Deck 10: Suicide Assessment

Question 1

According to the Centers for Disease Control and Prevention, suicide rates over the past 14 years in the U.S. are:

A) Rising
B) Falling
C) Staying steady
D) Fluctuating
E) Not something that can be reliably tracked

Answer 1

A

Question 2

IS PATH WARM is an acronym for remembering suicide warning signs and has:

A) Strong predictive validity
B) Good validity, but poor reliability
C) Minimal empirical support
D) An inverse relationship to suicidal behaviors
E) None of the above

Answer 2

C

Question 3

Which of the following is/are NOT a risk factor associated with death by suicide?

A) Marital status
B) Physical health
C) Birth order
D) The weather
E) Both C and D

Answer 3

E

Question 4

Which of the following factors is/are associated with an increased suicide risk?

A) Alcohol abuse/dependence
B) Anorexia nervosa
C) Social trauma and bullying
D) Borderline personality disorder
E) All of the above

Question 5

If you're working with a client who talks about suicide, the law requires that you:

A) Hospitalize the client as soon as possible. B. Immediately begin calling family and relatives.
C) Do whatever is in the best interests of the client, whether that means siding with life or siding with suicide.
D) Conduct an assessment to see if the client is imminently suicidal and whether you have a professional duty to protect.
E) Both A and D.

Question 6

Which of the following is NOT listed by the authors as a suicide risk factor for people diagnosed with schizophrenia?

A) Having a higher education level
B) Being female
C) Active hallucinations and delusions
D) Family history of suicide
E) Presence of insight into one's problems

Question 7

For people admitted to the hospital because of a mental disorder, the period of time __________ discharge carries increased suicide risk.

A) During
B) Directly before
C) Directly after
D) 1 month after
E) All of the above carry the same level of risk

Question 8

Bonnie is a male-to-female transgender adult. Which of the following factors is likely a protective factor against suicide?

A) Moderate alcohol use
B) Religious affiliation
C) Coming out or disclosing her transgender identity
D) Physical exercise
E) All of the above

Question 9

Which of the following psychiatric treatments may increase suicide risk?

A) Treatment with SSRI antidepressants.
B) Cognitive-behavioral therapy.
C) Discharge from a psychiatric hospital.
D) None of the above will increase suicide risk.
E) Both A and C can increase risk.

Question 10

The "P" in the acronym IS PATH WARM represents which suicide warning sign?

A) Plan
B) Proximity
C) Purposelessness
D) Place
E) None of the above

Question 11

In the context of other mental disorders _____________ has long been known to increase suicide risk. More recent data indicates this problem is also an independent risk factor.

A) High externalizing behavior
B) High internalizing behavior
C) Hypersomnia
D) Insomnia
E) Nightmares

Question 12

Sam comes to an interview and he's single and never married. Based only on this information, which statement most accurately expresses his suicide risk?

A) He's at the same risk as married males
B) He's at twice the risk of married males
C) He's at twice the risk of married females
D) He's at half the risk of married males
E) This information isn't related to suicide risk

Question 13

Which of the following mental disorders were listed as conferring greater suicide risk?

A) Depression
B) Post-traumatic stress disorder
C) Bipolar disorder
D) Schizophrenia
E) All of the above

Question 14

Which of the following statements about risk factors is true?

A) An absence of risk factors and warning signs in individual clients is no guarantee of safety from suicidal impulses.
B) An absence of risk factors and warning signs in individual clients is a good guarantee of safety from suicidal impulses.
C) An absence of protective factors indicates extremely high risk of suicide
D) The presence of protective factors overrides the influence of risk factors.
E) Risk and protective factors are completely unhelpful to suicide prevention

Question 15

The authors contend that:

A) The proliferation of suicide risk factor checklists isn't particularly helpful
B) Suicide risk factor checklists are essential in predicting suicide
C) What's important is to spend time understanding suicide risk factors and how and why they contribute to suicide risk
D) Suicide risk and protection is a mental health myth
E) Both A and C

Question 16

Which of the following psychiatric medication types has been identified as contributing to suicidality?

