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In this part of the test, you will a lecture on the topic of Secondary Prevention or Suicide While listening, answer questions in the spaces provided below. There will be a short space between each question You now have one minute to read through the questions and you will hear the talk once only.
Questions
1. Complete the following list. The number of suicide deaths in the US _______________ The number of suicide deaths worldwide almost _______________ The percentage of suicide deaths among all disease related deaths _______________ 2. Complete the following table. Suicidal behaviour Completed suicide Suicide
attempt Suicidal ideation Deliberate injury to oneself Unsuccessful attempt Definition
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Listening Part B
3. Complete the following notes. 83% of people who commit suicide or attempt suicide had contact with doctor within _______________________________________________________________________________ 66% of people who commit suicide or attempt suicide had contact with doctor within __________________________________________________________ __________________________________________________________ As a result, these statistics could be lowered with better
4. Complete the following table. Suicidal Prevention Strategy Primary suicide prevention ________________________________ ________________________________ Aim
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Listening Part B
_______________________________________________ _______________________________________________
6. Answer
the
following
questions.
o Why
is
the
clinical
evaluation
of
the
medical
and
psychiatric
history
of
a
patient
important?
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Listening Part B
o What two mood disorders are associated with over half of suicides? _________________________________________________________________________ _________________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________
o What does the percentage 80% represent? o What do physicians need to be taught? o Why should health professionals ask patients about suicidal ideation? o What are 3 reasons why health professionals may not ask such questions? _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________
7. Complete the gaps in the summary. Antidepressant medications are the most ____________________________used pharmacological interventions in secondary suicide prevention. However, according to studies, their effectiveness in __________________ suicide attempts have had variable results. For adults under 25 the effect of antidepressants seems to be ___________________on suicidal behavior. However, it does seem to reduce the risk of suicidal behavior in the __________________. Therefore, the relationship between _____________________ and ___________________requires further investigation before this class of medication can be ________________ used for the secondary prevention of suicide.
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Email: oetonline@gmail.com
Listening Part B
8.
Circle
the
best
answer.
1.
Suicide
rates
may
decrease
due
to
a) improved
physiological
treatment
of
depression
and
alcoholism
b) improved
psychological
treatment
of
depression
and
alcoholism
c) improved
psychological
and
pharmacological
treatment
of
depression
and
alcoholism
2.
Which
form
of
follow
up
care
has
had
no
impact
on
suicide
ideation?
a) Private
psychiatrists
b) Telephone
follow-up
c) Standard
after
care
3.
UK
studies
on
reduced
access
to
legal
means
of
suicide
a) Support
the
findings
that
it
can
reduce
the
number
of
suicides
b) Contradict
the
findings
that
it
can
reduce
the
number
of
suicides
c) is
outdated
so
therefore
not
relevant
Answer
the
following
questions.
o Why
have
media
black
outs
in
reporting
suicides
led
to
a
reduction
in
suicide
rates?
____________________________________________________________
____________________________________________________________
9.Complete
the
gaps
in
the
paragraph
below.
In
spite
of
our
increasing
knowledge
regarding
suicide
prevention,
there
are
still
many
__________________
in
the
research
and
looking
to
the
future,
thorough
__________________
and
appropriate
treatments
of
patients
with
____________disorders
and
other
psychiatric
_____________
should
help
to
improve
the
efficacy
of
secondary
prevention
of
suicide.
But,
it
is
also
clear
that
more
_________________
into
new
approaches
for
the
prevention
and
treatment
of
suicidal
behavior
remains
_____________.
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Listening Part B
End
of
Part
B
You
now
have
2
minutes
to
check
your
answers.
Now check your results and add up your score with on the answer sheet. Your Score________ Total
Marks
49
To
pass
the
listening
test
you
need
to
get
at
least
65%,
so
for
this
exam
you
need
to
get
at
least
32/49.
Answer
Sheet
Total
Marks:49
One
mark
for
each
correct
answer.
Underlined
words
essential.
