Seasonality of suicide in eastern Europe: a comment on "Evidence for lack of change in seasonality of & suicide from Timis County,Romania"

The seasonality of suicide in Hungary declined from the 1980s to the 1990s, contradicting the recent conclusion of Voracek, et al.     

Use of statistical techniques in studies of suicide seasonality, 1970 to 1997

The effect of seasons on suicides has been suggested repeatedly. In order to reveal a true seasonal pattern, an appropriate statistical technique, which is sensitive to a specific type of cyclic variation in the data, must be chosen. This study is a review of the use of statistical techniques for seasonality and of some important characteristics of study samples that were evaluated from 46 original suicide seasonality articles published in major psychiatric journals. The results showed that statistical techniques were applied in a majority of articles, but they were commonly lacking regarding analyses, which compared seasonal patterns among subgroups of a population. In recent studies more sophisticated statistical techniques were utilized for seasonality, like spectral analyses, as compared with earlier studies, in which the emphasis was on chi-square tests. Lack of reporting essential features of the data, such as the sample size and monthly values of suicides, were frequent. The calendar effect was adjusted only in 11 studies. Some recommendations concerning the methodological and reporting issues are summarized for future articles on the seasonal affect on suicides.     

Tobacco and alcohol tax relationships with suicide in Switzerland

Previous research has shown an empirical link between tobacco and alcohol use and suicide. If tobacco and alcohol use contribute to suicidal behaviors, then policies designed to reduce the tobacco and alcohol consumption may succeed in reducing suicides as well. To test this hypothesis, correlations for suicide rates with alcohol consumption, taxes on alcohol and tobacco in Switzerland were examined using sets of time-series data from Switzerland in 1965-1994. The tax on tobacco correlated significantly negatively with male standardized suicide rate. The tax on alcohol also correlated significantly with male standardized suicide rate in an autoregressive model. On the other hand, significant relationships with female suicide rate were not found. Policies designed to reduce tobacco consumption are consistent with a benefit of reducing suicides, particularly for men in this sample.     

Certification change versus actual behavior change in teenage suicide rates, 1955-1979

National data on firearm suicides and accidental firearm deaths for persons aged 15-19 from 1955 to 1979 were examined to test hypotheses of increases in reported suicide rates as resulting from (1) improved accuracy in the determination and certification of suicide in equivocal firearm deaths; (2) actual increases in the rate of firearm suicides among teens; or (3) some combination of these factors. Data presented support the hypothesis of certification changes as the primary factor influencing suicide rates during the first 12-year segment, but suggest a period of actual growth combined with continued certification change from 1967 to 1979.     

Historical change, cultural learning, and cognitive representation in Zinacantec Maya children

Against the background of an unchanging sequence of representational development, we demonstrate that implicit processes of learning and cognition can change from one historical period to another. One generation of Zinacantec Maya children was studied in 1969 and 1970, the next generation in 1991 and 1993. In the intervening two decades, the community, located in Chiapas, Mexico, was involved in a transition from an economy based primarily on subsistence and agriculture to an economy based primarily on money and commerce. A naturalistic study of weaving apprenticeship and an experimental study of visual representation showed that the ecological transition was linked to greater emphasis on independent cultural learning, abstract representation, and innovation, and, correlatively, a movement away from scaffolded guidance, detail-oriented representation, and imitative representational strategies. These changes constituted automatic adaptations with an implicit nature. In addition, historical variability in implicit modes of cultural apprenticeship predicted shifts in implicit processes of child and adolescent cognition. In sum, socialization and development are not fixed but adapt, in a coordinated way, to changing ecological conditions.     

Depression, suicide, and suicide prevention in schizophrenia

Suicide is the single largest cause of premature death among individuals with schizophrenia. Furthermore, epidemiological data indicate that nearly 80% of patients with the diagnosis of schizophrenia will experience a major depressive episode at some time during their lifetime. This report reviews recent findings relative to the risk of suicide in schizophrenia, including data from the Chestnut Lodge longitudinal study of schizophrenia subtypes and symptom domains. Paradoxically, those patients with schizophrenia who are most likely to recover or experience a good outcome are also those at greatest risk for suicide. The reduction of morbidity and mortality in schizophrenia should include depression and suicidality as targets for both psychopharmacological and psychosocial treatment.     

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.     

