Near-Death Experiences and Attempted Suicide

ABSTRACT: Attempted suicide is correlated with an increase subsequent risk of committed suicide. However, preliminary data and psychodynamic hypotheses suggest that serious suicide attempts followed by transcendental near-death experiences (NDEs) may decrease rather than increase subsequent overt suicide risk, despite the NDEs’ apparent “romanticization” of death. Studies of NDEs and of their influence on suicidal ideation are proposed which may yield greater understanding of self-destructive urges and new strategies of suicide prevention.     

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.     

Punitive Reactions to Completed Crimes Versus Accidentally Uncompleted Crimes1

Previous studies have shown that the harm caused by crime affects punitive reactions even if differences in the degree of harm are merely accidental. However, it remains unclear whether the effect is direct or whether it is mediated by attributed responsibility or blame. Participants were 303 university students who listened to 4 case vignettes (between‐subjects design). Half received information about a completed crime and half about an accidentally uncompleted crime. Crime type was either fraud or rape. The results suggest that individuals consider the actual harm to a significantly greater extent than attribution theory would predict. Moreover, the link between harm and punishment was virtually not mediated by attributed blame and not moderated by individual differences in morality. Future studies should investigate whether the harm‐punishment link is a result of an automatic act of retaliation or a desire to compensate for the harm done to the victim (restorative justice).     

Suicide among Attempted Suicides

ABSTRACT: A 10-year follow-up is presented of 484 patients who made serious suicide attempts. Of this group 23% had died, 9% from natural causes, 3% from accidents or from uncertain causes, and 11% from suicide. Suicide frequency is highest in the period immediately after the suicide attempt. Especially interesting is the distribution according to sex. During the first 5 years there is a preponderance of male suicides (which is in agreement with the findings of other investigators), but after 10 years this difference in sex disappears. Suicides are found especially among men from 50 to 60 years of age, disabled pensioners, and persons who have attempted suicide several times, and to a lesser degree among persons living alone and criminals.     

The Effectiveness of Victim Resistance Strategies against Stranger Child Abduction: An Analysis of Attempted and Completed Cases

Existing research, policy information, and materials intended to teach child safety assumes that certain behaviours will protect children in the event that a stranger tries to abduct them. However, there is little empirical basis for these assumptions. This paper examines the effectiveness of strategies thought to increase the likelihood that a child will be able to resist an attempted stranger child abduction event. Seventy‐eight cases of stranger child abduction that occurred in the UK between 1988 and 2014, including 25 attempted cases and 53 completed cases, were examined in order to ascertain the relative prevalence of various resistance types and to assess their effectiveness of six key resistance strategies based on whether the presence or absence affected the outcome of the abduction. Results show that direct, unequivocal verbal resistance, running away, and a composite approach where the victim runs away, calls for help, and reports the offence were highly effective means of resisting an offender, whereas physical resistance, indirect verbal resistance, and non‐resistance were not effective. Female victims were almost twice as likely to employ any kind of resistance strategy against an offender as male victims were. The implications of these findings for augmenting ways in which children are taught about safety are discussed. Copyright © 2016 John Wiley & Sons, Ltd.     

CSF 5-HIAA Predicts Suicide Risk After Attempted Suicide

Suicide risk after attempted suicide, as predicted by cerebrospinal fluid (CSF) monoamine metabolite concentrations, was studied in a sample of 92 psychiatric mood disorder inpatients admitted shortly after attempting suicide. The potential of the serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA) in the CSF to predict suicide risk within the first year after attempted suicide was studied by means of survival analysis after median split sub-grouping. Eleven patients (12%) committed suicide within 1 year after attempted suicide. Eight of these belonged to the below-the-median (< 87 nM) CSF 5-HIAA subgroup, that is, the suicide risk was 17% as compared with 7% among those with above-the-median CSF 5-HIAA. The cumulative number of survived patient-months during the first year after attempted suicide was significantly lower in the low CSF 5-HIAA subgroup. It was concluded that low CSF 5-HIAA predicts short-range suicide risk after attempted suicide in mood disorder psychiatric inpatients. These findings lend further support to the serotonin hypothesis of suicide risk.     

