts among chemically dependent adolescents. Am J Public Health American Journal of Public Health, 84(4), 634-639. Retrieved February 1, 2016.

Judge, B., & Billick, S. B. (2004). Suicidality in adolescence: Review and legal considerations. Behavioral Sciences & the Law Behav. Sci. Law, 22(5), 681-695. Retrieved February 1, 2016.

Kalat, J. W. (2015). Biological Psychology 12th Edition. London: Cengage Learning.

Méan, M., Righini, N. C., Narring, F., Jeannin, A., & Michaud, P. (2005). Substance use and suicidal conduct: A study of adolescents hospitalized for suicide attempt and ideation. Acta Paediatrica, 94(7), 952-959. Retrieved February 1, 2016.

Squeglia, L. M., & Gray, K. M. (2016). Alcohol and drug use and the developing brain. Current Psychiatry Reports Curr Psychiatry Rep, 18(5). Retrieved March 21, 2016, from https://www.ncbi.nlm.nih.gov/pubmed/26984684.

Wong, S. S., Zhou, B., Goebert, D., & Hishinuma, E. S. (2013). The risk of adolescent suicide across patterns of drug use: A nationally representative study of high school students in the United States from 1999 to 2009. Social Psychiatry and Psychiatric Epidemiology Soc Psychiatry Psychiatry Epidemiol, 48(10), 1611-1620. Retrieved February 1, 2016.

YRBSS Data & Documentation. (2015). Retrieved March 21, 2016, from http://www.cdc.gov/healthyyouth/data/yrbs/data.htm

Zhang, X., & Wu, L. (2014). Suicidal ideation and substance use among adolescents and young adults: A bidirectional relation? Drug and Alcohol Dependence, 142, 63-73. Retrieved February 1, 2016

END NOTES: This paper was originally presented at the Fourth Annual Montana Student Research Forum for Two Year Colleges on April 8, 2016. Research was conducted at Helena College University of Montana with Institutional Review Board approval through the University of Montana. Supervising faculty for this paper were Dr. Nathan Munn (PI) and Professor Peterson (analysis).
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Attitudes Towards Suicide Pre- and Post- QPR Training

April 18th, 2016
Authors: Shayla Crandell and Jamie Eastwood, Helena College University of Montana

Abstract

Objective: This study measures individual attitudes based on pre and post suicide prevention training between those trained and not trained in Question, Persuade and Refer (QPR) to see if individual attitudes could be changed by this particular prevention program. Methods: We compared 60 student’s individual attitudes between two classes. One class being trained in QPR and the other receiving no training in QPR, using an Attitude Toward Suicide Inventory. Results: We found that there was no significant positive attitude change with individuals trained and not trained in QPR. Conversely we found that there was an increased negative attitude in the individuals in the experimental group who were trained in QPR compared to those in a control group not receiving training. Conclusion: This study would benefit from a larger sample size as well as looking into not only attitudes toward suicide but individual’s actual behaviors. Further research will need to be conducted to insure that those receiving training understand the basis of the QPR.

