Talk:Suicidal ideation/Archive 1
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Archive 1 |
Suicide ideation?
Isn't the proper term "suicide ideation"? —Preceding unsigned comment added by 66.92.186.195 (talk • contribs) 21:17, 24 February 2007
- Not as far as I know. --Lukobe 23:16, 28 February 2007 (UTC)
Loneliness
...is a psychiatric disorder?? Chris 19:08, 29 June 2007 (UTC)
copyvio?
All of the bulleted lists here are from [1], which is one of the external links. Is that enough for copyvio? -- Mikeblas 02:13, 15 August 2007 (UTC)
Symptoms section
I am changing the title of the "Symptoms associated with suicide" to "Symptoms associated with suicide ideation" as this is much more accurate and less confusing Bobprime 19:07, 20 August 2007 (UTC)
Epidemiology
Should include reference to drugs (e.g. some antidepressants, some diet pills) for which suicidal ideation is a reecognised possible side effect. Discussion of this and cross-references would be worthwhile.
age at risk in men
the article at the mo says men 65+ are more at risk. Could someone find a source for this? Only my understanding was that it was young men who are more at risk of suicide than other age groups. Although maybe it was just that their risk/incidence of suicide is increasing? And maybe they are more at risk of suicide itself, whereas older men are more at risk of suicidal ideation? Special Random (Merkinsmum) 01:33, 4 March 2008 (UTC)
- Yes: in many parts of the world (e.g. Australia) it is now young men who are at the greatest risk of suicide. This article needs work, but sadly is only around 5 on my to-do list. Maybe I will prioritise it -- I mean it is rather important, isn't it? --Anonymaus (talk) 08:57, 23 June 2008 (UTC)
Victim?
The article uses the phrase "suicide victim". It seems rather odd to say that one is a "victim" of something that they have deliberately chosen to do in full knowledge of the outcome. --88.110.34.12
- That's quite normal and not unique to this article. People commit suicide as a result of desperation or mental illness - they are essentially victims of circumstance. Chris 19:08, 29 June 2007 (UTC)
- Perhaps, victims of their own actions and mindstate certainly. The use of the term 'victim' is valid in my opinion.--EchetusXe (talk) 23:48, 7 October 2008 (UTC)
ideation
"Most people who undergo suicidal ideation do not commit suicide", sounds like a retelling of the myth that 'If someone talks about suicide, then they won't do it', though it can be cited to http://www.aafp.org/afp/990315ap/1500.html . It seems to carry a connotation that if someone is undergoing ideation then they most likely won't, though it appears that ideation is a symptom of the risk though not a gaurantee. I think the sentence is factually correct, but sounds like it is saying something else.--Moriar 03:32, 15 November 2006 (UTC)
- Yes, I agree, it sounds like the message it is trying to say is that; people who experience suicidal ideation, are hardly serious about suicide and are more like threats for attention. although, as you said the sentence is correct - maybe it should be rewritten in a different way. --JamesDouch (talk) 09:20, 5 March 2010 (UTC)
- I think you mean "people who talk about committing suicide are... [threatening] for attention", as plenty of people have thoughts of suicide without talking about it, and that's hardly calling for attention. As for the original phrasing, I think it's accurate and doesn't give a false impression at all: the majority of people who think about committing suicide don't actually commit suicide. --aterimperator (talk) 01:00, 16 June 2012 (EST)
Improvement Possibilities
Perhaps expanding on the signs of Suicidal Ideation can help people who could be worried about a loved one. Some examples on the signs of Suicidal Ideation would also be helpful as well as informational. Also, the actual article is somewhat unclear as to the purpose and maybe a few more would make it seem more factual.
Details
The lists make it sound like any problem or disorder an individual has a possibility leading to suicidal thinking. They should use less links to certain pages and write the explanations and reasonings on this page. — Preceding unsigned comment added by KTomnitz (talk • contribs) 04:22, 18 September 2011 (UTC)
NPOV?
Although I sympathize with the general POV of this article, it does not seem to meet Wikipedia's standard of NPOV. ("should" statements...) Aleta 08:31, 7 December 2006 (UTC)
To me, it seems biased and suggests that commiting suicide is not the right thing to do for a depressed person. I also agree with Aleta's statements. --D. James 04:14, 8 December 2006 (UTC)
- Depression is a medical condition. The "right thing to do" for any medical condition is the medical treatment prescribed by doctors. It's not NPOV so much as common practice. The Transhumanist 14:54, 24 February 2007 (UTC)
- The second paragraph is problematic. I'm not sure whether it ought to be rewritten or just eliminated totally. Wikipedia is not a mental health support line; is this content really encyclopedic in scope? LeaHazel : talk : contribs 19:21, 14 January 2007 (UTC)
- No, it's not. I'm removing it.—Preceding unsigned comment added by Lukobe (talk • contribs)
- I'm glad someone agrees. Good removal, the article is much better now, short though it might be. Are there any other studies on suicidal ideation? The article could use expansion (in a way that doesn't involve the word "should"). LeaHazel : talk : contribs 06:41, 1 March 2007 (UTC)
- No, it's not. I'm removing it.—Preceding unsigned comment added by Lukobe (talk • contribs)
- On that topic, and I know its normal usage in English, but is 'commit suicide' the right way to say it? it really criminalizes suicide, and criminalization is kind of non-neutral. — Preceding unsigned comment added by 186.105.73.77 (talk) 19:42, 19 July 2012 (UTC)
Missing Risk Factors
There appear to be some obvious risk factors missing under "Life Events", such as job loss or financial problems, legal problems (especially criminal charges or those already incarcerated), and disgrace or extreme damage to reputation. The last one might not be as great a risk factor, but I'm certain the first two are quite significant. — Preceding unsigned comment added by 24.61.81.69 (talk) 19:50, 15 June 2013 (UTC)
- Hi 24.61.81.69! Welcome to Wikipedia, and you are quite right. Please, find some good and reliable sources, be bold and add to this section! Lova Falk talk 08:16, 24 June 2013 (UTC)
Anti-med POV?
Has there been any cases that have been proved to not be caused by failure to follow the doctor's orientations regarding dosages, frequency, interactions with other drugs etc? The way it is now it sounds like a big part of the article was written by people with an agenda against antidepressive medications --189.60.4.98 (talk) 03:53, 24 December 2013 (UTC)
Should this page have a warning?
The contents of this page, while referenced, seems to make statements which may be misintrepreted or misunderstood. The reference to borderline personality disorder appears to imply a diagnosis which is not supported by the referenced article. The reference to drug dangers without citation seems reckless.
The quality of this C Class article combined with it's topic make it's value questionable. Does this article have the potential to be harmful, if it has inaccuracies? If so, why does it not have a warning? Many incomplete Wikipedia pages do.
Compare this article quality, to this one: http://en.wikipedia.org/wiki/Suicide_prevention
-- just a human, concerned about other humans reading this — Preceding unsigned comment added by 60.240.172.112 (talk) 12:01, 23 April 2014 (UTC)
Socially acceptable suicidal ideation?
This whole page treats suicidal ideation as a Bad Thing.
Whereas, in the real world, in some countries and some US States, assisted suicide is fully legal.
And it's reasonable to assume that the people in those places who are assisted in committing suicide have experienced suicide ideation.
I think the article should acknowledge that aspect.
Comments welcome.
Advisory at Top of Article
I think as an article dealing with the topic of suicide, it should also include some manner of advisory at the top, noting something along the lines that individuals who are contemplating suicide should seek help, and maybe even offer a crisis assistance hotline number to contact. I think people who tend to look up this topic are themselves often ideating suicide attempts. For the sake of social responsibility that it should be included as a best practice for all suicide-related articles. I think some of the Wikipedias in the other languages do this as well. — Preceding unsigned comment added by 198.182.194.170 (talk) 20:49, 14 July 2016 (UTC)
Signs and Symptoms: unclear sentence
"The onset of symptoms like these with an inability to get rid of or cope with their effects, a possible form of psychological inflexibility, is one possible trait associated with suicidal ideation."
This sentence is poorly phrased, but I am not confident amending it, having no domain-specific expertise. The top-level grammar problem is that the "onset of symptoms" is not a "trait", but an event. The whole sentence is confusing. Its most salient content is that the troubling symptoms mentioned in the previous sentence may be compounded or exacerbated by psychological inflexibility, or a feeling that one is unable to rid oneself of or cope with unwanted psychological states. It should just say that; I think the frame ("The onset of symptoms... is one possible trait associated with suicidal ideation.") serves no useful purpose.
I would typically just be bold here and do it myself, but I can't check the source and I don't feel sure. Regulov (talk) 05:26, 8 August 2018 (UTC)
Mental Health Issues in Law Enforcement
This post is for my college English class. I am writing about mental health and suicides in public safety.The number of suicides by first responders continues to climb yearly. In 2018, the number of police officers who died by their own hand than those killed in the line of duty (Blue H.E.L.P., 2019). The number is higher that 2017. There is no database formally tracking the number of suicides so it is possible that the number of suicides may be much higher than they are believed to be. Continued exposure to traumatic and/or violent incidents takes a toll on first responders that can lead to excessive drinking, depression, anxiety, insomnia, physical health issues, and suicidal ideations. There is a stigma in law enforcement about appearing weak or unfit for duty that prevents officers from reaching out for help. Police departments are becoming increasingly aware of the problems that can be caused by repeatedly responding to highly charged incidents and the effects it has on employees. Police departments have begun to create programs to help employees through difficult times by having chaplains and counselors on site. Other departments have created wellness programs, or peer support programs, such as a buddy programs, that have officers checking in on each other to help identify when a colleague is in need of help. Finding other protective factors such as hobbies, exercise, maintaining a healthy diet, and a strong support system are necessary for mental health stability. — Preceding unsigned comment added by SFcitygirl22 (talk • contribs) 02:46, 5 January 2019 (UTC)
I feel like this probably isn't what your instructor had in mind. Regulov (talk) 15:41, 27 July 2019 (UTC)
High Place Phenomenon
I came across one study ("An urge to jump affirms the urge to live: an empirical examination of high place phenomenon"; Hames JL et al.; J Affect Disord; 2012 Feb; 136(3):1114-20), which finds no correlation between HPP and suicidal tendencies. Maybe an expert on the field should reconsider linking HPP here. --Vanderflauen (talk) 09:15, 31 August 2018 (UTC)
- Myself and some online discussions agree it is not a suicide intent.
But I can't find any other sources on this, I just have my theory about remnant of leaping trees.--Musaran (talk) 21:17, 15 April 2020 (UTC)
Medicalisation
The article sounds like it is suggesting that suicidal ideation is a mental disorder. I think it would be more accurate to say it 'can be' a symptom of a disorder rather than "is". You can clearly contemplate suicide and not meet the criteria for any disorder. You can be just reacting to a brief crisis or seeking relief from a chronic health condition as precipitator to the ideation and not meet the criteria for depression, anxiety or psychosis etc. 89.242.188.218 (talk)
- The lead already currently states that it "is not a diagnosis for the DSM-5, but is rather a symptom of many mental disorders." Flyer22 Frozen (talk) 23:48, 10 October 2020 (UTC)
Short description
The current short description for this article, which was pulled from Wikidata, is: "Having an unusual preoccupation with suicide". We should change the short description because the current version is inaccurate and pejorative. It is inaccurate because "preoccupation with suicide" describes one type of suicidal ideation. Missing from the description are other manifestations of suicidal ideation, such as "thinking about", "considering", or "planning for" suicide.
I seriously doubt anyone intended the current short description to come across as disparaging. The word "unusual" has two meanings in this context. It can mean "uncommon", which I assume is the intended meaning in the current short description. However, "unusual" can also mean "deviating from the normal; peculiar, strange."[1] Many people reading the current short description will read it as "having a strange preoccupation with suicide."
People suffering from major depressive disorder, schizophrenia-spectrum disorders, bipolar disorder, and substance use disorders, for example, often feel stigmatized. We do not want to pour salt on that wound.
