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Male suicides are often associated with masculinity norms that encourage certain behaviours that increase the risk of suicide. For example, research shows that restricted emotionality, avoidance of seeking help and self-reliance are associated with higher suicide risk. However, these pre-formulated aspects of masculinity do not necessarily reflect men’s subjective opinions of what masculinity is to them. Researchers argue that it is important to consider personal views about what masculinity is, not only stereotypes about masculinity. The aim of this study is to reveal and compare the subjective opinions about the masculinity of men with and without suicidal ideation. 281 men answered the open-ended question during the survey: “What does masculinity mean to you?”. The answers were analyzed using a content analysis method. We transformed qualitative data into quantitative and compared them statistically between two groups: men with and without suicidal ideation. It turned out that men with suicidal thoughts were more likely to mention that masculinity is the control of emotions, intelligence, and decision-making. Men without suicidal thoughts were more likely to mention family and caring for it as essential aspects of masculinity. The results showed that certain aspects of masculinity might be related to higher risk for suicide, but the study also revealed the masculinity that might be a source of coping.

The aim of the current study is to analyze how relatives understand in retrospect the suicide risk of their next of kin who died by suicide. We interviewed 103 adult relatives who lost their significant others to suicide, using qualitative content analysis to explore the data. Participants expressed difficulties understanding suicide risk by identifying

The research into the phenomenon of cultural trauma is growing as the effects of historical transformations are recognized and analysed. The concept of cultural trauma and the analytic concept of the cultural complex is a suitable theoretical approach for this research. The Lithuanian experience of cultural trauma after the historical shifts indicates the importance of the interplay between societal and individual factors in coping with trauma. Academic psychotraumatological studies carried out at Vilnius University indicate a stronger traumatic experience by people who are survivors of direct political repression and even intergenerational transmission of trauma, but this group also seems to demonstrate an intergenerational transmission of resilience. Paradoxically, from a long-term perspective, the victims of direct repression seem to have suffered less than the people who accommodated to the regime, and this applies also to their offspring. Analysis in terms of overcoming cultural trauma indicates that society is gradually integrating historic traumatic experiences, although a healthy cultural identity has not yet been restored.La recherche sur le phénomène du traumatisme culturel se développe alors que les effets des transformations historiques sont reconnues et analysées. Le concept de traumatisme culturel et le concept analytique du complexe culturel donnent un cadre théorique utile pour ce domaine d’études. L’expérience lithuanienne de traumatisme culturel après les changements historiques montre l’importance de l’interaction entre les facteurs sociétaux et individuels pour se débrouiller du traumatisme. Des études en psychotraumatologie faites à l’université de Vilnius montrent une expérience traumatique plus forte chez les personnes qui ont survécu à une répression politique directe, et même une transmission intergénérationnelle du traumatisme. Mais ces chercheurs semblent aussi pouvoir montrer une transmission intergénérationnelle de la résilience. De manière paradoxale, sur le long terme, les victimes d’une répression directe semblent avoir moins souffert que les personnes qui se sont adaptées au régime, et ceci s’applique également à leurs descendants. L’analyse s’occupant de surmonter le traumatisme culturel montre que la société procède peu à peu à l’intégration des expériences historiques traumatiques, bien qu’une identité culturelle saine n’ait pas encore été restaurée.Die Erforschung des Phänomens des kulturellen Traumas nimmt zu, je mehr die Auswirkungen historischer Veränderungen sichtbar und analysiert werden. Das Konzept des Kulturtraumas und das analytische Konzept des Kulturellen Komplexes bilden geeignete theoretische Ansätze für diese Forschung. Die litauische Erfahrung des kulturellen Traumas nach den historischen Verschiebungen zeigt, wie wichtig das Zusammenspiel von gesellschaftlichen und individuellen Faktoren bei der Bewältigung von Traumata ist. Akademische psychotraumatologische Studien der Universität Vilnius weisen auf eine stärkere traumatische Erfahrung von Menschen hin, die Überlebende direkter politischer Unterdrückung sind und sehen bei diesen gleichzeitig eine intergenerationale Weitergabe von Traumata. Diese Gruppe scheint jedoch auch eine Weitergabe von Resilienz zwischen den Generationen aufzuweisen. Paradoxerweise scheinen die Opfer der direkten Repression auf lange Sicht weniger gelitten zu haben als die Menschen, die sich mit dem Regime arrangiert hatten und dies gilt auch für ihre Nachkommen. Analysen mit dem Ziel der Überwindung kultureller Traumata zeigen, daß die Gesellschaft nach und nach historische traumatische Erlebnisse integriert, wenngleich eine gesunde kulturelle Identität noch nicht wiederhergestellt ist.La ricerca sul fenomeno del trauma culturale cresce man mano che gli effetti delle trasformazioni storiche vengono riconosciuti ed analizzati. Il concetto di trauma culturale ed il concetto analitico del complesso culturale sono degli adeguati approcci teorici per questa ricerca. L’esperienza lituana del trauma culturale dopo i cambiamenti storici indica l’importanza dell’interazione tra fattori sociali ed individuali nell’affrontare il trauma. Studi accademici di psicotraumatologia condotti all’Università di Vilnius indicano un’esperienza traumatica maggiore nelle persone che sono sopravvissute a dirette repressioni politiche ed addirittura trasmissioni intergenerazionali del trauma, ma questo gruppo sembra dimostrare anche trasmissioni intergenerazionali della resilienza. Paradossalmente, da una prospettiva a lungo termine, le vittime di repressioni dirette sembrano aver sofferto meno delle persone che si sono adattate al regime, e questo vale anche per i loro discendenti. L’analisi in termini di superamento del trauma culturale indica che la società sta gradualmente integrando esperienze traumatiche della storia, nonostante non sia stata ancora ripristinata una sana identità culturale.Область исследований феномена культурной травмы растет по мере того, как распознаются и анализируются эффекты исторических перемен. Понятие культурной травмы и аналитическое понятие культурного комплекса - подходящие для этого исследования теоретические концепции. Литовский опыт культурной травмы исторических перемен показывает важность взаимодействия между общественными и индивидуальными копинговыми стратегиями. Академические психотравматологические исследования, проведенный в Университете Вильнюса, свидетельствуют о более сильном травматическом опыте у людей, переживших политические репрессии и межпоколенческую травму. Однако у этой же группы наблюдается межпоколонеческая передача устойчивости. Парадоксально, что с точки зрения долгосрочной перспективы жертвы репрессий пострадали меньше, чем люди, которые приспособились к режиму. Это верно и для их потомков. В терминах преодоления культурной травмы анализ показывает, что общество постепенно интегрирует исторический травматический опыт, однако здоровая культурная идентичность еще не восстановлена.Mientras los efectos sobre las transformaciones históricas y sociales están siendo reconocidas y analizadas, la investigación sobre el fenómeno del trauma cultural está creciendo. El concepto de trauma cultural y el concepto analítico de complejo cultural es un abordaje teórico apropiado para dicha investigación. La experiencia Lituana de trauma cultural luego de los cambios históricos da cuenta de la importancia del inter-juego entre factores individuales y sociales para hacer frente al trauma. Estudios académicos psico-traumatológicos llevados a cabo e la Universidad de Vilnius indican la presencia de experiencias traumáticas más intensas en las personas sobrevivientes de una represión política directa, y también de la transmisión intergeneracional del trauma, pero este grupo, también pareciera demostrar la transmisión intergeneracional de resiliencia. Paradójicamente, desde una perspectiva a largo plazo, las víctimas de represión directa parecieran haber sufrido menos que quienes se acomodaron al régimen, y esto aplica también a los descendientes. El análisis, en términos de sobreponerse al trauma cultural indica que la sociedad está gradualmente integrando las experiencias traumáticas de la historia, aunque una identidad cultural saludable todavía no ha podido ser restaurada.随着人们越多地对历史性转变效应的觉察和分析, 关于文化创伤现象的研究也越发增多。文化创伤的概念 和分析心理学关于文化情结的概念 是适合于这类研究的理论取向。立陶宛在历史性转变之后所经历的文化创伤, 呈现了在应付创伤时, 社会与个体因素相互作用的重要性。在维尔纽斯大学进行的关于心理创伤的学术研究显示, 经历过直接的政治性压迫的幸存者, 具有更强的创伤经验, 甚至会把创伤进行隔代的传递, 但这个群体似乎也在隔代之间传递了弹性。矛盾的是, 从长期的角度看, 受到直接压迫的受害者似乎比那些适应了这个制度的人更少地感受到痛苦, 对于他们的后代来说也是如此。关于文化创伤的克服的分析显示, 社会在逐步整合历史性的创伤经验, 尽管一个健康的文化身份尚未恢复。.

