Master of Arts, Case Western Reserve University, 2019, Psychology

Dual diagnosis is the presence co-occurring disorders. Individuals with a dual diagnosis are more likely to have a pronounced psychiatric history, past traumatic events, and a decreased quality of life when compared to individuals who have one or no disorders The purpose of the present study was to evaluate how dual diagnosis is associated with individuals who experience clinically significant symptomatology in two different samples: Veteran (VA) psychiatric outpatient participants and medical examiner's (ME) subjects who died by suicide. Groups were compared on several dependent measures, using chi-square to examine categorical variables and independent t-tests to examine continuous variables. The VA dual diagnosis group was found to have higher rates of stressful life events when compared to the VA depression group. However, there were no significant differences between the VA groups in regards to symptom severity and previous suicide attempts. The ME dual diagnosis group was found to have higher rates of stressful life events when compared to the ME depression group. There were no significant differences between the ME groups in regard to violence of suicide method.

Committee: Jalessa Overholser (Committee Chair); Jalessa Overholser (Committee Chair); Norah Feeny (Committee Member); Norah Feeny (Committee Member); Arin Connell (Committee Member); Arin Connell (Committee Member) Subjects: Clinical Psychology

Master of Arts, Case Western Reserve University, 2019, Psychology

Older adults are at high risk for suicide compared to younger adults and differential risk factors may also exist across older adulthood. This study aimed to understand key risk factors for young-old (65-75 years old) and old-old (75+ years old) adults by testing a biopsychosocial framework using a psychological autopsy method. Correlational results indicated that hopelessness, depression, and negative attitude about physical health directly contributed to elderly suicide. While a more objective assessment of physical illness was associated with advanced age, it did not increase suicide risk. Advanced age was also associated with social isolation, which was significantly related with hopelessness, depression, and negative attitude about health. Multivariate analyses suggested that hopelessness fully mediates the relationships between isolation, negative attitude about health, depression, and suicide. Hopelessness and depression greatly contribute to suicide. Negative health attitudes may be an elderly-specific risk factor, while social isolation may increase risk for old-old adults.

Committee: James Overholser PhD (Committee Chair); Norah Feeny PhD (Committee Member); Arin Connell PhD (Committee Member) Subjects: Aging; Clinical Psychology; Gerontology; Psychology

Master of Arts, Case Western Reserve University, 2016, Psychology

Trait impulsivity is an important risk factor for suicide. New measures of trait impulsivity were developed. Psychological autopsy was used to evaluate 4 groups of deceased adults: suicide completers with prior attempts, suicide completers with no past attempts, individuals who died by natural causes who had previously attempted suicide, and individuals who had died by natural causes with no past attempts. Elevated rates of emotional impulsivity were seen in individuals who died by natural causes that had previously attempted suicide. Behavioral impulsivity was elevated in individuals with prior non-fatal suicide attempts who died by suicide or natural causes. Suicide completers who died by hanging had elevated rates of behavioral impulsivity. Higher levels of life stress were experienced by suicide completers and individuals with non-fatal suicide attempts. No relationship between suicidal planning and trait impulsivity was observed. Trait impulsivity may indirectly elevate suicide risk by increasing stressors.

Committee: James Overholser Ph.D. (Committee Chair); Norah Feeny Ph.D. (Committee Member); Heath Demaree Ph.D. (Committee Member); Josephine Ridley Ph.D. (Committee Member) Subjects: Clinical Psychology

Psy. D., Antioch University, 2009, Antioch Seattle: Clinical Psychology

Suicide is the thirteenth leading manner of death worldwide and eleventh in the United States. Approximately one percent of the U.S. population dies by suicidal means. On average, more than 30,000 people will kill themselves each year. This qualitative research study sought to explore and describe the experiences of how one family suffered and survived the unexpected loss of their thirteen-year-old son suspected of dying by suicidal means and how psychological autopsies might help survivors in dealing with this loss. Secondarily, the results also examined death investigation practices in one county of Washington State that uses psychological autopsies and how their use might broaden our understanding of teen suicide and survivorship. Analysis revealed eight topical areas of death investigation pursuant to determining the manner of death in the question of a completed suicide. From this medical-legal forensic structure of death investigation, psychological autopsy information was used to explore and describe in rich detail the family's experience of the loss of their son. The implications of this study accentuated the use of psychological autopsy information and its role in helping to facilitate the healing process for survivors of suicide.

Committee: Liang Tien Psy. D. (Committee Chair); Patricia Linn Ph.D. (Committee Member); Daniel Clark Ph.D. (Committee Member) Subjects: Psychology