Frequency of Suicidal Thought and Self-Destructive Behavior among Females

ABSTRACT: The focus of the present investigation was to examine the importance of a control group in suicide research and to develop an instrument to disguish between levels of suicidal thought among subjects who had a history of attempted suicide and among a comparison group of nonsuicidal individuals. The sample was comprised of female university students ranging in age from 18 to 25 years. A 31-item questionnaire designed by the investigator was given to 199 students, 20 of whom were found to have histories of one or more previous suicide attempts. The remaining 179 nonsuicidal subjects were divided into two categories based on the frequency of expressed suicidal thought. Fifty individuals were randomly selected from each of these two groups. The three groups (individuals who had attempted suicide, individuals who had not attempted suicide but who thought about suicide on a frequent basis, and individuals who had not attempted suicide and who thought about suicide on an infrequent basis) were compared on the variables of motivation for suicidal thoughts, history of self-destructive behaviors, probability of a future suicide attempt, and age of first suicidal considerations. A chi-square analysis was performed on each of these items in order to assess the extent to which the items discriminated among the three comparison groups. The differences among the three groups on each of the items were found to be statistically significant at less than the .01 level. The results of the study have provided support for the necessity of a distinction between groups within a nonsuicidal comparison population and for the suggestion that there may be a quantitative relationship between the frequency of suicidal thought and the likelihood of attempted suicide.     

Development of a tool to assess suicide risk factors in urban adolescents

Dramatic increases in the adolescent suicide rate over the past three decades have underscored the need for risk-assessment tools. The tools that do exist are oriented to older populations and their application to adolescents is questionable. A project was initiated at the University of Utah's Health Education Department to develop a pilot instrument to examine the differences between adolescents who have attempted suicide and other teenagers. Eighty-two subjects between the ages of 14 and 19 participated in the test of this instrument. Twenty-five subjects were identified by a physician or psychologist as having failed in a sincere suicide attempt within the previous 18 months. Fifty-seven nonsuicide attempters with similar demographic profiles served as a comparison group. An 86-item questionnaire was administered to both groups. Questions were generated from a review of the literature of the past three decades for problems associated with suicide in this population. Questions were sorted into three domains (family environment, social environment, and self-perceptions), with each domain having several subdomains. Statistical analysis revealed significant differences for each of the three domains and on 55 of 86 questions. The results were used to create a streamlined instrument for assessing suicide risk that can be administered in 20 minutes.     

Frequency of Nonsuicidal Self‐Injury in Adolescents: Differences in Suicide Attempts,Substance Use,and Disordered Eating

The relationship between frequency of nonsuicidal selfinjury (NSSI) and suicide attempts, substance use, and disordered eating was assessed in a community sample of 4,839 adolescents, 922 of whom reported NSSI in the past year. It was expected that the engagement in risk behaviors would significantly increase as NSSI frequency increased. Participants completed the Youth Risk Behavior Survey (Centers for Disease Control and Prevention, 2009) and were subdivided into five NSSI frequency groups: none, 1 time, 2–3 times, 4–5 times, and 6 or more times. A one‐way MANOVA found significant mean differences for all variables across NSSI frequency groups. The no NSSI group was significantly lower than all other groups on all variables. For suicide attempts, all frequency groups were significantly different from each other, with attempt frequency increasing with each increase in NSSI frequency. The six or more group reported significantly more substance use and disordered eating than all other groups. Overall, adolescents with more frequent NSSI represent a group at risk for concurrent unhealthy behaviors and suicide attempts.     

Normative data for eight neuropsychological tests based on a Danish sample

Normative neuropsychological data have been provided using a sample of 101 persons aged 20 to 54 years. Eighty-seven of the subjects were recruited among patients who had undergone minor surgery, and 14 subjects were volunteers from the staff at the hospital laundry. The measures consisted of seven subjects from the WAIS-R, the trail-making test, symbol digit modalities test, auditory-verbal learning test, story recall test, visual gestalt test, recurring figures test, verbal fluency, and Purdue pegboard test. These measures were selected because of suitability in regard to time taken for testing each subject and their sensitivity to subtle changes in neuropsychological functioning. The sample was arbitrarily divided into three age groups, and for each of the three samples, mean, standard deviation, and range were calculated for each test. The results of the Information and Vocabulary subtests from the WAIS-R, education, and social status were applied as independent variables in linear regression analyses where each of the neuropsychological tests, in turn, was the dependent variable. For the oldest age group, age in addition was used as an independent variable. Significant linear relationships, which accounted for an optimal part of the variance, were selected for clinical application.     

