Suicide epidemics and newspaper reporting

This paper looks at the relationship between suicide-related newspaper reports and a subway-suicide epidemic. More reports were published during the epidemic, without statistically significant differences between epidemic and nonepidemic years. There did not appear to be an excess of reports antecedent to the suicide. The role of newspapers is discussed with particular reference to suicide epidemics. The need for studies of content of newspaper items related to self-harm is emphasized.     

Correlates of Suicidal Ideation in Physically Injured Trauma Survivors

Epidemiologic studies have documented that injury survivors are at increased risk for suicide. We evaluated 206 trauma survivors to examine demographic, clinical, and injury characteristics associated with suicidal ideation during hospitalization and across 1 year. Results indicate that mental health functioning, depression symptoms, and history of mental health services were associated with suicidal ideation in the hospital; being a parent was a protective factor. Pre‐injury posttraumatic stress disorder symptoms, assaultive injury mechanism, injury‐related legal proceedings, and physical pain were significantly associated with suicidal ideation across 1 year. Readily identifiable risk factors early after traumatic injury may inform hospital‐based screening and intervention procedures.     

Gender in Spanish Daily Newspapers

The purpose of this study was to examine the portrayal of women and men in a Spanish daily newspaper and to find whether there were gender differences among the authors of the articles in said newspaper. A content analysis was conducted of 4,060 articles and advertisements from 24 issues of a randomly selected, large-circulation, Spanish newspaper. Men were found to be more commonly featured in the articles, photographs, and advertisements than women, and they would usually be soldiers, athletes or high-rank businessmen much more often than women were. Furthermore, we determined that the reporters writing the articles were more likely to be men than women. And, in addition, men were more likely to be cited as sources than women.     

Gender Differences in Nonfatal Suicidal Behavior in Pakistan: Significance of Sociocultural Factors

Suicidal behavior is an understudied subject in Pakistan. A variety of social, legal, and religious factors make reporting and data collection on suicide and nonfatal suicidal behavior difficult. To study the problem, a retrospective case-note analysis was carried out in which the sociodemographic and clinical characteristics of 262 female and 185 male suicidal individuals admitted to a university hospital in Karachi, Pakistan, are compared. Three quarters of the suicidal persons were under the age of 30 years. Compared to men, women were younger and more often married. Both women and men tended to use self-poisoning with benzodiazepines, but more women used organophosphate insecticides. In Pakistani society, legal, social, and economic discrimination predisposes women to psychological distress and subsequent suicidal behavior. The study highlights the need for culture-specific research on suicidal behavior in Pakistan.     

It Was Here a Minute Ago—An Elder's Lament

The story of the violence in Los Angeles, that was published in newspapers and visible on TV worldwide, was a horrifying spectacle that needs no retelling. A few facts will suffice: During the three days of disorder, 45 people died, 2,380 people were injured, and 9,500 were arrested. It was the most deadly civil disturbance in the United States in the 20th century. Rage was not limited to the poor and poverty stricken, but was felt throughout the entire African American community. Contrary to the initial television and newspaper reports, the first outbursts of anger occurred not in the poorest parts of black Los Angeles, but in some of its most stable, middle class black neighborhoods where a large percentage of homes are owned by their occupants. Also, it needs to be said that the looters and arsonists who acted out the anger and frustration of the black community were multi racial and a very small proportion of the effected population.     

Suicide coverage in U.S. newspapers following the publication of the media guidelines

A nationally representative sample of 968 local and national newspapers was examined to determine whether the 2001 U.S. media guidelines were followed in articles published in 2002-2003, and featuring individual cases of suicidal behavior (N = 157). We found that, during this period of time, U.S. newspaper suicide coverage did not consistently reflect the influence of the media guidelines. On the positive side, only 19% of stories included inappropriate imagery. On the negative side, suicide stories often detailed suicide method (56% of stories) and location (58%), and rarely provided information about warning signs and risk factors (1%), the roles of depression (4%) and alcohol (2%), and prevention resources (6%). Our findings, together with previous evidence, suggest the need for sustained dialogue with the media about suicide reporting.     