A) Serotonin Specific Reuptake Inhibitors
B) Analgesics
C) Benzodiazipines
D) Anticonvulsant medications
E) Psychiatric medications don't contribute to increased suicidality

Question 17

Which of the following is an example of a protective factor?

A) Frequent religious service attendance
B) Social trauma and bullying
C) Higher global functioning
D) All of the above
E) Only A and C

Question 18

Which of the following statements about predicting suicide is the most true?

A) Suicide risk factors can accurately predict suicide in most cases
B) Death by suicide is essentially impossible to predict
C) Suicide prediction is possible among recently hospitalized patients
D) About 1% of the U.S. population will die by suicide
E) None of the preceding are true

Question 19

Marcy is engaging in repeated and increasingly dangerous self-harm. Which statement is true about her suicide risk?

A) Her risk is low
B) Her risk is low because self-harm is related to emotional regulation and not suicidality
C) Her risk is high because she may be experimenting with suicide
D) Her risk is unknowable
E) Both A and B are true

Question 20

Which of the following factors did Shneidman posit as contributing to suicidality.

A) Psychache
B) Mental Constriction
C) Perturbability
D) All of the above
E) Only A and C

Question 21

Anhedonia refers to:

A) Loss of interest and pleasure in usually enjoyable activities
B) Loss of interest in psychotherapy
C) Depressive physical symptoms related to eating and sleeping
D) No words for emotion
E) No words to describe sadness

Question 22

Which of the following might steer individuals toward a more depressive mood state?

A) Watching too many television commercials advertising antidepressants.
B) When clinicians focus excessively on and overemphasize depressive and suicidal thoughts and behaviors.
C) Engaging in too many social activities
D) All of the above
E) Only A and B

Question 23

Which of the following is a one of the cognitive triad of depression symptoms?

A) Negative thoughts about the self,
B) Negative thoughts about others
C) Negative thoughts about the future
D) All of the above
E) Only A and B

Question 24

Mental constriction is best thought of as a:

A) Problem-solving deficit
B) Form of agitation
C) Form of psychic pain and suffering
D) Any of the above could be the essence of mental constriction
E) Only A and C

Question 25

Dan's client admits to having suicidal thoughts. First off, Dan should:

A) Call 9-1-1
B) Empathically validate and normalize his client's disclosure
C) Ask the client who would be a good person to contact about this information
D) Recommend antidepressant medications
E) Administer the Beck Hopelessness Scale

Question 26

Which of these is an example of gentle assumption?

A) "I've read that up to 50% of teenagers have thought about suicide. Is that true for you?"
B) "When was the last time when you had thoughts about suicide?"
C) "Have you been thinking about suicide recently?"
D) "Please rate your mood right now, using a zero to 10 scale"
E) None of these

Question 27

Monique has an attitude that enables her clients to speak openly with her about their suicidal thoughts and plans. What beliefs does she hold?

A) She wants her clients to share their suicidal thoughts
B) She believes deeply in the medical model
C) She encourages her clients to use antidepressant medications
D) All of the above
E) Only B and C

Question 28

Neurovegetative signs of depression include:

A) Loss of interest and pleasure in usually enjoyable activities
B) Loss of interest in psychotherapy
C) Depressive physical symptoms related to eating and sleeping
D) No words for emotion
E) No words to describe sadness

Question 29

According to Joiner's interpersonal theory of suicide, why might factors such as unemployment, divorce, and widowhood increase an individual's suicide potential?

A) They are socially embarrassing events.
B) They result in a downward spiral of self-blame and depression.
C) They result in a diminished sense of belongingness and a self-perception of being a burden to others.
D) They result in feelings of hopelessness and a lack of self-worth.
E) All of the above

Question 30

Which of the following symptoms is NOT a physical symptom of depression?