The most common definition for suicidal ideation is: "thinking about, considering, or planning for suicide", as stated and cited in the first sentence of the article. Our short description should be something like "ruminating about suicide". Mark D Worthen PsyD (talk) [he/his/him] 05:33, 5 October 2020 (UTC)
- Thanks for pointing this out. I agree it needs to be changed. How about "thinking about, considering, or planning for suicide"? "Ruminating", while accurate, may not be easily understood by the average Wikipedia reader. Sundayclose (talk) 16:57, 5 October 2020 (UTC)
- I second the motion! Good point about "ruminating". :0) Thank you. Mark D Worthen PsyD (talk) [he/his/him] 19:29, 5 October 2020 (UTC)
- I'd state that "thinking about, considering, or planning for suicide" is "having an unusual preoccupation with suicide." That is, if the "thinking about it" is prolonged or was persistent at some point in a person's life. I don't think of the "unusual" wording as pejorative, and I state that as someone who experiences suicidal ideation. I don't consider it the same as saying that someone with bipolar disorder, for example, isn't normal. The disorder (bipolar disorder) is atypical, but that doesn't mean that the person isn't normal. We wouldn't want to state that a person isn't normal. But as for the condition or disorder? We do use the word atypical in some cases. Experts on suicidal ideation are clear that suicidal ideation is an atypical way of thinking/behaving. It's normal for me and others who deal with suicidal ideation, but it's not typical for the general population to experience suicidal ideation. Despite the lead currently stating "thinking about", suicidal ideation is not a passing thought about suicide. It's persistent thoughts about suicide, or a pronounced enough thought about it that it is distressing or leads to suicide. Now I understand why the IP I reverted wanted to lead with the DSM-5 definition of "thoughts about self-harm, with deliberate consideration or planning of possible techniques of causing one's own death."
- I second the motion! Good point about "ruminating". :0) Thank you. Mark D Worthen PsyD (talk) [he/his/him] 19:29, 5 October 2020 (UTC)
- All that stated, I understand that your intention is good, Markworthen, and I can be okay with the current short description since it's the same as the lead. The short description usually isn't the same exact wording as the lead, though. Flyer22 Frozen (talk) 02:05, 6 October 2020 (UTC)
- And, yes, I know that the article also states "varies from fleeting thoughts to detailed planning." But the fleeting thoughts are persistent...at least for a time in the person's life. That's why they are considered a risk factor for suicide. I've yet to see an expert on this topic who feels that someone having thought about suicide once and with no serious consideration toward committing suicide as someone who has experienced actual suicidal ideation. Flyer22 Frozen (talk) 02:18, 6 October 2020 (UTC)
Do not breake the definition please. Long or short, in any way it should include the remark about deliberate consideration or planning, because it is the most simple way to indicate that just "thinking about suicide" is nothing more than thinking activity and is not a suicidal ideation. There was a reason for putting exactly such definition it DSM-5. — Preceding unsigned comment added by 37.78.189.116 (talk • contribs)
- IP, as you can see, I stated similarly above.
- This version of your text has been reinstated. Flyer22 Frozen (talk) 02:59, 31 October 2020 (UTC)
- I made some edits to begin the process of improving this disjointed, often inaccurate article (diff). Please read the references I cited for the first sentence before you conclude that DSM-5 has the last word on this topic. Thank you. Mark D Worthen PsyD (talk) [he/his/him] 20:10, 22 November 2020 (UTC)
___
References
- ^ "Merriam-Webster Unabridged". Retrieved 5 October 2020.
RfC on how to define "suicidal ideation" and compose the lead paragraph
I propose changing the first paragraph from: Suicidal ideation (or suicidal thoughts) is thinking about suicide with deliberate consideration or planning. Suicidal ideation is not a diagnosis, but is rather a symptom of many mental disorders.
to: Suicidal ideation means thoughts of engaging in suicide-related behavior, although this definition is not universal. For example, the American Psychiatric Association defines suicidal ideation as "thinking about suicide with deliberate consideration or planning." Suicidal ideation is not a diagnosis, but is rather a symptom of many mental disorders. // Submitted for your consideration by Mark D Worthen PsyD (talk) [he/his/him] 15:51, 28 November 2020 (UTC)
Explanatory notes
Note_1: A kind editor suggested that a survey (support or oppose) is not necessary and potentially counter-productive when discussing the wording of a lead paragraph. It is usually better to simply discuss and try to reach a consensus. I very much appreciate this appropriate and helpful suggestion. I changed "Survey" to "Discussion" (immediately below). I changed my own entry by striking through "Support" and editing the first sentence, but I left the other two editors' text intact, since it is theirs to edit or not. Thank you for your patience and understanding. - Mark D Worthen PsyD (talk) [he/his/him] 23:45, 29 November 2020 (UTC)
Note_2: See the table below for sourced descriptions and definitions of suicidal ideation. Kolya Butternut (talk) 11:40, 30 November 2020 (UTC)
Survey
* Support - Please see discussion above for context. (Talk:Suicidal ideation#Definition and Teminology section and Talk:Suicidal ideation#Short description). Briefly, the proposed change consistently comports with more reliable sources than the current version, and the proposed change is consistent with the article's short description ("thinking about, considering, or planning for suicide"), whereas the current lead paragraph contradicts the short description. Mark D Worthen PsyD (talk) [he/his/him] 15:51, 28 November 2020 (UTC)
- Opppose per my arguments in #Definition and Terminology section above. To repeat, having the lead sentence state "usually means thoughts of engaging in suicide-related behavior" is not a good WP:Lead sentence. The wording "engaging in suicide-related behavior" is vague while the wording "is thinking about suicide with deliberate consideration or planning" is clear and tells us exactly what it is. This is not only the DSM-5 definition. That is why the lower part of the lead tells us that passive suicidal ideation is "not wanting to be alive or imagining being dead", while active suicidal ideation "is thinking about different ways to die or forming a plan to die." The "is thinking about suicide with deliberate consideration or planning" covers those two aspects. There is no need to state anything in the lead about a definition not being universal. The table in the #Comment section below speaks to my point. Those sources, which are authoritative medical sources, show what I mean about how we should begin the lead sentence. Flyer22 Frozen (talk) 02:19, 29 November 2020 (UTC)
- And this 2014 "The Oxford Handbook of Suicide and Self-injury" source, from Oxford University Press, pages 17 to 18, speaks of what I meant in the "Definition and Terminology section" discussion above about the overlap. The source also makes a case that it is important to distinguish suicidal ideation from suicidal behavior. Flyer22 Frozen (talk) 01:56, 2 December 2020 (UTC)
- "Suicide-related behavior" or "suicidal behavior" appears to be the current jargon for trying to kill yourself. I agree with you that this will not be obvious to most people. If you thought that was plain English, you'd probably think that suicidal ideation includes anything that a person might do that's related in any way to suicide, such as sleeping too much (as a symptom of depression). On the other hand, I can't support the existing definition, because requiring "with deliberate consideration or planning" means that passive suicidal ideation doesn't count as suicidal ideation, which is wrong. WhatamIdoing (talk) 21:37, 29 November 2020 (UTC)
- As is clear by the "Definition and Terminology section" discussion above, we somewhat disagree on the passive aspect. Flyer22 Frozen (talk) 00:30, 1 December 2020 (UTC)
- oppose per Flyer22 rationale--Ozzie10aaaa (talk) 13:04, 29 November 2020 (UTC)
===Comment=== This paragraph, in the Monitoring and Evaluation section of Preventing Suicide: A Technical Package of Policy, Programs, and Practices (2017)[1] is apropos:
Gathering ongoing and systematic data is important for prevention efforts. However, it is also important to gather data that are uniform and consistent across systems. Consistent data allow public health and other entities to better gauge the scope of the problem, identify high-risk groups, and monitor the effects of prevention programs and policies. Currently, it is common for different sectors, agencies, and organizations to employ varying definitions of suicidal ideation, behavior, and death that can make it difficult to consistently monitor specific outcomes across sectors and over time. For example, the manner in which deaths are classified can change from one jurisdiction to another, and can change based on local medical and/or medico-legal standards. CDC’s uniform definitions[2] and recommended data elements for self-directed violence provide a useful framework to help ensure that data are collected in a consistent manner across surveillance systems. (emphasis added)
- Mark D Worthen PsyD (talk) [he/his/him] 16:23, 28 November 2020 (UTC)
- I'm going to have a read of the sources (and perhaps create some sort of table). The "suicide-related behaviour" term reminds me of terms like "reasonable" in law, a kind of "indirection" where what is suicide related is decided on a case-by-case basis (preferably with reference to other cases); a kind of "too hard to define". Adding a case to consider, suppose someone thinks about ways of killing themselves wherever they go, e.g. they see a knife they think about cutting their throat, they see a car they think of jumping in front of it, this might be considered *persistent* but still *passive* (in the sense that the thought is not directed). In another case, someone might careful plan how they would kill themselves with no actual intent to carry out the plan, this would be *active thought* but have no intent attached to. Talpedia (talk) 17:32, 28 November 2020 (UTC)
- I appreciate the table provided below. It speaks to my point. And the following is the WP:MEDRS guidance about following authoritative sources, which the DSM ad CDC are: Wikipedia:Identifying reliable sources (medicine)#Medical and scientific organizations. Flyer22 Frozen (talk) 02:19, 29 November 2020 (UTC)
- The table below lists "thinking about, considering, or planning for suicide" as one of the CDC's definitions. I don't think that "thinking about suicide with deliberate consideration or planning" is consistent with that. If someone cited that CDC definition, which does not mention deliberate consideration or planning, and stuck in the qualifier that it only counts if you're seriously considering or planning to enact the thoughts, then we'd tick them off for an OR violation.