Introduction to the Study

Suicide can be one of the most preventable cause of death, yet preventing it has been a huge struggle. According to the Center for Disease Control and Prevention (2014) suicide is the second leading cause of death in individuals between the ages of ten and thirty-four years; fourth leading cause of death in 35 to 54 years-of-age and 10th overall in the United States. Montana is ranked number one in the nation for number of suicide as of 2014 according to the American Foundation for Suicide Prevention (AFSP). Many prevention programs have focused on preparing individuals who may come in contact with suicidal individuals to respond in a way that encourages help seeking behavior. If these programs are successful they must achieve three things; (1) change the prevailing attitudes about suicides, (2) provide tools that a person can use to effectively intervene, and (3) motivate individuals to take action. The current research focuses on attitude change by investigating whether a popular suicide prevention program, Question, Persuade and Refer (QPR) can change individual’s attitudes. QRR is designed to teach people the appropriate signs and symptoms of other individuals that may be or become suicidal and get them to the proper place for care. A person trained in QPR they will learn to recognize the warning signs of suicide; know how to offer hope; and know how to get help and save lives (qprinstitute, 2013). QPR outlines statistics on a state to state and national basis, as well as provide the correct ways to approach and ask the appropriate questions in a crisis situation (qprinstitute, 2013), as well as, defines both myths and facts about those individuals who may be in crisis. There are several theories of attitude change which promote behavioral change (Zimbardo & Leippe, 1991), however, most of these models agree that individual attitudes are persuaded via two potential routes: (1) the peripheral route, and (2) the central route (Zimbardo, & Leippe, 1991; Petri, & Govern, 2004). The peripheral route results in short-term attitude change and includes change in attitudes due to the persuaders appearance, perceived expertise, and how attractively the argument is presented (Fiske, 2010; Leary, 2010). This type of attitude persuasion tends to work, but only for a short amount of time. In order to create long-term attitude change one must engage in central route processing (Fiske, 2010). Central route processing is when one deeply and cognitive evaluates information, makes a meaningful interpretation of information, and makes a social commitment to change (Ross, & Nisbett, 2011). However, in order for one to engage in central route processing, research has found that there must be five elements present which include:
1. The information must be made personally relevant.
2. The person has to be able to cognitively understand and interpret the information.
3. The person must be made to feel like he or she has the abilities and tools to engage in a given behavior.
4. The person must be able to practice or visualize him or herself engaging in the behavior.
5. The person must be able to engage in the behavior within novel and unexpected contexts (Fiske, 2010; Ross & Nisbett, 2011).
The question for this paper is whether or not QPR promotes central route processing to engage in more long-term attitude change? The research hypothesis there for is; QPR will influence a positive direction.

H_o: There will be no difference between groups from pre to post measurement.

H₁: The experimental group will have a significantly better attitude on post measure compared to control group.

Research Method

The sample for this study was comprised of 60 students enrolled in a local college who were attending Abnormal Psychology and a College Writing course. The final sample consisted of 38 females and 22 males. The mean age for all students was 26.37 (SD= 8.68); 18 of female and 11 male students (n=29) were surveyed in a course in which QPR training was provided (experimental group), and 20 females and 11 male students were surveyed in a course where QPR was not provided (control group) (n=31). This study was reviewed and approved by the University of Montana Institutional Review Board.

Measure. Attitude Toward Suicide Inventory (Knight, Furnham, & Lester, 2000) was measured with a questionnaire developed for use in this field. This survey contains 33 statements from the Attitude Toward Suicide Inventory. Questions were on a likert scale disagreement: (1) completely disagree, (2) do not agree, (3) undecided, and agreement: (4) agree, (5) completely agree. These were later broke down into five factors based on specific attitude categories that will be delineated in the results section. In this research for reliability the Cronbach’s alpha was .70, which is moderate and acceptable for reliability.

Procedures. Each group took five minutes before the start of class to complete the questionnaire. In the experimental group, after completing the pre-attitude questionnaire, were then trained in class for QPR. The control group, after their questionnaire, then sat through their regular scheduled lecture. After each class, both groups were given five minutes to complete a post- attitude questionnaire. A total of four classes were sampled, two in fall semester of 2015 and two in the spring semester of 2016. Initial analysis indicated no significant difference due to the time during which the research took place.

Results

After data had been cleaned for missing data points and outliers, a confirmatory factor analysis was conducted, consistent with work by (Knight, Furnham, & Lester, 2000) five factors emerged. Two factors were selected for the significant of this research. Factor 1, which measured ambivalence, and factor 5, which measured attitude of shame. After selecting these two variable analysis was conducted to assure normal distribution of data and sphericity of data to make sure repeated ANOVA analysis was appropriate for this data. Table 1 and 2 provide the means and standard deviations for both attitudes measured.