Background Studies show that people bereaved by suicide often feel a strong need for professional help. It is hypothesized that aspects related to suicide bereavement, such as stigmatization, shame or guilt, hinder help-seeking process of the bereaved. However, little is known about help-seeking behaviors of people who has lost someone due to suicide. Aims This study was conducted to attain a better understanding of the contributing factors, including the specific features of grief following suicide, to help-seeking behaviors of the bereaved by suicide. Methods The sample consisted of 82 adults bereaved by suicide (64 female; average age 37.79, SD = 14.33). Instruments assessing stigmatization, shame, guilt levels, well-being, tendency to disclose emotional distress and attitudes toward seeking professional psychological help were used. The participants were also asked an open-ended question what professional help-seeking barriers they had encountered. Comparisons between the groups, logistic regression analysis and thematic analysis of the qualitative data were performed. Results The findings revealed that bereaved participants who sought professional psychological help reported experiencing stigmatization and feeling guilty after the loss significantly more often. Also the results showed that attitudes toward mental health specialists had the highest prognostic value in predicting help-seeking behaviors of the bereaved. The participants themselves identified the gaps in the health care system as main barriers to seeking help. Conclusion The results challenge previously spread notion that stigmatization, guilt and shame after suicide can act only as help-seeking barriers.

Different elements of suicidal communication have been explored; however, the understanding of suicide attempters’ perception of surrounding people’s reactions is scarce. This study aims to unravel perceived reactions of surrounding people to suicidal communication and their effect on suicidal intent. Twenty-one person (7 men and 14 women, 18–62 years, M = 31.5) admitted to a general ( N = 6) or psychiatric ( N = 15) hospital after a suicide attempt participated. Hybrid thematic analysis was used for semistructured interview data analysis. Indifference and disengaging in helping are the most common perceived reactions to reports before the attempt. Reactions during the attempt are noticeably more active. Unresponsiveness and provocation to suicide are considered as impelling factors to commit suicide. Active reactions, for example, prohibitions are not viewed as such. Mostly suicide intent is communicated prior to attempt or after harming oneself, but it is taken into account by surrounding people more seriously during the attempt.

