Suicide in Texas: a cohort analysis of trends in suicide rates, 1945-1980

Recent clusters of teenage suicides in Texas suburban communities have focused national attention on the rise in teenage suicidal behavior. This study sought to clarify the teenage suicide phenomenon by using a cohort method of data analysis. Beginning with suicide rates for white males aged 15-19 in 1945, suicide rates were calculated and plotted for each 5-year age cohort entering the late teenage years, when suicide risk factors dramatically increase. Our analysis of these cohort patterns confirmed the ever-rising risk factor associated with the ages of 15-19. This trend is consistent with many studies suggesting that teenage suicide is a function of socioeconomic and psychological factors operating across community and national boundaries. In addition, our study revealed that as white males 15-19 years of age in 1945 aged, their suicide rates also increased, confirming earlier findings that the suicide risk factor increases with age. In fact, Texas data for 1980 revealed that older persons, not teenagers, had the highest suicide rates-a finding that confirms other studies' results. Finally, Texas cohort patterns for suicide revealed the recent curvilinearity tendencies of older adult male suicide rates. By 1980 Texas data revealed a bimodal distribution of high suicide risk, with white males in their late 20s and ages 55 and over having the highest rates.     

Managing Elder Suicide: A Profile of American and Canadian Crisis Prevention Centers

Suicides among older adults in the United States and Canada in the last decade have accounted for an increasing share of all suicides. In both countries the use of firearms among older adults has steadily increased. Despite these trends, little is known about the extent to which crisis centers are prepared to prevent elder suicide. A survey of AAS-listed crisis prevention centers examined the training, knowledge, and current practices relevant to elder suicide among personnel in 321 crisis prevention centers in both countries. Results revealed insufficient training, a lack of familiarity with recent suicide trends, and limited outreach to older adults.     

Risk Factors of a Suicide Reattempt by Seasonality and the Method of a Previous Suicide Attempt: A Cohort Study in a Japanese Primary Care Hospital

Suicide has a great impact on the individual whose life is lost and the bereaved family members. The risk of a suicide reattempt is particularly high during the first 12 months after a suicide attempt. In this cohort study, risk factors for a suicide reattempt were explored among 291 patients at suicide risk. Clinical and demographic data were collected from a Japanese primary care hospital. Past psychiatric history and multiple diagnoses were associated with suicide reattempts in both genders. Drug overdose, past psychiatric history, and the summer season were linked to suicide reattempts among males. Past psychiatric history and multiple diagnoses were linked to suicide reattempts among females. Appropriate assessment of past psychiatric history, season and method of suicide attempt, gender, and diagnosis may play a role in preventing suicide.     

The Growing Use of Firearms by Suicidal Older Women, 1979–1992: A Research Note

Suicide among older women (65 +) has received very little attention despite increasing numbers of suicides in this population. An examination of national mortality data from the National Center for Health Statistics for the years 1979 through 1992 shows an increasing trend in rates of suicide among older women and a declining trend among women under 65. Over the 14-year period, firearms replaced poisoning as the most prevalent method of suicide by women 65 and over. The results seem consistent with the assertion that the availability, familiarity, and cultural acceptability of firearms may play a role in the choice of suicide method among older women. Although violent death and the use of firearms are generally associated with males in our society, the trends reported here indicate that greater attention to firearm suicides among older women is warranted.     

Depressive Symptoms and Suicide Risk in Older Adults: Value Placed on Autonomy as a Moderator for Men but Not Women

Risk for suicide is elevated among older men. We examined whether value placed on autonomy amplifies the relation between depressive symptoms and suicide risk differently for older men and women. Participants were 98 community‐dwelling older adults, M age 73.6 (SD = 8.6), 65.1% female, 93.1% White. Questionnaires measured suicide risk (SBQ‐R), depressive symptoms (CESD), and value placed on autonomy (PSI‐II autonomy). Among men, depressive symptoms were associated with suicide risk only when PSI‐II autonomy was elevated. Among women, greater depressive symptoms were associated with suicide risk at all levels of PSI‐II autonomy. Further research on attitudes toward autonomy is warranted.     

The Evolution of Epidemic Suicide on Guam: Context and Contagion

Thirty years of suicide rates for Guam were analyzed by age, sex, period, and cohort. Youth suicide increased rapidly in the 1990s; certain cohorts have higher rates. Four explanatory factors are discussed, including ecological factors and migration from the Federated States of Micronesia. Direct and indirect suicide contagion followed the death by suicide of a respected politician, strongly influencing period and cohort patterns. Suicide pacts inflated suicide among young people. These factors acted in combination to produce epidemic levels of suicide in the 1990s.     

