PSYCHOSOCIAL CORRELATES OF SUICIDAL IDEATION AMONG PRISON INMATES: A STUDY OF NIGERIAN PRISONS SERVICE (MEDIUM SECURITY PRISON UYO, AKWA IBOM STATE)

PSYCHOSOCIAL CORRELATES OF SUICIDAL IDEATION AMONG PRISON INMATES: A STUDY OF NIGERIAN PRISONS SERVICE (MEDIUM SECURITY PRISON UYO, AKWA IBOM STATE)

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TABLE OF CONTENTS

Title Page        -           -           -           -           -           -           -           -           i

Certification    -           -           -           -           -           -           -           -           ii

Dedication      -           -           -           -           -           -           -           -           iii

Acknowledgement      -           -           -           -           -           -           -           iv

Table of contents        -           -           -           -           -           -           -           vi

Abstract          -           -           -           -           -           -           -           -           viii

CHAPTER ONE

INTRODUCTION

1.1       Background of Study -           -           -           -           -           -           1

1.2       Statement of the Problem       -           -           -           -           -           11

1.3       Purpose of the Study  -           -           -           -           -           -           13

1.4       Significance of Study -           -           -           -           -           -           14

CHAPTER TWO

LITERATURE REVIEW

2.1       Theoretical Framework           -           -           -           -           -           15

2.1.1    Hopelessness theory of suicide           -           -           -           -           15       

2.1.2    Escape theory of suicide (Baumeister 1990)  -           -           -           20       

2.1.3    Inter Personal Theory of Suicidal Behavior (Joiner, 2005)     -           24       

2.1.4    The Integration Theory of Suicide

(Durkheim 1897)         -           -           -           -           -           -           28

2.1.5    Carol Ryff’s Model of Psychological Well-Being, 1989        -           31

2.1.6    Eysenck’s Personality Theory (Eysenck, 1947)          -           -           36       

2.2       Review of Related Studies     -           -           -           -           -           39       

2.3       Hypothesis      -           -           -           -           -           -           -           53       

2.4              Operational Definition of Terms         -           -           -           -           53       

CHAPTER THREE

3.1       Design -           -           -           -           -           -           -           -           55       

3.2       Settings           -           -           -           -           -           -           -           55       

3.3       Participants     -           -           -           -           -           -           -           55       

3.4       Instruments     -           -           -           -           -           -           -           56       

3.4.1    Flourishing Scale of Psychological Wellbeing            -           -           56       

3.4.2    Big Five Inventory (BFI)        -           -           -           -           -           56       

3.4.3    Scale of Suicidal Ideation (SSI)         -           -           -           -           57

3.5       Procedures      -           -           -           -           -           -           -           57       

3.6       Statistics          -           -           -           -           -           -           -           58

CHAPTER FOUR

4.1       Result  -           -           -           -           -           -           -           -           59

CHAPTER FIVE

5.1       Discussion       -           -           -           -           -           -           -           63       

5.2       Implications of the study        -           -           -           -           -           65

5.3       Limitations of Study   -           -           -           -           -           -           66       

5.4       Conclusion      -           -           -           -           -           -           -           67

5.5       Recommendations      -           -           -           -           -           -           68       

References

            Appendixes

ABSTRACT

The study investigated the psychosocial correlates (Psychological wellbeing, Personality, Age, and Gender) of suicidal ideation among prison inmates. Two hundred (200) prison inmates (males =151, females = 49), aged 20-65 years, with the mean of 26.6 and standard deviation of 7.10 drawn from the Medium security prisons Uyo, Akwa Ibom state using purposive sampling technique. Three scales were used for data collection namely; Scale of Suicide Ideation (SIS), Big Five Personality Inventory (BFI), Flourishing Scale of Psychological wellbeing (FSPW). Data was analyzed using the Pearson Product Moment Correlation (Pearson r).Results showed that Psychological Wellbeing, Personality (Extraversion and Neuroticism), Gender and Age showed a positive relationship with suicidal ideation among prison inmates. It was suggested that clinical psychologist, health care workers/administrators, counselors and psychiatrists should assess, modify and integrate low level of psychological wellbeing, Extraversion and Neuroticism, Age and as the risk factors for suicidal ideation among prison inmates while administering care to them for holistic treatment and adjustment.


