Perception of behavioral contagion of adolescent suicide

In order to assess perceptions of behavioral contagion of suicide (what people thought a disturbed adolescent would do if the teen knew about a suicide in the community), and to assess actor-observer differences in such perceptions, 142 college students were asked to view a videotaped vignette of a distressed high school student, and then to assess her potential for committing suicide, running away, entering therapy, or abusing alcohol. Subjects who were told that the teenager knew of two recent suicides in the community (contagion group) rated the young woman as more likely to commit suicide or run away than did the subjects who were not told of the suicides (noncontagion group). Subjects who were instructed to imagine that they were the teenager (actors) blamed situational factors, and in particular the teen's parents, more for her distress than did subjects who were instructed just to rate the teenager on the videotape (observers). Contagion/actors rated suicide as more likely than did any other group. Apparently, people believe that behavioral contagion occurs when a suicide is reported, and they especially perceive themselves to be influenced by such information.     

Gender and Suicide Method: Do Women Avoid Facial Disfiguration?

This study hypothesizes that women are less likely than men to use suicide methods that disfigure the face. Gender differences in the use of suicide methods that disfigure the face were examined using medical examiner??s files of 621 suicides covering a 10-year period from Summit County, Ohio in the U.S. Results showed that while firearms are the preferred method for both women and men, women were less likely to shoot themselves in the head. A series of logistic regression analyses revealed that gender, age, stressful life events and prior suicide attempts were predictors of methods that disfigure the face/head. Significant differences between men and women in correlates of suicide method emerged when the sample was split by gender. The results support the position that women who commit suicide are more likely than men who commit suicide to avoid facial disfiguration.     

Youth suicide: insights from 5 years of Arizona Child Fatality Review Team data

Data on 153 youth suicides in Arizona (1994-1999) were used to explore demographic, behavioral, and experiential factors that distinguish between firearm suicide and suicide by other means. In bivariate analyses, White youths were more likely than non-White youths to use a firearm to commit suicide as were youths who had not experienced a life crisis or expressed suicidal thoughts in the past, relationships that hold in multivariate analyses at the p < 0.2 level. Targeted suicide prevention activities should supplement interventions focused on restricting access to highly lethal means of suicide such as firearms.     

Grief and Attitudes Toward Suicide in Peers Affected by a Cluster of Suicides as Adolescents

Eighty‐five young adults exposed to a cluster of peer suicides as adolescents completed measures of attitudes toward suicide, grief, and social support. Closeness to the peers lost to suicide was positively correlated with grief and the belief that suicide is not preventable, with grief further elevated in close individuals with high social support from friends. Overall, social support was related to healthy attitudes about suicide including preventability, yet it was also related to some stigmatizing beliefs. Compared with 67 young adults who had not been exposed to a suicide cluster, the exposed sample was more likely to think that suicide is normal but more likely to think of it as incomprehensible.     

San Diego suicide study: comparison of gay to straight males

Previous large studies of completed suicides have not considered sexual orientation in their data analyses. In this study, data from the known homosexual subpopulation (13 males, aged 21-42) in a series of 283 suicides were examined. They were compared with all other aged male suicides 21-42 (n = 106). Both groups showed considerable substance abuse plus a variety of other psychiatric diagnoses. Both also had a high frequency of relationship difficulties near the time of death. Gays who committed suicide did not have a history of more police trouble and were no more likely to be living alone than the comparison group. They did not have more prior suicide attempts or previous psychiatric treatment. We conclude that, among the factors examined here, there appears to be little difference between gay and heterosexual male suicides.     

Nonresident Suicides in England: A National Study

Little is known about the numbers and characteristics of people who travel away from home before dying by suicide. Therefore, this studied attempts to identify the sociodemographic characteristics, location, and method of suicide in people who died distant from home, in a national sample. Data were collected on all English suicides and a patient population; nonresident suicides resided in one Health Authority but died in a different one. Twelve percent of suicides were nonresident and features of these included: young age, social adversity, and severe mental illness. In conclusion, both individual‐ and area‐based factors are likely to contribute to suicide away from home.     

Soldier Background and Postinvestigative Events Associated With Timing of Suicide Following Deployment of U.S. Army National Guard Soldiers

The present study examined the timing of suicide and its associated soldier background and postinvestigative events among deployed Army National Guard (ARNG) soldiers from calendar years 2007 through 2014. Suicide deaths were nearly equally distributed between soldiers who had been deployed and those who had not. Among those deployed, however, suicides occurred mostly 1 year or more after having returned from deployment. Soldier background and postsuicide investigative events were associated with the timing of suicide. Having more years of military service, more previous deployments, and being married were associated with in-theater suicides. Soldiers younger in age (17–24 years), single, nonprior service, and lower in rank, in addition to having parent-family conflicts, full-time employment problems, and military transition problems were associated with suicides that had occurred 1–120 days and 120–365 days since return from deployment. Soldiers aged (24–29 years), married, and higher in rank, along with more reported problems including past behavioral health conditions, postdeployment behavior health referrals, criminal behaviors, and military performance were associated with suicides that had occurred 1 year or more after return. Findings likely represent time periods of suicide vulnerability for identifiable groups of soldiers, based on soldier background and events surrounding the suicide. Practical and theoretical implications of the findings are discussed.     