A long-term psychological trauma is considered to be a possible consequence of being informed of radioactive contamination. In the case of the Chernobyl disaster, various circumstances possibly have led to even more serious psychological damage. For example, the socio-political context of the accident could be linked to extremely restricted information given out to the public. This disaster particularly affected clean-up workers, some of whom were brought from Lithuania, part of the Soviet Union at the time. This study thus is aimed to reveal the perceived impact of the traumatic experience of clean-up workers 27 years after the Chernobyl Disaster. Semi-structured 32 interviews with clean-up workers (age varying from 47 to 77 years), who are currently living in Lithuania, were conducted. A thematic analysis of the responses reveals that the clean-up workers are still feeling influenced by what they have experienced in Chernobyl. First of all, they link various health problems, which they are suffering from, to their presence in Chernobyl and express anxiety about the possible future illnesses, as they believe their bodies are irreversibly damaged by radiation. Secondly, the clean-up workers express a lot of anger towards the government for insufficiently supporting them financially and not showing enough gratitude for the work that they have done. Also, they experience a feeling of injustice as they believe that the government considers their experience in Chernobyl to be voluntary and not significantly influencing their present physical and psychological condition. Finally, post-traumatic stress symptoms were also found to be manifested. As the most distressing of those symptoms the clean-up workers name general irritability and anxiousness, although symptoms of intrusion and avoidance can also be detected as well as helplessness and a feeling of constantly living under threat. All these findings raise the awarness of how important it is that the government and society would validate the clean-up workers’ experiences – at least symbolically recognizing the long-term impact of being in Chernobyl as well as its involuntary nature. This recognition should also lead to the necessary physical and psychological help in consideration of the clean-up workers’ traumatic experiences and the psychological component of their physical illnesses. Key words: Chernobyl accident, clean-up workers, psychological impact of exposure to radiotion, psychological trauma, health related stress.

Summary Lithuania has one of the highest suicide rates in the world, but the issue hasn’t been properly addressed at the state level. Scientists have demonstrated that the inappropriate media portrayal of suicide can lead to imitative suicidal behavior. Specialists who understood the impact that the media reporting on suicide may cause have set up and started distributing recommendations for reporting on suicide. Recent findings show that the Lithuanian media has not yet developed the practice of responsible reporting on suicide, but there are signs that the situation is slowly improving (Eimontas, 2013). Studies from around the world show that there are several factors that contribute to the way reporters use and appreciate the guideliness for reporting on suicide. The purpose of the present study was to explore the attitudes towards suicide of the Lithuanian journalists who have written most about suicide during the years 2010 and 2011 and to identify both favourable and unfavourable factors for compliance with the guidelines. Methods. After analyzing 721 articles about suicide written in 2010–2011, we identified 50 journalists who covered the topic of suicide most often. The total of 12 reporters had been interviewed. Six of them were selected from those who have written the majority of articles about suicide (which did not conform to the guideliness) during the years 2010 and 2011. Six others were selected from the ones that have reported on suicide many times during the period, but their articles did conform to the guidelines. A thematic analysis was used to examine the data gathered during the interviews. Results. In this study, four out of 12 (33 percent) journalists who have written most often about suicide in 2010–2011 were not aware of the recommendations for reporting on suicide. The thematic analysis of the interviews with journalists has allowed to distinguish at least five factors that help to explain what factors influence whether journalists would use the guidelines when reporting on suicide. These factors are: personal characteristics of a journalist, journalists’ experience with suicide, knowledge about suicide, attitudes towards suicide, as well as guidelines and external influences (such as the editor, or the policy of the editorial office). Key words: suicide imitation effect, guidelines for reporting on suicide, media, suicide, guidelines.

The study aimed to understand the tendencies of help seeking before a suicide attempt in Lithuania. An analysis of interviews with 21 Lithuanian adults demonstrated strong avoidance of seeking help. The main reasons for avoidance included a lack of trust in other people, thinking that one must solve problems independently without sharing them, avoiding troubling others, and a belief that showing genuine emotions is a sign of weakness. These findings may contribute to suicide prevention by more deeply understanding the barriers to help seeking among high suicide risk groups, particularly in countries with a traumatic historical experience.

Research regarding the role of psychoactive substance use in the process of suicide is lacking in current sui­cidology. In addition to this, evidence shows that im­pulsive suicide attempts are common among substance users. However there is no clear understanding of the impulsive suicide process. That makes it difficult to combine results of different studies and create clear guidelines for impulsive suicide risk evaluation. The purpose of this research is to depict the impulsive and non-impulsive process of suicide among psychoactive substance users. The participants of the study were 15 psycho­active substance (10 – alcohol, 5 – drug) users, who had attempted suicide during the last year. 8 of them attempted once, 4 – two or three times, other 3 – more than 5 times. All participants – 4 women and 11 men were patients from Vilnius Centre for Addictive Disorders and Vilnius Mental Health Centre. Quali­tative interviews based on Suicide Intent Scale were conducted about the suicide attempt or attempts. A thematic analysis of the interviews was used to depict the process of suicide. This study led to distinguishing 3 different types of attempted suicide – planned, unplanned and suicide attempts during a “blackout” – which are typical for psychoactive substance users. Both unplanned suicide attempts and suicide attempts during a “blackout” can be called impulsive, though the latter diverged by their hastiness, aggressiveness, inability to control one’s behaviour, intensive feeling of anger, serious danger caused to health and wellbeing, as well as a follo­wing amnesia of a major part of the suicide attempt. Intensive emotions, especially anger and stressors in interpersonal relationships, had a major impact for the respondents in the process of suicide. According to the participants of the survey, substance use had intensified their suicidal crisis having a clear effect on their emotional, relationship and other difficulties. In addition, alcohol and drug use was considered as one of the suicide methods. Despite several restrictions of the research, the study results provide some valuable insight in the suicide risk evaluation among psycho­active substance users.