Suicide among animals: clues from folklore that may prevent suicidal behaviour in human beings

Knowing the most likely reasons for suicide might increase the chances to identify the early signs of suicide. Folkloric tales on suicide among animals are a possible source of such information, since people probably explain animal suicide using the same reasons they would apply to their kin. Modern naturalistic studies ave found little evidence of self-harming conduct among nonhuman species. Nevertheless, mythological accounts often report suicidal behaviour among animals. Claudius Aelian's De natura animalium, a classic in its genre, written in the 2nd century AD, reports 21 cases of suicide among animals. In Aelian's tales, the severing of social ties emerges as an important motive for suicide, together with incest and rage caused by adultery. Paying attention to the mechanisms leading to suicide described in ancient mythology may help us understand unusual and uncommon motives for suicide and the reasons people feel suicidal.     

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.     

Epidemiology of suicide in the elderly.

Suicide rates in the United States and most other countries are higher among the elderly than among the population as a whole. Typically, rates peak in older adulthood. Epidemiological data for the current levels and trends in suicide among the elderly are presented with a focus on United States figures. Age, sex, race, marital status, and methods of suicide as factors in suicide among the old are detailed, followed by a discussion of past trends and future predictions of changes in elderly suicide rates. In addition to fatal suicidal behaviors, the data and literatures on parasuicide and survivors of elderly suicide are briefly noted.     

Shifting Patterns of Deadly Violence

ABSTRACT: To the casual observer, it would seem that the United States' suicide rate has been remarkably steady in recent years. However, this stability may be more apparent than real. While it is true that the total suicide rate has varied little, this composite figure masks a dramatic shift in the risk of suicide by age. In recent years there has been a reduction of suicide at older ages reciprocated by an unprecedented increase of suicide (and homicide) at younger ages. The extent of this change during the ten-year period 1966–75 is explored along with possible explanations for the increase of aggressive violent death among young people.     

Is Veteran Status and Suicide Risk Assessed in Community Long‐Term Care? A Review of the States' Assessment Instruments

Given recent policy initiatives to address suicide risk among older persons and veterans, community‐based elder serving agencies may serve an important role in identifying and referring individuals at risk for suicide. A review of state‐level long‐term assessment instruments was conducted to determine whether veteran status and suicide are assessed. Data from forty‐three state's Units on Aging instruments were content analyzed. Results indicate that over two thirds of the states in this review included questions about suicide and veterans in their assessments, 69.8% and 67.4% respectively. Suicide risk among elders and veterans must be addressed at local, state, and federal levels so that concerted attention and oversight can be provided for matching elders to the services they need.     

A case control study of suicide and attempted suicide in older adults

Risk factors for serious suicidal behavior among older adults were examined in a case control study of 53 adults aged 55 and older who died by suicide or made medically serious suicide attempts and who were compared with 269 randomly selected comparison subjects. Multivariate analyses suggested that risk of serious suicidal behavior was elevated among those with current mood disorders (OR = 179, CI = 52.8-607.6), psychiatric hospital admission within the previous year (OR = 24.4, CI = 1.9-318.7), limited social network (OR = 4.5, CI = 1.4-14.6). The predominant role of mood disorders was confirmed by population attributable risk (PAR) estimates (73.6%), suggesting that the improved detection, treatment and management of mood disorders should be the primary focus of suicide prevention strategies for older adults.     

Characteristics of problem gamblers 56 years of age or older: a statewide study of casino self-excluders

Gambling among older adults appears to be increasing, though little is known about the characteristics of older adult problem gamblers. The purpose of this study was to compare older adults to younger and middle-aged adults in a cohort of problem gamblers participating in a state-administered casino self-exclusion program. Self-reported problem gamblers (N = 1,601) who voluntary banned themselves from Missouri casinos from 2001 to 2003 were categorized by age as younger adults (ages 21 to 35; n = 490), middle-aged adults (ages 36 to 55; n = 950), and older adults (ages 56 to 79; n = 161), and were compared with respect to demographic variables, gambling participation, and reasons for self-exclusion. Older adult self-excluders typically began gambling in midlife, experienced gambling problems around age 60, reported preferences for nonstrategic forms of gambling, and identified fear of suicide as the primary reason for self-excluding. Implications for intervention, prevention and treatment are discussed. (PsycINFO Database Record (c) 2008 APA, all rights reserved).     

The impact of the nature of relationships on perceived burdensomeness and suicide ideation in a community sample of older adults

Older adults die by suicide at very high rates, and previous research indicates that perceived burdensomeness may contribute to deaths by suicide. In this study, the impact of the nature of relationships on perceived burdensomeness and suicide ideation was examined. Results indicated that older adults' perceptions of burden on younger generations were associated with greater overall perceived burdensomeness and suicide ideation when compared to the older adults' own or older generations. Thus, clinicians should examine general perceived burdensomeness as well as the types of relationships the older adult perceives himself or herself to be a burden on.     

