Lived experience: Near-fatal adolescent suicide attempt

165 Pages·2015·0.74 MB·English

University of South Florida
Scholar Commons
Graduate Theses and Dissertations Graduate School
3-31-2010
Lived Experience: Near-Fatal Adolescent Suicide Attempt
Phyllis Ann Dougherty
University of South Florida
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Dougherty, Phyllis Ann, "Lived Experience: Near-Fatal Adolescent Suicide Attempt" (2010). Graduate
Theses and Dissertations.
https://scholarcommons.usf.edu/etd/1617
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Lived Experience: Near-Fatal Adolescent Suicide Attempt

by

Phyllis Ann Dougherty

A dissertation submitted in partial fulfillment
of the requirements for the degree of
Doctor of Philosophy
College of Nursing
University of South Florida

Major Professor: Patricia A. Burns, Ph.D.
Co-Major Professor: Ona Z. Riggin, Ed.D.
Lois Gonzalez, Ph.D.
Robert Friedman, Ph.D.
Judith Karshmer, Ph.D.

Date of Approval:
March 31, 2010

Keywords: alienation, communication, parenting, qualitative, nursing science

© Copyright 2010, Phyllis Ann Dougherty
Dedication
This dissertation manuscript is dedicated with much love and affection to my
loving parents, Phyllis A. and Daniel F. Dougherty, whose lifelong foundations of love,
encouragement, support, and independence have inspired me and made all my dreams—
and more—possible.
I owe many thanks to my wonderful sisters, Carolyn Dougherty Koonce and
Denise Dougherty Kenyon, for their love and good listening skills.
I would also like to say thank you to my dear friends Don and Jennifer Munro
Golliher for their care and feeding of this wayward doctoral student.
And with love to my grandmother, Augusta Brooks Dougherty, who was always
my inspiration for independence and free-thinking, and to my dear grandfather, James
Deffley—I wish you both were here.
Acknowledgments
I wish to express my deepest gratitude to each of my committee members for their
infinite patience and kindness.
I wish to express heartfelt thanks to my professor, Ona Z. Riggin, Ed.D.,
Distinguished Professor Emeritus, University of South Florida, who made this possible
by inspiring me with my first research project on her NIH adolescent suicide grant.
I respectfully acknowledge Patricia Burns, Ph.D., Dean of the College of Nursing,
University of South Florida, for all her efforts in getting me to the end of the road. You
have been the dynamic force behind this endeavor. I truly appreciate it more than you can
ever know. Thank you for making me your ―swan song.‖
I would like to express my deepest personal and professional appreciation to
Robert M. Mayer, M.D., Ph.D. for his confidence in me and his unfailing support in my
endeavors and, without whose help, this research study would not have been possible.
I would truly like to thank Rachel E. Agustines, M.D. for her last minute dash to
assist in my study. I would like to extend my sincere gratitude to Mauro Rodriguez, M.D.
for his encouragement and support as well as to Beth Lowrey, M.D. for her support. My
deep appreciation goes to Alison Fuhr, M.S., A.R.N.P. for assisting me with my
professional duties. Thanks also to all the nurses and staff who lent their encouragement.
I also wish express my deep regard for the young women who so graciously spoke
of their heartbreaking experiences—thank you so much for teaching me—and others.
Table of Contents
List of Tables vi
List of Figures vii
Abstract viii
Chapter I Introduction 1
Extent of the Problem 1
Defining Suicide 4
Purpose of the Study 6
Importance of the Study 8
Specific Aims of the Study 11
Aim 1 11
Aim 2 11
Aim 3 11
Aim 4 11
Adolescence 11
Chapter II Review of Literature 13
Suicidology 13
Suicidal Behaviors 15
Victimology 16
Psychological Autopsy 17
i
Substance Abuse 19
Firearms 22
Gender Differences 26
Minority Suicide 27
Summary 30
Chapter III Method 34
Rationale for the Research Design Approach 34
Rationale for the Qualitative Research Approach 34
Rationale for the Case Study Method 36
Description of the Research Site 38
Sample 39
Criteria 40
Inclusion Criteria 40
Exclusion Criteria 41
Instrumentation 41
Risk-Rescue Rating Scale for Suicide Attempts 41
Description of Data Collection Method 45
Procedure for Informed Consent and Assent 45
Protection of Human Subjects 46
Interview Protocol 50
Study Protocol 51
Qualitative Research Criteria 52
ii
Credibility 52
Dependability 53
Transferability 55
Framework for the Content Analysis 56
Step 1 Note Making 56
Step 2 Immersion in Data 56
Step 3 Open Coding 56
Step 4 Developing Broader Categories 58
Step 5 Refinement of Categories 58
Step 6 Guarding Against Bias 58
Step 7 Establishing That Categories Cover All Aspects of the 58
Interviews
Step 8 Code Data into Identified Categories 58
Step 9 Further Code Data into Identified Categories 59
Step 10 Individual Analysis 59
Step 11 Checking Validity/Credibility 59
Step 12-14 Organizing and Writing Up the Data 59
Role of the Investigator 60
Summary 61
Chapter IV Results 62
Sample Consistency 63
Selection Criteria 66
iii
Psychiatrist‘s Assessment 67
Risk-Rescue Rating Scale Results 67
Data Analysis 70
Results of the Data Analysis 71
Alienation 71
Communication 72
Alienation: Estrangement from Parents 73
Alienation: Estrangement from Peers 85 69
Lack of Self-Identity 88
Lack of Coping Skills 90
Model of Path of Near-Fatal Adolescent Suicide Attempt 96
Summary 102
Chapter V Discussions, Implications, Recommendations, Conclusions 103
Specific Aims of the Study 104
Aim 1 104
Aim 2 105
Aim 3 106
Aim 4 106
Strengths of the Research 106
Credibility 106
Dependability 107
Transferability 109
iv
Role of the Investigator 109
Limitations of the Research 109
Restricted Sample Size 109
Limitations of the Method 111
Restricted Sample Size 113
Implications for Nursing 115
Recommendations for Future Research 116
Conclusions 118
References 123
Appendix 150
Appendix A 151
About The Author End Page

v
List of Tables
Table 1 Risk Factors for Suicide Attempts 43
Table 2 Rescue Factors for Suicide Attempts 44
Table 3 Demographics and Type of Poisoning of the Study Sample 65
Table 4 Risk-Rescue Rating Assessment Scores of the Study Sample 70

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