The emotional impact and ease of recall of warning signs for suicide: a controlled study

In light of concerns about potential iatrogenic effects of information about suicide, in the current study we examined the emotional impact of reading a list of warning signs for suicide in comparison to comparable lists for heart attacks and diabetes. All participants read two sets of warning signs, with the experimental group reading the suicide warning signs. Results confirm no difference in emotional impact across groups, along with providing evidence that warning signs for suicide are as easy to recall after exposure as warning signs for heart attack. Implications for pubic health campaigns are discussed.     

Exposure to a Mnemonic Interferes with Recall of Suicide Warning Signs in a Community‐Based Suicide Prevention Program

The incremental impact of adding a mnemonic to remember suicide warning signs to the Air Force Suicide Prevention Program (AFSPP) community awareness briefing was investigated with a sample of young, junior‐enlisted airmen. Participants in the standard briefing significantly increased their ability to list suicide warning signs and improved consistency with an expert consensus list, whereas participants in the standard briefing plus mnemonic demonstrated no learning. Both groups demonstrated positive changes in beliefs about suicide. Results suggest that inclusion of the mnemonic in the AFSPP briefing interfered with participants' ability to learn suicide warning signs, and that increased confidence in the perceived ability to recognize suicide risk is not related to actual ability to accurately recall warning signs.     

Sex differences in peer responsiveness to suicide ideation

Two surveys assessing attitudes toward and beliefs about suicide were conducted with undergraduates. There were 473 participants in Survey I and 692 participants in Survey II. Sex differences were found in participants' receptivity to suicidal individuals, beliefs about the behavior of suicidal peers, attitudes concerning the worth of suicidal people, incidence of adolescent suicide, and morality of suicide. There was no sex difference in participants' own frequency or seriousness of suicide ideation or suicide attempts. Results are discussed in terms of hypotheses concerning traditional socialization of males and females, resulting in sex-role differentiation that may influence attitudes toward and beliefs about suicide.     

The Dialectics of Stigma,Silence, and Misunderstanding in Suicidality Survival Narratives

Modern suicidologists have noted a dearth of qualitative research on suicide. The first author conducted 20 in-depth interviews with formerly suicidal adults to understand how they accounted for their experiences contemplating or attempting suicide. According to participants, stigma necessitated impression management, which contributed to the production of silence and misunderstanding. Silence and misunderstanding reinforced stigma. This complex, dialectical, belief system about stigma yields insight into the interpretive culture of surviving suicidal ideation or a suicide attempt. These beliefs about suicide may serve as a barrier to individuals seeking help, recovering from suicidality, and larger social change regarding attitudes toward suicide.     

A test of the validity of the IS PATH WARM warning signs for suicide

The 10 warning signs for suicide, encapsulated in the mnemonic IS PATH WARM, did not differentiate between genuine suicide notes and those written by people simulating a suicidal crisis or between notes written by completed suicides and those written by attempted suicides.     

Risk Factors,Warning Signs,and Drivers of Suicide: What Are They,How Do They Differ,and Why Does It Matter?

Research investigating suicide attempts and deaths by suicide has yielded many specific risk factors and warning signs for future suicidal behaviors. Yet, even though these variables are each valuable for suicide prevention efforts, they may be limited in their applicability to clinical practice. The differences among risk factors, warning signs, and “drivers,” which are person‐specific variables that lead individuals to desire death by suicide, are highlighted. The scarce evidence on drivers is described and specific recommendations for conducting future drivers‐focused research and targeting them in clinical practice are suggested.     

Mobilizing Schools for Suicide Prevention

ABSTRACT: Experience in providing consultation and survivor counseling to school personnel following student suicides led to the development of a program of prevention through training school personnel. The goal of the program was to increase the ability of resource persons available to adolescents—teachers, counselors and school nurses—to recognize signs of suicidal depression and to respond effectively to suicidal students. This report describes that program, the reaction of the participants and the observations of the project staff, and comments on the feasibility of this approach as a means of helping to prevent suicide among adolescents.     

Interpretation and misinterpretation of warning signage: perceptions of rockfalls in a naturalistic setting

The aim of the present study was to investigate the factors relating to non-adherence to warning signs about falling rocks from coastal cliff faces. Face-to-face interviews (n?=?62) in a naturalistic setting (in the vicinity of a high-risk rockfall area) were conducted to investigate attention to and comprehension of warning signs, as well as beliefs relating to non-adherence of the signage. It was found that, while most participants could correctly identify the danger in the area and had noticed the warning signage, less than half of the participants could correctly interpret the signage. The perception of danger did not differ significantly between the participants who had, or had not, entered the high-risk zone. Differences in knowledge and beliefs between local residents and visitors to the area were identified. It was concluded that the warning signs did not provide enough detail for people to make informed decisions about safe behaviours. Comprehension of the signage may have been hampered by a lack of prior-knowledge of the particular risk, a failure to think carefully about the situation (i.e. low-effort processing), and the pictorial representation on the signs misleading the participants as to the true danger.     

