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Biomedical subjects

A A Leenaars

Publications and source records attributed to A A Leenaars.

At least 19 recordsLinked to original sources
PubMed2000

Suicide prevention in Canada: a history of a community approach.

Suicide is a major mental health and public health problem in Canada. Canada's suicide rate ranks above average in comparison to countries around the world. The prevention of suicide predates the European presence in Canada and much can be learned from these endeavours. Current efforts grew largely from the grass roots, with little government support or initiative (with a few provincial/territorial exceptions). Canada's community efforts have been diverse and inclusive. Among such efforts have been: (a) traditional approaches among Native peoples, (b) the establishment of the first crisis centre in Sudbury in the 1960s, (c) the development of a comprehensive model in Alberta, (d) the beginning of a survivor movement in the 1980s, and (e) the national prevention efforts of the Canadian Association for Suicide Prevention. There are, however, striking lacks--most notable among them the paucity of support for research in Canada. Future efforts will call for even greater community response to prevent suicide and to promote wellness.

Canada↗
PubMed1999

Domestic integration and suicide in the provinces of Canada.

Canada's rate of suicide varies from province to province. The classical theory of suicide, which attempts to explain the social suicide rate, stems from Durkheim, who argued that low levels of social integration and regulation are associated with high rates of suicide. The present study explored whether social factors (divorce, marriage, and birth rates) do in fact predict suicide rates over time for each province (period studied: 1950-1990). The results showed a positive association between divorce rates and suicide rates, and a negative association between birth rates and suicide rates. Marriage rates showed no consistent association, an anomaly as compared to research from other nations.

Birth Rate↗
PubMed1999

Suicide prevention in schools: the art, the issues, and the pitfalls.

Suicide is a major mental health problem and public health problem worldwide. Schools and their communities must respond in a comprehensive fashion. Caplan's model of primary, secondary, and tertiary prevention--or prevention, intervention, and postvention--is proposed as a comprehensive response to suicide in youths. Current myths and facts about these fabrications are discussed for each mode of response. Research, clinical suggestions, and a call for further discussion are presented.

Art↗
PubMed1998

Social factors and mortality from NASH in Canada.

The NASH categories (Natural, Accident, Suicide, Homicide) used on death certificates are known to obscure many of the psychological dimensions of death. Although there are many studies of death certificates of the extent to which suicide may be misclassified as accidental or natural deaths, and a few studies comparing individuals who commit suicides to accidental death victims, this topic is often neglected at a sociological level. This analysis of the NASH modes of death examines if these deaths differ from a sociological perspective. Specifically, rates of divorce, marriage, birth, and unemployment were correlated with deaths of natural causes (stomach cancer, cirrhosis of the liver), accidents (motor vehicle accident), suicide, and homicide. The results suggest that the sociological associations with some causes of death (i.e., cirrhosis of the liver, suicide and, homicide) have a similar social pattern but are different from others (i.e., motor vehicle accidents and stomach cancer). Although there are problems of interpretation at a sociological level, it is suggested that the social epidemiology of death may be obscured by the NASH classification. Recent suggestions on terminology and taxonomy by the International Academy for Suicide Research (IASR) are offered as one step towards addressing this issue.

Accidents, Traffic↗
PubMed1998

Is there a regional subculture of firearm violence in Canada?

A study in Canada of the accidental death rate from firearms, and of suicide and homicide rates by firearms and by all other methods, for the period 1975-85, indicated that the rates were positively associated with one another. The results were interpreted using a subcultural theory of violence, and the social policy implications of the results were discussed.

Canada↗
PubMed1997

Rick: a suicide of a young adult.

A small but concerning percentage of completed suicides are seen as having left no clues. The classical case, albeit a literary one, is Robinson's Richard Cory. These people often dissemble, even about their suicide risk. An even smaller group of these individuals present themselves in therapy without communicating a sign of suicide risk. Utilizing an idiographic approach, the case of a young adult male (Rick) is presented. The narrative reconstruction gives voice behind the man's mask. The autopsy reveals a young man who was in deep pain and unable to adjust to life's demands. Rick lacked ego strength, being overly narcissistic and having deeply troubled, symbiotic attachments to his family in a world of interpersonal isolation. In the end, even the help of his therapist, who tried to reach through the mask, was not enough and Rick killed himself. The pain had become unbearable. A few guiding remarks for such cases are offered, noting that therapists must constantly address the dissembling in some suicidal patients.

Adult↗
PubMed1996

Suicide trends in eight predominantly English-speaking countries 1960-1989.