Remdamiesi ankstesnių tyrimų rezultatais keliame prielaidą, kad nuostatos savižudybių atžvilgiu yra svarbus kintamasis įvertinant savižudybės riziką (suicidiskumą) – nevilties lygis ir nuostatos savižudybių atžvilgiu geriau prognozuoja tiriamųjų savižudybės riziką negu tik nevilties lygis. Hipotezė yra tikrinama jaunų vyrų, atliekancių privalomąją karine tarnybą, imtyje (N = 368). Tyrimo metu nustatyta, kad įvairūs nuostatų savižudybių atžvilgiu aspektai ir nevilties lygis yra reiksmingai susije su tiriamųjų suicidiskumu. Stipriausiai su suicidiskumu koreliavo savižudybės priimtinumas (r = 0,36, p < 0,01). Taikant hierarchine daugiamate regresiją nustatyta, kad nevilties lygis prognozuoja 21,1 proc. suicidiskumo kintamojo variacijos, o nevilties lygis kartu su nuostatomis savižudybės atžvilgiu – 34,2 proc. Gauti rezultatai patvirtino prielaidą, kad nevilties lygio ir nuostatų savižudybių atžvilgiu sąveika vyrų suicidiskumą prognozuoja geriau, negu nevilties lygis atskirai. Pagrindiniai žodžiai: nuostatos savižudybių atžvilgiu, nevilties lygis, suicidiskumas, savižudybės. Level of Hopelessness, Attitudes towards Suicide and Suicide Risk Paulius Skruibis, Evaldas Kazlauskas, Danutė Gailienė Summary Objectives: There is a substantial level of evidence that affirmative attitudes towards suicide are connected to suicidality (suicide ideation, suicide attempts and completed suicide). Hopelessness is proved to be one of the best available predictors of the suicide risk. A hypothesis that attitudes can serve as mediating variable between hopelessness and suicidality was proposed in recent studies (Gibb et al., 2006). The main aim of this study is to test the hypothesis that interaction between attitudes towards suicide and hopelessness will be a better predictor of suicidality than hopelessness. Methods: Different aspects of attitudes towards suicide and suicidality were measured with Questionnaire on Attitudes Towards Suicide (ATTS). Hopelessness level was assessed with Beck Hopelessness Scale (BHS). The study was conducted in the sample of Lithuanian army conscripts (N = 368) aged between 18 and 26 (mean age was 20.46; SD = 1.29). Results: Suicidality index significantly correlated both with hopelessness (r = .45, p < .01) and various aspects of attitudes towards suicide. The strongest correlation was between acceptance of suicide and suicidality index (r = .36, p < .01), but we have also found significant correlations between five other aspects of attitudes and suicidality. Significant correlations between hopelessness and various aspects of attitudes towards suicide were found. Variables using hierarchical stepwise model were entered into multiple regression model. Hopelessness accounted for 21.1% of suicidality variance. Attitudes towards suicide, added into regression model on second step, increased prediction of suicidality to 34.2%. Conclusions: Results of this study show that different aspects of attitudes towards suicide correlate with the suicide risk. Correlation between hopelessness and suicidality was confirmed as well. Finally, the results indicate that attitudes towards suicide are significant predictors of suicide risk. Interaction of attitudes towards suicide and hopelessness predicts suicide risk better than hopelessness. Results of present study have confirmed, that attitudes towards suicide are significant mediators between hopelessness and suicidality. Keywords: attitudes towards suicide, hopelessness, suicidality, suicide.

Tyrimu siekiama nustatyti ir įvertinti nuostatų savižudybių atžvilgiu klausimyno ATTS lietuviskosios versijos psichometrines charakteristikas. Tyrime naudojama imtis (N = 1259) sudaryta is 16 tikslinių grupių, tirtų ATTS metodikos lietuviskąja versija nuo 2001 m. Patvirtinancioji faktorinė analizė nepatvirtino metodikos autorių Svedijoje nustatyto faktorinio modelio. Taciau atlikus tiriamąją faktorine analize, gautas 5 faktorių modelis (paaiskinantis 53,5 proc. bendrosios kintamųjų dispersijos), isoriskai yra panasesnis į kitus taikomus ATTS faktorinius modelius. Sio modelio vidinis suderinamumas – geras (Cronbacho alpha – 0,68). Tyrimo metu aptiki skirtumai tarp suicidiskų ir nesuicidiskų tyrimo dalyvių nuostatų yra traktuojami kaip vienas is kriterinio metodikos validumo patvirtinimų. Siekiant įvertinti ATTS lietuviskosios versijos stabilumą bėgant laikui, buvo atliktas pakartotinis tyrimas (angl. test-retest) – tirta medicinos studentų imtis (N = 30). Sio tyrimo rezultatai parodė, kad trijų faktorių stabilumas yra pakankamas (koreliacijos koeficientai nuo 0,62 iki 0,87), taciau likusių dviejų faktorių stabilumo rodikliai – menki (0,48 ir 0,59). Apibendrinus visus tyrimo rezultatus daroma isvada, kad lietuviskosios ATTS versijos patikimumas bei validumas laikomi patenkinamais ir metodika gali būti toliau naudojama mokslinių tyrimų tikslais. Pagrindiniai žodžiai: nuostatos savižudybių atžvilgiu, ATTS, klausimyno psichometrinės savybės. The Lithuanian Version of the Attitudes towards Suicide Questionnaire (ATTS) Paulius Skruibis, Danutė Gailienė, Lina Labanauskaitė Summary Several psychological models explaining formation of attitudes towards suicide and their influence on suicidal behaviour have been developed recently. Reliable an valid instruments measuring attitudes towards suicide are needed to test these models. There are several well known questionnaires in this field: Suicide Opinion Questionnaire (SOQ; Domino et al., 1982), Suicide Attitude Questionnaire (SUIATT; Diekstra & Kerkhof, 1988). Both these questionnaires have methodological or practical disadvantages that were taken into account when developing a new instrument – Attitudes Towards Suicide Questionnaire (ATTS; Salander Renberg & Jacobsson, 1998). Objective: Lithuanian version of ATTS was created in 2001 and was used in a number of studines since then. Availability of large data pool (N = 1259) collected with Lithuanian version of ATTS has created a good opportunity for examining reliability and validity issues of the instrument, which is the aim of this study. Method: The data for the present study was taken from studies conducted in the framework of European multicenter research project SUPPORT. Sample consisted of 16 target groups that were studied with the Lithuanian version of ATTS: army conscripts (N = 368), army sergeants (N = 106), army officers (N = 44), medicine students (N = 103), students of priest seminaries (N = 68), catholic religion students (N = 63), psychology students (N = 137), members and mayors of Municipality Councils (N = 55), students of journalism (N = 43), journalists (N = 43), volunteers of psychological help-line (N = 43), suicide attempters (N = 40), personnel of emergency hospital (N = 39), homosexual and bisexual men (N = 30), alcohol dependant patients (N = 38), alcohol dependant patients undergoing Minnesota rehabilitation program (N = 39). A test-retest survey was performed in a sample of medicine students (N = 30) in order to evaluate temporal stability of ATTS Lithuanian version. Results : Confirmatory factor analysis (implemented through SEM) hasn’t confirmed the original ATTS factor model obtained by developers in Sweden. However, an exploratory factor analysis produced 5 factor model (explaining 53.5% of total variance), which is very similar at face value to other proposed ATTS factor models. Internal consistency of this model is satisfactory (Cronbach alpha – 0.68). Differences between attitudes of suicidal and non-suicidal individuals are regarded as support for criterion validity of the instrument. ICC coefficients from test-retest study are satisfactory (ranging from 0.62 to 0.87) for three ATTS factors. The remaining have demonstrated low testretest reliability (ICC coefficients are 0.48 and 0.59). Conclusions: psychometric properties of Lithuanian ATTS version were found to be satisfactory, although structural validity indicators were somewhat controversial and two factors have demonstrated low test-retest coefficients. Lithuanian ATTS version can be used for scientific research of attitudes towards suicide. Keywords: attitudes towards suicide, ATTS, psychometric characteristics of the questionnaire.