The Emergence of Suicidal Ideation During the Post‐Hospital Treatment of Depressed Patients

There is a paucity of research on the emergence of suicidal ideation in recently hospitalized patients undergoing treatment for depression. As part of a larger clinical trial, patients (N = 103) with major depression without suicidal ideation at hospital discharge were followed for up to 6 months while receiving study‐related outpatient treatments. Fifty‐five percent reported the emergence of suicidal ideation during the outpatient period, with the vast majority (79%) exhibiting this problem within the first 2 months post‐discharge. Seventy percent of those reporting severe suicidality prior to hospitalization exhibited a reemergence of suicidal ideation post‐discharge. However, 29% without significant suicidality at the index hospitalization later developed suicidal ideation during the outpatient treatment period. A faster time to the emergence of suicidal ideation was predicted by both higher prehospitalization levels of suicidal ideation as well as greater depression severity at hospital discharge. Overall, rates of emergent suicidal ideation found in the current sample of recently hospitalized patients were higher than those reported in previous outpatient samples.     

Childhood Maltreatment,Emotional Response Inhibition,and Suicide in Psychiatric Inpatients

Childhood abuse and/or neglect adversely influences development of neurocognitive systems that regulate affect and behavior. Poor inhibitory control over emotional reactions is thus one potential pathway from maltreatment to suicide. Adult psychiatric inpatients completed the Childhood Trauma Questionnaire and an emotional stop-signal task indexing negative emotional action termination (NEAT): the ability to inhibit ongoing motor reactions to aversive stimuli triggered by negative affect. Clinical interviews assessed suicidal thoughts and behaviors during hospitalization (n = 131) and at follow-up assessments 6 months later (n = 87). Our primary aim was to examine whether maltreatment history and NEAT explain overlapping variance in suicidal behaviors (1) retrospectively and (2) 6 months following hospital discharge. Contrary to prediction, childhood maltreatment was unrelated to history of suicidal behaviors. However, NEAT was consistently associated with prior suicidal acts, even controlling for suicidal ideation and demographic covariates. NEAT similarly contributed to the prediction of post-discharge suicidal behaviors, whereas we found no effect of maltreatment history. The present study suggests that NEAT captures suicide risk independently of childhood maltreatment. Results implicated NEAT impairment specifically, rather than broader response inhibition deficits (e.g., to positive stimuli), in past and future suicidal behaviors. These findings provide preliminary support for NEAT as a behavioral vulnerability marker for suicide, with implications for understanding links between maltreatment history and suicidal acts.     

Nonsuicidal physically self-damaging acts in adolescents

To determine the frequency and correlates of nonsuicidal physically self-damaging acts in 12–14 year olds, a two stage epidemiologic survey with a self-administered questionnaire (N=3283) followed by a psychiatric interview of a subsample of the adolescents and their parents (N=444) was used. Prevalence estimates of interview validated nonsuicidal physically self-damaging acts were 2.46% in males and 2.79% in females. Significant relationships were found between nonsuicidal physically self-damaging acts and suicidal ideation, major depression and undesirable life events. Data suggest that physically self-damaging acts occur at substantial rates during early adolescence. The strong correlation between nonsuicidal self-destructive acts and both suicidal ideation and major depression clarifies prior conflicting reports in the literature and suggests that a history of self-damaging acts should be taken into consideration when evaluating for possible depression and suicide risk.     

The correlates and consequences of newspaper reports of research on sex differences

Correlates and consequences of newspaper accounts of research on sex differences were examined. In Study 1, articles from high-circulation newspapers were coded for the degree to which biological factors were used to explain sex differences. Results showed that political conservatism and traditional attitudes toward gender roles coded from other newspaper sections predicted greater use of biological explanations than did political liberalism and less traditional attitudes toward gender roles. In Studies 2 and 3, participants read a fictional newspaper article reporting research on a gender difference that cited either biological or sociocultural factors as explaining the difference. Results showed that exposure to biological explanations significantly increased participants' endorsement of gender stereotypes. Moreover, exposure to social explanations significantly increased participants' belief in the mutability of human behavior. Together, these studies show that political ideology influences how the popular press reports research findings and that such reporting in turn affects readers' beliefs and attitudes.     

the media's portrayal of urban and rural school violence: a preliminary analysis

Although the juvenile arrest rate has declined in the last few years, public awareness of juvenile crime has not diminished (Snyder 1996; Schiraldi 1998). The recent rash of rural school shootings has, in fact, heightened public awareness of juvenile crime and delinquent behavior. This research examines acts of school violence that have been committed by juveniles in three rural school districts and analyzes how the newspaper media present these acts relative to similar acts committed by juveniles in urban school settings. Our content analysis of the Wall Street Journal, Louisville Courier Journal, New York Times, St. Louis Post Dispatch, Los Angeles Times, and Washington Post reveals that these newspapers present school violence in these two settings very differently and that these differences are reflected in the way the political system reacts to such incidents.     

