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).     

Gender and Suicide Method: Do Women Avoid Facial Disfiguration?

This study hypothesizes that women are less likely than men to use suicide methods that disfigure the face. Gender differences in the use of suicide methods that disfigure the face were examined using medical examiner??s files of 621 suicides covering a 10-year period from Summit County, Ohio in the U.S. Results showed that while firearms are the preferred method for both women and men, women were less likely to shoot themselves in the head. A series of logistic regression analyses revealed that gender, age, stressful life events and prior suicide attempts were predictors of methods that disfigure the face/head. Significant differences between men and women in correlates of suicide method emerged when the sample was split by gender. The results support the position that women who commit suicide are more likely than men who commit suicide to avoid facial disfiguration.     

Suicide in the army national guard: an empirical inquiry

Since 2004, suicides in the U.S. military have risen, most notably in the Army National Guard (ARNG). Data used in this study were obtained for suicides occurring from 2007 to 2010 and for a random sample of nonsuicides from the general ARNG population. Of the military-related variables considered, a few showed relationships to suicide. Rather, the primary variables associated with suicide were soldier background characteristics, including age (17-24 years), race (White), and gender (male). Cluster analysis revealed two distinct suicide groups: "careerists" (about one third of all suicides) and "first-termers" (about two thirds of all suicides), each group exhibiting different concurrent behavioral problems.     

The Werther effect and assisted suicide

In the course of a large epidemiological study in the region of Basle, Switzerland, from 1992 to 1996, a considerable rise in suicides assisted by the right-to-die society EXIT was uncovered after wide press coverage of an assisted double suicide of a prominent couple in that region in March 1995. Further investigation revealed that the rise of assisted suicides for a period of 2 years after the critical event was statistically significant compared to the 2 years previous to the double suicide. This was especially true for women older than 65 years. Hence, the almost enthusiastic kind of reporting about this event was apt to induce imitation suicides or a "Werther-effect."     

Suicide by jumping and accessibility of bridges: results from a national survey in Switzerland

Rates of suicide by jumping show large regional differences. Barriers on bridges may prevent suicides but also may lead to a substitution of jumping site or method. The aim of our study was to compare suicide data from regions with and without suicide bridges and to estimate the effects on method and site substitution if bridges were to be secured. In a national survey, suicide data for the years 1990 to 2003 were collected. Regions with high rates of bridge suicides were identified and compared with regions with low rates, and the analysis revealed that only about one third of the individuals would be expected to jump from buildings or other structures if no bridge was available. The results suggest no method substitution for women. For men, a trend of a substituting jumping by overdosing in regions without suicide bridges was found. We conclude that restricted access to suicide bridges will not automatically lead suicidal individuals to choose another jumping site or suicide method. The results support the notion that securing bridges may save lives.     

Gender and Suicide Risk: The Role of Wound Site

That males have higher suicide rates than females is one of the most empirically documented social facts in suicidology, but the reasons for this continue to be debated. For the present paper, we tested a neglected contributing factor to the gender suicide ratio: wound site or the area of the body that is wounded in firearm suicides. Males may have a higher suicide rate, in part, due to their greater likelihood than women for shooting themselves in the head as opposed to the body. This has been related to gender differences in fear of facial disfigurement and suicide intent. Data from the Wayne County Medical examiner's office regarding 807 suicides committed with firearms was analyzed. The dependent variable was dichotomous and referred to the location of the site of the wound: gunshot to the head vs. gunshot to the body. Controls for demographic covariates of suicide included age and race of the suicide victim. The results of the multivariate logistic regression analysis determined that women were 47% less apt than men to shoot themselves in the head. Further analysis determined that women were less apt than men to use shotguns and rifles in their suicides (weapons that make head shooting more awkward). The findings are consistent with the notion that women are more concerned than men with facial disfigurement, and that women have a lower desire to die than men.     

Female Suicide Rates in Ghizer,Pakistan

Suicide is an understudied subject in Pakistan. There are many social, legal, and religious sanctions against it. National rates of suicides are not known. We calculated suicide rates of women in the Ghizer District of the remote Northern Areas of Pakistan. During years 2000 to 2004, 49 women committed suicide. Taking average mean population for women for 5 years as 65,783, we calculated annual crude suicide rates for women as 14.89/100,000/year. For women over the age of 15 years, rates were 33.22/100,000/year; age‐specific rates for 15–24 years were 61.07/100,000 per year. These figures are considerably higher than suicide rates in other parts of Pakistan and may be related to high psychiatric morbidity in Pakistani women. This study underscores the need for a standardized system of registration of suicides in Pakistan. There is also urgent need to address high psychological distress in women in Pakistan.     

