Predictors of police suicide ideation

Further inquiry into processes that lead to suicide in the police occupation is necessary. Suicide ideation in police officers and possible correlates associated with such ideation is explored in this paper. The focus was on psychologically traumatic police work experiences, the development of posttraumatic stress (PTSD) in officers, and the inordinate use of alcohol associated with this condition. The impact of these occupationally based factors and their association with suicide ideation has not yet been fully explored. Results suggest that certain traumatic police work exposures increase the risk of high level PTSD symptoms, which subsequently increase the risk of high alcohol use and suicide ideation. The combined impact of PTSD and increased alcohol use led to a ten-fold increase risk for suicide ideation.     

Tobacco and alcohol tax relationships with suicide in Switzerland

Previous research has shown an empirical link between tobacco and alcohol use and suicide. If tobacco and alcohol use contribute to suicidal behaviors, then policies designed to reduce the tobacco and alcohol consumption may succeed in reducing suicides as well. To test this hypothesis, correlations for suicide rates with alcohol consumption, taxes on alcohol and tobacco in Switzerland were examined using sets of time-series data from Switzerland in 1965-1994. The tax on tobacco correlated significantly negatively with male standardized suicide rate. The tax on alcohol also correlated significantly with male standardized suicide rate in an autoregressive model. On the other hand, significant relationships with female suicide rate were not found. Policies designed to reduce tobacco consumption are consistent with a benefit of reducing suicides, particularly for men in this sample.     

Risk Factors for Suicidality Among a Nationally Representative Sample of High School Students

Using the 2005 Youth Risk Behavior Surveillance data (n = 13,917) of high school students, we examined the association between four domains of risk factors (alcohol/drug use, aggression, HIV risk‐related behaviors, and health problems) and indicators of suicidality (considering a suicide attempt, making a plan to attempt suicide, and actually attempting suicide). Logistic regressions showed that drug use (e.g., recent smoking, drinking before 13), victimization (e.g., threatened at school, hit by girl/boyfriend), risky sexual behavior (e.g., forced to have sex, used a condom) and two health problems (health as fair/poor, has disability/health problem) were associated with all three indicators of suicidality. These findings suggest that programs to prevent alcohol/drug use, address aggression, promote safety, and prevent unsafe sexual practices may also prevent suicidality.     

Relationship between quantity and frequency of alcohol use and indices of suicidal behavior in an elderly Australian sample

Relatively little research has been conducted on the relationship between alcohol misuse and suicidal behavior among the elderly. The current study's aim was to examine whether quantity and frequency of alcohol use and the interaction between these variables are related to current suicidal ideation, previous suicidal ideation/intent, and past suicide attempts in a community sample of 1,010 Australian adults over age 60. Results partially supported our hypotheses. The interaction between quantity and frequency of alcohol use was significant, suggesting that those who use alcohol less frequently but in greater quantities (i.e., binge drinking) are more likely to have a history of suicide attempts.     

Alcohol and suicide death among American Indians of New Mexico: 1980-1998

The relationship between alcohol use prior to suicide was explored among American Indian decedents in New Mexico for the years 1980 through 1998. The suicide data were collected from New Mexico Vital Statistics and toxicology reports from the New Mexico Office of the Medical Investigator and matched on a case-by-case basis. Detailed analyses were undertaken for all cases of resident New Mexico Indians from the Navajo, Pueblo, and Apache cultures. Alcohol was detected in 69% of all suicides of American Indians with some variance by major tribal cultural groups (range = 62.1% to 84.4%). This is higher than in suicides among the overall New Mexico population (44.3%). The mean blood alcohol concentration (BAC) of the drinking Indian decedents at suicide was 0.198 (+/- SD of .088). Mean BACs were high for both males (0.199) and females (0.180) who had been drinking. Over 90% of the Indian decedents who had been drinking had BACs greater than the legal intoxication level of 0.08. The Navajo had the lowest percentage of cases that were alcohol involved, and their mean BAC was lower than the other two cultural groups. Alcohol use for completed suicides also varied somewhat by age, sex, method of suicide, and place of occurrence, but very little by whether the decedent was an on or off reservation resident. Analyses indicated that alcohol use prior to suicide was significantly more associated with male suicides than for females, and it was negatively correlated for those who died by overdose and also those using other drugs at suicide. Otherwise, alcohol use did not significantly differentiate American Indian suicides by age, use of firearms, hanging, use of other methods, or residence, for the presence of alcohol was a factor very commonly associated with all of these variables. Heavy alcohol consumption is, therefore, an important factor in over two thirds of all completed suicides among the Indians of New Mexico.     

