The LSARS-II: Lethality of Suicide Attempt Rating Scale-Updated

The concept of lethality is essential to the assessment of suicide risk; yet operational definitions of lethality for purposes of its measurement have been loose and varied. A number of scaling measures have been published in the literature, with no relative consensus on the best of these. In addition, only a few of these scales have published data on their psychometric properties. Of these, we argue that the best is the Lethality of Suicide Attempt Rating Scale (LSARS; Smith, Conroy, & Ehler, 1984). Presented here is a significantly revised and redesigned listing of drugs and chemicals and lethal ranges of ingestion (in caps, tabs, or ounces) by body weight to update that scale.     

Actuarial Prejudice Toward Women and Its Implications

A process called "actuarial prejudice" is discussed. Actuarial prejudice is a cognitive bias, based on available information about a group from the past and the present, that causes individuals to expect inferior performance from persons who belong to the group. The process, in part, explains why both women and men expect relatively low achievement from women and why women are less likely to achieve than are men. Hypotheses are proposed for future research to test the implications of this process.     

Dimensions of Suicide: Perceptions of Lethality,Time, and Agony

Two hundred ninety-one lay persons and 10 forensic pathologists rated the lethality, time, and agony for 28 methods of suicide for 4117 cases of completed suicide in Los Angeles County in the period 1988–1991. Whereas pathologists provided consistent ratings, lay persons demonstrated extreme variability and a tendency to inflate ratings of all three dimensions. Significant gender differences emerged, with females rating frequently used suicide methods more similarly to pathologists than the males did. Males who suicided used the most lethal and quickest methods whereas females selected methods varying in lethality, duration, and agony. African Americans were overrepresented in the use of the most lethal and quickest methods.     

Perturbation and Lethality as Precursors of Suicide in a Gifted Group

ABSTRACT: Thirty cases, for whom longitudinal personality data were available from 1921 to 1960, were analyzed. All the cases were Caucasian males with high I.Q.'s. Five individuals had committed suicide (all by gunshot), 10 (matched) individuals had died natural deaths from cancer or heart disease, and 15 were still living. A blind clinical analysis was conducted primarily in terms of two guiding concepts, perturbation and lethality, by means of a Meyerian “life chart” and a “psychological autopsy,” respectively. The results indicated that four of the five cases deemed to be most suicidal had, in fact, committed suicide—a chance probability of 1 out of 1,131. The prodromal clues—instability, trauma, and personality controls—are discussed. The role of the “significant other” and the “burning-out” of affect seem to be paramount. Suicide is seen as a discernible part of a life style and as a predictable outcome, in a person of 50, by the time that individual is 30 years old.     

Assisted Suicide,Euthanasia, and Suicide Prevention: The Implications of the Dutch Experience

What impact would legalization of assisted suicide and euthanasia have on our ability to treat suicidal patients and to prevent suicide? Information from a study of the Dutch experience illustrates how legal sanction promotes a culture that transforms suicide into assisted suicide and euthanasia and encourages patients and doctors to see choosing death as a preferred way of dealing with serious or terminal illness. The extension of the right to euthanasia to those who are not physically ill further complicates the problem. So too does the tendency of doctors in such a culture to begin to feel that they can make decisions about ending the life of competent terminally ill patients without consulting the patient. “Normalizing” suicide as a medical option lays the groundwork for a society that turns euthanasia into a “cure” for suicidal depression.     

Suicide: Dynamics and Implications for Counseling

‘The authors discuss the dynamics of suicide, how to work with a potentially suicidal client in the counseling relationship, and legal and ethical implications for the counselor.     

Connectedness and Suicide Prevention in Adolescents: Pathways and Implications

Adolescent suicide is a major public health concern. Stressing the need for public health–based solutions, the Centers for Disease Control and Prevention identified “connectedness” as one means of pursuing this agenda. To advance this effort in suicide prevention with adolescents, (1) consistencies and variation in the literature overtly linking connectedness to suicide thoughts and behaviors (STB) are reviewed, (2) three more specific mechanistic pathways are proposed whereby connectedness may influence STB, and (3) several implications related to use of connectedness as a public health framework for adolescent suicide prevention and intervention are outlined.     