Two forms of minority-group test bias as psychometric artifacts with an animal model (Rattus norvegicus)

Controversy abounds over attributing group differences on tests to nature, nurture, or test bias. Limitations of correlational sampling from natural populations necessitate experimental methods to resolve underlying issues. In classical psychometrics test items are selected from a larger item pool through analysis of item responses in a sample of subjects. Rats of six inbred strains (n = 366) were tested in multiple mazes to provide a large item pool. Six populations were created, each with differing proportions of each strain. Items selected through independent item analyses within each population yielded six tests. An independent cross-validation sample (n = 146) provided scores on all six tests. This sample was also tested in another set of maze problems defined as the criterion to be predicted. Strain means and intrastrain predictive validities for the six tests varied with strain representation in the population used for item selection (p less than .001). Conventional item-selection procedures clearly produced two forms of minority test bias.     

Stereotypes of Suicide Causes for Three Age/Gender Cohorts

On the basis of open-ended questions and interviews using vignettes of fictitious male and female suicide committers of ages 15, 40, and 60, a list of reasons attributed to their suicides was obtained. From this list, a 45-item (5-point Likert scale) checklist was developed. This checklist was administered to a total of 232 respondents in a factorial design. The subjects were asked to respond to items concerning the fictitious suicide committer of their own age and gender, as well as to items for the other two age/gender cohorts. Thus, two groups of subjects answered the checklist. One group of respondents rated the checklist separately for the 3 age cohorts of fictitious male committers (15-year-old male, 40-year-old male, and 60-year-old male). The other group rated the checklist for the three fictitious female committers. The rank of endorsement for each cause was tabulated separately for age/gender cohorts, and indices of overall agreement were computed. The results indicated high agreement among all respondents on the causes of suicide considered to be most likely for a given cohort, as well as a distinct differentiation among cohorts and gender groups. The findings were discussed with reference to cultural stereotypes about suicide causes, and arguments were elaborated on the contribution of these shared beliefs to an individual's decision to commit suicide.     

Attitudes toward suicide among highly creative college students

Two groups of college students (n = 58 each) were identified through a combination of teacher nominations and creativity test scores, were labeled as creative or control, and matched on gender, age, college major, and vocabulary level. Their attitudes towards suicide were assessed using the Suicide Opinion Questionnaire (SOQ). Seven of the eight SOQ scales statistically differentiated the two groups, with creative subjects showing greater agreement of endorsement on the Mental Illness, Right to Die, Normality, and Aggression scales, and greater disagreement on the Cry for Help, Religion, and Moral Evil scales. The results suggest considerable attitudinal differences towards suicide between highly creative subjects and their control peers, with creative students perceiving suicide in more liberal and less judgmental terms.     

A Machine Learning Approach to Identifying the Thought Markers of Suicidal Subjects: A Prospective Multicenter Trial

Death by suicide demonstrates profound personal suffering and societal failure. While basic sciences provide the opportunity to understand biological markers related to suicide, computer science provides opportunities to understand suicide thought markers. In this novel prospective, multimodal, multicenter, mixed demographic study, we used machine learning to measure and fuse two classes of suicidal thought markers: verbal and nonverbal. Machine learning algorithms were used with the subjects’ words and vocal characteristics to classify 379 subjects recruited from two academic medical centers and a rural community hospital into one of three groups: suicidal, mentally ill but not suicidal, or controls. By combining linguistic and acoustic characteristics, subjects could be classified into one of the three groups with up to 85% accuracy. The results provide insight into how advanced technology can be used for suicide assessment and prevention.     

Suicide prevention for high-risk persons who refuse treatment.

A program was developed to exert a suicide prevention influence on high-risk persons who decline to enter the health care system. There were 3,006 patients admitted to a psychiatric in-patient service because of a depressive or suicidal state who were contacted to determine if the post-discharge plan was followed. Half of those who refused their treatment program were contacted by telephone or letter on a set schedule. The contact was limited to expressing interest in the person's well-being. Mortality in the contact group was compared with the no-contact subjects and with the subjects who had accepted treatment, after 1, 2, 3, and 4 years. Suicidal deaths were found to diverge progressively in the three groups, the treatment subjects showing the highest rates, the no-contact group coming next, and the contact subjects showing the lowest. The observed divergence between the contact and no-contact groups provides tentative evidence that a high-risk population for suicide can be identified and that a system-atic approach to reducing that risk can be applied.     