Suicide Risk Factors In Alcohol Abuse

ABSTRACT: The “clinical model” approach to estimating suicide risk assumes that persons sharing specific attributes will also share certain indicators of vulnerability to suicide. This would warrant an empirically derived risk assessment scale applicable only to persons with those attributes. Nine hundred seventy eight persons at risk for suicide who met our criteria for alcohol abuse were interviewed at length and followed for two years, during which 53 (5.5 percent) committed suicide. Eleven variables which best differentiated those who suicided from those who did not in an index set were then applied to an independent validation set. Clinical implications of the findings are discussed.     

Psychiatric and substance use disorders as risk factors for attempted suicide among adolescents: a case control study

The objective of this research was to test substance-related and non-substance-related psychiatric disorders as predictors of attempted suicide among adolescents. Ninety-six psychiatrically disordered suicide attempters were matched one-to-one to 96 psychiatrically disordered non-attempters on age, race, gender, and the presence/absence of major depression. Conditional logistic regression was used to test psychiatric risk factors for their power to predict attempted suicide among adolescents. Bipolar disorder, cocaine use disorders, and conduct disorder were found to be predictive of attempted suicide in univariate testing. Bipolar disorder, inhalant use disorders, cocaine use disorders, and hallucinogen use disorders were found to be predictive of attempted suicide, after adjusting for all other covariates. Loglinear analyses revealed high odds ratios associated with the comorbidities of alcohol use disorder with conduct disorder and drug use disorders with conduct disorder in both groups. Higher rates of cocaine use disorder/conduct disorder, hallucinogen use disorder/conduct disorder, and alcohol use disorder/ conduct disorder were found among suicide attempters. Evaluation of these particular comorbid conditions should be part of the adolescent suicide risk assessment.     

Differentiating Adolescent Suicide Attempters from Ideators: Examining the Interaction between Depression Severity and Alcohol Use

Depressed mood, frequency of alcohol use, and their combination were examined to see if they differentiated nonsuicidal adolescents from those with suicidal ideation and adolescents with suicidal ideation from those who have made a suicide attempt. Hierarchical logistic regressions indicated that frequency of alcohol use did not differentiate nonsuicidal adolescents from those with current suicidal ideation, but severity of depressed mood did so. In contrast, alcohol use was a significant differentiating factor between adolescents who had attempted suicide compared to those with suicidal ideation only, with severity of depressed mood not being significant. However, there was also a significant interaction effect such that for adolescents with suicidal ideation and low levels of depression, increased frequency of alcohol use was associated with increased odds of a suicide attempt. These findings suggest that alcohol use may hasten the transition from suicidal ideation to suicide attempt in adolescents with low levels of depressed mood.     

A follow-up program for suicide attempters: evaluation of effectiveness.

Suicide attempters are a high-risk group in relation to ultimately completing suicide and are usually "treated and released" with little or no follow-up care. A 4-month follow-up outreach program for suicide attempters seen in the emergency room was developed with an emphasis on continuity and quantity of "treatment" received. Suicide attempters were randomly assigned to the "follow-up outreach" or "normal" treatment programs. Measures for the evaluation of effectiveness were (a) incidence of suicide reattempts and purposive accidents and (b) prevalence of drug misuse and excessive use of alcohol. The experimental group showed a statistically significant reduction in suicide reattempts and excessive use of alcohol, while the reduction of drug abuse, although not statistically significant, did conform to a trend indicating improvement. Purposive accidents occured at a relatively equal rate among both groups.     

