Temporal Trends and Geographic Patterns of Teen Suicide in Alaska, 1979–1993

The author analyzed death certificate and U.S. census data to document trends in suicide rates among Alaskans 14–19 years of age. During 1979–1993, Alaskan teenagers had a suicide rate of 31.5 per 100,000 persons per year. Suicide rates varied up to sixfold by race, gender, and local census area of residence; in particular, Alaska Native males had one of the highest documented suicide rates in the world. Suicide rates increased two- to threefold during the study period for persons less than 18 years of age, while remaining stable for older teenagers. Within census areas, suicide rates correlated inversely with the percentage of all households headed by a married couple.     

Adolescent Development and Youth Suicide

The adolescent years, being a period of unique developmental changes, are of great interest in understanding suicidal behavior. The occurrence of completed suicide by age in 1-year age groups in adolescence and young adulthood was studied via official Finnish mortality statistics and the population statistics. Suicide rates increased sharply by age during adolescence, starting somewhat earlier among boys than among girls. During the periods of rapidly rising and high suicide rates in the 1970s and 1980s among boys, the increase in suicide rates started at a younger age than during a spell of lower rates in the 1960s.     

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.     

Prison suicides in Austria, 1975-1997

Suicide prevention in custody is hampered by the lack of funds and professional staff. In order to evaluate the prison suicide phenomenon, a study was conducted evaluating all suicides that occurred in Austrian prisons between 1975 and 1997 (n = 220). In addition to evaluating the number of male versus female suicides, the preferred suicide methods were studied, as well as suicide risk of different circumstances of custody. Suicide rates of distinguishable, important subgroups of prisoners were calculated. The suicide rate for prisoners on remand was 236.0 per 100,000, and for offenders classified as mentally ill it was 205.4 per 100,000. That is about 8 times higher than the suicide rate in Austria's general population (1975-1997: 24.6 per 100,000). The suicide rate for sentenced offenders was 81.3 per 100,000, about twice the suicide rate in Austria's general male population. We recommend that psychologists or psychiatrists concentrate on the suicide prevention of high-risk offenders after screening the newly admitted offenders for their propensity to suicide.     

Questions of culture,age and gender in the epidemiology of suicide

Cultural values were examined as predictors of suicide incidence rates compiled for men and women in six age groups for 33 nations for the years 1965, 1970, 1975, 1980, and 1985. Hofstede's cultural values of Power-Distance, Uncertainty Avoidance, and Masculinity (i.e., social indifference) were negative correlates of reported suicide, and Individualism was a strong positive correlate. The proportion of variance in suicide reports generally related to these four cultural values was R2 = 0.25. Suicide by women and by middle-aged people was most related to cultural values, even though international variance in suicide is greater for men and for the elderly. Suicide incidence for girls and young women showed unique negative correlations with Individualism. For all age groups, Individualism predicted a greater preponderance of male suicides, and Power-Distance predicted more similar male and female suicide rates. Social alienation and Gilligan's feminist theory of moral judgment were hypothesized to explain some gender differences.     

Social and psychiatric influences on urban-rural differentials in Australian suicide

The purpose of this study was to investigate urban-rural differentials in Australian suicide rates, and to examine influences that previously have remained largely speculative. Suicide rates for males (all ages and young adults) were significantly higher in rural areas compared to urban areas. Urban-rural suicide rate differences in males were rendered nonsignificant after adjustment for migrant and area socioeconomic status. Adjusting for mental disorder prevalence, in addition to migrant status, reduced the excess suicide risk in rural areas; the excess was reduced further with addition of mental health service utilization. The implications of this study are that socioeconomic circumstances in rural populations contribute to higher male suicide rates compared to urban areas, but these conditions may be partly mediated by mental disorder prevalence and mental health service utilization.     

Elevated suicide rates at high altitude: sociodemographic and health issues may be to blame

Suicide rates are higher at high altitudes; some hypothesize that hypoxia is the cause. We examined 8,871 suicides recorded in 2006 in 15 states by the National Violent Death Reporting System, with the victim's home county altitude determined from the National Elevation Dataset through FIPS code matching. We grouped cases by altitude (low<1000m; middle=1000-1999m; high≥2000m). Of reported suicides, 5% were at high and 83% at low altitude, but unadjusted suicide rates per 100,000 population were higher at high (17.7) than at low (5.7) altitude. High and low altitude victims differed with respect to race, ethnicity, rural residence, intoxication, depressed mood preceding the suicide, firearm use and recent financial, job, legal, or interpersonal problems. Even after multivariate adjustment, there were significant differences in personal, mental health, and suicide characteristics among altitude groups. Compared to low altitude victims, high altitude victims had higher odds of having family or friends report of a depressed mood preceding the suicide (OR 1.78; 95%CI:1.46-2.17) and having a crisis within 2weeks before death (OR 2.00; 95%CI:1.63-1.46). Suicide victims at high and low altitudes differ significantly by multiple demographic, psychiatric, and suicide characteristics; these factors, rather than hypoxia or altitude itself, may explain increased suicide rates at high altitude.     