CHAPTER ONE

INTRODUCTION

1.1       Background of Study

The consequences of incarceration are not only debilitating but also predisposes an inmate towards having thwarted thoughts about self and the world, their personalities, physiological wellbeing and heighten their tendency to continuously contemplate suicide.

Suicidal ideation is the thought of ending one's life but not taking any active efforts to do so (Krug, Dahlberg, Mercy, Zwi & Lozano 2002; Spielberg, 2009). O’Carroll, Berman, Maris, Moscicki, Tanney and Silverman (1996) defined suicidal ideation as self-reported thoughts of engaging in suicide related behavior. Bagely (1975) and Beck, Kovacs and Weissman (1979) defined suicidal ideation as having thoughts, ideas and intentions about suicide and plans and wishes to commit suicide. Suicidal ideation involves a hierarchy of feelings from the thought that ‘‘life is not worth living’’ to the more serious articulation of a thought-out plan (Kirby, Bruce,Radic, Coakley & Lawlor, 1997).

The term suicidal ideation is often used more generally to refer to having the intent to commit suicide, including planning on how it will be done (Zung & Klose, 2007). The main difficulty in defining suicidal ideation lies in establishing the presence of suicidal intent. This is particularly important, as intention is a crucial link between thought and action, indicating the extent to which a person wants to die (Hjelmeland, 1997). Although ideation is not the same as action (Leenaars, De Leo, Dieskstra, Goldney, Kelleher, Lester & Nordstrom 1997), it has generally been subsumed under the rubric of suicidal behavior due to the variety of its conceptualizations (King, 1997; Yoder, 1999). There yet remains no agreement as to whether ideation automatically implies suicidal intent. The prevalence of suicide tends to be higher in African countries in the east and south, compared to those in the north and west (Schlebusch, Barrows & Vawda, 2009) and with the dearth of literature within the prison, there are likely to be no reports on suicide in Nigerian prisons but there have always been speculations that prison inmates die in the prison as a result of illness and also using death as a means to end their hopelessness future.

Suicidal behavior is a crucial concern worldwide (Hakansson, 2010; Diekstra, 1993). Suicidal behavior is more common among prison inmates (Sattar, 2003; Borrill, 2003; Kokkevi, 1995). Nowadays, there is great concern over the high rates of suicide and suicidal behavior in prisons, suicide ranks third as a cause of death in prisons (Bureau of Justice Statistics, 1993) Suicidal behavior and completed suicide are serious problems in prisons, leading to significant morbidity and mortality especially among inmates.

In Nigeria, prison inmates consist of two main categories: convicted persons serving out jail terms, and many others who are awaiting trial, but are remanded in prison custody. These inmates are divided into two sections within the prison yard; the awaiting trial and the convicted sections. Inmates found in the awaiting trial section are presumed to be innocent under the principles of many legal systems, and are therefore entitled to special benefits and preferential treatments. As a result of overcrowding problems or insufficiently segregated prison facilities, awaiting inmates are in some circumstances often mixed with the convicted ones, and this maybe disheartening for inmates waiting to be tried who may feel like they have already been sentenced to prison without trial. Using Shneidman's (1993) approach to suicide, the continuous exposure to life threatening events or environments will certainly lead to low psychological wellbeing of the inmates and their inability to cope with the pain. Hence, incarceration and the negative life experiences associated with incarceration will certainly predispose prison inmates developing distorted thoughts about ending their lives. This could be as a result of depression, anxiety and stress associated with incarceration.

Psychosocial factors as will be used in this study refer to both psychological and social factors which interplay to predispose inmates to suicidal ideation. Psychological factors as will be used in this study has been conceptualized as psychological wellbeing and personality ,also the social factors as will be used in this study has been conceptualized as Age and Gender.

