Eventual suicide in interrupted and uninterrupted attempters: a challenge to the cry-for-help hypothesis

A total of 499 patients hospitalized for suicide attempts (attempters) between 1970 and 1975 were followed until 1982; of this group, 28 (5.6%) eventually committed suicide. Six (14.6%) of the 41 patients who had been interrupted during their initial attempts eventually committed suicide, whereas only 22 (4.8%) of the 458 patients who had not been interrupted eventually committed suicide. The interrupted attempters were approximately three times more likely to commit suicide than the uninterrupted attempters.     

Social learning,sexual and physical abuse,and adult crime

This research examines the relationship between childhood physical and sexual abuse and the types of crimes committed by male adult offenders. We use the method of discriminant prediction to determine whether independent and dependent variables are related in ways that theories predict. Our analyses of data from the Survey of Inmates in State and Federal Correctional Facilities suggest that offenders model specific behaviors to which they have been exposed. Male offenders who were sexually abused as a child are more likely to commit sexual offenses, particularly sexual offenses against children, than nonsexual offenses. Offenders who were physically abused are more likely to engage in violent offenses than nonviolent offenses. Further analyses show that sexual offenders, and to a lesser extent violent offenders, are likely to specialize in those offenses. Our results are consistent with a social learning approach. They address a heretofore neglected issue: what exactly do children model when they are mistreated. Aggr. Behav. 35:489–501, 2009. © 2009 Wiley‐Liss, Inc.     

Method choice, intent, and gender in completed suicide

Women who commit suicide use less violent methods, such as drugs and carbon monoxide poisoning, than do men, who more often use violent methods such as guns and hanging. Theories that attempt to explain this finding focus on gender differences in suicidal intent, socialization, emotions, interpersonal relationships, orientation and access to methods, and neurobiological factors. Data from a psychological autopsy study were used to test the theory that women who commit suicide use less violent means because they are less intent on dying. Although women were significantly less likely to use a violent method than men, there was no difference in the lethality of their suicidal intent.     

Heroin addicts reporting previous heroin overdoses also report suicide attempts

Nonfatal heroin overdoses and suicide attempts are both common among heroin addicts, but there is limited knowledge about the association between them. The sample in the present study consisted of 149 regular heroin users in Malmö, Sweden. Out of these 98 had taken an unintentional heroin overdose at some time and 51 had made at least one attempt to commit suicide (but not using heroin). Suicide attempts were significantly more common among those who had taken unintentional overdoses as compared with those who had never taken any overdose (p < 0.01). The more overdoses, the greater the risk of suicide attempt.     

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.     

An exploratory analysis of the contexts and circumstances of filicide‐suicide in Chicago, 1965–1994

Filicide is the killing of a ward by a parent. Relative to many other types of homicide, filicide is an infrequent event. Filicide followed by the offender's suicide is less frequent still. The contexts and circumstances surrounding filicide‐suicide may nevertheless provide insight into parental psychology. Some research suggests, for example, that filicidal genetic parents are more likely to commit suicide than are filicidal stepparents. Five hypotheses are tested for this study, using a database that includes incident‐level information on over 22,000 homicides committed in Chicago during the years 1965–1994. Findings do not support the hypothesis of differential risk of suicide following filicide by genetic parents and stepparents. Previous work is replicated, indicating that: (1) filicides that include multiple victims are more likely to end in the offender's suicide than are filicides that include a single victim, (2) parents are more likely to commit suicide following a filicide of an older child than a filicide of a younger child, (3) older parents, relative to younger parents, are more likely to commit suicide following filicide, and that (4) fathers, relative to mothers, are more likely to commit suicide following filicide. Discussion suggests future directions for research that can inform our understanding of filicide and of filicide‐suicide. Aggr. Behav. 00:000–000, 2005. © 2005 Wiley‐Liss, Inc.     

Driving aggression in forensic and non‐forensic populations: Relationships to self‐reported levels of aggression,anger and impulsivity

A series of four questionnaires — the Buss‐Perry Aggression Questionnaire (AQ), the Barratt Impulsivity Scale (BIS‐11), the Driving Anger Scale (DAS) and a Driving Violence Inventory (DVI) — were administered to a sample of 473 British drivers consisting of undergraduates (N=185), members of the public (N=106) and offenders (N=182) serving sentences in closed prisons in England (violent=82, non‐violent=100). Offenders consistently rated acts of driving aggression as less severe compared with other drivers. Offender attributions of driving violence differed to other drivers in that they were equally likely to perceive obscene gesturing as high or low intensity responses; they also viewed assault as a high intensity response whereas members of the public rated it more severely. Trait levels of anger and aggression were the predictors of driving violence in all groups but previous aggressive behaviour was only a predictor for the offenders. Gender and age were found to be predictors of aggressive driving in non‐offenders. Even with the effects of age controlled, offenders (and violent offenders in particular) scored higher on measures of driving anger and aggression. These data suggest that offenders differ in their perceptions of aggressive behaviours experienced in everyday driving and as a consequence are more likely to commit acts that other drivers perceive as violent. As offenders are known to display similar perceptual biases in other domains, identified as precursors to their aggressive behaviour, it seems likely that experience effects (as reflected in the trait measures) underpin differences in driving aggression between offenders and non‐offenders.     

