Physiological Reactions to a Suicide Film: Suicide Attempters,Suicide Ideators,and Nonsuicidal Patients

A film about two teenagers who commit suicide was shown to three groups of psychiatric inpatients: 17 who had attempted suicide, 20 who had expressed suicidal thoughts, and 10 who were not suicidal. Anxiety before and after the film was evaluated with psychometric (anxiety rating scale) and physiological tools (heart and respiration rate, blood pressure, electromyogram). Values noted before and after screening, and the degree of change in these values, were compared. In addition, psychomotor agitation was rated at several points during the film. Most results were negative. The suicide attempters had significantly lower postscreening heart rates and a significantly lesser change in heart and respiration rates than the other two groups. The suicide attempters revealed an increase in psychomotor agitation until the discovery of the suicide and a decrease thereafter, whereas the agitation of the nonsuicidal patients continued to increase from the start to the end of the film. The study suggests that on some parameters, suicide attempters reveal less anxiety than nonsuicidal psychiatric patients following exposure to a simulated suicide. The reaction of suicide ideators falls somewhere between the two groups.     

Risk Factors Proximate to Suicide and Suicide Risk Assessment in the Context of Denied Suicide Ideation

Health care providers have significant opportunities to identify individuals at near‐term risk for suicide, but lack empirical data on near‐term risk factors. This study aimed to identify dynamic, state‐related risk factors observed by clinical practitioners within the last 30 days of life of 157 patients who died by suicide and to compare these near‐term risk factors among patients who denied versus responded positively to having suicide ideation (SI ) when last asked by a clinical practitioner prior to their death. Risk factors charted for the majority of all decedents were a history of prior suicide ideation and/or suicide attempt, current anxiety/agitation and sleep problems, current interpersonal problems or job/financial strain, current comorbid diagnoses, current social isolation/withdrawal, and a family history of mental disorder. Two‐thirds of patients denied having SI when last asked and one‐half of these patients were dead by suicide within 2 days. Decedents who denied having SI were quite similar in charted diagnoses, symptoms, behaviors, and environmental circumstances to decedents who responded affirmatively to having SI . Reliance on verbalized or reported SI as a gateway to a suicide risk assessment is questioned and the need for better understanding near‐term risk for suicide, particularly in the absence of stated SI , is highlighted.     

Emotional Impact of a Video‐Based Suicide Prevention Program on Suicidal Viewers and Suicide Survivors

In light of continuing concerns about iatrogenic effects associated with suicide prevention efforts utilizing video‐based media, the impact of emotionally‐charged videos on two vulnerable subgroups—suicidal viewers and suicide survivors—was explored. Following participation in routine suicide education as a part of the U.S. Air Force Suicide Prevention Program's video‐based community briefing, a sample of young active duty airmen demonstrated small decreases in positive emotional states and larger decreases in negative emotional states, especially among suicidal females. No evidence of iatrogenic effects were observed among suicidal or survivor subgroups when compared to controls. Results support the use of video‐based media as a safe educational strategy that might actually serve to decrease emotional distress among vulnerable subgroups.     

Homicide Followed by Suicide: A Comparison with Homicide and Suicide

Homicide‐suicides are a rare yet very serious form of lethal violence which mainly occurs in partnerships and families. The extent to which homicide‐suicide can be understood as being primarily a homicide or a suicide event, or rather a category of its own is examined. In total, 103 homicide‐suicides were compared to 3,203 homicides and 17,751 suicides. These are all events that took place in the Netherlands in the period 1992 to 2006. Logistic regression analyses show that homicide‐suicides significantly differ from both homicides and suicides with regard to sociodemographic and event characteristics. The findings suggest that homicide‐suicide might be considered as a distinct phenomenon from both homicide and suicide.     

Suicide by cop in film and society: dangerousness, depression, and justice

Provoking police officers to kill oneself or "suicide by cop" (SBC) has received scholarly as well as public attention. The extent to which film representations of SBC reflect SBC in society in relation to danger, depression, and other features was assessed in this study. Data on cinematic portrayals of SBC are from 16 American films; corresponding data on SBC in the real world are taken from 19 empirical studies. While the demographic features of SBC in the real world are largely reflected in film, major differences exist on motivations and incident characteristics. Motives for cinematic SBC were unlike SBC in society, wherein, respectively, 0% vs. 35% had attempted suicide in the past, 6% vs. 47% were chronically depressed, and 77% vs. 7% had recently killed someone. Cinematic SBC events disproportionately involve murderous, dangerous persons who are not depressed, and their deaths convey a sense of justice. While such media distortions can be profitable and entertain the audience, they also contribute to public misunderstandings of the nature of deviance and hinder the development of effective suicide and violence prevention programs.     