Impact of Client Suicide on Psychologists in Australia

Objective

This research aimed to assess the frequency and impact of client suicides on psychologists in Australia.

Method

Participants were 178 psychologists who completed an online self‐report questionnaire concerning the frequency of occurrence and impact of client suicide.

Result

Fifty six (31.5%) participants reported one or more client suicides. Psychologists with more years of experience reported more client suicides. Participants who had experienced a client suicide reported a range of emotional, cognitive and behavioural reactions as well as professional impacts. Ratings of responsibility, preventability and predictability of a client suicide were associated with emotional and/or professional impacts. Beneficial coping responses included talking to supervisors and colleagues, recognising the psychologist is not responsible and having increased acceptance of a client suicide.

Conclusions

The findings have important implications for training, workplace practices and research.     

Suicides among family members of elderly suicide victims: an exploratory study

This exploratory study compares elderly suicides with (n=13) and without (n=72) family member suicide. Previous episodes of suicidal behavior were more common among suicides who lost first-degree relatives by suicide (100% vs. 65%, p = .009). Six persons had lost an offspring by suicide prior to their own deaths. Substance use disorder was more prevalent among those with offspring suicide than those without (100% vs. 25%, p = .000). While informants reported that offspring suicides played a central role in the suicide of the elderly study case, sibbling suicides were not considered precipitating factors.     

Attempted suicide among Iranian population

Predictors of suicide attempts in Iran, to distinguish any similarities and differences of these predictors between suicide attempts in Iran and other developed and developing countries and to investigate the relation between general psychiatric symptoms and repetition of suicidal attempts were assessed. The validated Farsi version of the General Health Questionnaire-28 (GHQ-28) was used to assess multiple dimensions of quality of life of suicide attempters as depression, anxiety, social dysfunction, and somatic symptoms. Pivotal differences emerged in the clinical profiles of suicide attempters living in a developing country versus developed countries. In developing countries, those who attempt suicides are more likely to have no psychiatric disorder and are less likely to have used alcohol as part of the suicide attempt, but are more likely to have been assaulted physically or verbally. The results on the GHQ-28 indicate that the process through which individuals move from suicidal thought to action may decrease multiple dimensions of quality of life.     

Determination of precipitating events in the suicide of psychiatric patients

Data from therapists who were treating patients when they killed themselves were used to provide information about precipitating events that was missing from accounts obtained from suicide victims' relatives and friends. Among 26 patient suicides studied, the therapists identified a precipitating event in 25 cases; in 19 of these, supporting evidence linked the identified event to the suicide. A schema was developed that identifies nine types of evidence provided by therapists in determining that an event precipitated the suicide. Use of the schema is likely to improve accurate identification of events that precipitate patient suicides, and distinguish them from unrelated coterminous events or suicide risk factors.     

Suicide after suicide attempt in severe depression: a long-term follow-up

The temporal relation between completed suicide and first-ever suicide attempt was investigated in 58 future suicides with a primary severe depression/melancholia. The median survival after a first attempted suicide was 6.7 years. Male patients with initial ratings of psychomotor retardation lived significantly longer after their initial attempt than those who were not retarded. They also had more depressive episodes compared to other male suicides and retarded controls. Thus a slow suicidal process in the men with a severe depression and psychomotor retardation is proposed. Severity, repetition, and method of suicide attempt did not decrease the survival time.     

Suicide intervention trainees' knowledge of myths about suicide

The responses of 70 trainees in suicide intervention to 10 Suicide Opinion Questionnaire items were evaluated for accuracy of their knowledge about suicide myths. Participants were Canadian adults (62 women, 8 men, M (age) = 35 yr.) representing a wide variety of occupations and educational backgrounds. Analysis indicated knowledge for most items was high but less accurate for items concerning the most common method of suicide and suicide risk across the lifespan. Those trained in suicide intervention were more knowledgeable on four items than those awaiting training; they more frequently knew that most suicides are not triggered by an argument with a spouse, people who are depressed are more likely to commit suicide, a person whose parent has committed suicide is at greater risk for suicide, and that shooting is the most common method of suicide in Canada.     

Suicide mortality among Kentucky farmers, 1979-1985

Farmers may be at high risk for suicide because of their social environment and because of chemical exposure resulting in neurotoxic effects in the workplace. Age-specific suicide rates are compared for Kentucky white farmers, Kentucky white males, and U.S. white males. Data for suicides occurring in Kentucky represent the 7-year period between 1979 and 1985; data for the United States suicides represent the period 1980. Overall, suicide rates were highest for Kentucky farmers, followed by Kentucky males and then by U.S. males. All males were most likely to use firearms as the mode of suicide, but the farmers used firearms significantly more often than the U.S. males, as did the other Kentucky males. These findings and other evidence support the need to assess suicide rates in this occupational group in other states, to begin suicide prevention programs for Kentucky, and to work to identify risk factors contributing to the Kentucky farm suicides.     

