Are Suicide Note Writers Representative of All Suicides? Analysis of the National Violent Death Reporting System

While suicide notes can offer insights into the causes of suicide and clues for prevention, there is disagreement regarding the degree to which note leavers are representative of the general population of suicides. Previous relevant research on the United States is marked by a series of limitations: small local samples, an over focus on demographic constructs, and lack of multivariable analysis. This study uses a large national sample, a wide range of predictor variables, and multivariable statistical techniques to estimate more reliable similarities and differences between note leavers and other suicides. All data are taken from the National Violent Death Reporting System, which covers 17 states. A total of 9,048 note writers were compared to 21,522 other suicides in terms of 39 variables. In both bivariable (32/39 variables) and multivariable analyses (30/39 variables), note leavers differed from other suicides in most demographic variables, stressful life events, psychiatric issues, and methods of suicide. The national evidence suggests that caution be exercised in generalizing patterns found among writers of suicide notes to suicides in general. This is the first analysis of suicide notes using US data on the issue.     

A Comparison of Suicide Note Writers with Suicides Who Did Not Leave Notes

There is disagreement in the suicide literature on the value of suicide notes as a data source, particularly regarding the extent to which suicide decedents who write notes differ from those who do not. Using 10 years of suicide cases from Summit County, Ohio, these two groups were compared on 40 variables including sociodemographic characteristics, reported affect before death, precipitating events, physical and mental health status and care, and method of suicide. The only differences found were that note writers were more likely to have lived alone and had made prior suicide threats. These findings suggest that for research purposes, suicide cases with and without notes are essentially similar.     

Content Analysis of Multiple Messages in Suicide Notes*

ABSTRACT: Two hundred twenty individuals who committed suicide and who left notes, when compared with 813 non-note writers, were significantly more likely to be white, female, and, if female, to have any other marital status than “widowed.” With respect to method, the results indicated that note writers were more apt to have committed suiced with “Drugs” and less apt to have used “Other” methods. The question is raised as to whether or not note writers can be accepted as representative of the whole group of those who commit suicide. In 195 suicide notes for which content was available for analysis, the relative percentages of statements containing advice, instructions, and requests (31), other-directed positive affect (19), acknowledgment of wrongdoing (7), and hostile affect (5) were the same in the entire sample as in subsamples of age, sex, and marital status. Only for a few specific content categories did the relative frequency of content vary significantly with age, sex, or marital status. Advantages of the present method of content analysis are discussed, and suggestions for further research in this area are offered.     

Who Leaves Suicide Notes? A Six‐Year Population‐Based Study

Popular culture insists on the significance of suicide notes, but research has yielded conflicting results about who leaves notes. Utilizing 6 years of suicides from a comprehensive statewide data surveillance system, differences were examined between cases with suicide notes and those without in terms of demographics, circumstances of the suicide, and precipitating circumstances. Of the 2,936 suicides, 18.25% included a note. Demographics and circumstances did not differ for cases with a note compared to cases with no note. Results have implications for working with people bereaved by suicide in helping understand that the notes are uncommon and not systematic. However, it is also possible that for some individuals, the content of a note is meaningful and can help or hinder their course of bereavement.     

Content Analysis of Suicide Notes as a Test of the Motivational Component of the Existential‐Constructivist Model of Suicide

A sample of 40 suicide notes were analyzed for motivational content in relation to an existential‐constructivist theory of suicide. Results generally supported the 4 theoretical categories of somatic, relational, spiritual, and psychological motivations, with 39 notes having content that could be classified according to the aforementioned categories. Psychological motivations were found to be the most prevalent, followed by relational, spiritual, and somatic concerns. Notes of completed suicides included more relational motivations than did those of suicide attempters, and older writers of notes showed more psychological and fewer spiritual motivations than did younger writers. Recommendations are offered for revising the theory to provide a stronger meaning‐based understanding of suicidal behavior.     

A thematic comparison of suicide notes drawn from Northern Ireland and the United States

Suicide is a global concern hence cross-cultural research ought to be central to national suicide prevention strategies. This study sought to investigate suicide notes drawn from Northern Ireland and the United States as these countries have broadly similar suicide rates but markedly different cultures. A theoretical-conceptual analysis of sixty suicide notes drawn from these countries, matched for age and sex, was undertaken based on a thematic model of suicide developed by Leenaars (1996) across countries. The results suggested that there were more psychological commonalities than differences. Two differences emerged which suggested that aspects of the interpersonal components may be more salient in Northern Irish rather than American suicides. It is argued that more wide-ranging cross-cultural studies are required to enhance our ability to identify and predict those most at risk from suicide.     