University Students' Perceived Self‐Efficacy in Identifying Suicidal Warning Signs and Helping Suicidal Friends Find Campus Intervention Resources

Currently, suicide is the third leading cause of death among youth 18 to 24 years of age and the second leading cause of death on college campuses. A sample of students (N = 1,019) from three midwestern universities were surveyed regarding their perceived self‐efficacy in identifying suicide warning signs and campus suicide intervention resources. The results indicated that 11% strongly believed they could recognize a friend at suicidal risk, while 17% strongly believed they could ask a friend if he or she was suicidal. Students who had received high school suicide prevention education and who had ever had a family member or friend express suicidal thoughts to them were those most confident in recognizing a friend at risk, asking a friend if he/she is suicidal, and helping a friend to see a counselor. Most (71%) were not aware of on‐campus help resources. These findings underscore the importance of suicide prevention education throughout the high school and college years.     

The impact of rock videos and music with suicidal content on thoughts and attitudes about suicide

In Experiment 1, 133 college student volunteers watched a rock music video with or without suicidal content and then completed written measures assessing mood, priming of suicide-related thoughts, perceptions of personal risk, sensitivity to suicidality in others, and attitudes/beliefs about suicide. In Experiment 2, 104 college student volunteers listened to rock music with either suicidal or neutral content and then completed measures similar to Experiment 1, with the addition of a hopelessness measure. In both experiments, participants exposed to suicidal content wrote more scenarios with suicide-related themes in a projective storytelling task than those exposed to nonsuicidal content. However, there were virtually no group differences on explicit measures of affect, attitudes, and perceptions. Music and videos with suicide content appeared to prime implicit cognitions related to suicide but did not affect variables associated with increased suicide risk.     

Explaining the Relation between Religiousness and Reduced Suicidal Behavior: Social Support Rather Than Specific Beliefs

Religiousness has been associated with decreased risk of suicidal ideation, suicide attempts, and completed suicide, but the mechanisms underlying these associations are not well characterized. The present study examined the roles of religious beliefs and social support in that relation. A survey measuring religiousness, social support, suicidal ideation, and suicide attempts was administered to 454 undergraduate students. Involvement in public, but not private, religious practices was associated with lower levels of both suicidal ideation and history of suicide attempts. Social support mediated these relations but religious beliefs did not. Results highlight the importance of social support provided by religious communities.     

Teachers' knowledge of facts and myths about suicide

Suicidal behavior is a serious public health concern that has prompted the development of prevention strategies, which include increasing community members' knowledge about suicide. Given that teachers are in a key position to recognize and respond to suicidal behavior, this study examined teachers' knowledge about suicide to identify how they need to be educated relative to its prevention. 82 Canadian school teachers from middle and high schools were administered a revised version of the 32-item Facts on Suicide Quiz to examine their knowledge of suicide. Analysis indicated that general information about suicide was limited, while knowledge of clinically relevant information about suicide, e.g., "Suicide rarely happens without warning," was relatively high.     

Suicide coverage in U.S. newspapers following the publication of the media guidelines

A nationally representative sample of 968 local and national newspapers was examined to determine whether the 2001 U.S. media guidelines were followed in articles published in 2002-2003, and featuring individual cases of suicidal behavior (N = 157). We found that, during this period of time, U.S. newspaper suicide coverage did not consistently reflect the influence of the media guidelines. On the positive side, only 19% of stories included inappropriate imagery. On the negative side, suicide stories often detailed suicide method (56% of stories) and location (58%), and rarely provided information about warning signs and risk factors (1%), the roles of depression (4%) and alcohol (2%), and prevention resources (6%). Our findings, together with previous evidence, suggest the need for sustained dialogue with the media about suicide reporting.     

Suicide Prevention in Australian Aboriginal Communities: A Review of Past and Present Programs

A review of Aboriginal suicide prevention programs were conducted to highlight promising projects and strategies. A content analysis of gray literature was conducted to identify interventions reported to have an impact in reducing suicidal rates and behaviors. Most programs targeted the whole community and were delivered through workshops, cultural activities, or creative outlets. Curriculums included suicide risk and protective factors, warning signs, and mental health. Many programs were poorly documented and evaluations did not include suicidal outcomes. Most evaluations considered process variables. Results from available outcome evaluations suggest that employing a whole of community approach and focusing on connectedness, belongingness and cultural heritage may be of benefit. Despite the challenges, there is a clear need to evaluate outcomes if prevention is to be progressed.     

Do Written Reports of Suicide Induce High-School Students to Believe that Suicidal Contagion Will Occur?1

To see if high-school students who read that a distressed adolescent knew about suicide thought that suicidal contagion would occur, 66 consenting high-school students read a written account of John, a high-schooler with multiple problems including knowing someone who had died (either by suicide or viral illness). They then anonymously completed the UCLA Loneliness scale and a questionnaire about what John (or they in the same situation) might do. When John knew of a sympathetic response to a viral illness death, or an unsympathetic response to suicide, he was rated as relatively more likely to make new friends and less likely to want to die. These high school students saw themselves as immune to suicidal contagion from a written report, but thought that others might be vulnerable if people were sympathetic.     