The Effectiveness of Suicide Prevention Centers: A Review

This article reviews 14 studies examining whether suicide prevention centers have a preventive effect on suicide rates. Seven studies were identified that provide some support for a preventive effect, one found an increase in the suicide rates, and six failed to find any significant effects (either preventive or facilitative). The studies' different methodologies are reviewed, and limitations on the authors' conclusions pointed out. The conclusion of this article is that the evidence provides support for a preventive effect from suicide prevention centers, albeit small and inconsistently found.     

Clarifying the Relationship of Parental Bonding to Suicide Ideation and Attempts

Suicide and suicidal behavior are major public health problems, especially among adolescents and young adults. Previous research has established links between parental bonding and suicidality; however, it remains unclear whether parental bonding is associated with suicide ideation, the progression from suicide ideation to suicide attempts, or both. This study examined the relation of parental bonding to suicide ideation and suicide attempts in adolescents from two settings: (1) acute psychiatric care (n = 172) and (2) high school (n = 426). All participants were administered validated measures of parental bonding, suicide ideation, and suicide attempts, as well as emotion dysregulation, loneliness, and self‐worth. In the psychiatric sample, lower parental care significantly differentiated adolescents with a history of suicide attempts from those with suicide ideation only or without histories of suicidality. This pattern remained even after controlling for other known correlates of suicidality (i.e., emotional dysregulation, loneliness, and low self‐worth). Similar effects were found in the community sample, although these findings failed to reach statistical significance. In both samples, parental overprotection was not associated with suicide ideation or suicide attempts. Results suggest that parental care may be an important risk factor for youth suicidal behavior and may help differentiate suicide attempters from suicide ideators.     

Suicide among eminent artists

To evaluate suicide risk by profession among eminent artists data from Garzanti's Encyclopedia, a broad biographical repertory, were used. Six categories in the visual and literary arts were compared: architects, painters, sculptors, writers, poets, and playwrights. Only people whose deaths occurred in the 1800s or 1900s were included since it is likely that underestimation of suicide has been lower in the more recent centuries. A total of 59 suicides were observed in a sample of 3,093 people: this corresponds to a ratio of 1.90%. Suicides were 51 among men (ratio 1.75%) and 8 among women (ratio 4.30%). The comparison by profession indicates that poets and writers exceed the mean suicide ratio of the sample. Painters and architects, conversely, have a clearly lower risk than the mean. Mean age of suicides was 44 yr. (SD = 12), with writers being slightly older (48 yr., SD = 12) than other artists. Artists who died of causes other than suicide reach a mean of 65 yr. (SD = 10). Suicide among artists seems to have a peculiar pattern, clearly different from the pattern of the general population, wherein suicide risk is higher among men and older people. Adverse financial circumstances and the stress attributed to rejection of personal products may contribute to the specific risk of suicide among artists. The link between mental disorders, such as manic-depression, which imply a higher risk of suicide, and creativeness is discussed as a contributing factor.     

Suicide among foreign residents of Japan

The suicide rate of Koreans living in Japan is twice as high as that of Koreans in South Korea. Reasons for this high suicide rate are discussed, including effects of economic crises and discrimination.     

Media influence on attitudes toward suicide.

This experiment investigated the effects of viewing films on suicide and violence on attitudes toward suicide. Non-suicidal university students were assigned to one of three groups: One group was shown a film about suicide, a second saw a film about violence, and the third saw a neutral film. Perceptions of the appropriateness of suicide and level of emotional arousal were measured by a questionnaire administered before and after the films were shown. Both the suicide and violent film groups showed increases in arousal scores after viewing the films. The results suggest that arousal became linked to cognitions specific to film content as a result of viewing the films dealing with suicide and violence. Other findings suggest that, for the suicide and violent film groups, perceived relations with parents were important predictors of film-induced changes in attitudes toward suicide.     

Temperament,Hopelessness, and Attempted Suicide: Direct and Indirect Effects

This study evaluated whether hopelessness mediated the relations between temperament and recent suicide attempter status in a psychiatric sample. Negative temperament and positive temperament (particularly the positive emotionality subscale) uniquely predicted levels of hopelessness. Although these temperament constructs also demonstrated significant indirect effects on recent suicide attempter status, the effects were partially (for the broad temperament scales) or fully (for the positive emotionality subscale) mediated by the levels of hopelessness. These findings indicate that a tendency to experience excessive negative emotions as well as a paucity of positive emotions may lead individuals to experience hopelessness. Although temperament may also indirectly influence suicide attempter status, hopelessness mediates these relations.     

CSF 5-HIAA Predicts Suicide Risk After Attempted Suicide

Suicide risk after attempted suicide, as predicted by cerebrospinal fluid (CSF) monoamine metabolite concentrations, was studied in a sample of 92 psychiatric mood disorder inpatients admitted shortly after attempting suicide. The potential of the serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA) in the CSF to predict suicide risk within the first year after attempted suicide was studied by means of survival analysis after median split sub-grouping. Eleven patients (12%) committed suicide within 1 year after attempted suicide. Eight of these belonged to the below-the-median (< 87 nM) CSF 5-HIAA subgroup, that is, the suicide risk was 17% as compared with 7% among those with above-the-median CSF 5-HIAA. The cumulative number of survived patient-months during the first year after attempted suicide was significantly lower in the low CSF 5-HIAA subgroup. It was concluded that low CSF 5-HIAA predicts short-range suicide risk after attempted suicide in mood disorder psychiatric inpatients. These findings lend further support to the serotonin hypothesis of suicide risk.     