Suicidal Behaviors in Surviving Monozygotic and Dizygotic Co‐Twins: Is the Nature of the Co‐Twin's Cause of Death a Factor?

Genetically informative samples can address hereditary and experiential influences on suicide‐related behaviors. The frequency of suicide‐related behaviors was compared in twins from two survivor groups: (1) those whose co‐twins' deaths were suicides (monozygotic [MZ]: n = 47; dizygotic [DZ]: n = 31), and (2) those whose co‐twins' deaths were nonsuicides (MZ: n = 347; DZ: n = 170). The frequency of suicide attempts among suicide survivors was significantly higher in MZ than DZ twins, while the frequency of suicide attempts among nonsuicide twin survivors did not differ between MZ and DZ twins. Twin concordance for suicide attempts more likely reflects a genetic predisposition than a behavioral reaction to the loss.     

Effect of Socioeconomic Status on the Linkage Between Suicidal Ideation and Suicide Attempts

Previous suicide attempts are a leading risk factor for completed suicide. To identify specific characteristics of those at high risk for attempts, we investigated associations with socioeconomic status (SES). Data from the 2013 Korean Community Health Survey (KCHS) included adults who reported suicidal ideation (N = 220,245). Attempts in the past 12 months were assessed. Associations of demographic, socioeconomic, and suicide‐related behavioral factors were analyzed using multiple logistic regression. Among those with suicidal ideation, 862 (3.9%) had attempted suicide. After stratification by age and gender, results showed that low education and unemployed young adult men and women had significantly higher rates of attempts. The lowest income level was associated with significantly higher rates of attempts in only young adult women. Among those with the lowest and highest income, the association between ideation and attempts was attenuated, whereas it was enhanced among other income groups.     

Temperamental Vulnerability and Suicide Risk After Attempted Suicide

The aim was to extend recent findings of suggested temperamental features in attempted suicide and to explore possible domains of vulnerability to suicide risk after attempted suicide. Fifty-four psychiatric inpatients hospitalized after a suicide attempt underwent lumbar puncture for analysis of CSF 5-HIAA concentration and also completed the Karolinska Scales of Personality (KSP) before discharge from the hospital. Suicide attempters scored high on Somatic Anxiety, Psychic Anxiety, and Muscular Tension, and low on Socialization, findings that support recent findings in suicide attempters followed up after an emergency room visit. Five patients committed early suicide, i.e., within 3 years, and the overall long-term suicide mortality after attempted suicide was 13%. There were significant correlations between survival time among early suicides and CSF 5-HIAA (r = .87;p = .054), and the following KSP scale t scores: Somatic Anxiety (r = ?.96;p < .05), Impulsivity (r = ?.88; p < .05), and Socialization (r = .90; p < .05). KSP Socialization showed correlations with CSF 5-HIAA (r = .89; p = .046) among the early suicides. Features of temperamental vulnerability to suicide risk after attempted suicide might involve anxiety proneness, impulsivity, low socialization, and low CSF 5-HIAA.     

Factors Associated with Achieving Complete Mental Health among Individuals with Lifetime Suicidal Ideation

The objective of this study was to identify factors associated with complete mental health among Canadians who had ever seriously considered suicide. Data for this study were obtained from Statistics Canada's 2012 Canadian Community Health Survey–Mental Health (N = 2,844). The outcome variable examined in this study was complete mental health and was analyzed using binary logistic regression. Of the 2,844 respondents with lifetime suicidal ideation, 1,088 (38.2%) had complete mental health (i.e., had flourishing mental health, no mental illness, and no suicidal ideation in the past 12 months). Those who had a confidant were seven times more likely to have complete mental health. Other factors associated with achieving complete mental health among formerly suicidal respondents include being older, being a woman, having higher income, use of religious coping, and never previously having a mental illness. Considering the importance of these protective factors in formulating public health policies will allow for a more wide‐reaching approach to suicide prevention.     

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.     

