“It's a white thing”: An exploration of beliefs about suicide in the African‐American community

Although there has been an increase in black suicides in the past decades the white suicide rate is still nearly double the black suicide rate for men and women. The question asked is, Why is there relatively little black suicide? One persuasive answer proposed in the literature is that major social institutions, particularly religion and family, in the African‐American community provide amelioration or buffering of social forces that would otherwise promote suicide. We report on a qualitative investigation designed to identify the content of beliefs and perceptions of suicide that may act as a buffer against suicide in the African‐American community. From interviews with black pastors in a southern community we identify an intermingling of religious condemnatory beliefs and secular attitudes about suicide that view suicide as unthinkable sin and define it as a “white thing” alien to the black culture.     

Suicide risk among persons with foreign background in Denmark

There is a dearth of knowledge about factors correlated with suicide risk among minority groups in Western societies. In the present study we compared suicide risk among persons with foreign background with that of the majority population to determine whether certain minority groups are at a particular risk for suicide, as well as to illuminate gender differences herein. Suicide risk was generally higher among persons with foreign background compared with the majority population and the risk was highest among Nordic-born persons. Overall, suicide risk was significantly lower among Asian-born persons; however, there were gender differences in correlations between ethnicity and suicide risk.     

Suicides in the developing world: case study from Pakistan

There are no official data on suicide from Pakistan, a conservative South Asian Islamic country with traditionally low suicide rates. Both suicide and attempted suicide are illegal acts, as well as socially and religiously condemned, making research in this area difficult. Recent reports suggest an increase in suicide rates. In this study, police data from the Sindh province were examined to provide a unique picture of trends of suicide over 15 years (1985-1999). During this period there were 2,568 reported suicides (71% men, 39% women; ratio 1.8). The lowest number was 90 in 1987 and maximum was 360 in 1999. Poisoning by organophosphates was the most common method followed by hanging. This study, although limited in scope, provides evidence of an increase in suicide rates in Pakistan, from one data source. There is urgent need for further research on suicide in Pakistan; interventions for suicide prevention in the country can then be planned.     

Suicide ideation: its relation to depression, suicide and suicide attempt

A random sample of 3,935 adults from a general population were interviewed and asked to report how often they had thoughts of suicide as well as their opinion on the frequency of suicide ideation in others. Depression was found to be related to the respondent's reports of his/her own suicidal thoughts and to reports of frequent suicide ideation in others. A total of 5.4 percent of the respondents reported some degree of suicide ideation in the previous month and 9.1 percent reported that others think about suicide once a month or more. When the demographic characteristics of those who report suicide ideation in themselves or others were compared to those of suicide attempters and committers, some consistencies were found, suggesting that such questions may be useful in identifying those "at risk." Nevertheless, sufficient discrepancies were found which suggest that there may be a number of factors which increase or decrease the likelihood that someone with thoughts of suicide will attempt or commit suicide. Follow-up studies are necessary to uncover such factors and the degrees to which they influence the occurrence of suicide.     

The Epidemiology of Homicide followed by Suicide: A Systematic and Quantitative Review

This systematic review of population based studies of homicide followed by suicide was conducted to examine the associations between rates of homicide‐suicide, rates of other homicides and rates of suicide. The review analysed 64 samples, including the case of an outlier (Greenland) that were reported in 49 studies. There was a significant association between the rates of homicide‐suicide and those of other homicides in studies from the U.S.A. Outside the U.S.A. there was no clear association between homicide‐suicide and other homicide but there was modest but significant association between rates of suicide and homicide‐suicide. Homicide‐suicide appears to be closer in epidemiological terms to homicide than suicide in regions with high rates of homicide and measures to reduce homicide in these regions may also reduce homicide‐suicide.     

MMPI ratings of suicide risk.