- NIMH is also an authoritative source, and they give "thinking about, considering, or planning suicide", without any qualifications about seriousness, as their definition, too. WhatamIdoing (talk) 03:37, 1 December 2020 (UTC)
- The table has been updated since my "02:19, 29 November 2020 (UTC)" reply. But, regardless, I was clear that I was not tied to the "deliberate" piece the IP added to the lead. Not to mention that, as can be seen from the #Short description section above, I was the first one to revert the IP. I was clear that my main point has been that I've yet to see an expert on this topic who feels that someone having thought about suicide once and with no serious consideration toward committing suicide is someone who has experienced actual suicidal ideation. My main point has been that the thoughts are recurring. That is...until the person no longer experiences suicidal ideation. Can you point me to a valid source that defines suicidal ideation as a person having thought about suicide once and with no serious feelings with regard to not wanting to live or committing suicide? I do not see it anywhere in the literature. On the other hand, various sources emphasize "recurrent" and they do not view suicidal ideation as some non-serious thing. They instead view it as a risk factor for suicide. If it was a one-time thing without any serious thoughts or consideration toward suicide, it would not be a risk factor. The DSM-5 knows what it is talking about on this matter, and it is not the only source that addresses serious or deliberate consideration with regard to suicidal ideation. For a CDC listing in the table below, it clearly states that suicidal ideation was measured with the question, "During the past 12 months, did you ever seriously consider attempting suicide?" Making a suicide plan was measured with the question, "During the past 12 months, did you make a plan about how you would attempt suicide?" What matters when it comes to diagnosing suicidal ideation are the measures that are actually used. These show what suicidal ideation actually is and if the person is experiencing it, regardless of whatever simple definition is given before getting in-depth on the topic. Flyer22 Frozen (talk) 04:42, 1 December 2020 (UTC) Added a line to my post, and later tweaked my post. Flyer22 Frozen (talk) 05:10, 1 December 2020 (UTC)
- Perhaps more to the point, I see reliable sources that say "thinking about suicide" with no qualifiers or limitations, and I don't see any reliable sources that say that it's not suicidal ideation if it only lasts for a minute or two on one day. No source says that. Even the ones that offer some limitations don't require recurrence or intrustiveness. I personally suspect that the reason that so many sources don't offer any limitations is because they know that some people go from "thinking about suicide for the first time" to "dying" in less than a minute, but they do not explain why so many of them don't limit their definition to exclusively recurrent thoughts, exclusively "serious" thoughts, or exclusively any other subcategory someone might invent. WhatamIdoing (talk) 20:40, 1 December 2020 (UTC)
- Sources don't need to state that it's not suicidal ideation if it only lasts for a minute or two on one day. They are already clear about what is actual suicidal ideation by using qualifiers such as "recurrent" and asking questions like "Did you ever seriously consider attempting suicide"? Suicidal ideation can obviously last a day. But is it likely that it will stop after a day? No. The person is most likely to experience suicidal ideation days, weeks, or months later. Suicidal ideation is not the same thing as someone randomly thinking about suicide (like after reading a book in which a character commits suicide), shrugging their shoulders and then going about their way. I see nothing in the current "Signs and symptoms" section that makes suicidal ideation out to be some trivial, shrug-your-shoulders-at thing. This 2014 "The Oxford Handbook of Suicide and Self-injury" source, from Oxford University Press, page 19, states that "passive ideation, such as the wish to die, has been identified as a risk factor for death by suicide (Brown, Steer, Henriques, & Beck, 2005), with those reporting a wish to die being approximately 5 to 6 times more likely to end their life (Brown et al., 2005). Moreover, although several different terms have been used to refer to passive ideation (e.g., "better off dead", "thoughts of my own death"), it is only "a wish to die" that has been consistently associated with significantly increased risk, therefore eliminating other types of passive thoughts from the spectrum of suicidal ideation." That sure sounds like even passive suicidal ideation is a serious thing. That sure sounds like not all thoughts about suicide count as actual suicidal ideation, at least not "suicidal ideation" that experts focus as much on. The source also states, "A more precise delineation of discrete types of suicidal ideation and their associated definitions was reinforced by research findings that specific types of ideation are associated with elevated risk or subsequent suicidal behavior. In contrast, the dimensional approach to suicidal ideation did not show prediction, underscoring the need to classify types of suicidal thoughts with respect to intent to die and intent to act (Posner et al., 2001). The NIMH Suicide Research Centers Project offered an expert consensus on the definition of suicidal ideation and included wish to die, thoughts of killing oneself, and intent to kill oneself." Yes, the source notes that active suicidal ideation is more severe than passive suicidal ideation, but it does not state that passive suicidal ideation is not serious; it states that it is less severe. Flyer22 Frozen (talk) 01:56, 2 December 2020 (UTC)
- Perhaps more to the point, I see reliable sources that say "thinking about suicide" with no qualifiers or limitations, and I don't see any reliable sources that say that it's not suicidal ideation if it only lasts for a minute or two on one day. No source says that. Even the ones that offer some limitations don't require recurrence or intrustiveness. I personally suspect that the reason that so many sources don't offer any limitations is because they know that some people go from "thinking about suicide for the first time" to "dying" in less than a minute, but they do not explain why so many of them don't limit their definition to exclusively recurrent thoughts, exclusively "serious" thoughts, or exclusively any other subcategory someone might invent. WhatamIdoing (talk) 20:40, 1 December 2020 (UTC)
- The table has been updated since my "02:19, 29 November 2020 (UTC)" reply. But, regardless, I was clear that I was not tied to the "deliberate" piece the IP added to the lead. Not to mention that, as can be seen from the #Short description section above, I was the first one to revert the IP. I was clear that my main point has been that I've yet to see an expert on this topic who feels that someone having thought about suicide once and with no serious consideration toward committing suicide is someone who has experienced actual suicidal ideation. My main point has been that the thoughts are recurring. That is...until the person no longer experiences suicidal ideation. Can you point me to a valid source that defines suicidal ideation as a person having thought about suicide once and with no serious feelings with regard to not wanting to live or committing suicide? I do not see it anywhere in the literature. On the other hand, various sources emphasize "recurrent" and they do not view suicidal ideation as some non-serious thing. They instead view it as a risk factor for suicide. If it was a one-time thing without any serious thoughts or consideration toward suicide, it would not be a risk factor. The DSM-5 knows what it is talking about on this matter, and it is not the only source that addresses serious or deliberate consideration with regard to suicidal ideation. For a CDC listing in the table below, it clearly states that suicidal ideation was measured with the question, "During the past 12 months, did you ever seriously consider attempting suicide?" Making a suicide plan was measured with the question, "During the past 12 months, did you make a plan about how you would attempt suicide?" What matters when it comes to diagnosing suicidal ideation are the measures that are actually used. These show what suicidal ideation actually is and if the person is experiencing it, regardless of whatever simple definition is given before getting in-depth on the topic. Flyer22 Frozen (talk) 04:42, 1 December 2020 (UTC) Added a line to my post, and later tweaked my post. Flyer22 Frozen (talk) 05:10, 1 December 2020 (UTC)
- I appreciate the table provided below. It speaks to my point. And the following is the WP:MEDRS guidance about following authoritative sources, which the DSM ad CDC are: Wikipedia:Identifying reliable sources (medicine)#Medical and scientific organizations. Flyer22 Frozen (talk) 02:19, 29 November 2020 (UTC)
- I'm going to have a read of the sources (and perhaps create some sort of table). The "suicide-related behaviour" term reminds me of terms like "reasonable" in law, a kind of "indirection" where what is suicide related is decided on a case-by-case basis (preferably with reference to other cases); a kind of "too hard to define". Adding a case to consider, suppose someone thinks about ways of killing themselves wherever they go, e.g. they see a knife they think about cutting their throat, they see a car they think of jumping in front of it, this might be considered *persistent* but still *passive* (in the sense that the thought is not directed). In another case, someone might careful plan how they would kill themselves with no actual intent to carry out the plan, this would be *active thought* but have no intent attached to. Talpedia (talk) 17:32, 28 November 2020 (UTC)
- Oppose this proposal. It's too much emphasis on
just vaguesolely the vague term "thoughts" and this can be misleading regarding what sources actually say it means. And saying "although this definition is not universal. For example..." seems less than ideal, and has a risk of WP:Editorializing. I don't see that those sources, which all are connected to U.S. government agency definitions, necessarily outweigh the DSM-5 (and the review article also currently being used). Crossroads -talk- 04:44, 30 November 2020 (UTC) Clarified. Crossroads -talk- 21:58, 30 November 2020 (UTC)- Crossroads, but aren't "just vague thoughts" considered suicidal ideation? The sources below (especially the last few in the table) seem to indicate that it is. WhatamIdoing (talk) 05:45, 30 November 2020 (UTC)
- I clarified my comment. When I said "vague" I meant the text, not the thoughts themselves. Crossroads -talk- 21:58, 30 November 2020 (UTC)
- Crossroads, do you mean that you dislike "Suicidal ideation means thoughts..."? What do you think would be a good option? WhatamIdoing (talk) 03:39, 1 December 2020 (UTC)
- I clarified my comment. When I said "vague" I meant the text, not the thoughts themselves. Crossroads -talk- 21:58, 30 November 2020 (UTC)
- Crossroads, but aren't "just vague thoughts" considered suicidal ideation? The sources below (especially the last few in the table) seem to indicate that it is. WhatamIdoing (talk) 05:45, 30 November 2020 (UTC)
Alternate suggestions
Here are two suggestions around which we might build consensus.
(a) Change the lead sentence to: Experts differ on a precise definition for suicidal ideation. The most common definitions are "thinking about suicide with deliberate consideration or planning"; "thoughts of engaging in suicide-related behavior"; and "thinking about, considering, or planning suicide". [with appropriate citations]
(b)(1) Change the lead sentence to: Suicidal ideation is thinking about, considering, or planning suicide.
(b)(2) Change the short description to: "thoughts ranging from a wish to die to developing specific plans to kill oneself" (or something similar).
Thank you - Mark D Worthen PsyD (talk) [he/his/him] 00:16, 30 November 2020 (UTC)
- Support (b)(1) which is the version which was apparently stable from March 2019 to October 2020; it covers the broad variety of definitions, and perhaps most importantly it clearly and concisely desribes to the reader the types of ideation by juxtaposing them in a list: "thinking about", "considering", and "planning".
- This is supported by the Klonsky source in the lead[2] which itself cites the CDC:
"The use of vague or inconsistent terms and definitions has hindered progress in suicide research and theory...The scope of this review precludes a comprehensive discussion of issues of terminology and definition, but we emphasize a few key points. We utilize the definitions provided by the US Centers for Disease Control and Prevention...suicidal ideation is defined as thinking about, considering, or planning suicide."
Kolya Butternut (talk) 07:59, 30 November 2020 (UTC)- I agree with Kolya Butternut on this. "Suicidal ideation is thinking about, considering, or planning suicide" is a simple, accurate, easily sourced lead sentence. Alternative definitions, qualifications, and caveats could go elsewhere, even in a different section of the article. WhatamIdoing (talk) 04:52, 1 December 2020 (UTC)
- I think I'm leaning towards this position. I do think the article needs a couple of additional sentenced to deal with the "lower bound" question of what is and isn't suicide ideation. I'm thinking of the possibility of self-diagnosis and then unnecessary medication here, as well as the potential for mental health ideas to pathologize normal behaviour. I'm worried that the question of what is an isn't a lower bound, and along which "axis" (persistance, content, duration, intent etc) would make the definition, long, complicated, difficult to understand, and contentious. Talpedia (talk) 08:15, 2 December 2020 (UTC)
- @Talpedia: I like your idea of addressing the "lower bound" question of what is and isn't suicide ideation, somewhere in the body of the article. Mark D Worthen PsyD (talk) [he/his/him] 16:58, 2 December 2020 (UTC)
- I think I'm leaning towards this position. I do think the article needs a couple of additional sentenced to deal with the "lower bound" question of what is and isn't suicide ideation. I'm thinking of the possibility of self-diagnosis and then unnecessary medication here, as well as the potential for mental health ideas to pathologize normal behaviour. I'm worried that the question of what is an isn't a lower bound, and along which "axis" (persistance, content, duration, intent etc) would make the definition, long, complicated, difficult to understand, and contentious. Talpedia (talk) 08:15, 2 December 2020 (UTC)
- I agree with Kolya Butternut on this. "Suicidal ideation is thinking about, considering, or planning suicide" is a simple, accurate, easily sourced lead sentence. Alternative definitions, qualifications, and caveats could go elsewhere, even in a different section of the article. WhatamIdoing (talk) 04:52, 1 December 2020 (UTC)
Table
Contributor | Source | Source Type | Feature | Link + Quote |
---|---|---|---|---|
Talpedia | DSM | guidelines, usage | does not require plan | 'Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide' |
Talpedia | DSM | guidelines, glossary, definition | deliberate consideration | 'suicidal ideas (suicidal ideation) Thoughts about self-harm, with deliberate consideration or planning of possible techniques of causing one's own death.' |
Talpedia | ICD-11 | guideline | thinking better of dead or more serious | "Thoughts, ideas, or ruminations about the possibility of ending one's life, ranging from thinking that one would be better off dead to formulation of elaborate plans." [3] |