A Career Plundered

Dr. Margaret Bean-Bayog, a Boston psychiatrist, was sued by the Lozano family after a former patient, Paul Lozano, committed suicide. The case was widely and sensationally publicized in the newspapers and other media. A combination of inaccurate reporting, inept proceedings by the Massachusetts Board of Registration in Medicine, and the threat of ruinous legal fees led Dr. Bean-Bayog to surrender her license to practice medicine. Facts that were not reported in the press were described in Dr. Maltsberger's address, delivered on April 15, 1992, at the annual AAS meeting in San Francisco. The implications for therapists attempting to treat seriously suicidal patients in the current hostile forensic climate were further discussed. The text of the address is presented here.     

Experiential Research

ABSTRACT: This paper reports a research project that has focused on the inner experience of suicidal depression and its relationship to the social milieu. Adopting a suicidal identity, a clinical anthropologist lived in a psychiatric hospital, and then, along with a clinical psychologist, in several posthospital care facilities for periods from two weeks to a month in each setting. The evidence indicates the researchers were able to establish identities closely resembling those of genuinely suicidal persons. Their experiential accounts along with their observations of the social settings in which they lived provide the core material for analysis. Additional data from hospital records and posttreatment meetings with staff members and fellow patients supplemented the researchers' observations. Data are presented on social situational variables that support and/or undermine feelings of self-worth, the social presentation of a suicidal self, and introspective accounts of suicidal “world views” and styles of thinking. Suggestions are made for suicide prevention in institutional settings on the basis of life-supporting relationships and appropriately designed social-structural features.     

Recommending Interventions for a Borderline Personality Disorder Patient

Borderline personality disorder (BPD) is a severe personality disorder leading to unstable emotional state, impulsivity, disturbed relationships and personal distress. This paper suggests a 12-step intervention plan including Dialectical Behavior Therapy (DBT) to Mr. X, a 21 year old male psychiatric inpatient having BPD, to promote his mental health. Therapy could not be conducted as the patient dropped out of treatment and got himself discharged from the hospital. This paper outlines implications for treatment on the basis of the clinical presentation of Mr. X. Mr. X presents himself with the BPD features showing suicidal tendencies, substance abuse and disturbed emotions. In depth interview of the patient showed extreme emotional disturbance and difficulty in controlling emotions and suicidal ideations. He was admitted at the Nur Manzil Psychiatric Centre, Lucknow, India and was kept under close observation because of being obsessed with suicidal thoughts; he also tried to kill himself. The DBT skills training and problem solving approach along with contingency management and behavioral chain analysis are suggested according to the clinical profile of Mr. X in order to reduce his self mutilating acts and substance abuse. Thus a general feeling of personal well being can be achieved thereby reducing personal distress.     

Missed Opportunities: Newspaper Reports of Domestic Violence

News coverage can influence public views of important health problems, including domestic violence (DV). To understand how newspaper reports frame DV, this study examined 187 articles published across a single state over a one-year period. Coded variables included characteristics of the newspapers and articles; incident details; common DV themes (e.g., victim blame; DV as isolated or rare); and education, resources, and community context. Approximately one-third of articles framed DV using themes that might misinform the public about DV (e.g., victim blame). The majority of articles missed opportunities to provide educational information or resources about DV and failed to situate DV in a community context. These findings point to missed opportunities for newspapers to provide comprehensive information and resources to the public.     

Follow‐up with Callers to the National Suicide Prevention Lifeline: Evaluation of Callers’ Perceptions of Care

Continuity of care for suicidal individuals engaged with a variety of health and mental health care systems has become a national priority, and crisis hotlines are increasingly playing a part in the risk management and continuum of care for these individuals. The current study evaluated a national initiative to have crisis centers in the National Suicide Prevention Lifeline network provide follow‐up care to suicidal callers. Data were obtained from 550 callers followed by 41 crisis counselors from 6 centers. Two main data sources provided the information for the current study: a self‐report counselor questionnaire on the follow‐up activities completed on each clinical follow‐up call and a telephone interview with follow‐up clients, providing data on their perceptions of the follow‐up intervention's effectiveness. The majority of interviewed follow‐up clients reported that the intervention stopped them from killing themselves (79.6%) and kept them safe (90.6%). Counselor activities, such as discussing distractors, social contacts to call for help, and reasons for dying, and individual factors, such as baseline suicide risk, were associated with callers’ perceptions of the impact of the intervention on their suicide risk. Our findings provide evidence that follow‐up calls to suicidal individuals can reduce the perceived risk of future suicidal behavior.     

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.