Variations
in
vocabulary
and
grammar
are
acceptable
Slash
/
indicates
alternative
answers
Brackets
(_______)
indicate
optional
details
which
do
not
need
to
be
included
Question
1
30,000
900,000
1.5%
Question
2
successful
suicide
attempt
suicidal
thoughts
self-harm
behavior
Question
3
contact
with
doctor
within
a
year
(of
their
death)
contact
with
doctor
within
a
month
(of
their
death)
better
prevention
techniques
Question
4
reduce
number
of
new
cases
in
general
population
decrease
the
likelihood
of
a
suicide
attempt
in
high-risk
patients.
geographical
area
age
group
Question
5
medical
or
neurological
illnesses
cigarette
smoking
aggressive
personality
traits
poor
access
to
psychiatric
treatment
financial
troubles
a
family
history
(of
suicide)
drug
abuse
Question
6
it
enables
the
identification
of
risk
factors
major
depressive
disorder
bipolar
disorder
untreated
psychiatric
disorders
(to
recognize
the)
association
between
mental
disorders
and
suicide.
patients
will
often
talk
(frankly)
about
their
suicidal
thoughts
discomfort
(with
the
topic)
lack
of
time
lack
of
skills
(in
this
area)
Question
7
widely
reducing
neutral
elderly
antidepressants
suicide
safely
Question
8
1. C
2. B
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Listening Part B 3. A Question 9 (media reports) glamorize suicide (for vulnerable individuals) (it provides) accessible instructions Question 10 gaps evaluations depressive illnesses research essential
Transcript
Now
read
question
1
Pause
10
seconds
Suicide
poses
major
threats
to
public
health
worldwide.
In
2002,
suicide
ac-
counted
for
about
30,000
deaths
in
the
US
alone
and
almost
900,000
deaths
worldwide.
This
translates
to
1.5%
of
all
deaths
related
to
disease
.
However,
I
am
convinced
that
suicide
can
and
should
be
prevented.
Pause:
10
seconds
Now
read
question
2
Pause
15
seconds
According
to
recent
research,
suicidal
behavior
can
be
distinguished
into
4
distinct
categories
which
are
1. completed
suicide
where
a
person
has
been
successful
in
their
attempt
to
commit
suicide
2. suicide
attempt
where
a
person
has
been
unsuccessful
in
their
attempt
to
commit
suicide
3. suicidal
ideation
which
is
where
a
person
is
having
suicidal
thoughts
4. self-harm
behavior:
where
a
person
injures
themselves
deliberately
Pause
10
seconds
Now
read
question
3
Pause
15
seconds
It
is
important
to
realise
that
83%
of
people
who
commit
suicide
or
attempt
suicide
have
had
contact
with
a
doctor
within
a
year
of
their
death
and
up
to
66%
of
people
who
commit
or
attempt
suicide
have
had
such
contact
within
a
month
of
their
death.
Therefore,
with
better
prevention
techniques
these
figures
could
be
reduced.
Pause
10
seconds
Now
read
question
4
Pause
15
seconds
We
can
divide
suicide
prevention
into
3
categories
which
are
primary,
secondary,
or
tertiary.
Primary
suicide
prevention
aims
to
reduce
the
number
of
new
cases
of
suicide
in
the
general
population.
Secondary
suicide
prevention
aims
to
decrease
the
likelihood
of
a
suicide
attempt
in
high-risk
patients.
Tertiary
suicide
prevention
occurs
in
response
to
completed
suicides
and
attempts
to
diminish
suicide
in
a
particular
geographical
area
or
in
a
particular
age
group
Pause
10
seconds
Now
read
question
5
Pause
15
seconds
I
would
now
like
to
look
at
Secondary
suicide
prevention
in
more
detail.
Secondary
suicide
prevention
is
particularly
important
but
not
always
given
the
attention
that
it
deserves,
in
part
because
research
into
secondary
prevention
is
only
just
starting
to
be
applied
to
clinical
practice.
Now,
from
a
clinical
perspective,
Suicide
is
often
difficult
to
predict
due
to
its
complex
nature.
The
three
major
risk
factors
that
contribute
to
suicidal
behavior
are
Biological,
Psychological
and
proximal
stressors
which
are
recent
events
that
can
lead
to
increased
suicide
risk
Firstly
there
are
biological
risk
factors
for
suicide
which
include
Low
blood
cholesterol
levels
Medical
or
neurological
illnesses
such
as
multiple
sclerosis,
stroke,
Huntington
disease,
and
epilepsy
Cigarette
smoking
Secondly
there
are
Psychological
risk
factors
include
A
Childhood
history
of
physical
or
sexual
abuse
Aggressive
personality
traits
Low
self-esteem
Poor
access
to
psychiatric
treatment
Thirdly
there
are
the
proximal
stressors,
or
the
recent
events
that
can
lead
to
increased
suicide
risk
include:
Relationship
problems
with
a
spouse
partner
or
loved
one
Financial
troubles
caused
by
unemployment
or
large
amounts
of
debt
A
family
history
of
suicide
Major
depression
Drug
abuse
Pause
20
seconds
Now
read
question
6
Pause
15
seconds
The
suicide
assessment
The
clinical
evaluation
of
the
medical
and
psychiatric
history
of
a
patient
and
of
their
current
state
is
the
crucial
and
essential
element
of
the
suicide
assessment
process.