Potrauminis augimas yra teigiami psichologiniai padariniai po traumos, kurie pasireiskia saves suvokimo, požiūrio į pasaulį ir tarpasmeninių santykių pokyciais (Tedeschi and Calhoun, 1996). Pozityvūs procesai po traumos dar tik pradedami tyrinėti, todėl nėra žinoma, kokios yra potrauminio augimo (PTA), trauminio įvykio intensyvumo ir potrauminio streso sutrikimo (PTSS) sąsajos. Siekiant įvertinti rysius tarp trauminės patirties ir PTSS bei PTA, buvo istirti 104 studentisko amžiaus jaunuoliai, per savo gyvenimą patyre bent vieną trauminį įvykį. Tako analizės modelis parodė, kad subjektyvus trauminės patirties intensyvumasyra veiksnys, reiksmingai prognozuojantis tiek PTSS, tiek PTA. Kuo reakcija į trauminį įvykį yra stipresnė, tuo labiau isreiksti PTSS ir PTA požymiai. Nustatytas nestiprus teigiamas rysys tarp PTSS ir PTA parodė, kad, norėdami geriau suprasti, kaip jauciasi asmenys po traumos, turime atsižvelgti ir į teigiamus (PTA), ir į neigiamus (PTSS) traumos padarinius. Pagrindiniai žodžiai: trauma, potrauminis stresas, potrauminis augimas. RELATIONSHIP BETWEEN TRAUMA EXPOSURE, POSTTRAUMATIC GROWTH AND POSTTRAUMATIC STRESS DISORDER Evaldas Kazlauskas, Irma Simėnaitė, Danutė Gailienė Summary Objectives: The notion that traumatic experiences may have an impact on human mind is very old. Recent developments in psychotraumatology shifted the approach to a trauma from a purely negative to a more positive perspective. Research confirmed that traumatic events may lead not only to posttraumatic stress or other disorders, but also to positive changes. The present research was based on the concept of Posttraumatic Growth developed by Calhoun and Tedeschi (1996), which is widely known in the field of traumatic stress. Although the number of Posttraumatic Growth (PTG) research is growing rapidly, little is known about Posttraumatic Growth predictors. The present research was designed to find out the links between Posttraumatic Growth, Posttraumatic Stress and initial reactions to the traumatic event. We set up two goals of the study: 1) evaluation of how initial traumatic reactions predict PTG, and 2) assessment of links between PTG and PTSD. Methods: A group of 104 university students exposed to at least one life-time traumatic event participated in the study. The average time gap between exposure to a traumatic event and the time of research was 43 months. The intensity of initial reactions to a traumatic event was measured using a 10-item selfrating inventory developed by the authors of the present study. The Subjective Traumatic Experience (STE) inventory consisted of items covering cognitive, emotional and physiological reactions to a traumatic event. Posttraumatic Growth was measured using the Posttraumatic Growth Inventory (PGI) developed by Tedeschi and Calhoun (1996). Previous research showed satisfactory psychometric properties of the Lithuanian version of PGI (Gailiene & Kazlauskas, 2005). Posttraumatic Stress Disorder was measured using the Lithuanian version of Impact of Event Scale – Revised (IES-R). A recent validation of the IES-R on Lithuanian population showed its good psychometric properties (Kazlauskas et al., 2006).