Odour memory and odour hedonics in children

The characteristics of olfactory memory during development were investigated and the hypothesis that the pleasantness of smells may be affected by previous associations with pleasant or unpleasant objects or events was tested. This type of emotional memory was compared in the immediate and long-term recognition of olfactory stimuli. Children from three different age groups (mean ages: 6 years 6 months; 8 years 9 months; and 10 years 5 months) were subdivided into two groups. One group was presented with six different odours, each with a slide depicting a pleasant picture. The other group was presented with the odours accompanied by unpleasant pictures. Immediately after stimulus presentation the subjects underwent a recognition test. One month later the subjects underwent a second recognition test, at the end of which they were required to give an evaluation of the pleasantness of each odour on a nine-point scale. At no age level did the pictures matched to the odours affect the recognition score. Olfactory memory varied with age, chiefly because memory decay increased with age, perhaps because of greater proactive interference. With increasing age more rapid decay was set against better immediate recognition. The hypothesis that the hedonic characteristics of odours are partially learned and are affected by events experienced in other modalities was supported.     

Motivated memory: Dissociation between performance data and subjective reports

Summary Three experiments are reported to test a claim by previous subjects that lack of motivation for performing well in memory experiments yielded less than optimal performance. In each experiment the subjects of one group were informed of monetary incentives prior to study; in a second group they were informed of these incentives after study but prior to the test; no mention of incentives was made to the subjects of a third group. Recall and recognition procedures were used to assess memory performance. The data of all three experiments demonstrated no differences between the three groups with respect to performance. The claim that subjects in regular memory experiments would typically perform less than optimally is thus rejected. Subjective reports, however, revealed that incentives had affected the amount of effort put into the memory tasks. This dissociation between performance data and subjective reports is discussed in relation to the concept of motivation.     

Serial-position effects in motor short-term memory

This study examined the effect of the length of a series of movements on the recall of those movements. Subjects (n = 45) were randomly assigned to one of three experimental groups with each group recalling either three, six, or nine movements on a linear-slide apparatus. The subjects, while blindfolded, were presented with each movement by actively moving to a stop. Recall occurred 5 sec after the last movement to a stop on a trial. All subjects were given nine trials, each containing a different series of to-be-recalled movements. Results indicated that absolute error of recall of the three movements increased in a linear fashion. However, for six and nine movements, a bowing effect of the recall curve was noted following the fifth position. A primacy effect was more evident than was a recency effect. Accuracy of recall was a function of list length up to six movements, after which accuracy was not further impaired.     

Effect of instructional set on responses to the Geriatric Depression Scale

A community sample of elderly subjects (M age = 74 years) was randomly assigned to four variations in reference group instructions on the Geriatric Depression Scale (GDS). In one condition, subjects received no instructions as to reference group, which is the standard instructional format of the test. In the other three conditions, subjects were asked to compare themselves with one of three reference groups: age group peers, adults in general, or themselves at a younger age. Results indicated that the GDS is robust with respect to variation in reference group instruction.     

Serial-Position Effects in Motor Short-Term Memory

This study examined the effect of the length of a series of movements on the recall of those movements. Subjects (n =45) were randomly assigned to one of three experimental groups with each group recalling either three, six, or nine movements on a linear-slide apparatus. The subjects, while blindfolded, were presented with each movement by actively moving to a stop. Recall occurred 5 sec after the last movement to a stop on a trial. All subjects were given nine trials, each containing a different series of to-be-recalled movements. Results indicated that absolute error of recall of the three movements increased in a linear fashion. However, for six and nine movements, a bowing effect of the recall curve was noted following the fifth position. A primacy effect was more ‘ evident than was a recency effect. Accuracy of recall was a function of list length up to six movements, after which accuracy was not further impaired.     

A comparison of continuous and distributed reduced sleep schedules

After a night of normal sleep, 36 subjects were divided into three groups of 12. One group was allowed to continue sleeping normally, one group had four hours continuous sleep and the third group had three 80-min periods of sleep distributed throughout the 24-h period, for the next four days. Subjects were given a visual vigilance test on each day. Overall performance was rather better following distributed than following continuous reduced sleep, but rather worse than following 8 h of sleep. The main difference between the reduced sleep groups was in their decision criterion. It was suggested that this difference mainly reflected the difference in time since the two groups had last slept.     