Disentangling the Person and the Place as Explanations for Regional Differences in Suicide

Identifying whether suicides in a region are due to characteristics of the residents living there or to some enduring feature of the region is difficult when using cross‐sectional studies. To distinguish these factors, we compared the suicides of a region's residents with people who were temporarily visiting the region. Using U.S. death records from 1973–2004, we focused on states with the highest and lowest suicide rates over this period. The high suicide region consisted of Arizona, Colorado, Montana, New Mexico, Nevada, Oregon, and Wyoming; the low suicide region consisted of Connecticut, Illinois, Massachusetts, New Jersey, and New York. For each region, we considered three groups of decedents: residents who died inside the region, residents who died outside the region, and visitors to the region. Proportionate mortality ratios were calculated for all suicides and separately for firearm suicides. In the high suicide region, visitors to and residents away from the region both had elevated suicide levels, to about the same extent as residents dying inside the region. Therefore, short‐term exposure to the region and being a resident of the region each predicted suicide. In the low suicide region, the suicides of residents at home were reduced, but their suicides rose dramatically once they left the area. There was no decrease in suicides among visitors to the region. Firearm use was related to the suicide levels of each region. Overall, the results suggest that both the available means to commit suicide and the contextual features of the regions contributed to their extreme suicides. We discuss how an examination of visitors can help researchers generate novel inferences about the causes of suicide.     

An Examination of Potential Misclassification of Army Suicides: Results from the Army Study to Assess Risk and Resilience in Servicemembers

Debate continues about the accuracy of military suicide reporting due to concerns that some suicides may be classified as accidents to minimize stigma and ensure survivor benefits. We systematically reviewed records for 998 active duty Army deaths (510 suicides; 488 accident, homicide, and undetermined deaths; 2005‐2009) and, using research criteria, reclassified 8.2% of the nonsuicide cases to definite suicide (1), suicide probable (4), or suicide possible (35). The reclassification rate to definite suicide was only 0.2% (1/488). This low rate suggests that flagrant misclassification of Army deaths is uncommon and surveillance reports likely reflect the “true” population of Army suicides.     

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.     

Suicide without explicit precursors: a state of secret despair?

Although it is usually assumed that all those who commit suicide give some prior indication of their intention to take their own life, there is growing evidence that a small but significant proportion of suicides occur without any clear, explicit indicators. It is proposed that these suicides share similar pathways to other suicides but that the despair involved is not expressed so clearly, often being kept secret. In order to identify such suicides and potential suicides it is helpful to have an indicator of the dominant sub‐sets of constituents that are precursors to suicide. A 14‐item Suicide Precursors Scale (SPS) was therefore developed. This was applied to 128 cases of suicide that occurred between January 1997 and December 2000 in Stockport (South Manchester, UK). A very high alpha coefficient of 0.98 supported the reliability and homogeneity of the SPS. A Multi‐Dimensional Scaling (MDS) analysis of the SPS revealed three prototypical sub‐sets of expressions of suicidal actions—illness, life circumstances, and depressive history. These are offered as coherent themes in the life of potential suicides, which may be of assistance both in determining whether an equivocal death is suicide or not, and in alerting caring agencies to the potential for suicide even when the despair is kept secret. Copyright © 2004 John Wiley & Sons, Ltd.     

Health Problems and Male Firearm Suicide

Drawing on constructs of masculinity as it relates to both gun ownership and men's health, we use a rich data set, the New Jersey Violent Death Reporting System as well as hospital discharge data, to analyze 3,413 completed male suicides between the years of 2003 and 2009. We test the hypotheses that the use of firearms is more common when physical health problems are cited as suicide circumstances, and that suicide decedents who use firearms have poorer physical health than those who used other methods. Results show that firearms are disproportionately used in male suicides when physical health is listed as a circumstance. Additionally, among suicide decedents with a hospitalization during the 3 years prior to death, those who used firearms were in poorer health than those who used other methods. These findings have implications for prevention efforts, because restricting access to lethal means is an important aspect of suicide prevention.     

Investigating Correlates of Suicide Among Male Youth: Questioning the Close Affinity Between Suicide Attempts and Deaths

This study was based on a sample of male high school students who completed National Longitudinal Adolescent Health Surveys in 1994, 1995, and 2001. We studied these students prospectively, comparing those who later died by suicide (n = 21) with those who were still living (n = 10,101). We employed chi‐square and analysis of variance tests for statistical significance between suicide decedents and living respondents. Results showed suicide decedents were more likely to have experienced the suicide loss of another family member, to have been expelled from school, to have engaged in more delinquent actions including fighting, and to have greater involvement with the criminal justice system. Although one might have expected suicide casualties to have exhibited a greater amount of suicidal thoughts, attempts, and higher incidences of suicidality among their friends, our analyses did not find that these factors were associated with actual suicides. Should these findings be replicated, this would point to a need to refine youth suicide risk assessments. Collecting life histories, as well as identifying patterns of delinquency and fighting, may serve as more potentially fruitful means for assessing genuine suicide risk than some traditional risk assessment methods.z