It
is
important
because
it
enables
the
identification
of
risk
factors,
in
order
to
determine
the
patients
immediate
safety
and
the
best
setting
for
treatment,
and
also
to
develop
diagnosis
and
treatment
strategies.
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Email: oetonline@gmail.com
Listening Part B Psychiatric illness is a major contributing factor to suicide risk, with mood disorders such as major depressive disorder and bipolar disorder being associated with about 60% of suicides. Indeed, psychiatric disorders are diagnosed in more than 90% of completed suicides, and more than 80% of these psychiatric disorders are untreated. Thus, the recognition and treatment of individuals with psychiatric disorders, specifically mood disorders, are essential components of secondary suicide prevention. In addition, the subjective rating of the severity of depression is one of the most powerful predictors of future suicidal acts. Therefore, assessing and managing depression as well as being aware of the suicide risks in psychologically, medically, and neurologically disordered individuals is an important aspect of secondary suicide prevention . Consequently, physicians need to be taught to recognize the association between mental disorders and suicide. Additional information about the individual who may be at risk for suicide, such as medical and psychiatric treatment records, and toxicology screenings, should also be incorporated into the assessment. Equally importantly, clinicians and other professionals in a position to offer help should not hesitate to ask patients about suicidal ideation because, while it may seem surprising, patients will often talk frankly about their suicidal thoughts and tendencies if given the opportunity. Failure to ask about suicidal ideation may be related to the health professionals discomfort with the topic, lack of time, or lack of skills in this area. Clinicians need to overcome these obstacles to provide appropriate care to their patients. Pause 30 seconds Now read question 7 Pause 15 seconds What are the most effective secondary suicide prevention strategies? In a recent systematic review of suicide prevention strategies, Mann along with other researchers found evidence of effectiveness in five secondary suicide prevention methods including : 1. pharmacological interventions, 2. psychological interventions 3. follow-up care 4. reduced access to lethal means 5. responsible media reporting of suicide. Antidepressant medications are the most widely used pharmacological interventions in secondary suicide prevention, but studies of their effectiveness in reducing suicide attempts have had mixed results. Among adults younger than 25 the effect of antidepressants seems to be neutral on suicidal behavior but it seems to reduce the risk of suicidal behavior in the elderly. Thus, the relation between antidepressants and suicide needs further studies before this class of drugs can be safely used for the secondary prevention of suicide. Pause 20 seconds Now read question 8 Pause 15 seconds In terms of psychological interventions, suicidal patients often benefit from therapies that address the repetition of suicidal thoughts and behaviors, and other factors commonly associated with suicide. Better psychological and pharmacological treatment of depression and alcoholism, also appears to decrease suicide rates Social factors that should be addressed in follow-up treatment include availability and willingness of supports within the family. Support individuals who should be contacted about the suicide risk and follow-up arrangements include general practitioners, private psychiatrists, family, and friends. Some interventions, however, such as telephone and psychosocial follow-up, have shown no difference in suicidal ideation when compared with standard after-care. Many studies show that suicides by particular methods for example, firearms, domestic gas, or pesticides decrease after the introduction of legal restrictions that reduce access to such means. This reduction in suicide rates is particularly influential in regions where the specific means of restriction correlates with a common method of suicide. For example, in the UK the reduction of carbon monoxide in domestic gas since 1958 and the reduced availability of analgesics since the mid-1990s have both decreased UK suicide rates . Pause 20 seconds Now read question 9 Pause 15 seconds Finally, many studies have exposed a need for a decrease in reporting of suicide and for responsible reporting. Media black- outs in reporting suicide have coincided with a decrease in suicide rates , because reports of suicide in the media tend to glamorize suicide for vulnerable individuals. The Internet is also of increasing concern, with blogs and chat rooms providing accessible instructions for suicide. For these reasons, guidelines have recently been produced for the responsible reporting of suicide. Pause 20 seconds Now read question 10 Pause 15 seconds Despite our increasing knowledge about secondary suicide prevention, there are still many gaps in the research and looking to the future, thorough evaluations and appropriate treatments of patients with depressive disorders and other psychiatric illnesses should help to improve the efficacy of secondary prevention of suicide. But, it is also clear that more research into new approaches for the prevention and treatment of suicidal behavior remains essential.
This resource was developed by OET Online and is subject to copyright Website: http://oetonline.com.au
Email: oetonline@gmail.com