Suicide among American Indian adolescents: an overview

Suicide has become a major concern of many Indian tribes and pueblos, as the rates in these tribes have increased dramatically in the last decade. One of the critical research questions is how to explain the vastly different rates of adolescent suicide among tribes. Research has identified some common patterns in experience and behavior among Indian adolescent suicides; these patterns are similar in many ways to those found in Los Angeles suicide research of Teicher (1979). Chronic versus acute stress factors in suicide are examined. Recent research has also identified a number of factors characterizing tribes with high suicide rates; these include failure to adhere to traditional ways of living, to traditional religion, and to clans and societies, and the resulting chaotic family structure and adult alcoholism. The roles of adoption of Indian children, boarding schools, and high unemployment in many tribes are also discussed. Suicide prevention and intervention programs are briefly described.     

The Big Ten Student Suicide Study: A 10-Year Study of Suicides on Midwestern University Campuses

The Big Ten Student Suicide Study was undertaken from 1980–1990 to determine the suicide rates on Big Ten University campuses. The study design attempted to address many of the statistical and epidemiological flaws identified in previous studies of campus student suicides. The 10-year study collected demographic and correlational data on 261 suicides of registered students at 12 midwestern campuses. The largest number of suicides for both males and females were in the 20–24-year-old age group (46%), and amongst graduate students (32%). The overall student suicide rate of 7.5/100,000 is one half of the computed national suicide rate (15.0/100,000) for a matched sample by age, gender, and race. Despite the overall lower suicide rate, the analyses revealed that students 25 and over have a significantly higher risk than younger students. Although women have rates roughly half those of men throughout their undergraduate years, graduate women have rates not significantly different from their male counterparts (graduate women 9.1/100,000 and graduate men 11.6/100,000).     

Young male violent death trends in the general population during the Vietnam era.

Suicide and homicide rates significantly increased throughout the Vietnam War among young American civilian males who constituted the principal manpower pool for the war. Ironically, men who reached military age after the war were at greatest risk. Years of high combat intensity were not associated with higher suicide or homicide rates than years of low combat intensity. Suicide and homicide rates were correlated at .95, suggesting a common source of pathogenesis. No similar trend was found for motor vehicle death. Broad social forces, not the Vietnam War itself, were responsible for the changes in violent mortality trends that we observed among the birth cohorts of men in our study.     

Risk factors of attempted suicide in bipolar disorder

Suicide rates of bipolar patients are among the highest of any psychiatric disorder, and improved identification of risk factors for attempted and completed suicide translates into improved clinical outcome. Factors that may be predictive of suicidality in an exclusively bipolar population are examined. White race, family suicide history, and history of cocaine abuse were predictive of suicidal histories. Gender, nicotine use, medical comorbidity, and history of alcohol and other drug abuse were not, although a trend was noted for a history of benzodiazepine abuse. Attempts, although less common among African Americans, were equally as violent. Likewise, attempts were as violent among females as males, in distinction to general population studies.     

Changing Patterns in Methods of Suicide by Race and Sex

ABSTRACT: Suicide rates vary greatly by sex and race but the methods employed by these groups and changes in those methods have been studied neither closely nor systematically across time. In the present study annual official national statistics for specific methods of suicide by sex and racial group from 1923 to 1978 were examined. During this time period shifts were found among groups in the proportions of various suicide methods employed, most notably for women and Asian-Americans. Generally, firearm use increased among nearly all ethnic/racial-sex groups while the use of poisons declined. Although women continue to be more likely than men to kill themselves with solid and liquid poisons, in very recent years firearms have become a more common method. Among Japanese - and Chinese-Americans of both sexes the most frequently employed method has been hanging. Although this is still the case, the proportions have declined over time while the use of firearms has increased. Explanations are offered for the noted changes in method choice with particular attention being given to acculturation and changing societal roles.     

Suicide Crisis Syndrome: A review of supporting evidence for a new suicide‐specific diagnosis

Suicide is a major public health problem, and suicide rates are still on the rise. Current strategies for identifying individuals at risk for suicide, such as the use of a patient's self‐reported suicidal ideation or evidence of past suicide attempts, have not been sufficient in reducing suicide rates. Recently, research groups have been focused on determining the acute mental state preceding a suicide attempt. The development of an acute suicidal diagnosis, the Suicide Crisis Syndrome (SCS), is aimed at capturing this state to better treat individuals. The SCS has five main evidence‐based components—entrapment, affective disturbance, loss of cognitive control, hyperarousal, and social withdrawal. The SCS may provide clinicians with the ability to identify individuals who are experiencing an acute pre‐suicidal mental state, regardless of their self‐reported suicidal ideation. Future research leading to the incorporation of this diagnosis into clinical practice could improve the quality of care and reduce the personal, societal, and legal burden of suicide.     