Psychological well-being is a potential parameter of measuring overall health and good life of a person. It has been observed that poor psychological well-being is associated with deficiency in problem-solving, higher levels of stress and depression, lack of success and the existence of emotional problems. This could be an indication that absence of psychological well-being among prisoners may reflect in inmates’ expression of anger, depression and frustrations, which may cause a decrease in the levels of their happiness and satisfaction. According to Ward (2004), psychological well-being entails various psychological, emotional, physical health and wellness of individuals. Studies indicate three aspects of psychological well being, evaluative well-being - involving global assessments of how people evaluate their satisfaction in life; affective or hedonic well-being - involving measures of feelings such as happiness, sadness and enjoyment; and eudemonic wellbeing - which focuses on judgments about the meaning or purpose of one’s life and appraisals of constructs such as fulfillment .

Psychological well-being contributes most to a well lived life. It is the positive social relationships, ability to cope in stressful environment, wisdom, sense of meaning and purpose in life. Psychological well-being is also seen as a contentment and satisfaction (in the past), flow of happiness (in the present) and hope, optimism (for the future). Jefferies (1975) observes that the inmate’s self-concept is distorted as soon as he arrives prison Inmates necessarily need to come to terms with their present condition by having a sound frame of mind to know how to cope with the realities of life in prison. According to Wooldredge (1999) psychological well being is conceptualized as “reflecting inmate perceptions of insecurity, stress, depression, anger, low self esteem and loneliness felt during incarceration”. Particular aspects of the prison environment may lessen some of the negative psychological effects of incarceration, such as depression and alienation, but they depend on the unique need of the inmates (Toch, 1977).The factors that have a beneficial impact on psychological wellbeing while incarcerated include social integration (Lindquist, 2000), not being victimized (Leddy & O’Connell, 2002), and frequent visitation (Woolredge, 1999).and an inmate’s psychological wellbeing could be linked to his personality.

Personality is based on the essential insight that all people are similar in some ways, yet different in others (Phares & Chaplin, 1997). It is that pattern of characteristic thoughts, feelings, and behaviors that distinguishes one person from another and that persists over time and situations. (Phares & Chaplin, 1997). According to the Diagnostic and Statistical Manual of the American Psychiatric Association (2014), personality traits are enduring patterns of perceiving, relating to, and thinking about the environment and oneself that are exhibited in a wide range of social and personal contexts. Also, some theorists generally assume that; traits are relatively stable over time, differ among individuals, and influence behavior. This implies that personality do not usually change and vary along continuum between one extreme and the other (Feist, Jess Feist & Gregory, 2009). However, the most common models of traits incorporate three to five broad dimensions or factors and all trait theories incorporate at least two dimensions, extraversion and neuroticism, which historically featured in Hippocrates' humoral theory and can also predict human reactions to other people, problems, and stress (Winnie & Gittinger, 1973; Krauskopf & Saunders, 1994).

Goldberg (1990) proposed a five-dimension personality model, nicknamed the "Big Five". These traits are five broad domains or dimensions of personality that are used to describe human personality and the theory is based on the Big Five factors and it is called the five-factor model (FFM) (Costa & McCrae, 1992). The five factors are openness, conscientiousness, extraversion, agreeableness, and neuroticism. The Big Five model account for different traits in personality without overlapping.

Openness to Experience is the tendency to be imaginative, independent, and be interested in variety vs. practical, conforming, and interested in routine in which openness is a general appreciation for art, emotion, adventure, unusual ideas, imagination, curiosity, and variety of experience. People who are open to experience are intellectually curious, open to emotion, sensitive to beauty, are willing to try new things and tend to be more creative and more aware of their feelings. They are more likely to hold unconventional beliefs.

Conscientiousness which is the tendency to be organized, careful, and organized vs disorganized, careless, and impulsive is also a tendency to show self-discipline, act dutifully, and aim for achievement against measures or outside expectations. It is related to the way in which people control, regulate, and direct their impulses and high scores on conscientiousness indicate a preference for planned rather than spontaneous behavior. (Costa & McCrae, 1992)     

Extraversion is the tendency to be sociable, fun-loving, and affectionate vs. retiring, somber, and reserved. It is characterized by breadth of activities (as opposed to depth), assurgency from external activity/situations, energy creation from external means is marked by pronounced engagement with the external world (Laney, and Olsen, 2002). Hence, extraverts enjoy interacting, and are often perceived as full of energy and they tend to be enthusiastic, action-oriented individuals. Extraversion has been negatively associated with history of attempted suicide.