Suicide rates between 1960 and 1989 were explored for eight predominantly English speaking countries with similar national characteristics. New World countries showed significant similarities but differed from Old World countries. The two North American (NA) New World countries showed more similarity to each other than the two Australasian New World countries. The NA countries showed an unique plateau in the 1980s for males aged 15-29 years. Old World males of all ages showed common rises, suggesting a partial sex-specific influence in the young. However, trends among the 15- to 19-year-olds were significantly different to trends among the 20- to 29-year-olds in both sexes suggesting a substantial youth-related contribution to the rises. Rates among 15- to 19-year-old females rose in the early 1960s, ahead of males but in parallel with rises among older females, suggesting part of the rise was sex- as opposed to age-related. Although rates among the 15- to 19-year-old females showed little change since 1970, this may be partly a function of sex-related improvements-observable in older females disguising unfavourable youth-related influences. Possible aetiological factors are suggested but remain speculative. Studies of other nations with common cultural characteristics may clarify trends and aetiological issues. Care should be taken to differentiate sex- from age-related influences.

Adolescent↗
PubMed1996

Suicide notes at symbolic ages.

Symbolic ages, like 40, 65, or 70, are often stocktaking occasions. Phillips and Smith in 1991 showed that suicides peak at such ages for married males and suggested that suicide notes may be an avenue to analyzing such stocktaking in people's lives. 40 notes from symbolic and nonsymbolic ages were compared based on a multidimensional clinical perspective. No differences were noted. Although caution is in order in accepting the null hypothesis, it is speculated that macrosocial phenomena may not be easily translatable into psychological ones.

Adult↗
PubMed1996

Suicide: a multidimensional malaise.

No one really knows why human beings commit suicide. The goal of this paper is to provide a psychological point of view on the topic, among the many other perspectives that are needed. It addresses the question by providing a theory of suicide, arguing that it is theory that allows us to sort out the booming buzzing mess of experience (Wm. James). Suicide is a multi-dimensional malaise. Metaphorically speaking, it is an intrapsychic drama on an interpersonal stage. As sound theory must be empirically observable, the theory is next applied to research of suicide notes, studying such factors as age, sex, and method of suicide, cross-culture and cross-time. Next, because all theory must have clinical applicability, a clinical case study of Goethe's Werther is provided. Overall, it is concluded that we need to continue to develop models to understand the suicidal mind.

Adaptation, Psychological↗
PubMed1995

Clinical evaluation of suicide risk.

Suicide risk assessment may well be the most complex clinical task that mental health professionals face. Tests have shown to be of little use. To confront this complexity, assessment and prediction are best seen as interwoven with understanding suicide, a multi-dimensional malaise. With the essential concepts of lethality and perturbation, a clinical theory of suicide is presented. Intrapsychic aspects (i.e., unbearable psychological pain, cognitive constriction, indirect expressions, inability to adjust, and ego) as well as interpersonal aspects (i.e., interpersonal relations, rejection-aggression, identification-egression), are outlined to aid in assessment. Transference and countertransference issues in assessment are noted. A case illustration to aid in clinical insight is provided. It is concluded that all assessment and prediction of suicide risk ultimately depends on the skill of the clinician.

Adolescent↗
PubMed1995

The changing suicide pattern in Canadian adolescents and youth, compared to their American counterparts.

Canada has a high rate of suicide among adolescents and youth--higher than the rate in the United States. The study of variation in societal suicide rates is still guided primarily by Durkheim's (1897) theory which proposed a primarily social integration/regulation theory of suicide. There is evidence that social and economic predictors of suicide vary depending upon the particular subgroup--women or men, and young or old. Rates of birth, divorce, marriage, and unemployment were analyzed and compared to rates of suicide from 1965-1985 in Canada and the United States for particular subgroups. In Canada, measures of domestic integration (divorce and birth rates) and the economy (unemployment rate) predicted youth suicide rates more successfully than they did adult suicide rates. In the United States for the same period, there was less variation in the predictors of suicide by age. Further research as well as caution about overgeneralizing the results are warranted.

Adolescent↗
PubMed1994

Suicide and homicide rates in Canada and the United States.

Suicide and homicide rates by age were analyzed for Canada and the United States, indicating that suicide is higher in Canada and that homicide is higher in the United States. Results indicated a positive association between homicide and suicide rates in the United States but these two rates of death were not significantly associated in Canada. Holinger (1987) had associated the relative size of the cohort to the rates of suicide and homicide in young people in the United States. The more current data in both countries did not support Holinger's results. Using the measure devised by Easterlin (1980) and Ahlburg and Schapiro (1984)-that is, the proportion of youths aged 15-24 relative to adults aged 25-64-the correlation between the size of the youth cohort and the suicide rate of youths aged 15-24 was negative. It is concluded that the two patterns in these two countries may be explained from a historical perspective.

Adolescent↗