The Rorschach test for predicting suicide among depressed adolescent inpatients.

With the decreasing length of psychiatric hospitalizations, identification of test indicators of suicide risk becomes critically important. This Rorschach study was designed to model a clinical decision-making scenario concerning adolescent suicide risk. Using Psychiatric Evaluation Form (PEF) scores, we selected a sample of 25 severely depressed and suicidal adolescents; 26 severely depressed, not suicidal adolescents; and 28 not suicidal, not depressed adolescent inpatients at The Sheppard and Enoch Pratt Hospital. A Rorschach Index using the Exner (1986) Comprehensive System for scoring was developed to predict group membership. Four of six of the features on this index selected 64% of suicidal subjects. This constellation included traditional affective variables (vista responses, color-shading blends, color dominated responses, and morbid content) as well as measures of cognitive distortion (inaccurately perceived human movement responses [M-] and special scores). We discuss the implications of these findings for the diagnosis and treatment of the suicidal adolescent.     

Language performance on visual processing tasks in right hemisphere lesion cases

Seven language tests were constructed or adapted to assess the performance of three groups of 10 right-handed adult subjects: a right hemisphere lesion (RHL) group, a left hemisphere lesion (LHL) group, and a neurologically normal (NN) control group. Both the LHL and RHL groups produced poorer scores than the NN group on six of the seven tests. On two of the six significant tests, the RHL performed more poorly than the NN group. Analyses of words uttered during an oral story telling test indicated that the RHL group told significantly fewer complete stories using significantly more nouns, adjectives, and conjunctions than the NN group. On a 7-point scale, three judges rated the overall communication abilities of the RHL group as having “mild problems,” a significantly different rating than the ratings of the LHL and NN groups. The findings suggest that underlying visual spatial and perceptual deficits may be accompanied by clearly recognizable language differences in certain subjects.     

The role of perceptual laws in the Rorschach test

The purpose of this study is twofold: to ascertain the perceptual deficits in schizophrenic subjects and to test the assumption that the Rorschach is mainly a perceptual task. Forty-eight subjects participated in the study, distributed in six groups of eight subjects each: normals, affective disorders, and four groups of schizophrenics (chronic paranoid, chronic nonparanoid, acute paranoid, and acute nonparanoid). They were given a perceptual test developed by Fernández-Trespalacios, Bermudez, and Luna (1979). Contrary to previous findings, no differences in the perceptual test were found among the groups. In the second part of the study, a group of schizophrenic subjects was given the Rorschach and the perceptual test in a balanced order. Subsequently, subjects in the experimental group were trained in the perceptual laws they had failed. Comparison of the Rorschach protocols obtained before and after this training failed to show any significant differences in the expected direction, thus questioning the perceptual nature of this test. Interestingly, an increase in negative categories of the Rorschach subsequent to the perceptual training was observed.     

Effect of effort on resistance to extinction of the bar-pressing response

This study was designed to obtain more information on the relation between effort and resistance to extinction when all subjects receive equal acquisition experience on each effort level at which the response is subsequently to be extinguished. Twenty-four subjects were given 120 reinforcements on each of three weighted bars of 5, 40 and 70 gm. They were then ordered into three groups, each extinguished on one effort level. Analysis of the number of responses emitted in six daily 20-min. extinction sessions showed that resistance to extinction was not related to the amount of effort expended in extinction.     

Musical creativity and suicide

The different abilities involved in artistic creativity may be mirrored by differences among mental disorders prevalent in each artistic profession, taking poets, painters, and composers as examples. Using suicide rates as a proxy for the prevalence of mental disorders in groups of artists, we investigated the percentage of deaths by suicide in a sample of 4,564 eminent artists who died in the 19th and 20th centuries. Of the sample, 2,259 were primarily involved in activities of a linguistic nature, e.g., poets and writers; 834 were primarily visual artists, such as painters and sculptors; and 1,471 were musicians (composers and instrumentalists). There were 63 suicides in the sample (1.3% of total deaths). Musicians as a group had lower suicide rates than literary and visual artists. Beyond socioeconomic reasons, which might favour interpretations based on effects of health selection, the lower rate of suicides among musicians may reflect some protective effect arising from music.