Tyrimo tikslas yra placiai traumų psichologijos tyrimuose naudojamos potrauminio streso įvertinimo metodikos – Įvykio poveikio skalės – revizuotos versijos (IES-R) adaptavimas Lietuvoje. Istyrus 406 asmenis, patyrusius per gyvenimą nors vieną trauminį įvykį, nustatyta, kad metodikos struktūra ir patikimumas yra artimas angliskosios versijos rodikliams. IES-R metodikos lietuviskosios versijos subskalių Cronbacho alpha lygi 0,82–0,88, visos IES-R metodikos alpha lygi 0,93. IES-R metodikos lietuviskoji versija parengta taikyti Lietuvoje. Pagrindiniai žodžiai: potrauminis stresas, įvykio poveikio skalė, metodikos. PSYCHOMETRIC PROPERTIES OF THE LITHUANIAN VERSION OF THE IMPACT OF EVENT SCALE–REVISED (IES-R) Evaldas Kazlauskas, Danutė Gailienė, Vėjūnė Domanskaitė-Gota, Jelena Trofimova Summary Objective: The impact of Event Scale–Revised is widely used self-report measure for assessment of PTSD symptoms after a variety of traumatic events. The aim of this study was to examined the psychometric properties of the Lithuanian version of the Impact of Event Scale–Revised. Method: A non-clinical population sample of 406 young adults participated in the study. All participants were exposed to at least one life-time traumatic event meeting A criteria of PTSD according to DSM-IV. Traumatic experiences were assessed using the list of life-time traumatic experiences. Results: The Lithuanian version of Impact of Event Scale–Revised has a good internal consistency. The coefficient alpha for the instrusion subscale was .88, for avoidance subscale alpha .82, and for hyperarousal subscale alpha .85. The Coefficient alpha for the total of Impact of Event Scale–Revised was .93. Subscale intercorrelations were: Intrusion with Avoidance r = .62, Intrusion with Hyperarousal r = .79, and Avoidance with Hyperarousal r = .60. A series of factor principal component analysis using varimax rotation with forced two-, three- and four- factor solutions was undertaken. The two-factor solution explained 49.1% of variance – comprising two gactors Instruction (including Hyperarousal) and Avoidance. The three-factor solution accounted for 54.8% of the variance consistent with three symptom criteria of PTSD: Intrusion, Hyperarousal and Avoidance. Items 2, 12 and 20 loaded on improper factors; item 7 did not load on any of the factors. The four-factor solution explained 59.5% of the variance, yielding four factors: Hyperarausal, Avoidance, Intrusion and Numbing. Conclusions: The Lithuanian version of Impact of Event Scale–Revised was found to have satisfactory psychometric properties. We conclude that the new self-report means of post-traumatic stress is adapted for useon Lithuanian population. Issues concerning norms of Impact of Event Scale–Revised and the limitations of the present study are discussed. Keywords: post-traumatic stress, Impact of Event Scale–Revised, Assessment methods.

Straipsnio tikslas – įvertinti, ar skiriasi trauminis patyrimas, potrauminė simptomatika ir prisitaikymas gyvenime dviejų Lietuvos vyrų grupių – tarnavusių Afganistane ir Sovietų Sąjungos teritorijoje, kur nebuvo karo veiksmų. Tyrimo dalyviai yra 268 vyrai, atlikę privalomąją karinę tarnybą sovietinėje armijoje 1979– 1989 metais. Jie sudaro dvi grupes: 174 vyrai, tarnavę Afganistane – Afganistano karo metu, ir 94, atlikę karinę tarnybą SSRS teritorijoje. Tirti šie kintamieji: trauminis patyrimas tarnybos metu ir po jos, potrauminė simptomatika šiuo metu (Harvardo traumos klausimynas (Mollica, 1992)) ir psichosocialinė adaptacija sugrįžus po tarnybos Afganistane ar SSRS ir šiuo metu (adaptacijos šiuo metu indeksas sudarytas iš 5 kintamųjų: ištuokų paplitimo, išsilavinimo po tarnybos ir jo pokyčių, darboviečių keitimo rodiklio ir dabartinės darbinės padėties). [...] Nustatyta, kad po septyniolikos metų beveik trečdalis Afganistane tarnavusių vyrų turi potrauminio streso sutrikimą; tarnavusių SSRS tik – 2 proc. Afganistane tarnavę vyrai patyrė kur kas daugiau traumuojančių įvykių ir išgyvenimų nei vyrai, tarnavę Sovietų Sąjungoje. Afganistane tarnavusių vyrų adaptacija sugrįžus po tarnybos ir dabar yra prastesnė nei vyrų, tarnavusių Sovietų Sąjungoje. Traumuojantis patyrimas, PTSS ir adaptacija koreliuoja abiejose vyrų grupėse. A sample of 268 Lithuanian men who served in the Soviet Army in 1979–1989 was investigated on the average 17 years after the service; the questionnaire was completed focusing on life-threatening experience, posttraumatic stress reactions, and adaptation variables. The prevalence of posttraumatic stress disorder was 30% in the group of the men who served in Afghanistan and 2% in the group of the men who served in various places of the USSR. Lithuanian Afghanistan war veterans experienced significantly more service-related and non-service-related traumatic events and conditions, and their adaptation after the service and nowadays were poorer than in the men who served in the USSR. Life-threatening experience, PTSD and adaptation were correlated in both groups.