Among past attempts to use MMPI data to predict suicidal behavior, there has been a lack of research on the ability of clinicians to identify MMPI profiles of suicidal persons. In this study, the MMPI profiles of 20 male psychiatric patients who committed suicide and the MMPI profiles of 20 male patients who did not attempt or commit suicide were presented to six clinical psychologists with expertise in MMPI interpretation. The clinicians were asked to classify each MMPI profile as coming from a patient who did or did not later commit suicide, and to rate eight variables thought to be relevant to the assessment of suicide risk. Data analysis revealed that the clinicians could not identify suicide and nonsuicide patients from their MMPI profiles. Furthermore, the ratings of the eight suicide variable did not differentiate suicide and nonsuicide patients.     

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 in police--a critical review.

Police officers are commonly referred to as a high-risk group for suicide. So far no comprehensive review has been published about epidemiologic studies among police. This article systematically explores the worldwide literature on suicide in police. None of the recent nationwide studies show elevated suicide rates among police. Other studies show inconsistent results. Conclusively, it is not documented that there is an elevated suicide rate in police. A particular problem in previous research has been methodological shortcomings. There is need for further systematic research, and this review points out some strategies of research.     

Cognitive style and suicidal behaviour: implications for therapeutic intervention, research lacunae and priorities

Cognitive style is a well-established theoretical construct but there is considerable ambiguity in the way it has been used and uncertainty regarding the nature of its role in suicide. There is no evidence that specific cognitive dispositions prime people for suicide but there are indications that suicide is associated with a constriction in cognitive style. This constriction leads to decrements in problem-solving and information processing that can be addressed in therapeutic contexts. To help a suicidal person become a better problem-solver is not a trivial task but the evidence suggests that enriching cognitive styles through the development of thinking skills is possible when the therapy session is construed as a learning collaboration.     

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.     

Knowing When to Say Goodbye: Final Exit and Suicide in the Elderly

The publication of Derek Humphry's Final Exit in 1991 caused a large uproar. Although designed as a suicide manual for terminally ill persons, there has been considerable fear that the book's methods might be used by others, such as nonterminal elderly individuals who have made a “rational” decision to end their lives. This piece, a short story about an elderly couple that commits double suicide, explores rational suicide by using fiction, as opposed to a standard bioethical approach. Fiction does not provide answers, but rather highlights the ambiguities surrounding elder suicide, and reminds us to evaluate this issue in the context of individual life experiences.     

14 Culture and Suicide: From a Japanese Psychiatrist's Perspective

There have been numerous papers focusing on culture and suicide, but it seems that they have often emphasized cultural differences excessively, thus running the risk of increasing prejudice toward different cultures and reinforcing overgeneralizations. From my albeit limited knowledge and experience, it appears that there are more similarities than differences in suicide among various cultures. Most cases of suicide reflect complex human factors that are found universally among cultures. Despite the fact that some cultural differences in suicide admittedly exist in different societies and that these are important, they cannot explain every aspect of suicide. This article explains how I, as a Japanese psychiatrist, diagnose and treat suicidal patients against the backgrounds of Japanese culture by presenting my way of thinking in daily practice in order to show similarities and differences that exist in Japanese suicide, treatment, and prevention.     

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.     

Suicidality and psychosis: beyond depression and hopelessness

The present study examined recent suicide attempters with and without psychotic disorders in order to understand factors that contribute to suicide ideation during and following the suicide attempt. Patients with psychotic disorders endorsed higher levels of suicide ideation than patients without psychotic disorders. Even when depression, hopelessness, substance abuse, and social problem solving were controlled for, there was a significant association between psychotic disorder and suicide ideation. During the follow-up period, patients with psychotic disorders subsequently attempted suicide at a significantly higher rate than patients without psychotic disorders. The clinical relevance of these findings is discussed.     