Agreeableness is the tendency to be softhearted, trusting, and helpful vs. ruthless, suspicious, and uncooperative. Agreeableness trait reflects individual differences in general concern for social harmony, implying that agreeable individual’s value getting along with others. They are generally considerate, kind, generous, trusting and trustworthy, helpful, and willing to compromise their interests with others (Rothman & Coetzer, 2003). Agreeable people have an optimistic view of human nature.

Neuroticism is the tendency to be anxious, insecure, and self-pitying vs. calm, secure, and self-satisfied (Santrock, 2008). According to Eysenck's (1967) theory of personality, neuroticism is interlinked with low tolerance for stress or aversive stimuli (Norris, Larsen & Cacioppo, 2007). Neuroticism is also the tendency to experience negative emotions, such as anger, anxiety, or depression (Jeronimus, Riese, Sanderman & Ormel, 2014). Neuroticism is connected within a pessimistic approach toward work life. Neuroticism personality dimension is associated with negative emotions like depression and tendency to depression is considered a risk factor for suicide. Regarding personality traits (from the FFM), extraversion, agreeableness, and conscientiousness were expected to be positively related to reasons for living and negatively related to suicidal ideation, whereas neuroticism was expected to be negatively related to reasons for living and positively related to suicidal ideation in depressed prison inmates awaiting trial.

Shirley and Ilene (2010) reported that suicide completers had significantly higher scores on suicide ideation when compared with deceased controls, concluding that those who eventually commit suicide may endorse greater tendency towards introversion. Given the various dimensions of personality and the dynamics of each, suicidal ideation was positively predicted by Neuroticism. Neuroticism has an inherent negative denotation (Bradshaw, 1997) although (sometimes reversed and called emotional stability), an enduring tendency to experience negative emotional states and such feelings such as anxiety, anger, guilt, and depressed mood (Matthews & Deary, 1998). Similarly, Goleman (1997) found that they respond more poorly to environmental stress, are more likely to interpret ordinary situations as threatening and minor frustrations as hopelessly difficult. They are often self-conscious and shy, and they may have trouble controlling urges and delaying gratification. Neuroticism is associated with low emotional intelligence, which involves emotional regulation, motivation, and interpersonal skills. It is also a risk factor for "internalizing" mental disorders such as phobia, depression, panic disorder, and other anxiety disorders traditionally called neuroses (Hettema, Neale, Myers, Prescott & Kendler, 2006). Individuals who are high in neuroticism may show more emotional reactions whenever confronted with stressful situations (Heck, 1997). So it is plausible to assume that inmate’s personality would indicate or determine the tendency of prison inmates awaiting trial committing suicide.

Age is a period of human life, measured by years from birth, usually marked by a certain stage or degree of mental or physical development and involving legal responsibility and capacity. Ageing is an inevitable developmental phenomenon bringing along a number of changes in the physical, psychological, hormonal and the social conditions. Define age in terms of the biology; referring to “the regular changes that occur in mature genetically representative organism living under reprehensive environmental conditions as they advance in chronological age.

Perhaps there is some fundamental evolved difference between men and women in their propensity to kill themselves, a difference that is not reflected in their life evaluations or hedonic wellbeing.

Inmates who commit suicide in custody are generally male, young (20-25 years), unmarried, and first time offenders who have been arrested for minor, usually substance related, offences. Male prison inmates of all the ages commit suicide at a higher rate than female prison inmates although female inmates attempt suicide more often than males. They are typically intoxicated at the time of their arrest and commit suicide at an early stage of their confinement, often within the first few hours (because of sudden isolation, shock of imprisonment, lack of information, insecurity about the future). Individual establishments can reduce their suicide risk by paying attention to reception and first night procedures, induction processes, and levels of care for prisoners. A second period of risk for inmates is near the time of a court appearance, especially when a guilty verdict and harsh sentencing may be anticipated. A great deal of all prison suicides occurred within three days of a court appearance. Moreover, after 60 days of confinement a certain kind of emotional exhaustion was observed, which could be called “burn-out”. Women are said to 'attempt,' and men to be


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