Talpedia | New Oxford Textbook of Psychiatry | textbook | thoughts in OCD not suicidal ideation,usage |
"Nevertheless, it is important to note that suicidal thoughts may sometimes be a symptom of OCD (for example, ‘I might commit suicide’, ‘what is the prefer-able way to commit suicide’), and not a genuine suicidal ideation." [4]: 990 |
WhatamIdoing | Merk Manual | clinical textbook | all thoughts or plans, whether or not serious or deliberate | "Thinking about, considering, or planning suicide is referred to as suicide ideation." |
Kolya Butternut | National Institute of Mental Health | general information | definition | "Suicidal ideation refers to thinking about, considering, or planning suicide."[3] |
Markworthen | CDC (Crosby, et al., 2011) | uniform definitions and data elements for self-directed violence surveillance | thoughts do not necessarily involve "deliberate consideration or planning" | "...suicidal ideation (i.e., thinking about, considering, or planning for suicide)" "Suicidal thoughts can be a risk factor for subsequent fatal and nonfatal suicidal behavior and are sometimes associated with other disorders. In general suicidal thoughts do not focus upon the actual suicide process. Suicidal planning involves a much higher complex cognitive process."[5] |
Markworthen | U.S. Surgeon General and National Action Alliance for Suicide Prevention | National strategy | thoughts, not necessarily "with deliberate consideration" | "Suicidal ideation—Thoughts of engaging in suicide-related behavior."[6] |
Markworthen | National Action Alliance for Suicide Prevention: Youth in Contact with the Juvenile Justice System Task Force | Literature review | thoughts about ending life | "'Suicidal ideation' is defined as thoughts of engaging in behavior intended to end one’s life."[7] |
Markworthen | O'Carroll, et al. (1996) | seminal article | definition | "Suicidal Ideation: Any self-reported thoughts of engaging in suicide-related behavior."[8] |
Markworthen | Columbia University, University of Pennsylvania, & University of Pittsburgh with National Institute of Mental Health support | Columbia–Suicide Severity Rating Scale (C-SSRS) | Empirically-grounded suicide assessment protocol | One of the most reliable and valid suicide measures,[9][10][11] the Columbia–Suicide Severity Rating Scale (C-SSRS), assesses several risk factors including suicidal ideation, a category that includes two suicidal ideation items (interview questions) that assess ideation without "deliberate consideration or planning".[a] |
Talpedia | CDC | Research | serious consideration | 'Suicidal ideation was measured with the question, “During the past 12 months, did you ever seriously consider attempting suicide?” Making a suicide plan was measured with the question, “During the past 12 months, did you make a plan about how you would attempt suicide?”' |
Markworthen | See cited references | scholarly literature[12][13][14] | passive suicidal ideation is a suicide risk factor | "Taken together, these findings suggest that suicidal ideation is not the only starting point on the trajectory to making a suicide attempt, and thus assessing desire for death in people who deny suicidal thoughts would be clinically useful. Querying individuals on desire for death has the same value as assessing suicidal ideation to examine the risk for suicide attempts ...."[15] |
- Here's the Merck Manual: ideation "Thinking about, considering, or planning suicide is referred to as suicide ideation." I'm not quite sure how to fill in all the columns for that in User:Talpedia's table. WhatamIdoing (talk) 18:42, 28 November 2020 (UTC)
- :) Not sure what I'm doing! I added your source, if you want to add a couple of words that you think distinguishes this sources from others you could add it in the "feature" column. The idea is that people can see a summary of the issue at a glance. I'm aware that different groups law, researchers, psychologists, psychiatrists, "general doctors" are likely to have different perspectives, and that different types of sources will have different types of definitions, so I think including this information might help one understand the argument (at the risk of imposing a way of thinking about the problem). I'm also suspicious that "usage" might be the best of way of understanding the definition (i.e. how do you use the word versus how you define it), but am also aware that this sort of thinking is a little "original researchy" Talpedia (talk) 14:26, 29 November 2020 (UTC)
- Hey Kolya Butternet, I moved your definition in the table so that it's next to another one that's very similar. Feel free to revert me if you like :) Talpedia (talk) 10:16, 30 November 2020 (UTC)
- I did the same with one of Markworthens's.[4] Kolya Butternut (talk) 11:05, 30 November 2020 (UTC)
- The descriptions by editors in the above table are not always accurate. For example, I see nothing in the Merk Manual source that classifies all thoughts about suicide as suicidal ideation or anything about suicidal ideation not being serious. Flyer22 Frozen (talk) 05:04, 1 December 2020 (UTC)
- Yup, Whenever there is interpretatation or summary there can be disagreement, that's part of the reason I added a contributor column. Not sure what to do about this! Ideally there might be some sort of collapsable folder underneath each row for discussion if there is disagreement. We could add an internal "discussion link" column for people to talk about a source, and maybe change a row as a result of the discussion. Or we could be could have discussion away from the table and hope that people thoroughly review it - though if thorougly reviewing discussions was easy we wouldn't need a table! I'm reminded of what tutte said about the purpose of visualizations of data, that its functions is to admit comparison between different data, so maybe the table is there to make it easy to compare sources. Talpedia (talk) 08:55, 1 December 2020 (UTC)
- For my part, I see nothing in the Merck Manual that says "only some thoughts about suicide count" or "only serious thoughts count", and if someone cited the Merck Manual to write "some serious thoughts about suicide are suicidal ideation, but others aren't", then I'd say that was an obvious violation of the Wikipedia:No original research policy. WhatamIdoing (talk) 20:07, 1 December 2020 (UTC)
- That "someone" obviously would not be me. But to repeat just a bit of what I stated to you above, "Suicidal ideation is not the same thing as someone randomly thinking about suicide (like after reading a book in which a character commits suicide), shrugging their shoulders and then going about their way." The idea that "all thoughts about suicide is suicidal ideation" make no sense and is not supported by sources. More on this is seen in my reply to you in the Survey section (and in my reply to Markworthen below). Flyer22 Frozen (talk) 01:56, 2 December 2020 (UTC)
- For my part, I see nothing in the Merck Manual that says "only some thoughts about suicide count" or "only serious thoughts count", and if someone cited the Merck Manual to write "some serious thoughts about suicide are suicidal ideation, but others aren't", then I'd say that was an obvious violation of the Wikipedia:No original research policy. WhatamIdoing (talk) 20:07, 1 December 2020 (UTC)
- Yup, Whenever there is interpretatation or summary there can be disagreement, that's part of the reason I added a contributor column. Not sure what to do about this! Ideally there might be some sort of collapsable folder underneath each row for discussion if there is disagreement. We could add an internal "discussion link" column for people to talk about a source, and maybe change a row as a result of the discussion. Or we could be could have discussion away from the table and hope that people thoroughly review it - though if thorougly reviewing discussions was easy we wouldn't need a table! I'm reminded of what tutte said about the purpose of visualizations of data, that its functions is to admit comparison between different data, so maybe the table is there to make it easy to compare sources. Talpedia (talk) 08:55, 1 December 2020 (UTC)
- The descriptions by editors in the above table are not always accurate. For example, I see nothing in the Merk Manual source that classifies all thoughts about suicide as suicidal ideation or anything about suicidal ideation not being serious. Flyer22 Frozen (talk) 05:04, 1 December 2020 (UTC)
- Megaman en m, considering that you made this revert, do you have any thoughts on the above -- whether commenting in the RfC, commenting on the table, or commenting on the topic in general? Flyer22 Frozen (talk) 05:16, 1 December 2020 (UTC)
- In the revert you (Flyer22 Frozen) reference, Megaman en m wrote, "This version is incorrect, as it implies that simply thinking about suicide counts as actual suicidal ideation." Actually, Megaman en m is not correct on this point, as several references in the above table and elsewhere in this thread demonstrate. Megaman en m supported his statement by citing DSM-5, which, as we have discussed, is not the final word on all things psychological/psychiatric (although some folks—in general, I am not referring to any editor involved in this discussion—seem to think it is). Mark D Worthen PsyD (talk) [he/his/him] 18:22, 1 December 2020 (UTC)
- You are misinterpreting the literature/relaying it in an extremely literal way when it comes to "thinking about suicide" since no medical professional is going to state that a person having thought about suicide while, for example, talking to someone about people who have committed suicide (or to someone who is suicidal) and trying to imagine what those people went through (or what the person who is suicidal is going through) is someone who has suicidal ideation. Is putting yourself in one's shoes with regard to suicide not thinking about suicide? Yes, yes, it is. But it obviously is not suicidal ideation. And stuff like that is no doubt what Megaman en m was talking about. If all thoughts about suicide were suicidal ideation, there would be no need to measure whether or not one has suicidal ideation. A CDC listing in the table above clearly states that suicidal ideation was measured with the question, "During the past 12 months, did you ever seriously consider attempting suicide?" Making a suicide plan was measured with the question, "During the past 12 months, did you make a plan about how you would attempt suicide?" I noted to WhatamIdoing in the Survey section that this 2014 "The Oxford Handbook of Suicide and Self-injury" source, from Oxford University Press, page 19, states that "passive ideation, such as the wish to die, has been identified as a risk factor for death by suicide (Brown, Steer, Henriques, & Beck, 2005), with those reporting a wish to die being approximately 5 to 6 times more likely to end their life (Brown et al., 2005). Moreover, although several different terms have been used to refer to passive ideation (e.g., "better off dead", "thoughts of my own death"), it is only "a wish to die" that has been consistently associated with significantly increased risk, therefore eliminating other types of passive thoughts from the spectrum of suicidal ideation." It also states, "A more precise delineation of discrete types of suicidal ideation and their associated definitions was reinforced by research findings that specific types of ideation are associated with elevated risk or subsequent suicidal behavior. In contrast, the dimensional approach to suicidal ideation did not show prediction, underscoring the need to classify types of suicidal thoughts with respect to intent to die and intent to act (Posner et al., 2001). The NIMH Suicide Research Centers Project offered an expert consensus on the definition of suicidal ideation and included wish to die, thoughts of killing oneself, and intent to kill oneself." The source also makes a case that it is important to distinguish suicidal ideation from suicidal behavior, which is one reason why your proposed lead sentence is nowhere close to ideal.
- In the revert you (Flyer22 Frozen) reference, Megaman en m wrote, "This version is incorrect, as it implies that simply thinking about suicide counts as actual suicidal ideation." Actually, Megaman en m is not correct on this point, as several references in the above table and elsewhere in this thread demonstrate. Megaman en m supported his statement by citing DSM-5, which, as we have discussed, is not the final word on all things psychological/psychiatric (although some folks—in general, I am not referring to any editor involved in this discussion—seem to think it is). Mark D Worthen PsyD (talk) [he/his/him] 18:22, 1 December 2020 (UTC)
- As for the authority of the DSM? It's interesting that when I reverted the IP, I stated, "Re-added wording that explains the matter in plain English. We don't only go by the DSM-5 here. And, more importantly, we are supposed to put things in our own words." And that isn't the first time I've stated something like that. By contrast, I can point to different instances of you making it seem like the DSM is the be-all and end-all. That stated, the DSM is one of our medical authorities, and lesser sources cannot be given the same authority by simply citing them. Lesser sources are not the ones involved in the actual diagnosis of those with suicidal ideation. They are not the ones with criteria that are followed by medical experts. The 2014 "Oxford Handbook of Suicide and Self-injury" source, page 20, states that "adoption of clear guidelines for classifying suicidal ideation and behavior by the US regulatory bodies and agencies, as well as the inclusion of suicidal behaviour and nonsuicidal self-injury in the DSM-5, demonstrate that the classification of suicidal behaviour is moving in the direction of uniformity in classification of suicidal behavior." And that was six years ago. So where are we now? The source obviously does not consider the DSM-5 an outlier on the topic of suicidal ideation and suicidal behavior. And neither do other sources. Flyer22 Frozen (talk) 01:56, 2 December 2020 (UTC)
lesser sources cannot be given the same authority by simply citing them
I would place academic systematic reviews as more authorative than guidelines, since guidelines don't undergo the same peer review process, and often have something of the political to them. For example, I have seen a few NICE guidelines that are not supported by the evidence that underlies them - something that would be unlikely to happen in systematic reviews. The specific cases are encouraging CO testing in pregnant women and guideliness for use of antipsychotics following first episode psychosis, in both cases there's a tinge of "misrepresenting science for compliance". While guidelines are informative, and should be quoted for context, I think wikipedia should be guided by truth, rather than the complicated trade offs of policy (moral, political, coercive, professional interests in terms of risk and influence), and so academic sources should be preferred (though the ideal case is alignment between guidance and science). This perhaps and overly general level of argument for the problem at hand, and I note that the argument you provide includes other sources.- I'm also slightly put off by the fact that the DSM definition comes from a glossary in the document, so am suspicious that insufficient consideration might have gone into the definition.
- I have heard psychiatrists express a preference for the ICD over the DSM, and so have included a definition from ICD-11. This sets the "lower bound" for suicidal ideation as "better of dead" which I think broadly aligns with the quotations you include here (e.g. "intent to die").