A thematic comparison of suicide notes drawn from Northern Ireland and the United States

Suicide is a global concern hence cross-cultural research ought to be central to national suicide prevention strategies. This study sought to investigate suicide notes drawn from Northern Ireland and the United States as these countries have broadly similar suicide rates but markedly different cultures. A theoretical-conceptual analysis of sixty suicide notes drawn from these countries, matched for age and sex, was undertaken based on a thematic model of suicide developed by Leenaars (1996) across countries. The results suggested that there were more psychological commonalities than differences. Two differences emerged which suggested that aspects of the interpersonal components may be more salient in Northern Irish rather than American suicides. It is argued that more wide-ranging cross-cultural studies are required to enhance our ability to identify and predict those most at risk from suicide.     

A last defence: the negotiation of blame within suicide notes

This paper presents a discursive analysis of 172 suicide notes left by 120 suicide victims. Instead of searching for the underlying psychological reasons for suicide in the content of notes, we argue that such notes should be viewed as acts of communication which serve to manage the blame accorded to both author and recipients of the suicide note. Consequently notes may provide evidence of socially shared beliefs as to when suicide is more or less acceptable. The analysis largely confirms this approach. It is found that matters relating to blame are referred to more frequently than any other issue (87% of notes). The precise arguments which are used to justify the actions of both self and others are then described in detail and some evidence is provided that the nature of these arguments may vary as a function of the social position of the author and also the identity of the recipient. The implications of these findings, and for a general use of a discursive approach to suicide, are then discussed. Copyright © 2000 John Wiley & Sons, Ltd.     

An Inquiry into Relationship Suicides and Reciprocity

Few theories on suicide have been grounded in the norm of reciprocity. There is literature on suicide, however, describing motivations such as retaliation and retreat which can be interpreted as modes of adaptation to the norm of reciprocity. We propose a reciprocity‐based theory to explain suicides associated with relationship problems. Employing a content analysis of suicide notes, we tested the theory, finding evidence of exploitation, exploiter guilt, retaliation, and retreat as motives for committing relationship‐based suicide. Reciprocity‐based note writers were more likely to have used alcohol or drugs in the hours prior to committing suicide, and they were also more likely to have made their intentions known beforehand. Implications for future research as well as for suicide prevention are discussed.     

A predictive approach to Freud's formulations regarding suicide

This study of suicide notes involved the deduction of 25 protocol sentences that reflected important specific aspects of Freud's formulations regarding suicide. Independent judges noted the incidence of contents corresponding to the protocol sentences in 33 genuine and 33 simulated notes. Comparisons between genuine and simulated notes revealed that the protocol sentences discriminated significantly as a set in favor of the genuine notes. Individual statements found significantly more frequently in genuine notes indicated loss and/or rejection, preoccupation with a lost person, ambivalence toward a lost person, identification with a lost person, communicating feelings of anger toward oneself but appearing to be angry toward someone else, turning back upon oneself murderous wishes or impulses, and seeing the act as a fulfillment of self-punishment. A frequency count of the sentences in the notes indicated that these statements occurred quite frequently (i.e., at least one-third of the time) in the genuine notes. Implications of the results are discussed.     

Suicides in the developing world: case study from Pakistan

There are no official data on suicide from Pakistan, a conservative South Asian Islamic country with traditionally low suicide rates. Both suicide and attempted suicide are illegal acts, as well as socially and religiously condemned, making research in this area difficult. Recent reports suggest an increase in suicide rates. In this study, police data from the Sindh province were examined to provide a unique picture of trends of suicide over 15 years (1985-1999). During this period there were 2,568 reported suicides (71% men, 39% women; ratio 1.8). The lowest number was 90 in 1987 and maximum was 360 in 1999. Poisoning by organophosphates was the most common method followed by hanging. This study, although limited in scope, provides evidence of an increase in suicide rates in Pakistan, from one data source. There is urgent need for further research on suicide in Pakistan; interventions for suicide prevention in the country can then be planned.     

Suicide Rates in the World: 1950–2004

The cross‐country differences and the trends of suicide rates in 71 countries from 1950 to 2004 are described. The data are from the World Health Organization's Mortality Database. It shows that suicide rates vary greatly across countries, even within the same region or at similar levels of development. Random‐effect models were used to examine the between‐country and within‐country stabilities in suicide rates. The results show that more than 90% of the variance in suicide rates is due to between‐country differences, suggesting suicide rates display a strong temporal stability.     

Suicide notes of the older adult.

