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CCAMH, Caritas Cambodia

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CCAMH, Caritas Cambodia

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    1. 9/3/2012 CCAMH, Caritas Cambodia 1 Caritas-CCAMH, Cambodia is collaborating with the Division of Psychiatry, Department of Clinical Sciences, Ume University, Sweden in the area of operational research, and this presentation is a part of the study. This also happens to be part of my PhD project. di(Sandwich model)Caritas-CCAMH, Cambodia is collaborating with the Division of Psychiatry, Department of Clinical Sciences, Ume University, Sweden in the area of operational research, and this presentation is a part of the study. This also happens to be part of my PhD project. di(Sandwich model)

    2. 9/3/2012 2 Cambodia Cambodia, as many of you might know is a developing nation, located south-west of Thailand, south of Laos and east of Vietnam where Caritas Cambodia is working since 19.....Cambodia, as many of you might know is a developing nation, located south-west of Thailand, south of Laos and east of Vietnam where Caritas Cambodia is working since 19.....

    3. 9/3/2012 CCAMH, Caritas Cambodia 3 Cambodia - Brief history Since ancient angkorian times till today, Cambodia had faced internecine war and trumoil!Since ancient angkorian times till today, Cambodia had faced internecine war and trumoil!

    4. 4 KR Era of Social Engineering There was collective trauma and suffering during the 70s and 80s. Social engineering in search of utopian idealism brought death and suffering to millions of Cambodians.There was collective trauma and suffering during the 70s and 80s. Social engineering in search of utopian idealism brought death and suffering to millions of Cambodians.

    5. 9/3/2012 CCAMH, Caritas Cambodia 5 Contemporary history Studies show suicide has increased in transitional economies, in the immediate aftermath of free-market economy following the downfall of totalitarian regimes. But not much is known about suicidal expression in Cambodia.Studies show suicide has increased in transitional economies, in the immediate aftermath of free-market economy following the downfall of totalitarian regimes. But not much is known about suicidal expression in Cambodia.

    6. 9/3/2012 CCAMH, Caritas Cambodia 6 Young people in LMI countries Worldwide 18 million people attempt suicide/yr Under-reporting due to social stigma, religion, legal-status, unreliable population count and non-reporting of death Less published studies on suicide among adolescents in low and middle income countries Few studies on suicidal expressions, attitudes and misconception

    7. 9/3/2012 CCAMH, Caritas Cambodia 7 There has been many terminologies such as para-suicide and deliberate self-harm. In this presentation when we say suicidal expressions, we mean all the asepcts of suicide from life-weariness to suicidal attempts, other than completed suicides. There has been many terminologies such as para-suicide and deliberate self-harm. In this presentation when we say suicidal expressions, we mean all the asepcts of suicide from life-weariness to suicidal attempts, other than completed suicides.

    8. 9/3/2012 CCAMH, Caritas Cambodia 8 Attitudes, Misconceptions Attitude: the way you think and feel about sb/sth; the way you behave towards sb/sth that shows how you think and feel Misconceptions: A belief or an idea that is not based on correct information (and that might arise from the influence of society, culture religion etc) -Source: Oxford Advanced Learners Dictionary, 6th Edition (2000) Attiitude and misconceptions. We focus on the following misconceptions in this presentation (list them). How do we understand the role of attitudes in the context of suicidal expressions. Attiitude and misconceptions. We focus on the following misconceptions in this presentation (list them). How do we understand the role of attitudes in the context of suicidal expressions.

    9. 9 Factors related to Suicidal expressions The risk factor and contagion are most often studied and reported. Attitudes towards suicide are less studied and reported and more diffcult to interpret!The risk factor and contagion are most often studied and reported. Attitudes towards suicide are less studied and reported and more diffcult to interpret!

    10. 9/3/2012 CCAMH, Caritas Cambodia 10 Aim To examine the misconceptions about suicide in the background of gender, suicidal expression and exposure to suicide among young people in Cambodia

    11. CCAMH, Caritas Cambodia 11 Methods Responders: students from diverse backgrounds (psychology 27, geography 18, Khmer literature 67). Voluntary participation and informed consent Option to contact/ seek help in confidential setting Permission from Vice-rector, RUPP and HODs

    12. 9/3/2012 CCAMH, Caritas Cambodia 12 Instrument for Assessment Attitudes Towards Suicide (ATTS) First part is about exposure to suicide, Second part measures attitudes and misconceptions towards suicide Third part records one own suicidal expressions Add information on process Has been used in other settings such as Nicaragua The instrument was translated into Khmer, after detailed discussion among psychologists and team leaders at CCAMHAdd information on process Has been used in other settings such as Nicaragua The instrument was translated into Khmer, after detailed discussion among psychologists and team leaders at CCAMH

    13. 13 On a lickert-type scale, where the respondents answer over five point scaleOn a lickert-type scale, where the respondents answer over five point scale