- I wonder if part of the issue might be the "lower bound" of suicidal ideation is different along different dimensions. E.g. persistance, level of consideration, content, so the "real" definition might be "thoughts of death or suicide that according to professional judgment suggest an increased risk of suicide" the issue being that the definition is horribly relative and requires you to understand the professional judgment of different field. Talpedia (talk) 07:40, 2 December 2020 (UTC)
- Isn't there a difference between suicidal ideation as a recognized symptom and a more general meaning? I feel like an isolated instance of imagining one's suicide out of despair qualifies as suicidal ideation (for example the first 1.5 minutes of this monologue[5]) even though it may not qualify as a symptom. Kolya Butternut (talk) 13:02, 2 December 2020 (UTC)
- Well, suicidal ideation itself is not a symptom, recurrent suicidal ideation is a symptom. I want to be careful to distinguish between definitions of the symptom and definitions of the term. Kolya Butternut (talk) 13:09, 2 December 2020 (UTC)
- That's an interesting point. Yep, I think suicidal ideation exists as a psychological, literary, "experiential" concept separate from the prevention of suicide, and it so it seems reasonable that the article should address these themes, and then the definition can basically be a dictionary definition, while a section on medicine can talk about the term as a diagnosis. I should check whether the article deals with nonmedical aspects... Talpedia (talk) 13:43, 2 December 2020 (UTC)
- I think suicidal ideation *is* a symptom in the sense that it's meaning within medical contexts is more precise than it would be in a literary sense. Existential philosophers come to mind as "literary" discussions of suicidal ideation. Talpedia (talk) 13:43, 2 December 2020 (UTC)
- I'm just referring specifically to how the DSM only describes "recurrent suicidal ideation" as a symptom rather than just "suicidal ideation", but I know that's only one source and the term is generally used to describe a symptom. Kolya Butternut (talk) 17:47, 2 December 2020 (UTC)
- I think that taking (intentional) actual definition "in an extremely literal way" is exactly what Wikipedia editors should do. We might make a few very small assumptions (e.g., it requires thinking about your own death from suicide rather than thinking about suicide as a social problem or a someone else's medical situation), but I don't think that we can stretch a source that says "thinking about suicide" into "recurrent or intrusive thoughts about suicide". WhatamIdoing (talk) 23:03, 2 December 2020 (UTC)
- No, we should go by what the literature states and with WP:Due weight. And nowhere does the literature on this topic state that all thoughts about suicide are suicidal ideation. And per my above posts, it's clear why they don't. Flyer22 Frozen (talk) 23:55, 2 December 2020 (UTC)
- Hmm... Some of the entries in the table do seem to imply all thoughts: e.g. ""Suicidal Ideation: Any self-reported thoughts of engaging in suicide-related behavior.". I imagine the issue is that when they say "thoughts" they don't really mean all thoughts. Talpedia (talk) 00:13, 3 December 2020 (UTC)
- "Any self-reported thoughts of engaging in suicide-related behavior" is not the same thing as "all thoughts about suicide." The wording "Any self-reported thoughts of engaging in suicide-related behavior" obviously has "engaging in suicide-related behavior" in it, and I tackled the "suicidal ideation" vs. "suicidal behavior" aspect above (with a source). Flyer22 Frozen (talk) 00:25, 3 December 2020 (UTC)
- Yes I suppose there is a difference in terms of e.g. thinking about *others* suicide. I don't know how it applies to "suicide in the abstract", since you could argue that this in some sense applies to the individual. Talpedia (talk) 00:34, 3 December 2020 (UTC)
- When I focused on the "thoughts of engaging in suicide-related behavior" part, I also thought about how it is different than thoughts about wanting to die without imagining ways that can be achieved. The aforementioned source I cited focuses on such; it states "wish to die, thoughts of killing oneself, and intent to kill oneself." Flyer22 Frozen (talk) 00:41, 3 December 2020 (UTC)
- Yes I suppose there is a difference in terms of e.g. thinking about *others* suicide. I don't know how it applies to "suicide in the abstract", since you could argue that this in some sense applies to the individual. Talpedia (talk) 00:34, 3 December 2020 (UTC)
- "Any self-reported thoughts of engaging in suicide-related behavior" is not the same thing as "all thoughts about suicide." The wording "Any self-reported thoughts of engaging in suicide-related behavior" obviously has "engaging in suicide-related behavior" in it, and I tackled the "suicidal ideation" vs. "suicidal behavior" aspect above (with a source). Flyer22 Frozen (talk) 00:25, 3 December 2020 (UTC)
- Hmm... Some of the entries in the table do seem to imply all thoughts: e.g. ""Suicidal Ideation: Any self-reported thoughts of engaging in suicide-related behavior.". I imagine the issue is that when they say "thoughts" they don't really mean all thoughts. Talpedia (talk) 00:13, 3 December 2020 (UTC)
- No, we should go by what the literature states and with WP:Due weight. And nowhere does the literature on this topic state that all thoughts about suicide are suicidal ideation. And per my above posts, it's clear why they don't. Flyer22 Frozen (talk) 23:55, 2 December 2020 (UTC)
- As for the authority of the DSM? It's interesting that when I reverted the IP, I stated, "Re-added wording that explains the matter in plain English. We don't only go by the DSM-5 here. And, more importantly, we are supposed to put things in our own words." And that isn't the first time I've stated something like that. By contrast, I can point to different instances of you making it seem like the DSM is the be-all and end-all. That stated, the DSM is one of our medical authorities, and lesser sources cannot be given the same authority by simply citing them. Lesser sources are not the ones involved in the actual diagnosis of those with suicidal ideation. They are not the ones with criteria that are followed by medical experts. The 2014 "Oxford Handbook of Suicide and Self-injury" source, page 20, states that "adoption of clear guidelines for classifying suicidal ideation and behavior by the US regulatory bodies and agencies, as well as the inclusion of suicidal behaviour and nonsuicidal self-injury in the DSM-5, demonstrate that the classification of suicidal behaviour is moving in the direction of uniformity in classification of suicidal behavior." And that was six years ago. So where are we now? The source obviously does not consider the DSM-5 an outlier on the topic of suicidal ideation and suicidal behavior. And neither do other sources. Flyer22 Frozen (talk) 01:56, 2 December 2020 (UTC)
Talpedia, above, you argued, "I would place academic systematic reviews as more [authoritative] than guidelines." As seen in this long discussion at Talk:Dissociative identity disorder, I argued similarly about the underlying literature. I argued that we follow the general literature rather than just what an organization (like the WHO), or manual like the DSM-5, or a diagnostic code like the ICD-11 states. I noted that WP:MEDRS tells us that statements and information from reputable major medical and scientific bodies are generally less authoritative than the underlying medical literature. I argued, "If the DSM or ICD necessarily or always represented the underlying medical literature, the aforementioned DSM-5 discussion at WP:Med would not have taken place." But the DSM and ICD cannot be described as just guidelines, or even precisely as guidelines. They are authoritative documents, or rather authoritative taxonomic tools, that are responsible for the diagnosis and treatment of many disorders and similar. And they are adhered to by many sources, including internationally. But then again, they are sometimes referred to as guides. I also wouldn't describe them as very political, although the DSM-5 has been criticized on political grounds (among other things) and the DSM and ICD can be stated to be a little political. Scientific research isn't completely free of politics either way, though. Flyer22 Frozen (talk) 23:55, 2 December 2020 (UTC)
- That is an interesting point. In computing the term "canonical" is often used for this sort of definition, one that exists in order to be shared between people, I have less issue with the term than authoratative - because a canonical definition can still be *bad*. I guess the value of a canonical definition is that it makes statistics consistent and interpretable - the cost is that it might be bad, in the sense that e.g. it combines together two entities with quite different properties, and undermines statistical analysis due the the different mixes of these entities in different populations. I imagine literature might discover definitions that better describe reality in this sense. I agree that scientific research is not free of politics, particular with regards *what* is researched, I think there is a little less self-interest: doctors need to get a job *done*, and also more room for revision; I imagine concision and the dreaded "simple and clear messaging for lay-readers" might come into play as well. I'm not exactly sure if guides *will* determine treatment, you'll get an odd effect if clinicians have "better" categories than those of a guide - I imagine either the categories will move around, or people will ignore them and use them record keeping (potentially making them less likely to be true). Talpedia (talk) 00:27, 3 December 2020 (UTC)
- The canonical definitions appear to be quite broad. Merely "thinking that one would be better off dead" is in the ICD as suicidal ideation – no "seriousness", no "recurrence", no "intrusiveness", no "intention" is required. I think this article should be as broad as those canonical sources. WhatamIdoing (talk) 03:29, 23 December 2020 (UTC)
Notes
- ^ The two items are: (1) Wish to be Dead - Subject endorses thoughts about a wish to be dead or not alive anymore, or wish to fall asleep and not wake up; and (2) Non-Specific Active Suicidal Thoughts - general non-specific thoughts of wanting to end one's life/commit suicide (e.g., I've thought about killing myself") without thoughts of ways to kill oneself/associated methods, intent, or plan during the assessment period.
References
- ^ Stone, Deb, et al., Preventing Suicide: A Technical Package of Policy, Programs, and Practices, Division of Violence Prevention, National Center for Injury Prevention and Control (Atlanta, GA: Centers for Disease Control and Prevention, 2017): 45.
- ^ Crosby AE, Ortega L, Melanson C. Self-directed Violence Surveillance: Uniform Definitions and Recommended Data Elements, Version 1.0. Atlanta (GA): Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2011
- ^ "ICD-11 - Mortality and Morbidity Statistics". icd.who.int. Retrieved 2020-12-02.
- ^ Gelder, Michael G.; Andreasen, Nancy C.; Jr, Juan J. Lopez-Ibor; Geddes, John R. (2012). New Oxford Textbook of Psychiatry. Oxford University Press. ISBN 978-0-19-969675-8.
- ^ Crosby, Alex E., LaVonne V. Ortega, and Cindi Melanson, Self-directed Violence Surveillance: Uniform Definitions and Recommended Data Elements, (Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Violence Prevention, 2011): 60.
- ^ U.S. Department of Health and Human Services (HHS) Office of the Surgeon General and National Action Alliance for Suicide Prevention, 2012 National Strategy for Suicide Prevention: Goals and Objectives for Action, (September 2012): 143.
- ^ National Action Alliance for Suicide Prevention: Youth in Contact with the Juvenile Justice System Task Force, Suicidal Ideation and Behavior among Youth in the Juvenile Justice System: A Review of the Literature, (September, 2013): 2.
- ^ O'Carroll, Patrick W., Alan L. Berman, Ronald W. Maris, Eve K. Moscicki, Bryan L. Tanney, and Morton M. Silverman, "Beyond the Tower of Babel: a Nomenclature for Suicidology," Suicide and Life‐Threatening Behavior 26, no. 3 (1996): 247.
- ^ Posner, Kelly, Gregory K. Brown, Barbara Stanley, David A. Brent, Kseniya V. Yershova, Maria A. Oquendo, Glenn W. Currier, et al. The Columbia–Suicide Severity Rating Scale: Initial Validity and Internal Consistency Findings From Three Multisite Studies With Adolescents and Adults. American Journal of Psychiatry 168, no. 12 (December 2011): 1266–77.
- ^ "About the [C-SSRS] Protocol". Columbia Lighthouse Project. Retrieved 29 November 2020.
In 2011, the Centers for Disease Control and Prevention adopted the protocol's definitions for suicidal behavior and recommended the use of the Columbia Protocol for data collection. In 2012, the Food and Drug Administration declared the Columbia Protocol the standard for measuring suicidal ideation and behavior in clinical trials.
{{cite web}}
: CS1 maint: url-status (link) - ^ Columbia Suicide Severity Rating Scale (C‐SSRS): Supporting Evidence. New York: Columbia Lighthouse Project/Center for Suicide Risk Assessment (12 December 2019).
- ^ May, Christine N., James C. Overholser, Josephine Ridley, and Danielle Raymond, Passive Suicidal Ideation: a Clinically Relevant Risk Factor for Suicide in Treatment-seeking Veterans, Illness, Crisis & Loss 23, no. 3 (2015): 261, 264. ([How was "passive suicidal ideation" defined or operationalized?] "Individuals respond yes or no to questions such as whether the participant feels he or she would be better off dead or if the participant’s family would be better off if he or she were dead. Individuals who respond yes to both questions are identified as passive ideators. If individuals respond yes to only one of the two questions, they were not included in the passive suicidal ideation category." [Conclusion] "Participants were assessed for a depressive disorder using a structured clinical interview and completed self-report measures. Individuals with passive suicidal ideation scored similarly to active ideators and significantly higher than nonsuicidal ideators on measures of depression, suicidal behavior, and hopelessness.")
- ^ Silverman, Morton M., and Alan L. Berman, "Suicide Risk Assessment and Risk Formulation Part I: A Focus on Suicide Ideation in Assessing Suicide Risk," Suicide and Life-Threatening Behavior 44, no. 4 (August 2014): 425. ("... when passive SI [suicidal ideation] is expressed, clinicians see less risk than when active SI is expressed. The reality is that there is simply no empirical support for this supposition.")
- ^ Barry, Lisa C. Passive Suicidal Ideation in Older Adults: Implications for Suicide Prevention, American Journal of Geriatric Psychiatry 27, no. 12 (December 2019): 1411 ("Among older adults, thoughts about death can be normative and innocuous reactions to aging-related stressors. Conversely, thinking about death and/or wishing for one’s death in later life may be a marker of increased suicide risk. Frequently referred to as “passive” suicidal ideation (SI), these types of thoughts are prevalent among older persons with depression or clinically significant depressive symptoms. However, growing evidence points toward a subgroup of individuals who endorse passive SI in later life outside the context of clinical depression.")