Suicide Ideation in Female Survivors of Military Sexual Trauma: The Trauma Source Matters

Female veterans who have experienced military sexual trauma (MST) are at elevated suicide risk, yet knowledge is limited regarding correlates of suicide ideation (SI) in this population. MST is associated with a higher risk of posttraumatic stress disorder (PTSD) relative to other trauma types; however, no studies have examined whether experiencing SI differs based on the source of PTSD symptoms (MST‐related, non–MST‐related). Female service members/veterans (SM/Vs; n = 311) who screened positive for MST and reported exposure to a Criterion A event completed an online survey assessing self‐reported demographics, PTSD, depression, the source of their PTSD symptoms, and SI. Ninety‐one (29.3%) reported experiencing current SI, and 223 (71.7%) identified MST as the source of their current PTSD symptoms. Participants who identified MST as the source of their PTSD symptoms were over two times more likely to report SI, compared to those who described non–MST‐related events as the source of their PTSD symptoms. Compared to those who reported the source of their PTSD symptoms as combat‐/deployment‐related, those who identified MST as the source were at least three times as likely to report current SI. Results underscore the importance of efforts to address MST‐related PTSD symptoms when working with female SM/Vs.     

The Escalating Incidence of Suicide Among African Americans: Implications for Counselors

Suicide rates have soared among African Americans within the past 2 decades. Curiously, this fact remains poorly understood within and outside the African American community. This article includes a review of M. Compton, N. Thompson, and N. Kaslow's (2005) study, recently published in Social Psychiatry and Psychiatric Epidemiology, and identifies important implications for counseling professionals.     

Suicide and Suicidal Attempts in the United States: Costs and Policy Implications

The national cost of suicides and suicide attempts in the United States in 2013 was $58.4 billion based on reported numbers alone. Lost productivity (termed indirect costs) represents most (97.1%) of this cost. Adjustment for under‐reporting increased the total cost to $93.5 billion or $298 per capita, 2.1–2.8 times that of previous studies. Previous research suggests that improved continuity of care would likely reduce the number of subsequent suicidal attempts following a previous nonfatal attempt. We estimate a highly favorable benefit–cost ratio of 6 to 1 for investments in additional medical, counseling, and linkage services for such patients.     

The Female Body and Its Meanings

A renewed interest within psychoanalysis in sexuality and the body has stimulated a reexamination of the female body and its relationship to concepts of “femininity” and feminine body image. The role of the genitals in determining female self-concept needs to be expanded to include object relations and cultural and personal meanings. Nevertheless, specific aspects and determinants of the female body and female anatomy such as the capacity for reproduction do influence female psychology and determine experiences. These are explored in the light of recent contribution.     

Biography and Choice: Female Converts to Islam in the Netherlands

This article assesses the relevance of the rational-choice approach for understanding female conversion to Islam in the Netherlands. Rational-choice theories are important for focusing on the increasingly pluralistic character of the religious market and the active nature of religious actors. It is argued that women are active actors who make sensible choices. Yet the rational choice conception of rationality is rather limited and the specific characteristics of the commodity ‘Islam’ are not accounted for in this approach. In addition, the actors are presented as agents without identity and history. By analysing the life stories of three Dutch converts, it is shown how certain Islamic narratives become meaningful in their lives. By using a biographical approach, an attempt is made to bring the history and identity of the actors and the content of their faith into focus without denying the ‘rationality’ of their choice.     

Toward a Consideration of Intimacy in the Female/Female Therapy Relationship

No abstract available for this article.     

Suicidal Behavior: Toward an Explanation of Differences in Female and Male Rates

ABSTRACT: The explanation of sex differences is based on Breed's five “components of a basic suicide syndrome” which appears to be a satisfactory model for explaining male suicide. Thus far it has not been used to explain female suicidal behavior and sex differences in attempts. It appears that if sex differences are noted the model is adequate. This is because the same factors affect the sexes differently; the content and structure of the roles are different. Failure for males is obvious, but the female role is diffuse and lacking in standards for both success and failure. Female commitment to role and cultural goals is not less, just different and diffuse. Rigidity of roles varies but male goals are usually more specific. Shame, when men do blame themselves, is in the context of a narrow role. Contrary to popular belief, isolation of men is probably greater than that of women.     

The Prevalence of and Psychosocial Risks for Suicide Attempts in Male and Female College Students in Taiwan

The prevalence of and psychosocial risks for suicide attempts was investigated in college students in Taiwan by gender, after controlling for depressive symptoms. Self‐reported data were collected from a nationally representative sample of 2,835 college students; 11.90% of females and 8.87% of males reported they had attempted suicide in the preceding 12 months. After controlling for depression, suicidal ideations were associated with suicide attempts in females, whereas there were fewer positive expectations toward the future associated with suicide attempts in males. Several explanations for the high prevalence of suicide attempts among college students in Taiwan were discussed. In the future, further verification of the findings is necessary.