Ambivalence

The first attitude measured was ambivalent, which consisted of questions such as “I would feel ashamed if a member of my family committed suicide” and “people who commit suicide are usually mentally ill.” As figure 1 indicates for the experimental group ambivalence increased; however, in the control group ambivalence decreased. According to a repeated measures ANOVA the model was non-significant (F (1,45) = .094, p = .761), and there were no group differences (F (1,45) = .095, p =.760). However, as Figure 1 indicates there was a significant interaction (F (1,45) = 1382.62, p < .001) this can be contributed to sample size, as a power analysis indicated a sample of 186 participants would be necessary to reach significant effect.

Shame

The second variable of interest was shame (factor 5), example questions included “people do not have the right to take their own lives” and “Those who commit suicide are cowards who cannot face life’s challenges.” As Figure 2 indicates in the experimental group shame increased, while in the control group shame remained roughly the same. According to a repeated measures ANOVA the overall model approach significance (F(1,45) = 2.857, p < .10), and there was a significant interaction (F(9,45) = 3.941, p = .05).

Discussion, Conclusions, and Recommendations

Based on the hypothesis of this study, the findings do not support that QPR training positively changes attitudes toward suicide, but based on the interactions may create a more negative attitude in comparison to a control group. However, because there was no main effect the interaction must be qualified and cautioned. These findings could be influenced by a number of different factors such as, presenter, lack of engagement between training, the inability to randomly assign individuals to the control and experimental conditions, and individual participant variables. As noted, an individual must be able to practice or see him or herself engaging in the behavior (Fiske, 2010; Ross & Nisbett, 2011). The relevance of the information could also play a part in the findings. If a person does not find themselves being able to relate to the information this could create a negative attitude if thinking this situation will not happen to them. As mentioned: an individual must be able to make information personally relevant (Fiske, 2010; Ross & Nisbett, 2011, p.?). Sample size could also be cause for these findings. A sample of 186 participants would be beneficial in a further study looking into QPR training and attitude change toward suicide, the sample size maybe the culprit in not achieving a main effect. Furthermore, a further study should focus not only understanding attitude change but also actual behavior of individuals.

References

American Foundation for Suicide Prevention. Suicide Statistics. (2014). Retrieved October 28, 2015, from http://afsp.org/

Center for Disease Control and Prevention. National Suicide Statistics. (2016, August 28). Retrieved October 28, 2015, from http://www.cdc.gov/

Fiske, S.T. (2010). Social Beings: Core Motives in Social Psychology. Danver, MA: John Wiley & Sons, Inc.

Knite, Matthew T.D., Furnham, Adrian F., & Lester David. (2000). Lay Theories of Suicide. Personality and Individual Differences, Vol 29(3), 453-457.

Leary, M.R. (2010). Affiliation, acceptance, and belonging: The pursuit of interpersonal connection. In Fiske, S.T., Gilbert, D.T., & Lindzey, G. (Eds) Handbook of Social Psychology (5th ed). Danver, MA: John Wiley & Sons, Inc.

Petri, H.L. & Govern, J.M. (2004). Motivation: Theory, Research, and Application (5th ed). Belmont CA: Wadsworth Publishing

QPR Institute | Practical and Proven Suicide Prevention Training (2013). Retrieved April 01, 2016, from http://www.qprinstitute.com/

Ross, L., & Nisbett, R.E. (2011). The Person and the Situation: Perspectives on Social Psychology. New York, NY: McGraw Hill, Inc.

Zimbardo, P.G., & Leippe, M. (1991). The Psychology of Attitude Change and Social Influence. New York, NY: McGraw-Hill, Inc.

END NOTES: This paper was originally presented at the Fourth Annual Montana Student Research Forum for Two Year Colleges on April 8, 2016. Research was conducted at Helena College University of Montana with Institutional Review Board approval through the University of Montana. Supervising faculty for this paper were Professor Curtis Peterson, Professor Karen Henderson, and Dr. Nathan Munn.
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