- ^ Baca-Garcia, Enrique, M. Mercedes Perez-Rodriguez, Maria A. Oquendo, Katherine M. Keyes, Deborah S. Hasin, Bridget F. Grant, and Carlos Blanco, Estimating Risk for Suicide Attempt: Are We Asking the Right Questions?: Passive Suicidal Ideation as a Marker for Suicidal Behavior, Journal of Affective Disorders 134, no. 1–3 (2011): 331.
Definition and Terminology section
This is a continuation from the #Short description section above.
I reverted Markworthen here and here. And this is why: Having the lead sentence state "usually means thoughts of engaging in suicide-related behavior" is not a good WP:Lead sentence. The wording "engaging in suicide-related behavior" is vague while the wording "is thinking about suicide with deliberate consideration or planning" is clear and tells us exactly what it is. This is not only the DSM-5 definition. That is why the lower part of the lead tells us that passive suicidal ideation is "not wanting to be alive or imagining being dead", while active suicidal ideation "is thinking about different ways to die or forming a plan to die." The "is thinking about suicide with deliberate consideration or planning" covers those two aspects. There is no need to state anything in the lead about a definition not being universal. It is beneficial to have a Terminology section, or a "Definitions" section that can also be about terminology. If anything in the section needs cutting, then let's discuss that.
If Markworthen feels that the issue is with the IP having added "deliberate", we can discuss that. But, like I noted above, suicidal ideation is not a passing thought about suicide. It's persistent thoughts of suicide, or a pronounced enough thought about it that it is distressing or leads to suicide. I also noted above that "I know that the article states 'varies from fleeting thoughts to detailed planning.' But the fleeting thoughts are persistent...at least for a time in the person's life. That's why they are considered a risk factor for suicide. I've yet to see an expert on this topic who feels that someone having thought about suicide once and with no serious consideration toward committing suicide as someone who has experienced actual suicidal ideation."
We can list sources for our arguments here. But let's leave the WP:Status quo in place while we discuss. I'm fine with reverting the IP's change to the lead while we discuss. Flyer22 Frozen (talk) 05:30, 24 November 2020 (UTC)
- You will not be surprised to learn that I disagree with your analysis. Here is why your reasoning is faulty:
- You (Flyer22 Frozen) wrote, "The wording 'engaging in suicide-related behavior' is vague ...." The full sentence was, "Suicidal ideation usually means thoughts of engaging in suicide-related behavior, although this definition is not universal." You might consider part of the sentence to be vague, but, as the four (since deleted) references showed, this definition was developed 20 years ago, and has continued as the recommended definition by the U.S. Surgeon General, the National Action Alliance for Suicide Prevention, and the Centers for Disease Control and Prevention. The definition is broad, not vague. It is broad because suicidal ideation covers a lot of territory. In particular, contrary to the DSM-5's ill-conceived definition, it does not refer to deliberate consideration or planning alone.
- You wrote, "while the wording 'is thinking about suicide with deliberate consideration or planning' is clear and tells us exactly what it is." Simply because you (Flyer22 Frozen) assert that your preferred definition is accurate does not make it so.
- And, with regard to your statement that the current wording "is clear": While we all prefer clarity and conciseness in Wikipedia prose, clarity and conciseness are not truth.
- You assert that "thinking about suicide with deliberate consideration or planning" covers passive suicidal ideation, which the article describes as "not wanting to be alive or imagining being dead". How do you reconcile "deliberate" with "passive"? If you "passively" think about going for a walk, is your thinking "deliberate"? passive means "not acting but acted upon : subject to or produced by an external agency; lacking in energy or will; not active or operating : not moving : inert, quiescent".[1] And deliberate means "characterized by or resulting from slow careful thorough calculation and consideration of effects and consequences : not hasty, rash, or thoughtless; characterized by presumed or real awareness of the implications or consequences of one's actions or sayings or by fully conscious often willful intent"; and "deliberate always indicates full awareness of what one is doing and, used precisely, implies careful and unhurried consideration of procedures or consequences".[2] Mark D Worthen PsyD (talk) [he/his/him] 15:23, 28 November 2020 (UTC)
- I'm not getting into all of that, especially since I'd be repeating myself, I would have to list no telling how many sources, and you have now started a RfC. I'll just state that I stand by what I've argued and that the table in the #Comment section below speaks to my point. Those sources show what I mean about how we should begin the lead sentence. There is no "Simply because [I] (Flyer22 Frozen) assert that [my] preferred definition is accurate makes it so." Everyone knows that I don't argue that way and that I instead adhere to the literature and our policies and guidelines...such as what is a better lead sentence for readers. Flyer22 Frozen (talk) 02:19, 29 November 2020 (UTC)
- And as for the "deliberate" wording, which I did not indicate being tied to, what I stated is that the "is thinking about suicide with deliberate consideration or planning" wording is covered by the lower part of the lead because passive suicidal ideation is "not wanting to be alive or imagining being dead", while active suicidal ideation "is thinking about different ways to die or forming a plan to die." Saying that not wanting to be alive or imagining being dead is not deliberate consideration is something that one can consider questionable. There is overlap on this topic. If one is arguing that the passive matter is an intrusive thought matter, that person should provide sources for that. And we should not be relying on dictionary definitions for the topic or for words of the definition(s). My main point has been that I've yet to see an expert on this topic who feels that someone having thought about suicide once and with no serious consideration toward committing suicide is someone who has experienced actual suicidal ideation. My main point has been that the thoughts are recurring. And the literature backs me up on that. Flyer22 Frozen (talk) 05:47, 29 November 2020 (UTC)
- Passive suicidal ideation is thoughts of wanting to not be alive, not necessarily wanting to not be alive. The DSM below lists recurrent suicidal ideation as a sympton of Major Depressive Disorder, etc.; suicidal ideation itself isn't necessarily defined by recurring thoughts, because that would be redundant to say that a sympton of Major Depression is recurrent recurring thoughts of suicide. Kolya Butternut (talk) 07:23, 30 November 2020 (UTC)
- Kolya Butternut,
you appear to have followed me here. And I wondered if you would while I was away, but I hoped that you would not since medical topics are out of your field of expertise. Follow me to an article again, and I will be reporting you. You've been warned on your talk page before about WP:Hounding me in any way.As for your commentary on this matter, I pay it no mind since you do not know what you are talking about. I do. Flyer22 Frozen (talk) 00:21, 1 December 2020 (UTC) I took this matter to the editor's talk page. I stand by this post and what I stated on the editor's talk page.
- Kolya Butternut,
- Passive suicidal ideation is thoughts of wanting to not be alive, not necessarily wanting to not be alive. The DSM below lists recurrent suicidal ideation as a sympton of Major Depressive Disorder, etc.; suicidal ideation itself isn't necessarily defined by recurring thoughts, because that would be redundant to say that a sympton of Major Depression is recurrent recurring thoughts of suicide. Kolya Butternut (talk) 07:23, 30 November 2020 (UTC)
- And that suicidal ideation is a symptom of major depressive disorder does not negate the fact that suicidal ideation is a recurring matter. That it is recurring is why sources speak of "thoughts." It is not defined as having thought about suicide once in a non-serious manner. Similarly, many people have thought about killing someone without it being serious, often as an intrusive thought matter; this does not mean that the person is homicidal. Flyer22 Frozen (talk) 01:22, 1 December 2020 (UTC)
- Flyer, as I explained on my talk page,[6] I came here by way of Markworthen. I'm sorry you feel this way; but I am not responsible for your perceptions. I'm not responding further to content-unrelated matters. Kolya Butternut (talk) 02:11, 1 December 2020 (UTC)
- Markworthen, as a fan of your advice, I noticed many "you" statements in your above comments which may not be ideal. I hope you're giving yourself breaks to watch funny pet videos :-). Kolya Butternut (talk) 04:00, 30 November 2020 (UTC)
References
- ^ Webster's Third New International Dictionary of the English Language, Unabridged, ed. Philip B. Gove (Springfield, MA: G. & C. Merriam, 1961, 1993, periodically updated as Merriam-Webster Unabridged), https://unabridged.merriam-webster.com/unabridged/passive
- ^ Webster's Third New International Dictionary of the English Language, Unabridged, ed. Philip B. Gove (Springfield, MA: G. & C. Merriam, 1961, 1993, periodically updated as Merriam-Webster Unabridged), https://unabridged.merriam-webster.com/unabridged/deliberate
Tower of Babel: Nomenclature for Suicide
Consider the recommendations from "Rebuilding the Tower of Babel: A Revised Nomenclature for the Study of Suicide and Suicidal Behaviors" which uses "suicide-related ideations" and describes them anywhere from casual and transient to persistent and with intent. doi: 10.1521/suli.2007.37.3.264 . Kolya Butternut (talk) 15:08, 17 January 2021 (UTC)
- That looks like a very good source... Talpedia (talk) 15:21, 17 January 2021 (UTC)
RFC on "committed suicide"
There is a RFC on the use of "Committed suicide" language open at VPP, with the intention to add language to MOS:BIO on a consensus-based conclusion. The RFC is here: WP:VPP#RFC: "Committed suicide" language. Kolya Butternut (talk) 15:44, 17 January 2021 (UTC)
Requested move 13 February 2021
- The following is a closed discussion of a requested move. Please do not modify it. Subsequent comments should be made in a new section on the talk page. Editors desiring to contest the closing decision should consider a move review after discussing it on the closer's talk page. No further edits should be made to this discussion.
The result of the move request was: No consensus - there are strong arguments for both sides, though it tilted "support" earlier and "oppose" later. The discussion isn't too active anymore, and while I can't say there is a clear consensus to not move, there is certainly not a clear consensus to move either. (closed by non-admin page mover) Elliot321 (talk | contribs) 18:39, 24 February 2021 (UTC)
Suicidal ideation → Suicidal thoughts – After reviewing a number of sources on this topic, it looks like "suicidal ideation" is the term favored in sources that are written for healthcare professionals while "suicidal thoughts" is the most common name used in sources that are written for a general audience. Since Wikipedia is a general use encyclopedia targeted towards non-expert readers, I think we should be using the more common lay term for this article's title, as that is the term that our average readers are more likely to recognize. Rreagan007 (talk) 23:21, 13 February 2021 (UTC)
- Support per WP:RECOGNIZABILITY, WP:NATURALNESS. "Ideation" in an article title is excessive, unnecessary jargon when there is a decent plain English alternative. Common usage of "suicidal thoughts" includes "thinking about, considering, or planning suicide", I believe, so it would not change the article scope. (t · c) buidhe 23:56, 13 February 2021 (UTC)
- Support per Buidhe. "Ideation" is an unnecessarily unfamiliar term. Aza24 (talk) 02:09, 14 February 2021 (UTC)
- Support - Great idea and excellent points by all. Mark D Worthen PsyD (talk) [he/his/him] 06:11, 14 February 2021 (UTC)
- Comment "Suicidal ideation" is the term for the symptom. If these terms are not interchangeable in the medical literature we'll need a separate section discussing "suicidal ideation" as a symptom. Kolya Butternut (talk) 06:18, 14 February 2021 (UTC)
- @Kolya Butternut: Good point, and I think we can do that without too much trouble in a new article titled "Suicidal thoughts". Mark D Worthen PsyD (talk) [he/his/him] 07:38, 14 February 2021 (UTC)
- The article will obviously continue to cover the more technical aspects of suicidal ideation, such as its use as a symptom used as a diagnostic criteria. But from what I can tell, "suicidal thoughts" and "suicidal ideation" are indeed interchangeable terms. "Ideation" is just the more technical term that is more often used in medical literature, though the medical literature also uses the term "thoughts". Rreagan007 (talk) 18:26, 14 February 2021 (UTC)
- @Kolya Butternut: Good point, and I think we can do that without too much trouble in a new article titled "Suicidal thoughts". Mark D Worthen PsyD (talk) [he/his/him] 07:38, 14 February 2021 (UTC)
- Don't care as long as the first sentence contains both terms in bolded text. Also, note that there was a discussion last year about whether those were actually synonyms, with some editors claiming that suicidal "thoughts" had to be persistent or intrusive before they counted as "ideation". WhatamIdoing (talk) 21:49, 14 February 2021 (UTC)
- "Suicide-related ideation" I think is the clearest term for the symptom. Although it's not common, perhaps we could use it in the opening of a section on "suicidal ideation". See above at #Tower of Babel: Nomenclature for Suicide. Kolya Butternut (talk) 23:30, 14 February 2021 (UTC)
- Support per Buidhe, though as people have said above "ideation" may be the best term when discussing medical literature on the topic. --Bangalamania (talk) 11:15, 15 February 2021 (UTC)
- support per editors above--Ozzie10aaaa (talk) 13:36, 16 February 2021 (UTC)
- Strong oppose per WP:MEDTITLE, which is clear as day about this sort of thing:
The article title should be the scientific or recognised medical name that is most commonly used in recent, high-quality, English-language medical sources, rather than a lay term (unscientific or slang name)...For example, heart attack redirects to myocardial infarction.