Although not true in all countries, older adults are the developmental age group at highest risk for death by suicide in the United States. Our knowledge of suicide in the elderly is, however, limited. The psychological characteristics for suicide cannot be attributed primarily or even solely to being old. One avenue to understanding this complicated act in the elderly is suicide notes. Despite their limitations, suicide notes contain special revelations of the human mind and there is much one can learn from them about suicide in the older adult. This paper outlines the sparse literature on the topic of suicide notes of the older adult and then presents the author's own life-span research related to the elderly. The research indicated that long-term instability was critical in understanding suicide in the older adult. However, indirect expressions (e.g., ambivalence, unconscious implications) were much less frequently observed in the notes of the elderly than other adults. The research also found that older males often wrote about painful problems in their interpersonal relations in their final letters and this pain was significant in making their final decision. Future research, specifically regarding a protocol analysis based on a review of the research on suicide in the elderly, will be discussed.     

Effects of Guided Notes on Enhancing College Students’ Lecture Note-Taking Quality and Learning Performance

This study investigates the intervention effects of guided notes on college students’ quality of lecture note-taking and learning performance under the provision of outline notes. It adopted a quasi-experimental pretest–posttest–delayed-posttest design. Sixty-five undergraduates from two psychology classes in a university were recruited as participants. One class was assigned to the experimental group and the other to the control group. Students in the experimental group were provided with outline note plus guided note handouts and asked to complete the guided notes in class, whereas students in the control group received outline note handouts only. The results showed that (1) in the delayed posttest, the experimental group performed better than the control group on the quality of note-taking; (2) in the posttest and delayed posttest, the experimental group performed better than the control group on learning performance; (3) the experimental group had a positive attitude towards the guided notes.     

"Seeing things in my head": a synesthete's images for music and notes

We explored synesthetic experiences (photisms) elicited by music and notes for GS, a 22-year-old female college student, who is a genuine digit synesthete (Mills et al 1999 Cognitive Neuropsychology 16 181-191). After extensive interviews, we conducted five studies using synthesizer notes in different octaves and in different instrument sounds. GS described, drew, or selected her photisms from alternatives. The results were: (a) her photisms had shape, color, movement, and texture: (b) different instruments had photisms with different shapes and families of instruments had similar shapes; (c) low-pitched notes were darker and larger than high notes; (d) instrument and pitch affected each other; (e) a given note was perceived as darker after a high note than after a low note; and (f) GS's drawings of notes became more consistent with repeated trials. Theoretical observations are discussed on the basis of these results.     

Statistical classification of black-capped (Poecile atricapillus) and mountain chickadee (Poecile gambeli) call notes

Both black-capped (Poecile atricapillus) and mountain chickadees (Poecile gambeli) produce a chick-a-dee call that consists of several distinct note types. In some regions, these 2 species live sympatrically, and it has been shown that 1 species will respond weakly to songs of the other. This suggests that chickadee song, and potentially other of their vocalizations, contains species-specific information. We tested the possibility that call notes were acoustically sufficient for species identification. Black-capped and mountain non-D notes were summarized as a set of 9 features and then analyzed by linear discriminant analysis. Linear discriminant analysis was able to use these notes to identify species with 100% accuracy. We repeated this approach, but with black-capped and mountain D notes that were summarized as a set of 4 features. Linear discriminant analysis was able to use these notes to identify species with 94% accuracy. This demonstrates that any of the note types in these chickadee calls possesses sufficient information for species classification.     

Examining the narrative roles in suicide notes

The present study examines suicide notes, using a sample of suicide notes from published corpora (N = 50), combined with a sample of recent suicide notes from a suicide website (N = 50). The present study proposes a model of differentiation in completed suicides. The characteristics of the suicide notes were analysed using a content dictionary developed by Giles in 2007, and the data subjected to smallest space analysis. Four themes of suicide completer were discovered: Egoistic Victim, Anomic Hero, Altruistic Professional and Fatalistic Revenger. The implications of these findings and the potential use in therapy work with suicide survivors and those with suicidal ideation are discussed, as well as suggestions for the direction of future research.     

An empirical investigation of Shneidman's formulations regarding suicide

This study of suicide notes involved the deduction of 50 protocol sentences that reflected important aspects of Shneidman's formulations regarding suicide. Independent judges noted the incidence of contents corresponding to the protocol sentences in 33 genuine and 33 simulated notes. Statements that were found significantly and more frequently in genuine notes included the following: the experience of adult trauma such as a calamitous relationship; a rejection; the withdrawal of a significant person resulting in despair; perceiving another as dooming one to the suicide; expressions of ambivalence; feelings of love, hate and other emotions; feelings of helplessness, pessimism and emotional confusion; appearing to be intoxicated by one's overpowering emotions and constricted perceptions; and the communications appearing to have unconscious implications. Statements of "egression" and more logical reasoning were more characteristic of the simulated notes. A frequency count in the genuine notes indicated that many protocol sentences were also very predictive of the content. Implications of the results are discussed.