Religious Commitment,Attitudes Toward Suicide,and Suicidal Behaviors Among College Students of Different Ethnic and Religious Groups in Malaysia

The variation in suicide patterns across ethnic groups with different religious background is a puzzling social phenomenon. This study sought to examine the impact of religious commitment and attitudes toward suicide on suicidal behaviors of college students across major ethnic and religious groups in a multicultural society of Malaysia. A total of 139 college students completed Religious Commitment Inventory-10, Attitudes Toward Suicide Scale, and Suicidal Behavior Questionnaire-Revised. Findings showed significant discrepancies in attitudes toward suicide, but not suicidal behaviors across ethnic and religious groups. Suicide acceptance significantly affected suicidal behaviors as well. Although religious commitment is not associated with suicidal behaviors, its deviation is reflected in students’ acceptance of suicide. Additionally, college students’ suicide risk, lifetime, and recent suicide ideation, as well as their likelihood of future suicide attempt can be associated with their acceptance of suicide. The influence of attitudes toward suicide and religion, therefore, should be taken into consideration while implementing suicide prevention programs as it helps shape the norms about suicide among youths.     

Suicide Among Minority Elderly: A Preliminary Investigation

ABSTRACT: In the United States, suicide has traditionally been considered a White elderly phenomenon. Suicide rates have been increasing for Nonwhites in recent years, but it is not clear how this may have affected the age distribution, particularly for specific Nonwhite groups. An investigation of official 1976 suicide statistics among minority elderly revealed that suicide rates are also highest among the old for Chinese-, Japanese- and Filipino-Americans. Among Blacks and Native Americans, however, suicide rates are extremely low for the aged. Explanations for these findings are suggested and the need for a long-term study is indicated.     

A Critical-Mass Theory of National Suicide Rates

Suicide rates in nations of the world from 1970 to 1980 were examined to see whether absolute increases were related to the size of the suicide rates. It was found that nations with higher suicide rates experienced greater increases in their suicide rates. The results are seen as supporting a “critical-mass” theory and are consistent with an explanation in terms of suggestion.     

Comparative Analysis of Suicide,Accidental, and Undetermined Cause of Death Classification

Suicide determination is not standardized across medical examiners, and many suspected suicides are later classified as accidental or undetermined. The present study investigated patterns between these three groups using a medical examiner database and 633 structured interviews with next of kin. There were similarities across all three classification groups, including rates of mental illness and psychiatric symptoms. Those classified suicide were more likely to be male, to have died in a violent fashion, and have a stronger family history of suicide. Chronic pain was very common across all three groups, but significantly higher in the accidental and undetermined groups.     

An epidemiological profile of suicides in Beijing, China

Suicide rates in the Beijing region increase with age. The rural suicide rate is about two to five times of the urban in various age-sex groups. The elderly suicide rate is very serious, especially in the rural area. The average suicide rate for the Beijing region for the period 1987-1996 was 9.8 per 100,000 (6.0 and 17.3 for urban and rural areas, respectively). A low male-to-female ratio was also observed. The female suicide rate for the 15-34 age group was higher than that of its male counterparts, which is unique in other areas of the world. These phenomena can be explained by some of the distinct cultural and economic traits of China. Also, suicides rates in the Beijing region were shown to be on a decreasing trend among the teenaged and the old-age groups. Our findings suggest that the suicide rate in China should not be as high as the estimated rate (31.0 per 100,000), suggested in the Global Health Statistics by Murray and Lopez (1996b, p. 824).     

Sex-role change, anomie and female suicide: a test of alternative Durkheimian explanations.

Durkheim's influential book, Suicide, provides general (economic) anomie, conjugal anomie, and sex-role convergence explanations of changes in suicide rates under conditions of social change. We used trend analyses of American suicide rates and female/male suicide ratios from 1950 to 1984 and the regression of the ratios on female educational attainment, white female labor force participation, white fertility rates, and divorce rates to examine these explanations. The general anomie explanation of female suicide trends is supported for the middle-aged (30 to 54 years) but not for the young (10 to 30 years) or the elderly (55 to 74 years). The conjugal anomie proposition is at best supported for age groups between 15 and 44 when general anomie is not pronounced. The role convergence explanation is rejected for all 13 5-year-age-groups. General anomie may not be a viable explanation of suicide trends for groups actively supporting relevant social changes or not yet tradition-bound or for groups whose retirement status reduces the importance of some social changes.     

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.