(Emphasis in source.) OP noted that ""suicidal ideation" is the term favored in sources that are written for healthcare professionals" without realizing this is precisely why the move should not occur. In line with this, compare PubMed's 14,482 results for "suicidal ideation" with the 2,856 for "suicidal thoughts". Since MEDTITLE has not been mentioned yet, I am pinging back the supporters to see if they wish to change their 'vote' now that it has been pointed out: Rreagan007, Buidhe, Aza24, Markworthen, Bangalamania, Ozzie10aaaa. Crossroads -talk- 04:47, 17 February 2021 (UTC)
- As "suicidal thoughts" is also used in the medical literature, it can't really be considered "unscientific or slang name" as WP:MEDTITLE seems to envision. So "suicidal thoughts" is still a "scientific term" in that sense. I'll grant you that it's not the most common term in the medical literature, but in this specific case I think WP:COMMONNAME (which is official policy) should override the strict letter of WP:MEDTITLE (which is only a guideline) because of how much more familiar our average readers are likely to be with "suicidal thoughts" over "suicidal ideation". And the example of heart attack isn't a very good analogy for this case, as there is some ambiguity with "heart attack" as it is used to refer to both a myocardial infarction or cardiac arrest. Rreagan007 (talk) 05:32, 17 February 2021 (UTC)
- Crossroads, are there any better examples? I see that we use Bruise instead of contusion despite that there are 8,688 results in PubMed for contusion[7] but only 803 for bruise[8]. Kolya Butternut (talk) 11:21, 17 February 2021 (UTC)
- Well, I learn something new about Wikipedia editing at least every week, and this is my new learning for this week. Thank you Crossroads for pointing out this important consideration. I want to think about it and see what other editors say, but you clearly raise a valid objection. ¶ Some more background info: In terms of potentially relevant statistics, on the English Wikipedia (using Google site search), the terms are used in equal numbers: "suicidal ideation" - about 1,070 results; "suicidal thoughts" - about 1,080 results. ¶ In terms of Google searches, significantly more people search for "suicidal thoughts". These links to Google Trends show data for the last 5 years: Worldwide | United States. ¶ In terms of books, which likely includes self-help books, but (probably) more professional texts, the term "suicidal ideation" has increasingly predominated since 1980: Google Ngram Viewer results. ¶ In terms of Wikipedia policy, on the side of "suicidal thoughts" are these guidelines from Deciding on an article title: Recognizability – The title is a name or description of the subject that someone familiar with, although not necessarily an expert in, the subject area will recognize; and Naturalness – The title is one that readers are likely to look or search for and that editors would naturally use to link to the article from other articles. Such a title usually conveys what the subject is actually called in English. ¶ On the side of "suicidal ideation" is this guideline also from WP:CRITERIA: Consistency – The title is consistent with the pattern of similar articles' titles. Many of these patterns are listed (and linked) as topic-specific naming conventions on article titles, in the box above. (The "box above" links to WP:MEDTITLE.) Mark D Worthen PsyD (talk) [he/his/him] 19:05, 17 February 2021 (UTC)
- Oppose. When I edited as an anon, I was told in no uncertain terms that "heart attack" is titled "myocardial infarction" and "brain freeze" or "ice-cream headache" is titled "cold-stimulus headache" on Wikipedia because of the rules. People still don't know why we're using the title "cold-stimulus headache".[9] So what gives for not sticking with "suicidal ideation"? Does consistency not matter? "Suicidal thoughts" may not be unscientific, but it is the lay term, and "suicidal ideation" is a lot more accessible to readers than "myocardial infarction." I don't think those voting to change the title thought things through. Take grammar, for instance. Are we going to say "Suicidal thoughts is thinking about, considering, or planning suicide."? How is the terminology to be handled in terms of the diagnostic material when the refs use the term "suicidal ideation"? The intro says "It is not a diagnosis." Yeah, "suicidal thoughts" are not a diagnosis. Are we going to change "passive suicidal ideation" to "passive suicidal thoughts" even though the refs don't call it that? I, frankly, see nothing wrong with the title remaining "suicidal ideation." In fact, it appears that this title is more accurate. Raining Parade (talk) 18:50, 17 February 2021 (UTC)
Support(Waffling towards oppose; the lead sentence is from sources using "suicidal ideation". My thought is that if suicidal thoughts and suicidal ideation are not equivalent, then suicidal thoughts is the broader subject, so it would be appropriate regardless of MEDTITLE. Using the definition of thoughts, the lead could read "Suicidal thoughts are instances of thinking about, considering, or planning suicide." Besides Bruise, another analogous article title is Goosebumps, which does not use the terms piloerection or cutis anserina. Brain freeze is obviously an inappropriate title because the brain itself cannot feel cold. Ice cream headache actually is used in medical literature, but it is only a piece of the broader subject:(ICHD-3) defines cold stimulus headache (CSH) as headache brought on by a cold stimulus applied externally to the head or ingested or inhaled [1]. This includes headache following exposure of the unprotected head to a very low environmental temperature. Ice cream headache (ICH), also known as “brain freeze,” and headache attributed to ingestion or inhalation of a cold stimulus are also incorporated under this definition.[10]
- If suicidal thoughts and suicidal ideation are equivalent, then I might agree that the policy COMMONNAME overrides MEDTITLE where the common name is not decidedly informal. A doctor will write "goosebumps", but they are less likely to write "farts". But suicidal thoughts does seem to be used equivalently in medical literature: "
We searched PubMed for studies published in English... We did two separate searches of the scientific literature. One search was for suicidal thoughts using the query ('suicidal thoughts' OR 'suicidal ideation')
"[11] While it may be original research to conclude from that that the terms are identical, we know ideations are thoughts. Kolya Butternut (talk) 08:30, 18 February 2021 (UTC) Waffling Kolya Butternut (talk) 07:15, 19 February 2021 (UTC)
- The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.
Again about description
The previous description exist only in the words of single man in the single research and has no real source. Second, the therm "thinking about suicide" means anybody thinking about suicide in any context has suicide ideation, what is extremely incorrect, so that term is vague.
That is what I have written in the edit notes. DSM-5 (page 830, definitions) and ICD-11 both include a point about the context of thoughts, "possibility" in term of ICD-11 and "deliberate consideration or planing" in term of DSM-5. The context has to be adressed in any description. - Unsigned comment by user from IP 46.159.143.61 at 05:54 UTC, 28 April 2021
- See consensus at Talk:Suicidal_ideation/Archive_1#RfC_on_how_to_define_"suicidal_ideation"_and_compose_the_lead_paragraph
- "
Suicidal ideation as typically operationalised has various closely related definitions along the lines of 'thinking about, considering or planning suicide', or 'thoughts of engaging in suicide-related behaviour'.
[12] We could add both of these as a compromise. Kolya Butternut (talk) 14:32, 28 April 2021 (UTC)- What do you mean both? In your definition "thinking about suicide" is suicidal ideation, it is extremely incorrect. You can't use such blurred definition. You have to adress the context. Suicidal ideation is not thinking about suicide, it is thinking about performing suicide, these are very different things. CDC definition, that is not even clearly presented (there is no clear citation for it), can't be called consensus. It is just some phrase, that someone liked and used. In any way "ICD" > "DSM" > "CDC words" at least because ICD is worldwide, while CDC words and DSM are USA. In all other articles ICD or DSM are used. I don't understand this obsession about supposed blurred CDC definition.
- I can see that my old edit with the DSM definition have made a lot of noise in talk page. Let's go from the other side. Why don't you want to choose between the clear definitions from ICD or DSM and forget the CDC? Are these definitions bad for you? Too accurate maybe? Again "thinking about suicide" is extremely inaccurate.
- The United States Centers for Disease Control and Prevention (CDC) defines suicidal ideation "as thinking about, considering, or planning suicide".[1]
- What does this citation has in deal with the text???
- It is irrelevent that that definition may have originated with the CDC; that definition is frequently cited. Kolya Butternut (talk) 08:48, 1 May 2021 (UTC)
- It is also irrelevant if that definition is citated or not. The question is which definition really defines the term.
- Answer ALL the questions please.
So, you don't want to discuss, than do not change the page, simple. I also don't understand why do you turn the definitions part, which I have splited, back to solid text.
References
- ^ House, Allan; Kapur, Nav; Knipe, Duleeka (November 2020). "Thinking about suicidal thinking". The Lancet Psychiatry. 7 (11): 997–1000. doi:10.1016/S2215-0366(20)30263-7.
Exposure and attention to suicide related images or words seemingly not a risk factor
"Exposure and attention to suicide related images or words" is said to be a risk factor under the past life section however the source seems to suggest that people with a past of suicidal behavior or that are showing suicidal behavior have an "Attentional Bias toward Suicide-Related Stimuli" rather than exposure to suicide related stimuli increase suicidal ideation.
Thoughts? TheRatMaster (talk) 21:47, 25 May 2021 (UTC)
redirect for L’appel du vide is incorrect
L’appel du vide redirects here but it shouldn't... L’appel du vide isn't suicidal ideation, it's a psychological phenomenon distinct from suicidal ideation. See https://www.healthline.com/health/call-of-the-void?c=487972266184 or just Google the term. Most references specify that it's distinct from suicidal ideation. Minerva9 (talk) 14:56, 15 March 2021 (UTC)
- I figured out how to remove the redirect and have done so. Minerva9 (talk) 15:45, 15 March 2021 (UTC)
- Redirect seems to be back :/. This article doesn't even bother making any mention of L’appel du vide, why even redirect here? 185.163.103.83 (talk) 07:03, 4 June 2021 (UTC)
It would be good to add a number for a hotline on top of this article
For the people who are going through very difficult moments, especially in these lonely times, this article can be depressing or disturbing, as put on top of this page, certainly.