The Family Therapy of Attempted Suicide

Suicidal behavior is a multidetermined act based upon a variety of factors among which family tensions and patterns of interaction predominate. Family therapy, nevertheless, is underutilized for suicidal situations because too few practitioners possess the requisite skills in both suicidology and family treatment. This paper attempts to integrate the two fields, describes some assessment procedures, and presents an account of the method of family therapy utilized by the author with suicidal persons. The basic goals of therapy are to help initiate and to catalyze a healing process that will enable the participants to accept changes in both individual and family existence; to decrease the amount of destructive family interaction; to deal with the inevitable anxiety that accompanies growth and development; to make contact with and among the family members; and to provide hope.     

Attempted Suicide: An Ethological Perspective

ABSTRACT: Attempted suicides are complex phenomena. Examination of the observed and described behavior permits an analogy to be drawn between them and the biological concept of “conservation withdrawal.” This takes cognizance of innate responses, individual differences and changing socio-cultural standards. Such a formulation more readily allows a non-judgmental approach to the patient, with acceptance of both the appeal and wish to die components. In addition, it offers a different view of the nosological debate, rendering the differences more apparent than real.     

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.     

Beyond Randomized Controlled Trials in Attempted Suicide Research

There is a lack of evidence about what is the best treatment for people who present to hospital after self harm. Most treatment trials have been small and involved unrepresentative groups of patients which result in inconclusive findings. Here we note some of the characteristics of attempted suicide which make it a difficult subject to study. We describe the problems of doing randomized controlled trials in attempted suicide and outline the advantages and difficulties of randomized controlled trials, Zelen designs, patient preference designs, and cluster randomized trials in attempted suicide intervention trials. Researchers and consumers should consider other research designs when asking what is effective after self harm.     

Attempted Suicide in a Xhosa Schizophrenia and Schizoaffective Disorder Population

Suicide risk behavior is a significant contributor to the mortality and morbidity of schizophrenia. We previously reported affected sibship status in a Xhosa schizophrenia or schizoaffective disorder sample to be protective in nature; given the counterintuitive nature of this finding, we expanded the sample size to seek further clarification. Subjects were assessed with the Diagnostic Interview for Genetic Studies and then stratified into two groups: with (n = 137) or without (n = 837) a previous suicide attempt. The presence of lifetime bizarre behavior (OR 1.5; 95%CI 1.12–1.87) or cannabis use or abuse (OR 1.2; 95%CI 10.01–1.47) was a significant predictor of suicide attempts, while a higher global alogia score (OR 0.84; 95%CI 0.74–0.96) was a protective factor. Our data seem to support that in this population, encouraging family members to report bizarre behavior and implementing dual diagnosis interventions for cannabis use or abuse could be an appropriate starting point toward developing a targeted suicide prevention program for further research.     

Suicide Ideations,Suicide Attempts,and Completed Suicide in Persons with Pathological Gambling and Their First‐Degree Relatives

We examined the relationship between suicidal ideations and attempts in 95 probands with pathological gambling (PG), 91 controls, and 1075 first‐degree relatives. The results were analyzed using logistic regression with generalized estimating equations. Thirty‐four PG probands (35.8%) and 4 controls (4.4%) had attempted suicide (OR = 12.12, p < .001); in 13 probands, the attempt occurred before PG onset. Lifetime suicidal ideations occurred in 60 PG probands (63.2%) and 12 controls (13.2%) (OR = 11.29, p < .001). Suicidality in PG probands is a marker of PG severity and is associated with greater psychiatric comorbidity. Offspring of PG probands had significantly higher rates of suicide attempts than control offspring.     

Temperament,Hopelessness, and Attempted Suicide: Direct and Indirect Effects

This study evaluated whether hopelessness mediated the relations between temperament and recent suicide attempter status in a psychiatric sample. Negative temperament and positive temperament (particularly the positive emotionality subscale) uniquely predicted levels of hopelessness. Although these temperament constructs also demonstrated significant indirect effects on recent suicide attempter status, the effects were partially (for the broad temperament scales) or fully (for the positive emotionality subscale) mediated by the levels of hopelessness. These findings indicate that a tendency to experience excessive negative emotions as well as a paucity of positive emotions may lead individuals to experience hopelessness. Although temperament may also indirectly influence suicide attempter status, hopelessness mediates these relations.     

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.     

中国自杀未遂的流行特征及影响因素研究

自杀是一个严重的社会问题和公共卫生问题。但目前尚未完全了解自杀的影响因素以及预防自杀的方法。流行病学研究表明自杀未遂是自杀的重要预测因素,了解自杀未遂的特征以及影响因素将有助于减少自杀行为的发生。本文对自杀未遂的流行特征以及影响因素进行了综述。