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     

Method of Suicide in the Mentally Ill: A National Clinical Survey

Comparisons of psychiatric patients who die by suicide using different methods are scarce. We aimed to establish the methods of suicide used by those who are currently or have recently been in contact with mental health services in England and Wales (N = 6,203), and describe the social and clinical characteristics of suicides by different methods. We found that hanging, self‐poisoning, and jumping (from a height or in front of a moving vehicle) were the most common methods of suicide, accounting for 79% of all deaths. The implications of these and other findings are discussed.     

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.     

The Suicidal Inmate: A Comparison of Inmates Who Attempt Versus Complete Suicide

The aim of this study was to identify risk factors distinguishing inmates who attempt suicide from inmates who complete suicide. Compared with attempters, completers tended to be older, male, more educated, and married or separated/divorced; pretrial, committed for a violent crime, incarcerated in jail, housed in an inpatient mental health unit or protective custody setting, living in a single cell, not on suicide precautions, not previously under close observation; and more likely to act during overnight hours and die by hanging/self‐strangulation. Targeted assessment of a broad range of risk factors is necessary to inform suicide prevention efforts in correctional facilities.     

Psychopathy in Italian female murderers

Over the years, the number of homicides in Italy has progressively decreased, ultimately becoming one of the lowest rates in Europe (357 = 0.7 per 100,000 inhabitants in 2017, according to ISTAT 1 ISTAT: Italian Institute of Statistics.
). The number of homicides committed by women was about 9% of the total number of homicides during our study period. The percentage has increased in recent years because the total number of homicides has decreased without a proportionate decrease in the number of female homicides. Indeed, murder is an unusual type of crime for a woman and is often associated with a mental disorder, so when a woman committed a homicide, a psychiatric assessment was often performed. A forensic psychiatry expert was assigned to investigate the offender's psychopathology and mental state at the time of the offense. The root causes of the crime remained unexplained, however, due to the lack of a psychiatric precedent to justify this kind of assessment. The role of psychopathy in homicide has seldom been studied in female offenders, even though psychopathy has an important role in violent crimes. The investigators examined, clinically and historically, a sample of women who committed murder with different levels of criminal responsibility (female homicide offenders found not guilty by reason of insanity, having partial criminal responsibility, and convicted as criminally responsible and sentenced to prison) to identify the prevalence of the psychopathic dimension and its possible role in this sample. Prevalence and degree of psychopathic traits were examined in these female offenders using the Psychopathy Checklist‐Revised. This study showed that females who had committed homicide were likely to suffer from mental illness; most of the homicidal acts were committed impulsively; and most female homicides occurred within the family, especially among women who were psychotic, but less so if they were psychopathic. Psychopathy tended to co‐occur more with personality disorders than with psychotic psychopathology. Psychopathy was more evident among female homicide offenders who had been abused or traumatized. Psychopathic women who killed had high factor F1 scores and low antisocial component of factor F2.     

Trajectories of Suicide Ideation,Nonsuicidal Self‐Injury,and Suicide Attempts in a Nonclinical Sample of Military Personnel and Veterans

Nonsuicidal self‐injury (NSSI) is a risk factor for suicide attempts, but little is known about NSSI among military personnel and veterans, or about the temporal sequencing of NSSI relative to suicide ideation and attempts. This study evaluates trajectories of suicide ideation, NSSI, and suicide attempts in a sample of 422 military personnel and veterans. Of those with a history of NSSI, 77% also experienced suicide ideation. Suicide ideation emerged before NSSI (67%) more often than the reverse (17%). Of those with a history of suicide attempt, 41% also engaged in NSSI. NSSI emerged prior to the first suicide attempt (91%) more often than the reverse (9%). The length of time from suicide ideation to suicide attempt was longer for those who first engaged in NSSI (median = 3.5 years) compared with those who did not engage in NSSI (median = 0.0 years), Wald χ²(1) = 11.985, p = .002. Age of onset was earlier for participants reporting NSSI only compared with those reporting both NSSI and suicide attempts (16.71 vs. 22.08 years), F(1, 45) = 4.149, p = .048. NSSI may serve as a “stepping stone” from suicide ideation to attempts for 41% of those who attempt suicide.     

Rural‐Urban Differences in Suicide Rates for Current Patients of a Public Mental Health Service in Australia

Rural versus urban rates of suicide in current patients of a large area mental health service in Australia were compared. Suicide deaths were identified from compulsory root cause analyses of deaths, 2003–2007. Age‐standardized rates of suicide were calculated for rural versus urban mental health service and compared using variance of age‐standardized rates with 95% confidence intervals. There were 44 suicides and the majority (62%) were rural. Only urban patients used jumping from heights as a method of suicide (4/17; p = 0.02). Rural patients had 2.7 times higher rates of suicide, similar to findings for rural versus urban community suicides and may reflect the underlying community rates, differences in mental health service delivery, or socioeconomic disadvantage.