Suicide and suicidology in the Soviet Union

This study was conducted in order to obtain information on suicide in the Soviet Union, an important subject for which we have no scientific literature. Studies of attempted suicide in Soviet psychiatric journals were analyzed. This information was supplemented by interviews with Soviet psychiatrists now living abroad. The results of this inquiry show that suicide is a subject that clearly has become of increasing concern in the Soviet Union. Furthermore, in spite of the absence of essential statistical data on mortality, there is evidence indicating that the rate of Soviet suicide may be rising in certain parts of the country. Finally, growing concern about suicide has led to expanded prevention programs and to a new emphasis on social and psychological etiological explanations. In particular, the role of the Soviet family in crisis has been emphasized as a major influence in understanding the causes of suicidal attempts.     

Self-reported suicidal behavior in Dutch secondary education students

From nearly 10,000 secondary education students in The Netherlands, aged 14-20, data were collected on the prevalence of suicide attempts and recent thoughts about suicide and death. In this sample, 3.3% of the girls and 1.3% of the boys indicated that they had attempted suicide. The youngest students already reported as many attempts as the eldest, which is remarkable. Differences between boys and girls and between various types of schools were not substantial. We also found that 5.2% of the girls and 2.2% of the boys currently had thoughts of suicide. Again, there was no substantial difference as regards sex, type of school, and age. There was, however, a (small) difference between boys and girls concerning thoughts of death--namely, 9.3% of the girls versus 4.8% of the boys.     

Evaluation of a Suicide Prevention Center by Sampling the Population at Risk*

ABSTRACT: At present there are no clear guidelines for assessing the effectiveness of suicide prevention and crisis centers. This report focuses on one readily available source of data, specifically that segment of the population at risk made up of persons admitted to the inpatient service of a mental health center due to depressive and/or suicidal states, including suicide attempts. To determine the role of the suicide prevention center in providing services to this group, 575 persons meeting these criteria were interviewed. The findings included the following: (a) 11 percent had utilized suicide prevention center services, with 59 percent of these experiencing substantial benefit; (b) 20 percent stated they were unaware of the center; (c) 8 percent expressed the view that calling the center would be inappropriate because a suicide attempt was not imminent; and (d) 26 percent indicated an inclination to call the center in the event of subsequent difficulties. Experience suggests that response to a crisis (intervention) as well as response to low lethality callers with “everyday problems” (prevention) constitute valid functions of a suicide prevention and crisis center. Preoccupation with short-term goals, such as reducing the apparent suicide rate, should not dominate the conceptualizing of program evaluation methods.     

Revisiting impulsivity in suicide: Implications for civil liability of third parties

Previous research and popular conceptualizations of suicide have posited that many suicides are the result of impulsive, “on a whim” decisions. However, recent research demonstrates that most suicides are not attempted impulsively, and in fact involve a plan. Legally, suicide has historically been considered to be a superseding intervening cause of death that exonerates other parties from liability, but currently there are two general exceptions to this view. Specifically, another party may be found responsible for a suicide if that party either caused the suicide or failed in its duty to prevent the suicide from occurring. Both of these exceptions assume that the resulting suicide was foreseeable. Given that recent research has indicated that most suicides are planned, and thereby foreseeable to a certain extent under many circumstances, this article discusses issues of foreseeability as they pertain to litigation involving third party liability for the suicide of university students, prison inmates, and mental health patients. The authors contend that the surest way for universities, prison staff, and mental health practitioners to avoid being held liable for a suicide is to appropriately assess for suicidal intent. Copyright © 2008 John Wiley & Sons, Ltd.     

Suicide and the Creative Class: A Cross-National Examination

Studies on suicide have illustrated the role society plays in the very individual act of suicide. Suicide research has examined the role of economic development within cities, states, and countries. Florida suggested that a new form of economic development, built around the creative class, is being implemented by the most prosperous cities and countries. Using a cross-national analysis of 59 countries the study finds that as the percent of the creative class increased, suicide increased. The findings indicate that there could be a negative consequence to areas pursuing economic development along the creative class model.     

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.