A) Unintentional weight loss
B) Insomnia
C) Hypersomnia
D) Hyperventilation
E) All of the above are physical symptoms of depression

Question 31

Which cognitive factor is most strongly associated with increased suicidality?

A) Hopelessness
B) Automatic thoughts
C) Internal locus of control
D) Low self-efficacy
E) None of the above

Question 32

Which of these is an example of a normalizing frame?

A) "I've read that up to 50% of teenagers have thought about suicide. Is that true for you?"
B) "When was the last time when you had thoughts about suicide?"
C) "Have you been thinking about suicide recently?"
D) "Please rate your mood right now, using a zero to 10 scale"
E) None of these

Question 33

Ned is a very skilled interviewer. Which of the following methods for assessing suicide ideation is he LEAST likely to use?

A) Directly ask: "Have you been thinking about suicide?"
B) He will use a normalizing frame
C) He will use gentle assumption
D) He will ask about mood using a rating scale with a suicidal floor
E) All of the above are equal in sophistication

Question 34

Obtaining a verbal or written contract from a suicidal client should be done within the context of which of the following?

A) Hospitalization
B) Residential treatment
C) Private practice settings
D) A medical setting
E) None of the above, no-suicide contracts are not considered appropriate.

Question 35

When it comes to suicide assessment and treatment, the authors emphasize that clinicians should:

A) Adhere to the medical model for understanding and treating suicide ideation
B) Have a stronger emphasis on clients' strengths, resources, and potentials.
C) Move away from illness-based weaknesses, deficits, and limitations and instead
D) Both A and B
E) Both B and C

Question 36

Which of the following is a risk associated with using the medical model when working with suicidal clients?

A) Holding the belief that suicide ideation is pathological can create distance between clinician and client
B) If clients sense negative judgments, they'll be more open and honest about their suicidal thoughts
C) The medical model allows both clinician and client to work more effectively on the problems leading to the suicidal impulses
D) The medical model helps create closeness and connection between clinician and client
E) Only B and C

Question 37

Theresa asks her client, "How long do these suicidal thoughts stay with you once they start?" What is she trying to assess?

A) Suicide ideation frequency
B) Suicide ideation duration
C) Suicide ideation intensity
D) Suicide ideation triggers
E) Suicide ideation safety plan

Question 38

Which of the following interpersonal factors did Joiner (2005) propose as proximal causes of suicidal intent?

A) Thwarted belongingness (social isolation)
B) Perceived burdensomeness
C) Thwarted retribution
D) Agitation
E) Only A and B

Question 39

Jobes (2007) developed a model for suicide assessment known as CAMS (collaborative assessment and management of suicidality). Which of the following statements is NOT true of the CAMS approach?

A) The CAMS approach has both empirical and theoretical support.
B) Clients are seen as the experts on their suicidal thoughts.
C) Suicidal behaviors are seen as representing a deviant mental state requiring medical intervention.
D) Client and interviewer work together to develop an individualized treatment plan.
E) All of the above are true

Question 40

Noriko wants to follow the gold standard for assessing suicide risk. Which approach will she use?

A) A comprehensive and collaborative suicide assessment interview
B) The Beck Hopelessness Scale
C) The Beck Depression Scale
D) The Columbia Teen Screen
E) Only B and C

Question 41

Some clinicians are not well-suited to working with suicidal clients. Which of the following individuals might want to avoid working with a lot of suicidal clients?

A) An individual who suffers from depression.
B) An individual with strong religious beliefs against suicide.
C) An individual with strong pro-suicide philosophical beliefs.
D) All of the above.
E) Only A and B

Question 42

If a client states that there's no hope and he feels like killing himself, a good intervention strategy includes which of the following?