Sociodemographic and Clinical Differences Between Suicide Ideators and Attempters: A Study of Mood Disordered Patients 50 Years and Older

Our study sought to characterize mood disordered suicide ideators and attempters 50 years and older admitted to a psychiatric ward either for a recent suicide attempt or for ongoing suicidal ideation. We enrolled 50 patients with suicide ideation consecutively admitted to an inpatient department and 50 patients admitted for a suicide attempt made in the last 48 hours. Suicide attempters more frequently had low social support and an age of onset of mood disorder of 46 years and older, and less frequently had a history of suicidal behaviors in the family members and pharmacological treatment, despite the fact that the groups did not differ with regard to antidepressants prescribed. The groups were not distinguishable based on several variables assumed to be risk factors for suicide behavior, such as proximal life events and stressors or alcohol use disorders. In both samples, comorbidity with organic diseases, the presence of stressful life events in the past 12 months, and a diagnosis of major depression were frequently reported. In conclusion, the presence of low social support and the absence of a pharmacotherapy may increase suicidal behaviors in patients at risk.     

Regional Analyses of Alcohol and Suicide in Norway: Some Empirical Considerations

The association between alcohol consumption and suicide was analyzed on aggregate-level data from Norway, applying regional units in the analyses. Thereby two purposes could be served: to validate previous estimates derived from time series analyses, and to assess an empirical indication of alcohol and suicide as alternative solutions. The effect of alcohol consumption on suicide rates tended to be higher for women than for men, which is contrary to results from time series analyses and what might generally be expected. The results are discussed with reference to causal mechanisms and alcohol and suicide as alternative choices of action, and methodological considerations are outlined.     

Modernization and the Male–Female Suicide Ratio in India 1967–1997: Divergence or Convergence?

The traditional view that modernization is likely to increase male vulnerability to suicide while protecting females from such self-destruction was offered by Durkheim (1951). This implies a theory of divergence of suicide rates such that the male-female suicide ratio should increase with modernization. Contemporary researchers have questioned whether modernization has had such an impact. We conducted a time series analysis of male and female suicide data to determine the impact on the suicide ratio for India for the years 1967 to 1997. We developed a modernization index comprised of urbanization, female literacy, and female work participation rates. Moreover, to improve methodological efficacy, we controlled for the passage of time. However, we found that there is no significant relationship between modernization and the male-female suicide ratio. Our conclusion is that using national male-female suicide ratios to determine modernization effects may mask significant regional gender and age differences, particularly in developing countries such as India.     

Mental disorders and communication of intent to die in indigenous suicide cases, Queensland, Australia

In comparing Indigenous to non-Indigenous suicide in Australia, this study focussed on the frequency of the association between some psychiatric conditions, such as depression and alcohol abuse, and some aspect of suicidality, in particular communication of suicide intent. Logistic regression was implemented to analyze cases of Indigenous (n = 471) versus non-Indigenous suicides (n = 6,655), using the Queensland Suicide Register as a data source. Compared to non-Indigenous suicides, Indigenous cases had lower odds of being diagnosed with unipolar depression, seeking treatment for psychiatric conditions or leaving a suicide note. Indigenous suicides had greater odds of verbally communicating suicide intent and having a history of alcohol and substance use. The magnitude of these differences is remarkable, underscoring the need for culturally sensitive suicide prevention efforts.     

Teen suicide and changing cause-of-death certification, 1953-1987.

This study examines whether the purported tripling in teenage suicides since the 1950s represents a real increase or is simply an artifact of the increased skill of medical examiners in distinguishing youth suicides from fatal accidents. This study examines firearms and poisoning deaths, which together account for 75% of all certified youth suicides, from 1953 through 1987, and concludes: (a) a past undercount of youth suicides is likely, (b) the increase in youth suicide that has occurred is less dramatic than reported and resembles increases in adult suicide, and (c) the suicide increase indicated among youths and adults occurred from 1964 to 1971 and has since stabilized.     