Suicide in Ibsen's Plays

ABSTRACT: The suicides and homicides in Ibsen's plays are examined in relation to Hendin's hypotheses about Scandinavian suicide. In general, the suicides had dependency loss characteristics; the victim-precipitated homicides had characteristics of guilt over transgression, as expected. However, elements of suicide as a vehicle for preserving or restoring an ideal self-image were also present in many of the characters, suggesting that Hendin's conclusions about the Scandinavians may be oversimplifications.     

Suicide by jumping and accessibility of bridges: results from a national survey in Switzerland

Rates of suicide by jumping show large regional differences. Barriers on bridges may prevent suicides but also may lead to a substitution of jumping site or method. The aim of our study was to compare suicide data from regions with and without suicide bridges and to estimate the effects on method and site substitution if bridges were to be secured. In a national survey, suicide data for the years 1990 to 2003 were collected. Regions with high rates of bridge suicides were identified and compared with regions with low rates, and the analysis revealed that only about one third of the individuals would be expected to jump from buildings or other structures if no bridge was available. The results suggest no method substitution for women. For men, a trend of a substituting jumping by overdosing in regions without suicide bridges was found. We conclude that restricted access to suicide bridges will not automatically lead suicidal individuals to choose another jumping site or suicide method. The results support the notion that securing bridges may save lives.     

The Association Between Gun Ownership and Statewide Overall Suicide Rates

An extensive body of research has demonstrated an association between gun ownership and suicide that extends beyond the effects of a range of covariates. We aimed to expand on extant research by examining the extent to which gun ownership predicts statewide overall suicide rates beyond the effects of demographic, geographic, religious, psychopathological, and suicide‐related variables. By extending the list of covariates utilized, considering those covariates simultaneously, and using more recent data, we sought to present a more stringent test. Gun ownership predicted statewide overall suicide rates, with the full model accounting for more than 92% of the variance in statewide suicide rates. The correlation between firearm suicide rates and the overall suicide rate was significantly stronger than the correlation between nonfirearm suicide rates and the overall suicide rate. These findings support the notion that access to and familiarity with firearms serves as a robust risk factor for suicide. Therefore, means safety efforts aimed at reducing accessibility and increasing safe storage of firearms would likely have a dramatic impact on statewide overall suicide rates.     

Suicide in the Subway: Psychodynamic Aspects*

ABSTRACT: Fifty-one cases of suicide attempts in the subway have been investigated to examine the question of whether the method used has psychodynamic significance or is merely adventitious. We found that no single characteristic distinguished subway suicide from all other suicide modalities, although as a group the subway cases had a higher proportion of psychotic and previously suicidal patients than other series quoted in the literature. However, there were important differences between subway suicide cases seeking a “traumatic” death (jumping in front of a train; lying across the track awaiting destruction) and those seeking a “nontraumatic” death (electrocution on the live “third rail”). The traumatic group had histories of exposure to violence, other traumatic suicide attempts, hostile or destructive delusions, and many “destroy” words on psychological test protocols. The smaller nontraumatic group had no such history of exposure to violence; their previous suicide attempts were nontraumatic; delusions, when present, were not menacing; and the psychological tests showed more “escape” words than “destroy” words.     

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: A decade review of the sociological literature

Major works on suicide are reviewed and classified into four analytic categories according to their theoretical emphasis: cultural, economic, modernization, and social integration perspectives. The research under these paradigms is assessed in terms of four themes. First, attention is drawn to research evidence that questions traditional theories. An example is Durkheim's position on social class and suicide. Second, the review notes several new theories including Phillips’ imitation thesis and the author's own model of migration's effects on suicide. Third, the paper observes and reviews explanations of new trends in suicide rates such as the rapid increase in youth suicide and the decline in suicide among the elderly. Finally, the review calls attention to explanations of suicide, such as that linking suicide to low marital solidarity, that have withstood the test of the more rigorous empirical testing of recent times.     

Suicide: Right and reason

Ethical issues surrounding the act of suicide are confounded by the difference between the complexity of suicide and the popular and professional clinical view of suicide. In elaborating these different views, it is shown that the dominant view of suicide as a manifestation of mental illness has a weak scientific base and limits our efforts at understanding the multi-faceted concept “suicide.” In particular, the rationality of those who kill themselves is examined. Finally, the right of a person in our society to take his or her own life is supported; the state is shown to have no base for a compelling interest in preventing suicide.