Reactive aggression and suicide: Theory and evidence

Aggression confers risk for suicide. However, “aggression” is a heterogeneous construct, and it is likely that subgroups of individuals with particular types of aggression are at higher risk. We postulate that a subtype of aggression, reactive aggression, underlies the link with suicide with implications for suicide risk-recognition and prevention. The theoretical rationale and empirical evidence for the role of reactive aggression in suicide is presented from the perspectives of neurobiology, psychopathology, and overt violent behavior. It is hypothesized that partner–relationship disruptions amplify risk for suicide in the near term among reactive aggressive individuals, particularly those with psychiatric disorders, and preliminary evidence in support of this hypothesis is reviewed. We also discuss being jailed as a potential precipitant of suicide in reactive aggressive individuals. Recommendations are made to advance the study of reactive aggression and suicide, including methodological innovations and a greater focus on research of women and older adults.     

Identifying the role of sociodemographic factors in major depressive disorder and suicidality among Spanish-speaking Latino patients in a federally qualified health center

Rates of suicide and major depressive disorder (MDD) are currently at the highest point in the history of the United States (US). However, these rates are not distributed evenly among the population and Latinos show disproportionately high rates of both suicide and MDD. Yet, past research has infrequently explored factors related to suicide and MDD in primary care settings that serve as the major community portal for mental health among the Latino population. Thus, the current study investigated sociodemographic variables (marital status, nativity, education, employment, primary language, age, and gender) in terms of their relations with suicidal ideation, suicide risk, MDD, and MDD symptom severity among Latino primary care patients in a Federally Qualified Health Center (N = 634, M _age = 39.46, SD = 11.46, 87.1% female). Results indicated that gender and Nativity were associated with suicidal ideation, older age was associated with suicide risk, and higher education and having a partner were negatively associated with MDD and depressive symptom severity. These results provide novel insight into the role of sociodemographic factors predicting suicide and MDD among Latinos in primary care, and suggest greater scientific and clinical attention can be focused on certain sociodemographic factors to offset mental health disparities among this group.     

Adolescent suicide prevention: Gender differences in students' perceptions of the acceptability and intrusiveness of school-based screening programs

Suicidal behavior is a significant problem among adolescents in the United States. Three types of school-based suicide prevention programs have been proposed to address this problem including curriculum programs, staff in-service training, and school-wide screening. The relative acceptability of these three programs among older adolescents was examined. The sample included 662 freshmen (496 females, 161 males) enrolled in a large private university. Respondents rated the degree to which they considered adolescent suicide to be a significant problem, and the acceptability, intrusiveness, and time demands of the three suicide prevention programs. A majority (85.9%) of the sample agreed that adolescent suicide was a significant problem. Significant gender differences were observed in relation to the acceptability ratings of the school-based suicide programs. Female participants rated the curriculum-based program and staff in-service training as more acceptable than male participants. In addition, female participants rated the curriculum-based program as significantly less intrusive and less time demanding than male participants. Implications of these findings for implementation of suicide prevention programs and for future research are discussed.     

Suicide notes of the older adult.

Although not true in all countries, older adults are the developmental age group at highest risk for death by suicide in the United States. Our knowledge of suicide in the elderly is, however, limited. The psychological characteristics for suicide cannot be attributed primarily or even solely to being old. One avenue to understanding this complicated act in the elderly is suicide notes. Despite their limitations, suicide notes contain special revelations of the human mind and there is much one can learn from them about suicide in the older adult. This paper outlines the sparse literature on the topic of suicide notes of the older adult and then presents the author's own life-span research related to the elderly. The research indicated that long-term instability was critical in understanding suicide in the older adult. However, indirect expressions (e.g., ambivalence, unconscious implications) were much less frequently observed in the notes of the elderly than other adults. The research also found that older males often wrote about painful problems in their interpersonal relations in their final letters and this pain was significant in making their final decision. Future research, specifically regarding a protocol analysis based on a review of the research on suicide in the elderly, will be discussed.     

Control across the life span: A model for understanding self-direction

A comprehensive four-factor interactive model on physical, psychological, and environmental processes related to the sense of control is presented for adult development with an emphasis on later life. The four experienced components are (1) control from within oneself, (2) control over oneself, (3) control over the environment, and (4) control from the environment. Control over oneself and over the environment measure self-directed control, while control from within oneself and from the environment measure nonself-directed control. Coping (a bidimensional control scale) measures control from powerlessness and suicide to overcontrolling. Findings confirm a significant loss of coping in an older cohort group from a white, rural sample composed primarily of single subjects with low coping representing a significant drop in self-directed behavior. A discussion of the relationship between self-direction and health in the older cohort group follows.