Contribution of imitative suicide to the suicide rate in prisons

Suicide rates in prisons are high. Our aim was to investigate the contribution of imitative suicide to the prison suicide rate. We used Knox tests for space-time clustering in a case register of natural and self-inflicted deaths in prisons in England and Wales and model simulations to estimate the effect size. We found significant space-time clustering among 657 self-inflicted deaths in 90 prisons over 10 years but no space-time clustering among 430 deaths from natural causes in 87 prisons over this period. Model simulations with an imitation rate of 5.8% (CI 1%-11%) reproduced the observed space-time clustering.     

National differences in intelligence and population rates of suicidal ideation, suicide plans, and attempted suicide

Population rates of suicidal ideation, suicide plans or attempted suicide from three independent multinational epidemiological surveys (the WHO/EURO and WHO SUPRE-MISS studies and a third one) were not significantly associated with national IQ figures. This result conflicts with previous evidence from cross-national studies (by Lester and by Voracek) of a positive ecological correlation between level of national intelligence and rates of completed suicide. Across nations, the indicators for the prevalence of suicidal behavior also lacked close correspondence with suicide rates, which may be due to the higher unreliability of assessing covert suicidal behavior (suicide ideas, thoughts, plans, and, to a lesser extent, also suicide attempts) as compared to suicidal behavior that is indisputably overt (completed suicide). Several alternative explanations for the current nil findings are also discussed.     

Counseling in Switzerland: Past,Present, and Future

The authors review counseling in Switzerland and compare it with counseling in the United States. They evaluate the role of professional associations and programs and argue that the evolution of counseling is situated within the history and economic, social, and political systems of Switzerland. Findings suggest that Swiss counselors are ready to reach out, evolve, and learn from mental health professionals around the world and to adopt best practices so as to work with those in need.     

Assessing the effects of peer suicide on youth suicide

Using data from all waves of the National Longitudinal Survey of Adolescent Health, we investigated the short-term and long-term impact of an adolescent friend's suicide on an adolescent's depression and suicidality. Results suggest that a friend's suicide is associated with heightened suicide thoughts and attempts and greater depression during the first year after loss. Six years later, analyses show concurrent behaviors most relevant to explain suicidality fluctuations. Findings suggest the importance of therapeutic availability, especially during the first year, for those losing a friend to suicide.     

Death, suicide and the older adult.

Elderly people who are at high risk for suicide often have characteristics that are associated with reduced opportunity or inclination to communicate (e.g., male, living alone, residing in a low-income transient urban area, suffering from a depressive state). This paper attempts to provide converging perspectives on death and suicide from the standpoints of both the external observer and the elderly person. An interpretation of the statistical pattern is followed by a critique of current policy proposals for limiting society's response to the needs of vulnerable people on the basis of a "natural life span." Studies of elderly people themselves reveal a great diversity of attitudes toward death that is not well served by generalizations and stereotypes. However, it appears that stressful conditions of life arouse more anxiety among older people than does the prospect of death.     

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.     

Method choice, intent, and gender in completed suicide

Women who commit suicide use less violent methods, such as drugs and carbon monoxide poisoning, than do men, who more often use violent methods such as guns and hanging. Theories that attempt to explain this finding focus on gender differences in suicidal intent, socialization, emotions, interpersonal relationships, orientation and access to methods, and neurobiological factors. Data from a psychological autopsy study were used to test the theory that women who commit suicide use less violent means because they are less intent on dying. Although women were significantly less likely to use a violent method than men, there was no difference in the lethality of their suicidal intent.     

Epistemology, the History of Epistemology, Historical Epistemology

A brief discussion of the ways in which awareness of and sensitivity to the history of philosophy can contribute to epistemology even if epistemology is understood as a distinctively philosophical and not primarily historical enterprise.     

Predicting the suicide attempts of lesbian, gay, and bisexual youth

In this study predictors of serious suicide attempts among lesbian, gay, and bisexual (LGB) youth were examined. Three groups were compared: youth who reported no attempts, youth who reported attempts unrelated to their sexual orientation, and youth whose attempts were considered related to their sexual orientation. About one third of respondents reported at least one suicide attempt; however, only half of the attempts were judged serious based on potential lethality. About half of all attempts were related to youths' sexual orientation. Factors that differentiated youth reporting suicide attempts and those not reporting attempts were greater childhood parental psychological abuse and more childhood gender-atypical behavior. Gay-related suicide attempts were associated with identifiability as LGB, especially by parents. Early openness about sexual orientation, being considered gender atypical in childhood by parents, and parental efforts to discourage gender atypical behavior were associated with gay-related suicide attempts, especially for males. Assessment of past parental psychological abuse, parental reactions to childhood gender atypical behavior, youths' openness about sexual orientation with family members, and lifetime gay-related verbal abuse can assist in the prediction of suicide attempts in this population.