Coping mechanisms as predictors of suicidal ideation among the medical students of Pakistan.

OBJECTIVE: To identify the coping mechanisms as positive and negative predictors of suicidal ideation among medical students. METHODS: This cross-sectional analytical study was conducted from January to October 2017, and comprised students aged 19-25 years selected from 3 public-sector medical colleges located in Gujrat and Lahore, both in the Punjab province of Pakistan. Multilevel mixed methods sampling was used. Two standardised scales were used to assess the suicidal ideation and coping mechanisms of the participants. RESULTS: Of the 1200 subjects, 640(53%) were males and 560(47%) were females. Besides, 390(32%) subjects hailed from Gujrat and 810(68%) from Lahore. Self-distraction (p<0.05)), active coping (p<0.0001), use of emotional support (p<0.05), use of instrumental support (p<0.001) positive reframing (p<0.0001), planning (p<0.001), humour (p>0.05), acceptance (p<0.001) and religion (p<0.0001) were negative predictors of suicidal ideation whereas denial (p<0.0001), substance use (p<0.05), venting (p>0.05) and self-blame (p<0.0001) were positive predictors of suicidal ideation. CONCLUSIONS: A psycho-educational programme must be introduced for medical students to enable them to adopt the right coping strategies in order to handle stressful situations.

Social exclusion, mental health and suicidal ideation among adults with hearing loss: protective and risk factors.

OBJECTIVE: To investigate social exclusion, mental health and demographic characteristics as risk and protective factors of suicidal ideation among adults with hearing loss. . METHODS: This analytical, cross-sectional study was conducted in Lahore, Pakistan, from June 2016 to January 2017, and comprised people with hearing loss. Multistage proportionate stratified sampling procedure was used. Mental Health Inventory, Social Exclusion Scale and Suicidal Ideation Attributes Scale were administered to the participants. RESULTS: Of the 415 subjects, 246(59.3%) were males and 169(40.8%) females. Suicidal ideation was significantly and positively related to social exclusion (p<0.001), psychological distress (p<0.001), age (p<0.001)) and severity of hearing loss (p<0.05), whereas a significant negative relationship of suicidal ideation (p<0.05) was observed with psychological well-being. Hierarchical regression analysis indicated social exclusion (p<0.001), psychological distress (p<0.001), age (p<0.001), severity of hearing loss (p<0.001) and gender (p<0.001) as significant positive predictors (risk factors), whereas psychological well-being (p<0.05)) was a significant negative predictor (protective factor) of suicidal ideation. CONCLUSIONS: Social exclusion, psychological distress, severity of hearing loss and age were risk factors, whereas psychological well-being was a protective factor regarding suicidal ideation.

Prevalence and Predictors of Non-Suicidal Self-Injury among Children with Autism Spectrum Disorder.

OBJECTIVES: To find the prevalence as well as to identify the predictors as protective and risk factors of Non-Suicidal Self-Injury (NSSI) among children with autism spectrum disorder (ASD). METHODS: In this analytical cross sectional survey 83 children with ASD age range from 8 to 18 years were selected through convenient sampling technique from five special schools of Lahore city. The Urdu form of a standardized tool was used to assess NSSI. RESULTS: Statistical analysis indicated overall point prevalence of NSSI was 33%. Moreover banging/self-beating (47%), scratching (38), pinching (35%), picking scabs (33%), self-biting (32%), pulling hair (30%) and rubbing skin (19%) emerged as common forms of challenging behavior. Further regression analysis showed that age B(1.68*, P<.05), gender B(3.72, P<.001) and severity level of ASD B(1.85***, p<.0001) as risk factors/positive predictors of NSSI. However early intervention (-0.66***, P<.0001) and involvement of parents in counselling (-2.66*, P<.05) emerged as protective factors/negative predictors of NSSI among children with ASD. CONCLUSION: Non-suicidal self-injury is a serious challenge among children with ASD. Early intervention, counselling and parental involvement in managing the children with ASD will not only prevent but reduce the challenging behaviors.