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.     

Correlates of motives for suicide

Analysis of a large sample of suicide notes from 262 suicides in Australia showed separated/divorced suicides and suicides who abused alcohol were more likely to give love/romance as a precipitant for suicide while those who used gas (natural or car exhaust) were more likely to give depression and guilt as a motive.     

Real-World Knowledge Facilitates Interpretation of Paintings by Naive Art Observers

It is often assumed that women kill themselves because of love and men because of achievement problems. The authors evaluated the suicide notes of 56 U.S. adult women and men with regard to love and achievement motives. Love themes were significantly more common than achievement themes, independent of sex and age. This suggests that, at least for U.S. adults who leave suicide notes, relationship concerns may be a dominant component of the motivation for suicide.     

Love and achievement motives in women's and men's suicide notes

It is often assumed that women kill themselves because of love and men because of achievement problems. The authors evaluated the suicide notes of 56 U.S. adult women and men with regard to love and achievement motives. Love themes were significantly more common than achievement themes, independent of sex and age. This suggests that, at least for U.S. adults who leave suicide notes, relationship concerns may be a dominant component of the motivation for suicide.     

Farewell to the world: suicide notes from Turkey

There has been limited study of suicide in Islamic countries. This paper marks the first study of suicide notes in Turkey, an Islamic country. Using a classification scheme, 49 suicide notes (a rate of 34.5%) were studied. The results show that note writers do not differ greatly from other suicides. Further analysis of younger (<40) and older (>40) suicide note writers reveal few significant differences. Our results, together with the results of classification studies in different countries, suggest that caution is in order in transposing findings from one country to other countries. Future study of suicide notes should, in fact, focus on cross-cultural investigation.     

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.     

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.     

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.     

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.     

Drop-in suicide prevention group decreases suicidal ideation among Veterans

This study examined the effectiveness of a weekly, drop-in therapy support group designed for Veterans identified at increased risk for suicide. Veterans were identified as at risk for suicide and referred to the group following hospitalization on the inpatient psychiatric unit after an increase in suicidal ideation (SI), presentation to a provider with SI with a plan, or having made a suicide attempt. An archival chart review was performed on 359 patients who were referred to the Coping, Understanding, Support, and Prevention Group from 2009 through 2011. Documented risk of suicide was collected from the chart including: frequency of inpatient psychiatric hospitalization, visits to the emergency department or mental health walk in clinic for SI, reported SI in clinical notes, consults resulting from calls to the Veteran’s Crisis Line, and assignment or removal of suicide risk behavior flags in the electronic medical record, for a period of 12 months prior to referral to the group and for a period of 12 months after referral to the group. Negative binomial regression models found that Veterans attending the support group showed a significantly greater reduction in frequency of endorsing SI post-referral compared to those who did not attend the group. Results imply that offering Veterans an ongoing therapeutic group format to give and receive support from peers also struggling with suicide risk factors is an effective way to reduce suicide-related thoughts.     

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.     

Last Words: Analysis of Suicide Notes from an RECBT Perspective: An Exploratory Study

A sample of 86 suicide notes was analyzed to identify the common cognitive and emotional themes contained in the text from a rational-emotive and cognitive behavior therapy (RECBT) perspective. Using grounded theory and statistical analysis to examine the data, this study found that the most frequent emotional categories to be present in these suicide notes are autonomous depression, sociotropic depression, guilt, shame, hurt and anger. It was also discovered that men, more than women, are likely to write about their experience of guilt in their suicide notes at the end of a relationship, while women are more likely to express feelings of hurt. This study may enable RECBT practitioners to better understand the cognitive and emotional factors of suicide behavior, and it may encourage future research into more specific suicide prevention protocols.     

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 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.     

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.     

Menninger's motives for suicide in the notes of completed and attempted suicides.

Brevard, Lester, and Yang in 1990, studying Menninger's motives for suicide, reported more evidence for the wish to be killed (i.e., self-blame or self-punishment) in suicide notes for completed suicides than in parasuicide notes for attempted suicide; however, they did not control for age and sex. A comparison of notes written by completed and attempted suicides that controlled for age and sex showed no differences in the presence of content which reflected Menninger's three motives for suicide, including the wish to be killed.     

Suicide notes in alcoholism

Alcoholism is associated with a vast number of suicides. The most systematic study of suicide among alcoholics is the work of Eli Robins and George Murphy. The suicide notes in these studies have remained unanalyzed to date. The present analysis suggested that these suicide notes of alcoholics did not differ from those of nonalcoholics; core themes in their deaths are unbearable psychological pain, cognitive constriction, indirect expressions, rejection-aggression, and identification-aggression. Although caution is in order in accepting the null hypothesis, we can at least suggest that further study is needed.     

An empirical investigation of Shneidman's formulations regarding suicide: age and sex

This study of suicide notes, concerning the demographic variables of age and sex, involved the deduction of 50 classifications (protocol sentences) that reflected important aspects of Shneidman's formulations with regard to suicide. Independent judges noted the incidence of contents corresponding to the protocol sentences in the notes left by 60 suicides-20 notes written by individuals (females and males) in each of the three categories of Young, Middle, and Late Adulthood. Age (notably in regard to Young Adults), but not sex, was found to be a critical discriminating variable on a number of specific classifications and clusters of these classifications (Perturbation, Relations, Cognitions Regarding Self, and Long-Term Instability), although considerable similarities were also noted across the adult life span. Implications of the results are discussed.     

Suicide: a 15-year review of the sociological literature. Part I: cultural and economic factors

Cultural and economic patterns from 130 sociological works on suicide from 1981 to 1995 are reviewed in this article. The traditional Durkheimian perspective on suicide was often questioned by research on the impact of the mass media, alcohol, class, modernization, religion, and politics. Major theoretical developments included the application of differential identification theory to Phillips's model of copycat suicide, the application of criminology's opportunity theory to suicide, and new explanations for the link between alcohol and the social suicide rate. Explanations are reviewed for the major new suicide trend: after half a century of convergence, male and female suicide rates are diverging. Finally, the review notes patterns of continued stability in suicide research findings in areas such as racial differences and economic strain.