The Growing Use of Firearms by Suicidal Older Women, 1979–1992: A Research Note

Suicide among older women (65 +) has received very little attention despite increasing numbers of suicides in this population. An examination of national mortality data from the National Center for Health Statistics for the years 1979 through 1992 shows an increasing trend in rates of suicide among older women and a declining trend among women under 65. Over the 14-year period, firearms replaced poisoning as the most prevalent method of suicide by women 65 and over. The results seem consistent with the assertion that the availability, familiarity, and cultural acceptability of firearms may play a role in the choice of suicide method among older women. Although violent death and the use of firearms are generally associated with males in our society, the trends reported here indicate that greater attention to firearm suicides among older women is warranted.     

A Follow-up Study of 53 Suicides Known to a Suicide Prevention Center

ABSTRACT: The operation of the Cleveland Suicide Prevention Center is reviewed, and 53 known suicides during the Center's first four years of operation are discussed. A suicide rate of 288 per 100,000 suggests that persons contacting the Center represented a high suicide risk group. Of the suicides, 57 percent were women. This high proportion of females was statistically significant when compared to the smaller percentage of female suicides for Cuyahoga County, Ohio. Of the persons who committed suicide, 26 percent initiated direct contact with the Center themselves, and none recontacted the Center just prior to death. The question is raised whether contact initiated by another may in itself be suggestive of greater suicidal risk. Some of the practical problems in evaluation and referral are discussed.     

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.     

Suicide without explicit precursors: a state of secret despair?

Although it is usually assumed that all those who commit suicide give some prior indication of their intention to take their own life, there is growing evidence that a small but significant proportion of suicides occur without any clear, explicit indicators. It is proposed that these suicides share similar pathways to other suicides but that the despair involved is not expressed so clearly, often being kept secret. In order to identify such suicides and potential suicides it is helpful to have an indicator of the dominant sub‐sets of constituents that are precursors to suicide. A 14‐item Suicide Precursors Scale (SPS) was therefore developed. This was applied to 128 cases of suicide that occurred between January 1997 and December 2000 in Stockport (South Manchester, UK). A very high alpha coefficient of 0.98 supported the reliability and homogeneity of the SPS. A Multi‐Dimensional Scaling (MDS) analysis of the SPS revealed three prototypical sub‐sets of expressions of suicidal actions—illness, life circumstances, and depressive history. These are offered as coherent themes in the life of potential suicides, which may be of assistance both in determining whether an equivocal death is suicide or not, and in alerting caring agencies to the potential for suicide even when the despair is kept secret. Copyright © 2004 John Wiley & Sons, Ltd.     

Possible relation of suicide rates of elderly with societal crime: a cross-national study

There are few studies examining the relationship between elderly suicides and societal crime. Therefore, a cross-national study examining the relationship between suicide rates of elderly persons and the percentage of the population victimised by different categories of crime was undertaken by using cross-national data from the World Health Organisation and United Nations databases. The main finding was a negative correlation between suicide rates in elderly men age 75+ years and women in both the elderly age-bands with the percentage of the population victimised by the crime of robbery. The findings were at variance with the study's hypothesis and may be explained by several factors, including methodological issues. Individual-level case-control or cohort studies of suicides and attempted suicides by elderly persons are suggested to examine the relationship of suicides by elderly and experience of being victimised by crime.     

Attempted Suicides—35 Years Afterward

ABSTRACT: Most follow-up studies of suicides are made after a relatively short period of time. The present study involved 229 attempted suicides (93 men and 136 women) hospitalized during the years 1933–1942. It was possible to trace 96.8% of the men and 95.6% of the women. An earlier investigation 0 to 12 years after hospitalization showed that in the first 4 years 9 men (9.7%) and 5 women (3.7%) had committed suicide. The observation time for the present study ranges from 21 to 42 years, with a mode of 35 years. It was found that an additional 4 men and 7 women had committed suicide in the interim—in the cases of 2 men and 6 women, 15 years or more after the initial attempt. This incidence of suicide so long after the original attempt, at least in the case of the women, statistically exceeds the expected incidence. In the time now elapsed, 10.9% of the study sample (14% of the men and 8.8% of the women) have taken their own lives.     

Homicide Followed by Suicide: A Comparison with Homicide and Suicide

Homicide‐suicides are a rare yet very serious form of lethal violence which mainly occurs in partnerships and families. The extent to which homicide‐suicide can be understood as being primarily a homicide or a suicide event, or rather a category of its own is examined. In total, 103 homicide‐suicides were compared to 3,203 homicides and 17,751 suicides. These are all events that took place in the Netherlands in the period 1992 to 2006. Logistic regression analyses show that homicide‐suicides significantly differ from both homicides and suicides with regard to sociodemographic and event characteristics. The findings suggest that homicide‐suicide might be considered as a distinct phenomenon from both homicide and suicide.     

Suicides among family members of elderly suicide victims: an exploratory study

This exploratory study compares elderly suicides with (n=13) and without (n=72) family member suicide. Previous episodes of suicidal behavior were more common among suicides who lost first-degree relatives by suicide (100% vs. 65%, p = .009). Six persons had lost an offspring by suicide prior to their own deaths. Substance use disorder was more prevalent among those with offspring suicide than those without (100% vs. 25%, p = .000). While informants reported that offspring suicides played a central role in the suicide of the elderly study case, sibbling suicides were not considered precipitating factors.     

