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      The Perceived Impact of Suicide Bereavement on Specific Interpersonal Relationships: A Qualitative Study of Survey Data

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          Abstract

          People bereaved by suicide have an increased risk of suicide and suicide attempt, yet report receiving less support than people bereaved by other sudden deaths. Reductions in support may contribute to suicide risk, yet their nature is unclear. We explored the impact of suicide bereavement on the interpersonal relationships of young adults in the UK using an online survey to collect qualitative data. We conducted thematic analysis of free-text responses from 499 adults to questions capturing the impact of bereavement on relationships with partners, close friends, close family, extended family, and other contacts. We identified four main themes describing the changes in relationships following the suicide: (1) Social discomfort over the death (stigma and taboo; painfulness for self or others to discuss; socially prescribed grief reactions); (2) social withdrawal (loss of social confidence; withdrawal as a coping mechanism); (3) shared bereavement experience creating closeness and avoidance; (4) attachments influenced by fear of further losses (overprotectiveness towards others; avoiding attachments as protective). These findings contribute to understanding deficits in support and pathways to suicidality after suicide bereavement. Such disrupted attachments add to the burden of grief and could be addressed by public education on how to support those bereaved by suicide.

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          Using thematic analysis in psychology

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            Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.

            Qualitative research explores complex phenomena encountered by clinicians, health care providers, policy makers and consumers. Although partial checklists are available, no consolidated reporting framework exists for any type of qualitative design. To develop a checklist for explicit and comprehensive reporting of qualitative studies (in depth interviews and focus groups). We performed a comprehensive search in Cochrane and Campbell Protocols, Medline, CINAHL, systematic reviews of qualitative studies, author or reviewer guidelines of major medical journals and reference lists of relevant publications for existing checklists used to assess qualitative studies. Seventy-six items from 22 checklists were compiled into a comprehensive list. All items were grouped into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. Duplicate items and those that were ambiguous, too broadly defined and impractical to assess were removed. Items most frequently included in the checklists related to sampling method, setting for data collection, method of data collection, respondent validation of findings, method of recording data, description of the derivation of themes and inclusion of supporting quotations. We grouped all items into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. The criteria included in COREQ, a 32-item checklist, can help researchers to report important aspects of the research team, study methods, context of the study, findings, analysis and interpretations.
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              How Many People Are Exposed to Suicide? Not Six

              It has long been stated that six people are left behind following every suicide. Despite a lack of empirical evidence, this has been extensively cited for over 30 years. Using data from a random-digit dial survey, a more accurate number of people exposed to each suicide is calculated. A sample of 1,736 adults included 812 lifetime suicide-exposed respondents who reported age and number of exposures. Each suicide resulted in 135 people exposed (knew the person). Each suicide affects a large circle of people, who may be in need of clinician services or support following exposure.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                21 May 2019
                May 2019
                : 16
                : 10
                : 1801
                Affiliations
                [1 ]UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London W1T 7NF, UK; valeriya.azorina.14@ 123456ucl.ac.uk (V.A.); n.morant@ 123456ucl.ac.uk (N.M.); hedvig.nesse.14@ 123456ucl.ac.uk (H.N.); d.osborn@ 123456ucl.ac.uk (D.O.); michael.king@ 123456ucl.ac.uk (M.K.)
                [2 ]UCL Research Department of Primary Care & Population Health, Rowland Hill St, London NW3 2PF, UK; f.stevenson@ 123456ucl.ac.uk
                [3 ]Camden and Islington NHS Foundation Trust, St Pancras Hospital, London NW1 0PE, UK
                Author notes
                [* ]Correspondence: a.pitman@ 123456ucl.ac.uk ; Tel.: +44-20-7679-9467
                Author information
                https://orcid.org/0000-0003-4022-8133
                https://orcid.org/0000-0002-9742-1359
                Article
                ijerph-16-01801
                10.3390/ijerph16101801
                6572476
                31117207
                240ca31a-2f46-40fe-91a9-428904a074c9
                © 2019 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 06 April 2019
                : 18 May 2019
                Categories
                Article

                Public health
                suicide bereavement,qualitative research,grief,bereavement,social support,interpersonal relationships,kinship

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