Lietuvos savižudybių rodiklis jau desimti metai (nuo 1996 m.) yra didžiausias pasaulyje. Straipsnyje pateikiami duomenys apie savižudybių rodiklių dinamiką Lietuvoje 1990–2002 m. ir, pasiremiant naujausiais tyrimų duomenimis, aptariami veiksniai, kurie gali lemti ilgalaikius aukstus savižudybių rodiklius. Lietuvoje iki siol vyrauja „sovietinis“ mirtingumo modelis (jam būdingas labai aukstas prieslaikinio mirtingumo lygis bei miesto ir kaimo gyventojų mirtingumo skirtumų didėjimas), o psichikos sveikatos pagalbos sistema nepakankama. Susidaro užburtas ratas: savižudybių labai daug, jokių racionalių priemonių jų sumažinti valstybėje nėra, stiprėja ne tik pasyvi, bet ir savižudybėms palanki nuostata, o tai savo ruožtu didina suicidine riziką. VICIOUS CIRCLE: SUICIDES IN LITHUANIA AFTER THE INDEPENDENCE Danutė Gailienė Summary During the last 80 years suicide mortality in Lithuania has shown great variation. Nowadays Lithuania has the highest registered suicide rate in the world besides the other Baltic countries and Russia. After the sharp decrease in the mid-80’s, since 1991 the suicide rates start to rise again. In 2002 1551 suicide occurred in Lithuania (44.7 per 100.000 persons). The ratio of male to female rates was 4.5–6.1 in 1990–2002, in the young and middle age it reached 8–10. The suicides are more widespread in rural areas. Among rural men they occur twice as often as among the urban and among women – 1.4 times. By age the highest suicide risk is for middle-aged men. Among the males aged 45–54 years suicide rate reaches 154.6. The most common method of suicide remains hanging, both for males and females. The dramatic increase in suicide rates of the early 1990s corresponds to the collapse of the Soviet Union and the regaining of the independence of Lithuania and other Baltic states. Heavy transition from the system based on communist ideology to the open society and market economy was ensuing. However analysis of the trends of suicide mortality in Eastern Europe and in the „newly independent states“ of the former Soviet Union showed that rapid transformations of society do not per se necessarily produce more suicides. Neither the absolute economic changes, nor the level of prosperity in itself correlates significantly with the changes in suicide rates. Intermediate role of culture should be also taken into consideration. The undercurrent reasons of the incredible suicide spread in Lithuania lie in the long lasting effects of the 50 years under the communist regime on the ability of individuals and groups to manage psychosocial stress and changes. „Soviet“ mortality pattern, which is characterized by very high level of premature mortality and growth of urban-rural mortality differences, has not changed during transition period. This leads to vicious circle when the spread of suicides and helpless, indifferent attitude towards suicide prevention, causes the suicide approving attitudes, which increases the risk of suicidal behaviour. The approving attitude towards suicide among Lithuanian schoolchildren increased almost twice over the last decade. The media also „contributes“ to this process, but attempts to change the presentation of suicide in the mass media in 1996–2000 were rather unsuccessful. The national plan of suicide prevention is required to break off the vicious circle.

Tyrime dalyvavo 724 buve politiniai kaliniai, nukentėje nuo komunistinių represijų. Potrauminė simptomatika buvo matuojama Traumos simptomų klausimynu (TSK-35). Tyrimo duomenų analizė atlikta naudojant hierarchine daugialype regresiją. Potraumine simptomatiką geriausiai prognozavo: traumų, patirtų per visą gyvenimą, kiekis, vidinė darna, sutuoktinio mirtis, lytis, sveikatos pablogėjimas po represijų ir dabartinės sveikatos siejimas su represijų patirtimi. Galutinė regresijos lygtis paaiskino 43,7 proc. traumos simptomų klausimyno rezultatų variacijos. Tyrimo rezultatai patvirtino traumų psichologijos teorinį teiginį, kad traumos intensyvumas geriausiai paaiskina jos psichologinius padarinius, taciau tyrimas taip pat parodė, kad prognozuojant potraumine simptomatiką būtina atsižvelgti į daugiau veiksnių. Pagrindiniai žodžiai: trauma, politinės represijos, potrauminis stresas, rizikos veiksniai, ilgalaikiai padariniai. LINKS BETWEEN POSTTRAUMATIC REACTIONS, HEALTH EFFECTS, TRAUMATIC EXPERIENCES AND SENSE OF COHERENCE AMONG LITHUANIAN SURVIVORS OF POLITICAL REPRESSION Evaldas Kazlauskas, Danutė Gailienė Summary Background: During Nazi and Soviet occupations in the years 1940–1958 one third of Lithuanian population were killed or deported to Siberia. Almost 300,000 people were deported to highly remote regions of Siberia. Former political prisoners and deportees experienced prolonged torture and persecutions, even after release from prison. Little is known in traumatic stress literature about effects of such extreme and prolonged traumatisation. The aim of the present study was to find out predictors of posttraumatic reactions in the group of survivors of political imprisonment. Methods: Former political prisoners (n = 724) were randomly selected from the national registry of Genocide and Resistance Research Centre of Lithuania. All former political prisoners are officially acknowledged as victims of Soviet repression by Lithuanian laws and are fully rehabilitated. The mean age of political prisoners was 75.8 (SD = 5,8) years. Questionnaires covering questions about lifetime traumatic experiences, exposure to political violence, posttraumatic symptoms as well as possible mediating factors between trauma and consequences have been mailed to participants of the study. Posttraumatic reactions were assessed using Lithuanian version of Traumatic Symptom Checklist (TSC-35). Results: Posttraumatic reactions correlated with demographic factors (gender, level of education), health effects, traumatic experiences and sense of coherence. Variables using hierarchical stepwise model were entered into multiple regression analysis. Demographic factors explained 8.1 % of posttraumatic reactions variance. Both health effects and demographic variables explained 19.6 % of variance. Traumatic experiences increased prediction of posttraumatic reactions to 31.6 %. Final equation, with sense of coherence entered on the fourth step, explained 43.7 % of posttraumatic symptom variance. Significant predictors of posttraumatic reactions among former Lithuanian political prisoners were: accumulative lifetime traumatic experiences, sense of coherence, gender (women showing higher levels of victimization), death of spouse, somatic complains immediately after imprisonment or forced deportation, and attribution of current poor health status to experienced political violence. Keywords: trauma, political repression, posttraumatic stress, risk factors, long-term effects.