A) Talk about the finality of death and the moral issues at stake.
B) Agree that suicide is one choice, but that there are many other options as well. Then try to explore these other options.
C) Ask the client to complete a questionnaire.
D) Ask about firearms.
E) These are all bad ideas.

Question 43

The acronym SLAP provides an easy way to remember four areas of inquiry into a client's _________________.

A) Suicide ideation
B) Suicide plan
C) Suicide risk factors
D) Self-control
E) Self-esteem

Question 44

Which of the following need not be thoroughly documented when working with a suicidal client?

A) The fact that you consulted with other professionals.
B) The fact that you obtained historical information about the client.
C) The fact that you provided the client with resources (i.e., hotline number).
D) You should document all of these actions.
E) Only B and C

Question 45

Suicide intent is usually evaluated __________ a suicide attempt.

A) Following
B) Preceding
C) During
D) All of the above
E) None of the above

Question 46

According to Shneidman's theory, the primary thought disorder in suicide involves the following:

A) The client is suffering from paranoid thinking.
B) The client has narrowed his or her focus, seeing only two choices-enduring something terribly painful, or death.
C) Death is always seen as impermanent to a suicidal person.
D) Both A and C are correct.
E) Both B and C are correct.

Question 47

Tracy states to her therapist that she has always felt like ending her life for as long as she can remember and she doesn't think that she will ever feel differently. She states that nothing in the world could make her feel any better. What important cognitive symptom of depression is Tracy expressing?

A) Worthlessness
B) Preoccupation
C) Hopelessness
D) Guilt
E) None of the above

Question 48

Which suicide intervention approach is based on the idea that many suicidal clients really desires to eradicate the feelings of intolerable pain rather than to eradicate the self? Hospitalization

A) Separating the psychic pain from the self
B) Alternatives to suicide
C) Safety planning
D) Neodissociation
E) Becoming directive

Question 49

What's the first rule of working therapeutically with suicidal clients?

A) Listen and be empathic
B) Use standardized assessment instruments
C) Make referrals early and often
D) Develop a safety plan
E) Identify alternatives to suicide

Question 50

Which of the following is a component that's included in an assessment of client self-control?

A) A direct question about client self-perception of self-control
B) Observation for agitation
C) Determination of hopelessness
D) Both A and B
E) Both B and C

Question 51

Instead of the traditional no-suicide contracts, contemporary approaches to suicide intervention emphasize:

A) Hospitalization
B) Commitment to individualized treatment or safety plans
C) Medication
D) A and C
E) None of the above

Question 52

What should you do if your client states: "Nothing helped. Nothing ever helps."

A) Ask about lethality and firearms
B) Ask "Yes-no" questions about what has helped and not helped
C) Avoid "Yes-no" questions and use a continuum to assess what has helped more or less
D) More or less focus on the positive, because it's obvious that your client is incapable of doing so.
E) Panic and let your client you need to take a break to call your supervisor

Question 53

When conducting a suicide assessment, you find your client has no suicide risk factors; what should you do?

A) Discontinue the suicide assessment because the client is not at risk.
B) Seek information from the client's family to confirm the absence of risk factors.
C) Continue with the assessment and remain attuned to possible suicidal impulses.
D) Continue with the assessment with full confidence that the client is unlikely to be at risk of suicide.
E) None of the above

Question 54

Previous attempts are considered:

A) The strongest of all suicide predictors
B) Something to avoid talking about
C) Something that should always be discussed in grueling detail
D) Irrelevant to suicide assessment
E) Both A and C

Question 55

Which of the following is an example of outside information that can be used to initiate risk and protective factor assessment?

A) Client Records
B) Assessment Instruments
C) Collateral Informants
D) All of the above
E) Only A and C

Question 56

When an therapist asks a client how she intends to kill herself, for example with firearms or by using pills, which of these is the therapist NOT assessing?

A) Lethality of the method
B) Extent of suicidal intent
C) Differential activation
D) Specificity of the plan
E) None of the above