An Integrative Suicide Prevention Program for Visitor Charcoal Burning Suicide and Suicide Pact

An integrative suicide prevention program was implemented to tackle an outbreak of visitor charcoal burning suicides in Cheung Chau, an island in Hong Kong, in 2002. This study evaluated the effectiveness of the program. The numbers of visitor suicides reduced from 37 deaths in the 51 months prior to program implementation to 6 deaths in the 42 months post‐implementation period. The number of visitor suicide pacts decreased from 7 pacts (15 individuals) to 1 pact (2 individuals). No statistically significant differences in the numbers of visitor suicide attempts and resident suicides were observed in the two time periods. No statistically significant changes in visitor suicides during the study period were observed on the comparison islands. The consistency and timing of reduction in visitor suicides correlated with the development and delivery of the integrative program on the intervention island, suggesting a causal association between program delivery and reduction of visitor suicides. The possibility of displacement seems small because there was no increase in visitor suicides on the comparison islands during the study period. This integrative approach in preventing target‐specific suicides may serve as an example for other communities to develop suicide prevention programs that make use of the existing local resources.     

Amount of newspaper coverage of high school athletics for boys and girls on sports page and newspaper circulation

This study analyzed the amount of coverage for high school athletics in 43 newspapers with small circulation by devoting 40% of their interscholastic athletics coverage to girls in athletics, printed significantly more articles about girls' athletics than did the newspapers with medium (33%) or large (32%) circulation. Therefore, the smaller the newspaper circulation, the more equitable the coverage of athletics for girls and boys. This finding was consistent with some prior work but not all.     

Temperamental Vulnerability and Suicide Risk After Attempted Suicide

The aim was to extend recent findings of suggested temperamental features in attempted suicide and to explore possible domains of vulnerability to suicide risk after attempted suicide. Fifty-four psychiatric inpatients hospitalized after a suicide attempt underwent lumbar puncture for analysis of CSF 5-HIAA concentration and also completed the Karolinska Scales of Personality (KSP) before discharge from the hospital. Suicide attempters scored high on Somatic Anxiety, Psychic Anxiety, and Muscular Tension, and low on Socialization, findings that support recent findings in suicide attempters followed up after an emergency room visit. Five patients committed early suicide, i.e., within 3 years, and the overall long-term suicide mortality after attempted suicide was 13%. There were significant correlations between survival time among early suicides and CSF 5-HIAA (r = .87;p = .054), and the following KSP scale t scores: Somatic Anxiety (r = ?.96;p < .05), Impulsivity (r = ?.88; p < .05), and Socialization (r = .90; p < .05). KSP Socialization showed correlations with CSF 5-HIAA (r = .89; p = .046) among the early suicides. Features of temperamental vulnerability to suicide risk after attempted suicide might involve anxiety proneness, impulsivity, low socialization, and low CSF 5-HIAA.     

Dreams and Suicide

The dreams of suicidal patients are contrasted to those of nonsuicidal, depressed patients. The dreams of suicidal patients often reveal wishes for revenge, punishment, reunion, fusion, and rebirth. Confusions between the patient's body and that of others are suggested by the dreams of some suicidal patients. Dreams in suicidal individuals may portray disintegration of the self (self-state dreams). The phenomenon of transparency in suicidal dreams is discussed as it pertains to Rorschach studies.     

Religion and Suicide

Religion impacts suicidality. One’s degree of religiosity can potentially serve as a protective factor against suicidal behavior. To accurately assess risk of suicide, it is imperative to understand the role of religion in suicidality. PsycINFO and MEDLINE databases were searched for published articles on religion and suicide between 1980 and 2008. Epidemiological data on suicidality across four religions, and the influence of religion on suicidality are presented. Practice guidelines are presented for incorporating religiosity into suicide risk assessment. Suicide rates and risk and protective factors for suicide vary across religions. It is essential to assess for degree of religious commitment and involvement to accurately identify suicide risk.     

Suicide and Youth

The problem of suicide among young people is increasing at phenomenal rates. More young people die by suicide than from cancer and heart ailments combined. More than 4,000 young suicides are recorded each year, but no one knows how many suicide attempts fail. This article examines the problem of adolescent suicide and suicide attempts in relation to cultural factors, sex differences, and probable causes. Case studies help to identify symptomatic behavior. The importance of parents, teachers, and counselors in becoming alert to conflict and stress situations in youths is delineated. Community and school responsibility for leading youth to self-understanding and self-direction is crucial, and the article suggests several means of prevention through mental health and moral responsibility.     

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.     

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.     

Correlates of Suicide Stigma and Suicide Literacy in the Community

Public knowledge and attitudes toward suicide may influence help‐seeking for suicidality. This study aimed to identify correlates of suicide attitudes and knowledge. Australian adults were invited to complete an online survey, with 1,286 responders. Less exposure to suicide, older age, male gender, less education, and culturally diverse backgrounds were associated with poorer knowledge; while younger age, male gender, and culturally diverse backgrounds were associated with more stigmatizing attitudes toward people who die by suicide. The results suggest suicide literacy and stigma reduction programs would benefit community members, particularly males and individuals from culturally diverse backgrounds.     

War and Suicide*

ABSTRACT: The suicide rate generally appears to decline during the time of war. The traditional psychodynamic explanation that this decrease results from the legitimization of outward aggression is questioned. World War II evidence from both occupied and neutral countries, together with fluctuations of the suicide rates among the Scandinavian countries, are better understood as reflecting the social conditions of wartime, rather than the presence of actual fighting. These data, and others, point to the hypothesis that the decreased suicide rate during wartime is tied to the greater social integration–increased patriotism, ease of promotions, greater sense of purpose, and so forth–resulting from a state of war.     

Suicide and Infantile Fixations

ABSTRACT: Infantile fixations upon primary parental figures and relationships is one of several features central to the suicidal situation. The association of infantile fixations to suicidal behavior relates not only to their presence or degree but to their traumatic quality and to the occurrence of patterns of relationship with others who are similarly fixated. Other significant features of such infantile fixations are their rigid and repetitive character. Case illustrations highlight both the infantile fixation phenomenon and efforts to change by forming new or different attachments, and the conflict between the two. Lastly, implications for psychotherapy include the needs to reduce anxiety and self hatred associated with infantile ties; to provide a temporary regression as a first step towards transformation of fixation and mastery; and to accept, rather than to attack, the suicidal patient's infantile attachments and patterns.