The Gender Ratio of Chinese Suicide Rates: An Explanation in Confucianism

The gender (male to female) ratio of the Chinese suicide rates is different from those found in the rest of the world. None of the other societies with known suicide data has had female suicide rates higher than those for the males. While we investigate the factors that contribute to the relatively high suicide rates for Chinese women, we also need to ask what makes the relatively low suicide rates for Chinese men. In this study we try to examine some social and cultural variables in rural Chinese youths in order to identify the factors that account for the relatively low rate for men and relatively high rate for women. In rural China, 392 suicides (both men and women) aged 14–35 years consecutively sampled from 16 counties of three provinces were studied with 416 community living controls of the same age range and from the same locations. Case–control psychological autopsy method was used for the data collection. It is found that believing in Confucianism and being married are both protecting the rural young men from suicide, while the two same variables are either risk or non-protecting factors for the Chinese rural young women’s suicide. In rural China, social structure and culture may play an even more important role determining a society’s suicide rates as well as the gender ratios. Thus, suicide prevention may need to include culture specific measures.     

Disentangling the Person and the Place as Explanations for Regional Differences in Suicide

Identifying whether suicides in a region are due to characteristics of the residents living there or to some enduring feature of the region is difficult when using cross‐sectional studies. To distinguish these factors, we compared the suicides of a region's residents with people who were temporarily visiting the region. Using U.S. death records from 1973–2004, we focused on states with the highest and lowest suicide rates over this period. The high suicide region consisted of Arizona, Colorado, Montana, New Mexico, Nevada, Oregon, and Wyoming; the low suicide region consisted of Connecticut, Illinois, Massachusetts, New Jersey, and New York. For each region, we considered three groups of decedents: residents who died inside the region, residents who died outside the region, and visitors to the region. Proportionate mortality ratios were calculated for all suicides and separately for firearm suicides. In the high suicide region, visitors to and residents away from the region both had elevated suicide levels, to about the same extent as residents dying inside the region. Therefore, short‐term exposure to the region and being a resident of the region each predicted suicide. In the low suicide region, the suicides of residents at home were reduced, but their suicides rose dramatically once they left the area. There was no decrease in suicides among visitors to the region. Firearm use was related to the suicide levels of each region. Overall, the results suggest that both the available means to commit suicide and the contextual features of the regions contributed to their extreme suicides. We discuss how an examination of visitors can help researchers generate novel inferences about the causes of suicide.     

Attributes of Suicide in Females

Long-term trends in suicides among females were investigated using data from Sacramento County, California. Of the 3,741 cases, 3,398 were Caucasian and 952 (25.4 percent) were females. These analyses focus on 837 Caucasian and Hispanic females. Female suicide rates in Sacramento County have increased gradually since 1925 with a corresponding decline in the male/female sex ratio. The suicide data suggest that a minimum of three types of female suicides can be identified and that the incidence of each type varies with the age of the women. Indicators that help in identifying cases and in tentatively describing an etiology include marital status, employment status and occupation, physical ill health, familial loss or disruption, and psychiatric symptoms.     

Alcohol and suicide death among American Indians of New Mexico: 1980-1998

The relationship between alcohol use prior to suicide was explored among American Indian decedents in New Mexico for the years 1980 through 1998. The suicide data were collected from New Mexico Vital Statistics and toxicology reports from the New Mexico Office of the Medical Investigator and matched on a case-by-case basis. Detailed analyses were undertaken for all cases of resident New Mexico Indians from the Navajo, Pueblo, and Apache cultures. Alcohol was detected in 69% of all suicides of American Indians with some variance by major tribal cultural groups (range = 62.1% to 84.4%). This is higher than in suicides among the overall New Mexico population (44.3%). The mean blood alcohol concentration (BAC) of the drinking Indian decedents at suicide was 0.198 (+/- SD of .088). Mean BACs were high for both males (0.199) and females (0.180) who had been drinking. Over 90% of the Indian decedents who had been drinking had BACs greater than the legal intoxication level of 0.08. The Navajo had the lowest percentage of cases that were alcohol involved, and their mean BAC was lower than the other two cultural groups. Alcohol use for completed suicides also varied somewhat by age, sex, method of suicide, and place of occurrence, but very little by whether the decedent was an on or off reservation resident. Analyses indicated that alcohol use prior to suicide was significantly more associated with male suicides than for females, and it was negatively correlated for those who died by overdose and also those using other drugs at suicide. Otherwise, alcohol use did not significantly differentiate American Indian suicides by age, use of firearms, hanging, use of other methods, or residence, for the presence of alcohol was a factor very commonly associated with all of these variables. Heavy alcohol consumption is, therefore, an important factor in over two thirds of all completed suicides among the Indians of New Mexico.