Straipsnyje analizuojami ilgalaikio traumavimo, kurį patyrė isgyvenusieji politines represijas, psichologiniai efektai. 50 buvusių politinių kalinių, kurie buvo istremti į Sibiro lagerius, lyginami su panasaus amžiaus kontroline grupe. Nors po traumavimo jau praėjo daugiau kaip 40 metų, nustatyti potrauminio streso sutrikimui būdingi požymiai, kurie parodė, kad ypac sunkaus ir ilgalaikio traumavimo klinikiniai psichologiniai padariniai islieka ilgai. COMPLEXITY OF LONG-TERM PSYCHOLOGICAL EFFECTS OF POLITICAL REPRESSIONS IN LITHUANIA Evaldas Kazlauskas, Danutė Gailienė Summary OBJECTIVE: This study examined long-term consequences of political repressions during the Soviet regime in Lithuania. Between 1940 and 1958 more than 300,000 Lithuanians were arrested and deported to Siberia (Anusauskas, 1996). Conditions of imprisonment in Gulag camps were extremely hard and mortality rate from exhaustion and disease was high. Victims who managed to return back to Lithuania suffered from persistent persecutions. Traumatic experiences of former political prisoners were neglected for decades; they had to keep in secret the fact of the imprisonment. Less than 5,000 survivors of political imprisonment still live in Lithuania. Since the introduction of posttraumatic stress disorder in DSM-III (1980) trauma effects have been studied mostly in terms of posttraumatic stress disorder (PTSD). But clinicians and trauma researchers acknowledge controversies in modern understanding of PTSD (Yahuda, MacFarlane, 1995). Severe impairments in personality of victims have been reported by clinicians working with survivors of holocaust, sexual abuse, and victims of torture, but these changes in personality are not accepted in current understanding of PTSD. The concept of PTSD receives more and more critics due to limitations in describing psychological effects after long term traumatic experiences that may lasts for years. Complex posttraumatic stress disorder has been introduced (Herman, 1992) in result of these discussions to describe variety of effects of long term trauma, and acceptance of this concept is growing in the field. There are only few studies on psychological effects of political repressions in former Soviet Union territory. This is the first study of psychological effects of political imprisonment in Lithuania. The goal of present study was to examine traumatic experiences and psychological effects among non-clinical sample of former Lithuanian political prisoners. METHOD: The group of former political prisoners (N=50), with a history of deportation to Gulag camps, was compared with an age and sex matched control group (N=50). Former political prisoners were imprisoned for 6.9 years on average. 43.1 years have passed since their return to Lithuania at a time of research. Semi-structured interviews were used to measure experiences during and after imprisonment. Posttraumatic effects were measured using Lithuanian versions of self-rating scales: Harvard Trauma Questionnaire (Mollica et al., 1992), Impact of Event Scale - Revised (Weiss, Marmar, 1996), Trauma Symptom Checklist (Briere, Runtz, 1989). CONCLUSIONS: Results suggest that traumatic experiences dealing with political imprisonment and exile have long-term complex posttraumatic effects on Lithuanian former political prisoners. Concept of complex posttraumatic disorder is partly supported by results of this study. Limitations of the study due to retrospective nature of the study, elderly age of participants and control group selection are discussed. Further research is required to assess the impact of political oppression during Soviet regime on population of former Soviet Republics.

The goal of this study was to determine the influence of suicide examples in media on teenagers and young peoples’ emotions and thoughts about suicide imitation. Conclusions: 1) Teenagers and young people encounter with examples of suicidal behavior in all forms of media, mostly, newspapers and television. 2) Some of young people experience a high emotional effect of suicide description or depiction. 3) Models of suicidal behavior presented in media mostly affect the young people who are experiencing existential frustration and have more expressed suicidal tendencies.

The aim of the present study was to assess the effect of issuing guidelines for suicide reporting on the actual practice of reporting in three main dailies of Lithuania. In 1994 we conducted 12 months survey of suicide reporting in “Lietuvos rytas”, “Lietuvos aidas” and “Respublika”. In 1995 the results were presented in written guidelines for suicide reporting and in the seminars for journalists. Following this intervention, a second, identical evaluation of suicide reporting covering three major dailies was carried out during the year 1996. The main variables on form, content and style of the newspaper reports before and after the intervention were compared (588 reports). In 1996 1,7 times more publications on suicide were published. Positive and negative changes in the quality of reporting were found in the second period of analysis. It is possible that the results were affected not only by the action of suicidologists, but also by the political action of one of the deputies of Lithuanian Seimas, who declared the intention to burn himself. This aroused a rather hot reaction in the society and in the newspapers.

The situation and development of clinical psychology in Lithuania is inextricably related to the socio-political situation of the country and its rather dramatic history. The article describes the beginnings of Professional psychology in Lithuania after re-establishing and independent state in 1918, the situation of psychology under the soviet occupation, the beginning of clinical psychology, the new development of clinical psychology after regaining independence in 1 991, and the present situations and problems of clinical psychology in Lithuania.

The article presents epidemiological data of years 1924-1991. This data analysis showed the before the war suicide level was low, even lower than in the neighboring countries, for example, Estonia. During the years of soviet occupation, the number of suicides has grown constantly and reached its pinnacle in 1984. During the reform movement, this number decreased significantly, but it is beginning to increase recently. The number of suicides in villages and among middle-aged men is especially large. The data is discussed with the reference to Dukheim theory.