    14. 9/3/2012 CCAMH, Caritas Cambodia 14 Table 1 Misconceptions about suicide Suicide deciders can not be stopped- 82.1% disagreed Talking will evoke suicide- 49.7% agreed Happens without warning- 52.3% agreed! Talking people do not commit-16.6% agreed!* Suicide can be prevented- 78.8% agreed People threatening seldom committ , 34.3 agreed; 25.0 were undecided; 40.7 disagreed People commit suicide are mentally ill: 65.2 agreed, 12.5 undecided and 22.3 disagreed Suicide deciders can not be stopped- 82.1% disagreed Talking will evoke suicide- 49.7% agreed Happens without warning- 52.3% agreed! Talking people do not commit-16.6% agreed!* Suicide can be prevented- 78.8% agreed People threatening seldom committ , 34.3 agreed; 25.0 were undecided; 40.7 disagreed People commit suicide are mentally ill: 65.2 agreed, 12.5 undecided and 22.3 disagreed

    15. 9/3/2012 CCAMH, Caritas Cambodia 15 Table 2 Suicidal Expression More comments! This study fails to show any gender difference unlike others. More comments! This study fails to show any gender difference unlike others.

    16. 9/3/2012 CCAMH, Caritas Cambodia 16 Table 3 Exposure to Suicide/Attempt Among parents- 5.4% (6.9/ 3.9) Sibling- 5.3% (8.6/ 2.0) Partner- 18.3% (24.1/ 20) Other relatives- 24.8 (34.5/ 13.7)* p= .012 Friends- 26.6 ( 31.0/ 21.6) Any exposure- 44.5 (58.6/ 39.6)* p= .043 Among parents- 5.4% (6.9/ 3.9) Sibling- 5.3% (8.6/ 2.0) Partner- 18.3% (24.1/ 20) Other relatives- 24.8 (34.5/ 13.7)* p= .012 Friends- 26.6 ( 31.0/ 21.6) Any exposure- 44.5 (58.6/ 39.6)* p= .043

    17. 9/3/2012 CCAMH, Caritas Cambodia 17 Table 4 Exposure and Expression Among parents: Ideation- OR=1.012, CI= 0.111-9.215; Probability- OR= 2.361, CI =0.401-13.888 Sibling: Ideation- OR= 4.914, CI= 1.175-20.556 ; Probability- OR= 4.200, CI= 1.016-17.364 Partner: Ideation- OR= 1.339, CI= 0.339-4.607, Probability- OR= 2.296, CI= 0.754-6.992 Other relatives: Ideation- OR= 3.032, CI= 1.052-8.735, Probability- OR= 3.227, CI= 1.162-8.964 Friends: Ideation- OR= 2.667, CI= 0.933-7.619, Probability- OR=1.640, CI= 0.581- 4.628 Any exposure: Ideation- OR= 3.033, CI= 0.999-9.211; Probability- OR= 3.675, CI= 1.230-10.984 Among parents: Ideation- OR=1.012, CI= 0.111-9.215; Probability- OR= 2.361, CI =0.401-13.888 Sibling: Ideation- OR= 4.914, CI= 1.175-20.556 ; Probability- OR= 4.200, CI= 1.016-17.364 Partner: Ideation- OR= 1.339, CI= 0.339-4.607, Probability- OR= 2.296, CI= 0.754-6.992 Other relatives: Ideation- OR= 3.032, CI= 1.052-8.735, Probability- OR= 3.227, CI= 1.162-8.964 Friends: Ideation- OR= 2.667, CI= 0.933-7.619, Probability- OR=1.640, CI= 0.581- 4.628 Any exposure: Ideation- OR= 3.033, CI= 0.999-9.211; Probability- OR= 3.675, CI= 1.230-10.984

    18. 9/3/2012 CCAMH, Caritas Cambodia 18 Summary Majority (80%) consider suicide can be prevented but there are misconceptions related to aspects of communicating suicide, as almost 50% consider talking to someone may evoke suicide-expressions and just as many consider suicide happens without warning. Comparitive note, More girl students were undecided about those who talk do not attempt, shows they need more awareness in this area.Comparitive note, More girl students were undecided about those who talk do not attempt, shows they need more awareness in this area.

    19. 9/3/2012 CCAMH, Caritas Cambodia 19 Summary (...contd) Exposure to suicide is high in Cambodia and there is gender difference in reporting Exposure is associated with suicidal expression This study fails to find significant association between misconception and suicidal expression Exposure seems to have no association to misconceptions/ attitude in this study Limitation of the study (small sample in university setting) Add a line on gender difference in reporting exposure to suicideAdd a line on gender difference in reporting exposure to suicide

    20. 9/3/2012 CCAMH, Caritas Cambodia 20 Conclusion Young people exposed to suicide should be the focus of suicide prevention programs Gender difference in misconception need to be addressed in sensitizing young people about suicide Study conducted in larger setting, in rural, semi-urban and urban areas might throw better light on misconceptions, suicidal expression and exposure among young people in Cambodia

    21. 9/3/2012 CCAMH, Caritas Cambodia 21

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