Cross‐national comparisons of attitudes towards suicide and suicidal persons in university students from 12 countries

This paper reports the results of a comparative investigation of attitudes to suicide and suicidal persons in 5,572 university students from 12 countries. Participants filled out two scales measuring attitudes towards suicide and suicidal persons, a measure of psychological distress together with the questions about suicidal behavior. Results showed that the highest suicide acceptance scores were observed in Austrian, UK, Japanese and Saudi Arabian samples and the lowest scores were noted in Tunisian, Turkish, Iranian and Palestinian samples. While the highest social acceptance scores for a suicidal friend were noted in Turkish, US, Italian and Tunisian samples, the lowest scores were seen in Japanese, Saudi Arabian, Palestinian and Jordanian samples. Compared to participants with a suicidal past, those who were never suicidal displayed more internal barriers against suicidal behavior. Men were more accepting of suicide than women but women were more willing to help an imagined suicidal peer. Participants with accepting attitudes towards suicide but rejecting attitudes towards suicidal persons reported more suicidal behavior and psychological distress, and were more often from high suicide rate countries and samples than their counterparts. They are considered to be caught in a fatal trap in which most predominant feelings of suicidality such as hopelessness or helplessness are likely to occur. We conclude that in some societies such as Japan and Saudi Arabia it might be difficult for suicidal individuals to activate and make use of social support systems.     

Causal uncertainty and correction of judgments

We examined whether raising uncertainty about the causes of one’s judgments motivates correction. Specifically, we examined whether activating chronically accessible causal uncertainty (CU) beliefs with a conditional warning about possible bias enhances correction of weather judgments for tropical weather primes and of word frequency judgments for the availability bias. In two studies we showed that activating chronic beliefs led to careful correction of target judgments. Moreover, Study 2 revealed that chronically high-CU individuals who received a conditional warning felt more uncertain than did other participants, but that this uncertainty was suppressed somewhat by adjusting for the bias. Results are discussed in light of recent models of judgment correction (e.g., Wegener & Petty, 1997), and the causal uncertainty model (Weary & Edwards, 1996).     

Religion and spirituality along the suicidal path

The inner experience of spiritual and religious feelings is an integral part of the everyday lives of many individuals. For over 100 years the role of religion as a deterrent to suicidal behavior has been studied in various disciplines. We attempt to systematize the existing literature investigating the relationship between religion/spirituality and suicide in this paper. After an overview of the attitudes of the dominant religions (e.g., Catholicism, Islam, and Buddhism) toward suicide, the three main theories that have speculated regarding the link between religion and suicide are presented: "integration theory" (Durkheim, 1897/1997), "religious commitment theory" (Stack, 1983a; Stark, 1983), and "network theory" (Pescosolido & Georgianna, 1989). Subsequent to this theoretical introduction, we report on studies on religion/spirituality keeping the suicidal path as a reference: from suicidal ideation to nonlethal suicidal behavior to lethal suicidal behavior. Studies presenting indications of religious beliefs as a possible risk factor for suicidal behavior are also presented. The last section reviews possible intervention strategies for suicidal patients and suicide survivors. Indications for future research, such as more studies on nonreligious forms of spirituality and the use of qualitative methodology to achieve a better and deeper understanding of the spiritual dimension of suicidal behavior and treatment, are offered.     

Influence of Religious Factors on Attitudes Towards Suicidal Behaviour in Ghana

The objective of this qualitative study was to understand how religion influences lay persons’ attitudes towards suicide in Ghana. Twenty-seven adults from both rural and urban settings were interviewed. Interpretative phenomenological analysis was used to analyse the data. Results showed that the participants are committed to core and normative religious beliefs and practices they perceived as life preserving. Such an understanding influenced their view of suicidal behaviour as unacceptable. Nevertheless, religion facilitated their willingness to help people during suicidal crisis. Religious commitment theory is used to explain some of the findings of this study. Implications for suicide prevention are discussed.     

The cycle of schizoaffective disorder, cognitive ability, alcoholism, and suicidality

In this study we investigated the putative role of cognitive dysfunction, diagnosis (schizoaffective versus schizophrenia disorder), and alcoholism as risk factors for suicidal behavior among individuals with DSM-TV schizophrenia or schizoaffective disorders. Subjects received cognitive tests and medical records were reviewed for evidence of a history of suicide attempts or suicidal ideation. Discriminant analysis was used to identify cognitive test performance measures that distinguished those with versus those without suicidal behavior. None of the cognitive measures discriminated between the two groups. The rates of suicidal behavior (suicidal ideation and suicide attempts) did not differ between participants with versus those without comorbid alcohol use. An association was found between suicidal behavior and the diagnosis of schizoaffective disorder. It was concluded that the history of prominent mood syndromes characteristic of schizoaffective disorder contributes to increased risk of suicidal behaviors. Cognitive dysfunction and/or alcoholism did not contribute additionally to risk in this study.