An Examination of Historical Loss Thinking Frequency and Rumination on Suicide Ideation in American Indian Young Adults

No research has empirically investigated whether frequency of historical loss thinking is a potential risk factor for suicide ideation in American Indians. Results of this study demonstrated that the frequency of historical loss thinking was positively associated with brooding and reflection at a small magnitude, but was not directly related to suicide ideation. Bootstrapping analyses indicated small indirect effects of historical loss thinking frequency on suicide ideation through brooding and reflection individually, but only through brooding when analyzed in a parallel mediation model. These findings suggest that American Indians who more frequently engage in historical loss thinking may be susceptible to suicide ideation via an increase in ruminative tendencies, specifically brooding.     

Suicide and the Rorschach: A Rueful Postscript

A review of the Rorschach suicide literature written 10 years ago called for cross validation studies and the use of refined methodology in order to enhance the usefulness of the test as a device for the identification, prediction, and understanding of suicidal ideation and behavior. The present followup review was undertaken and it was concluded that careful and refined research methodology can somewhat enhance sensitivity of the Rorschach to suicidal activity. It was also concluded the replicative research has not supported previously promising Rorschach suicide indicators, suggesting that the Rorschach may be an inappropriate technique for assessing suicidal activity.     

Suicidal behavior among youth with severe emotional disturbance

The purpose of this study was to replicate an investigation of risk behaviors associated with suicidal behavior in public high school students, in a population of high school age youth with severe emotional disturbance (SED). Subjects for the study were clients of the South Carolina Continuum of Care (COC) (N=83). Information on suicidal thoughts and acts, aggressive behaviors, substance use and physical recklessness was gathered using a modified version of the self-report National Youth Risk Behavior Survey. Four percent of the youth reported seriously considering suicide, 8% reported planning how they would attempt suicide, 10% reported actually attempting suicide at least once, and 6% reported attempts requiring medical treatment Of the 13 youth who reported attempting suicide, four (31%) did not report planning an attempt. All suicidal behaviors except thoughts occurred more in girls than boys with SED. Alcohol and illicit drug use were associated with suicidal behavior, with larger odds ratios for attempts than for thoughts/plans. Youth with SED who use alcohol and illicit substances are particularly at risk of suicidal behavior. A high index of suspicion is appropriate when evaluating suicidal risk in girls with SED, especially in the presence of known alcohol or substance use.Continuum of Care for Emotionally Disturbed Children Division, S. C. Office of the Governor.     

Risk for Suicidal Ideation and Attempt among a Primary Care Sample of Adolescents Engaging in Nonsuicidal Self‐Injury

One in five adolescents in the United States has engaged in nonsuicidal self‐injury (NSSI), one in eight have had serious thoughts of suicide, and one in 25 have attempted suicide. Research suggests that NSSI may increase risk for suicide attempt, yet little is known about the relationship between NSSI and suicidal ideation or attempts. In a primary care setting, 1,561 youth aged 14–24 years completed a brief, comprehensive, mental health screen as part of a routine well visit to determine which factors were most likely to predict suicidal ideation and attempt among youth engaging in NSSI. Results of recursive partitioning revealed that current depression and history of alcohol use best differentiated youth engaging in NSSI with low versus high risk for suicidal ideation and attempts. This simple algorithm is presented as a clinical screening tool that might aid medical providers in determining which youth would benefit from more intensive assessment and intervention.     

Predictive and concurrent validity of the Suicidal Ideation Questionnaire among American Indian adolescents

Suicide is currently the second leading cause of death for ages 15–24 years; reports indicate that 6–8% of American teens have attempted suicide. Rates of suicide and suicide attempts are at least as high, if not higher, for American Indian adolescents and young adults. The Suicidal Ideation Questionnaire (Junior High School Version) (SIQ-JR) could be used to identify young people who may be at risk for attempting suicide, since this questionnaire focuses on suicidal ideation, a major risk factor for suicide attempt. However, little is known about the predictive validity of the SIQ-JR, particularly in American Indian adolescent populations. A suicide attempt cluster at an American Indian boarding school provided the unique opportunity to examine the performance of the SIQ-JR in a group of American Indian high school students who had taken the SIQ-JR approximately 2 months prior to the outbreak of attempts. The SIQ-JR proved to be an excellent predictor of future suicide attempts when compared to other measures of distress: anxiety, depression, and alcohol use. The SIQ-JR is an effective screener for suicide risk in this American Indian adolescent population.