I may get my nose bitten off by some sad bureaucrat who is afraid of setting a precedent that we may drop professionalism to save a few lives, but whatever: we should really include a link to List of suicide crisis lines or something of that order on top of this page. It's common for suicidal people to walk around the edges and have a morbid curiosity with gore, death, suicide, ... before going for it. If someone replies to this by asking for a source, they're deeply sad individuals --Spafky (talk) 17:19, 1 December 2021 (UTC)
- The article itself probably provides sources for your clcaim. I'm not sure this is a bad idea. I myself am doubtful about how helpful suicide helplines actually are as they are often "captured" by psychiatry to different degrees, who will often do a good job of preventing you from immediately commiting suicide at the price of making your life far worse. Compare "if you are thinking of commiting a crime please call the police" If you wanted to make this change "through the back door" the fact that suicide hotlines numbers are frequently displayed on bridges, railway lines and near cliffs would probably be relevant for the article. Talpedia (talk) 18:27, 1 December 2021 (UTC)
- Sad bureaucrat here, although I'm not fond of biting noses. I doubt seriously that a suicidal person will end up at this article. And if they do, they have to read the
grossly uniformedcomments that poorly reflect current knowledge of psychiatry like the one above that encourages suicide over psychiatric treatment by claiming that psychiatry "makes your life worse". If they do come to the article and actually bother to read it, there is an link at the bottom that is dead but it does direct you to a page with the phone number to the National Suicide Prevention Lifeline. Sundayclose (talk) 19:03, 1 December 2021 (UTC)- @Sundayclose: calling people grossly uninformed is probably a personal attack. I remember visiting a psych ward once where they were talking about cutting off a mans feet because of diabetes probably from being continuously drugged with benzodiazapine's and not being able to go outside. He also had chronic tooth decay and was unable to see a dentist. Having been in prison before he commented that he would prefer to be in prison than a psych ward because at least there was something to do there. I remember that the ward had been given a small barey usable manual treadmill because of suicide prevention. Keep you grossly ill-informed comments about oher people's informedness to yourself (not WP:ANI) Talpedia (talk) 21:08, 1 December 2021 (UTC)
- I said the comment is grossly uninformed. If I went to Talk:Pablo Picasso and commented that Picasso draws like a child, that doesn't entitle me to take offense if someone says that my opinion is grossly uniformed. The fact that you retorted with the very same phrase clearly lets us know that it's not a personal attack, just an opinion. Feel free to call any of my opinions uninformed. Right or wrong, everyone has an opinion. If you don't want your opinions challenged, don't add them to a talk page. But if it will unbruise your ego, I'll revise my comment to reflect the status of psychiatry among those who are informed. Basing your comment on one visit to a psych ward only reinforces the fact that your opinion is uniformed. Wikipedia is a wonderful resource, but one of the major limitations of Wikipedia is that anyone, regardless of expertise, can fancy themselves to be an expert. This is a medical article, and although WP:MEDRS does not apply to talk pages, if you're so confident that your opinion is "informed", try espousing your opinions about psychiatry in the article and see how long before it's removed. Spend over 30 years working in the trenches of psychiatry, then come back and give us your opinion. And no, I will not obey your command to keep my comments to myself. These talk pages are for expressing opinions, which you have done profusely. Sundayclose (talk) 00:07, 2 December 2021 (UTC)
- I guess having coerced, tortured, and wrecked people lives I would have to justify myself that I wasn't doing harm, particularly if such opinions were necessary to be a member of a social group. That might be why I spend my time insulting people who challenge the fact that sometimes perhaps coercion can cause harm and sometimes a professionals perceived risk of an individual harming themselves might be at odds with reality, and might be motivated not by a desire to protect your own income and sense of culpability rather than for the well being of patient, as if fairly well document. I mean.. someone incapable of thinking that their profession can cause harm probably shouldn't be given coercive powers over others.
- A terrible property of the psychiatric profession is it's ability to combine coercion, scholarship, judgment of mental capacity and the treatment of patients; interesting for the practitioner, but perhaps fraught with conflict of interest. The wonderful property of wikipedia is it opens the literatures (rather than the self-serving and society-serving half truths that professions hold up as truth for group- and self-interest) to public scrutiny. Much as members of professions would like to clearly divide all processes into "those that serve the public" and "those that are for professionals" so that they can "protect" others (and incidentally avoid scrutiny) wikipedia is not a resource for practictioners to educate their patients, but rather a tool to accurately represently scholarship which is unfortunately often very different from "what psychiatrists think". I guess you don't have to "obey my commands" as you say, I would think that sources are better than just stating that people are grossly ill-informed, but hey years of being able to define truth in other people's head may well leave habits behind. I guess as we are expressing opinions, psychiatry's completely failure to acknowledge that "personal expertise" and "coercion" are extraordinarly dangerous bedfellows is highly problematic. When "making choices about my healthcare" becomes "challenging my professional expertise" you have a situation where ego causes real harm. Most of the world mantains judicial oversight of the psychiatric profession for a reason and perhaps having to interact with people who weren't educated (and indoctrinated) into your profession in wikipedia is a similar concept.
- We aren't in a psych ward where disagreeing with you means not being able to leave.
- Actually addressing the issue:
- In the interests of fairness, I recognise that psychiatry can be useful in preventing suicide, but the interventions can also be damaging due to their coercive nature, and the judgment of psychiatrists is difficult and often motivated by factors *other* than the interest of the patient.
- There is a subgroup of people who will be harmed by interventions. There is a subgroup of people who will have their lives saved. The question is whether psychiatry is able to cleanly separate the two. Maybe it can. But there is clearly a massive conflict of interest between the patients well-being, and a professionals liability, and this conflict of interest is quite problematic when we are relying on "psychiatric expertise" Talpedia (talk) 01:13, 2 December 2021 (UTC)
- I really can't respond to most of your commentary because it is so full of inaccuracies, misperceptions, glaring exaggerations, and assumptions of truth based on personal bias. But two things I can say with much certainty. You have virtually no knowledge of psychiatry as it has existed for the last 50 years or the body of scientific literature that it is grounded in. Psychiatry has a lot of problems, but you are oblivious to the real problems and hyperfocused on your preconceptions that are not based in reality as it exists in the 21st rather than the 19th century. Secondly, it's easy to espouse fringe opinions on a talk page. But I challenge you to share your ideas at WT:WikiProject Medicine/Psychiatry task force. I'm sure you can come up with lots of excuses for not doing so, ranging from "Everyone there is biased" to "It's a waste of my time". But if you don't have the courage to even try that, you and I are done here because there's nothing more I can say that you would even consider to be realistic. So I'll let my comments stand for any poor soul who is suicidal and happens to venture here. Now, I'm sure you'll have the last word because I doubt that you can tolerate not appearing to be the greatest expert on this talk page. Cheers. Sundayclose (talk) 02:32, 2 December 2021 (UTC)
- You seem to know a lot about me so I'll leave you to it. Have a look at my contributions if you like, you'll notice that my edits aren't getting reverted. Having a look at the tasks on that board I might work on Eugen Bleuler as I've been expanding the Psychoanalysis article with a historic interest in the influences of psychoanalysis and the development of its alternatives. Having charted the influences on attachment theory and CBT I am interested in looking at the influence on Trauma and it seems to the case that some ideas flowed from Freud's contemporaries to Freud and then have been "sanitized" into more contemporary theories of Trauma. I think I remember reading in Henri Ellenberger (also on the task list) book that these ideas may have actually derived from work with Bleuler so that could be interesting to look into. As I've read a reasonable chunk of Ellenberger's book for this work I may as well expand that as well. This work is more an interesting diversion for my main project which is expanding Medical Sociology I had a reasonable stab at getting some coverage of Eliot Freidson (indeed much of my analysis ahove derives from Freidson - though this happens to coincide with my own thinking and experiences) but this very much still early stage stuff and I would be keen to link this up to more modern interpretations Talpedia (talk) 03:54, 2 December 2021 (UTC)
- I agree it does seem to the case that most of the antipsych / critical of psych folk burn themselves out in a flame of self-righteous attack. What's unfortunate is a large number of their critiques actually exist within the medical profession itself or not too far away in sociology. I'm not quite sure why. I suspect it might be that they are mostly there to find someone to fight with to confirm their worldview, or maybe they are not putting in the work. Perhaps you are correct that they are just afraid... or maybe there is just a negative correlation between the skills required to edit wikipedia and the experiences that would make one interested in issues surrounding the ethical limits of psychiatry. Talpedia (talk) 04:11, 2 December 2021 (UTC)
- Ugh, that got a little out of hand. Not to say that I "regret" it exactly. Necessity can look quite ugly at times, but all things being equal it's probably better to avoid nasty exchanges and focus on more constructive and factual and fewer sociological (and perhaps even personal) factors - critique should be a scalpel and not a hammer, and the use of it as a hammer suggests a lack of planning. On the point at had "Psychiatry can be good, psychiatry can be bad; psychiatry probably shouldn't be the only one saying whether it's bad if it can tell people what to do..."
- I'm happy for my section of the comment to be folded up and replaced with "Talpedia thinks that sometimes psychiatric intervention can cause harm because it's coercive, making the consideration a little less straightforward but it's not necessarily a bad idea. But there is probably WP:DUE reasons to talk about about such phonelines in the article. SundayClose disagree and the pair have some ideological differences about the social role of psychiatry and the merits of its critique. Both agree on the value of due weight, good sourcing and accuracy in summarizing literature" as I would agree that this potentialy distracts from the talk page. I imagine it would be best to ask SundayClose to agree with this and the wording of any summary, but we can leave it too. With that said I shall let this page die down for a few days unless unless there is a lot of activity Talpedia (talk) 09:13, 2 December 2021 (UTC)
- @Talpedia: I said I was out of this discussion, but since you are trying to put words in my mouth I am compelled to comment. My difference with you is not "ideological". It's scientific and medical. But I don't plan to argue about this as that would be pointless with you. But don't speak for me again. Ever. Sundayclose (talk) 00:19, 3 December 2021 (UTC)
- To readers here, it's worth noting that we are talking about referring people to organizations that will potentially detain them against their will and drug them. I think this needs some consideration, SundayClose would appear to disagree. This can lead to individuals losing jobs, friends, and relationships, and can itelf be a causal factor in later suicide. Anyway, i imagine there are scientific differences are involved, readers might detect ideological differences as well - I define ideology quite loosely here, one could call them epistemic and social differences . If anyone had a desire to fold this up I imagine they could act as an intermediary in choosing a summary, but there doesn't seem to be so fine - we can leave that for later. I will avoid addressing you directly where possible, ever. Until you ask me to. Might create problems if you want to comment on my edits or vice versa, but we'll solve that if it happens. I disagree about your comments about me, but fine. Time to back awayTalpedia (talk) 09:43, 3 December 2021 (UTC)
- @Talpedia: I said I was out of this discussion, but since you are trying to put words in my mouth I am compelled to comment. My difference with you is not "ideological". It's scientific and medical. But I don't plan to argue about this as that would be pointless with you. But don't speak for me again. Ever. Sundayclose (talk) 00:19, 3 December 2021 (UTC)
- I really can't respond to most of your commentary because it is so full of inaccuracies, misperceptions, glaring exaggerations, and assumptions of truth based on personal bias. But two things I can say with much certainty. You have virtually no knowledge of psychiatry as it has existed for the last 50 years or the body of scientific literature that it is grounded in. Psychiatry has a lot of problems, but you are oblivious to the real problems and hyperfocused on your preconceptions that are not based in reality as it exists in the 21st rather than the 19th century. Secondly, it's easy to espouse fringe opinions on a talk page. But I challenge you to share your ideas at WT:WikiProject Medicine/Psychiatry task force. I'm sure you can come up with lots of excuses for not doing so, ranging from "Everyone there is biased" to "It's a waste of my time". But if you don't have the courage to even try that, you and I are done here because there's nothing more I can say that you would even consider to be realistic. So I'll let my comments stand for any poor soul who is suicidal and happens to venture here. Now, I'm sure you'll have the last word because I doubt that you can tolerate not appearing to be the greatest expert on this talk page. Cheers. Sundayclose (talk) 02:32, 2 December 2021 (UTC)
- I said the comment is grossly uninformed. If I went to Talk:Pablo Picasso and commented that Picasso draws like a child, that doesn't entitle me to take offense if someone says that my opinion is grossly uniformed. The fact that you retorted with the very same phrase clearly lets us know that it's not a personal attack, just an opinion. Feel free to call any of my opinions uninformed. Right or wrong, everyone has an opinion. If you don't want your opinions challenged, don't add them to a talk page. But if it will unbruise your ego, I'll revise my comment to reflect the status of psychiatry among those who are informed. Basing your comment on one visit to a psych ward only reinforces the fact that your opinion is uniformed. Wikipedia is a wonderful resource, but one of the major limitations of Wikipedia is that anyone, regardless of expertise, can fancy themselves to be an expert. This is a medical article, and although WP:MEDRS does not apply to talk pages, if you're so confident that your opinion is "informed", try espousing your opinions about psychiatry in the article and see how long before it's removed. Spend over 30 years working in the trenches of psychiatry, then come back and give us your opinion. And no, I will not obey your command to keep my comments to myself. These talk pages are for expressing opinions, which you have done profusely. Sundayclose (talk) 00:07, 2 December 2021 (UTC)
- @Sundayclose: calling people grossly uninformed is probably a personal attack. I remember visiting a psych ward once where they were talking about cutting off a mans feet because of diabetes probably from being continuously drugged with benzodiazapine's and not being able to go outside. He also had chronic tooth decay and was unable to see a dentist. Having been in prison before he commented that he would prefer to be in prison than a psych ward because at least there was something to do there. I remember that the ward had been given a small barey usable manual treadmill because of suicide prevention. Keep you grossly ill-informed comments about oher people's informedness to yourself (not WP:ANI) Talpedia (talk) 21:08, 1 December 2021 (UTC)
- Sad bureaucrat here, although I'm not fond of biting noses. I doubt seriously that a suicidal person will end up at this article. And if they do, they have to read the