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.     

The Confrontation with Death and the Renewal of Life

ABSTRACT: Several writers have argued that a majority of suicidal acts are “gambles with death.” A distinction is made between cases where the gamble with death is merely consequential (i.e., arising from ignorance, apathy, indifference) and cases where it is the very essence of the act. Typically in these latter cases others are excluded from possible intervention. The individual is thus playing a game of “pure” chance. Death is summoned and challenged in order that life may continue. It is argued, from an interactionist perspective, that such acts are desperate efforts to confirm existence in situations of extreme uncertainty and represent a distinct form of what Shneidman has called “egotic” suicide.     

Deaths of Despair: Conceptual and Clinical Implications

Since the late 1990s, mortality rates for middle-aged (45-55), White non-Hispanic (WNH) Americans began to rise while rates declined for all other demographic and age groups. Coinciding with the rise in mortality, rates of death due to suicide, drug- and alcohol-related overdoses, and alcohol-related liver diseases increased as well for this demographic. Research suggests these causes of death (i.e., suicide, poisoning, alcohol-related liver disease) are driving the overall mortality rate for middle-aged WNHs and have been described as “deaths of despair” in the literature. In the current paper, we describe the social and clinical features of “deaths of despair,” explore theoretical models of psychopathology (e.g., depression, posttraumatic stress disorder) that may inform our understanding of mechanisms of risk for negative mental health outcomes, and propose an initial conceptual model of “deaths of despair” to identify intervention targets. We then review an applied case example demonstrating how this model could be used for clinical application. We conclude our paper by describing how current cognitive-behavioral interventions may address these mechanisms of “despair.”     

Suicide in the Subway: Psychodynamic Aspects*

ABSTRACT: Fifty-one cases of suicide attempts in the subway have been investigated to examine the question of whether the method used has psychodynamic significance or is merely adventitious. We found that no single characteristic distinguished subway suicide from all other suicide modalities, although as a group the subway cases had a higher proportion of psychotic and previously suicidal patients than other series quoted in the literature. However, there were important differences between subway suicide cases seeking a “traumatic” death (jumping in front of a train; lying across the track awaiting destruction) and those seeking a “nontraumatic” death (electrocution on the live “third rail”). The traumatic group had histories of exposure to violence, other traumatic suicide attempts, hostile or destructive delusions, and many “destroy” words on psychological test protocols. The smaller nontraumatic group had no such history of exposure to violence; their previous suicide attempts were nontraumatic; delusions, when present, were not menacing; and the psychological tests showed more “escape” words than “destroy” words.     

Play as dynamic movement in an assemblage: A novel approach to the concept of “play”

As Johan Huizinga argued in Homo Ludens, “play” has not only been part of all human societies throughout history, it has also contributed to the development of numerous cultural, social and political activities, including structured games and sports, certain judicial and legal activities, war, and numerous forms of art. Despite its importance, “play”, with its various manifestations, is often relegated to being a children’s activity or an occasion of pure waste, and is a surprisingly marginalised topic in academic scholarship. In part to remedy this deficit, my aim in this article is to create a novel philosophical conception of “play” by adapting selected concepts from the philosophy of Gilles Deleuze and Felix Guattari, as well as from the theories of Brian Sutton-Smith and Mihaly Csikszentmihalyi. The concept of “play” that I propose is not only a useful heuristic for mapping various forms of “play”, it also highlights the creative and transformative potential that is inherent to “play” phenomena.     

Perceived Social Status and Suicidal Ideation in Maltreated Children and Adolescents

Research on Child and Adolescent Psychopathology - Recent decades have seen an alarming increase in rates of suicide among young people, including children and adolescents (“youth”)....     

A test of Durkheim's theory of suicide in primitive societies.

Primitive societies were classified as high, moderate, or low on independent measures of social integration and social regulation to test Durkheim's theory of suicide. The estimated frequency of suicide did not differ between those societies predicted to have high, moderate, and low suicide rates. Thus, Durkheim's theory was not confirmed. Possible reasons for these results are discussed.     

The Preventive Effect of Strict Gun Control Laws On Suicide and Homicide

ABSTRACT: States with stricter handgun control laws in 1968 were shown to have lower suicide rates by firearms both in 1960 and in 1970. These states also had higher rates of suicide by “other means.” In contrast, no such effect of strict handgun control laws was found for mortality from homicide by firearms. More detailed analyses indicated that restrictions on selling and buying handguns were more important than restrictions on carrying handguns.     

Can Shneidman's “Ten Commonalities of Suicide” Accommodate Rational Suicide?

Shneidman's (1985 ) commonly reproduced “Ten Commonalities of Suicide” cannot accommodate rational suicide, as the concept has been defined in recent literature, and therefore are not “commonalities” of all suicides. Quotes from Shneidman describing the “commonalities” are provided and selected items are briefly examined in light of one set of criteria for rational suicide. It is suggested that Shneidman's list, which is inherently biased against allowing for the possibility of rational suicide, be renamed so that its contents will not continue to be inappropriately used as evidence that suicide cannot be rational.     

Double Jeopardy: Suicide Rates in Forensic Hospitals

While a number of studies have described high and increasing rates of completed suicide among psychiatric patients, the suicide risk of forensic hospital patients is virtually unknown. This paper reports on the suicides that have taken place in the country's oldest continually operating institution housing persons formerly labeled “criminally insane,” the Bridgewater State Hospital. The results show considerable variation in the suicide rate by historical period, with suicide prior to 1968 a considerably more infrequent event. By contrast, the post-′68 rate of 232 per 100,000 is comparable to data reported in a series of studies of psychiatric suicides, and significantly higher than that found in U.S. studies of correctional populations. These differences are discussed. The results strongly suggest that forensic hospital populations have suicide rates broadly comparable to other psychiatric populations.     

Suicide Behavior

ABSTRACT: A survey of community attitudes and beliefs concerning suicidal behavior is reported, in which women from two suburbs differing widely in their rates of hospital treated self-poisoning and self-injury were interviewed. Sympathetic attitudes to suicidal behavior and to those who engage in it were significantly more prevalent in the low-risk area. Community beliefs regarding lethality, etiology, and ability to distinguish suicide and “attempted suicide” are reported, and the relationship of these beliefs to attitudes is discussed.     

The Predictors of Suicidality in Previous Suicide Attempters following Case Management Services

Suicide attempts constitute a serious clinical problem. People who have attempted suicide are at an elevated risk for additional suicide attempts, but there is limited evidence regarding the predictors of suicidality of suicide attempters following case management services. In the present study the indicators of suicidality after case management were examined. A total of 1,056 subjects who had recently attempted suicide were recruited from January 1, 2011, to June 30, 2011. The suicide prevention center of Kaohsiung City in Taiwan provided case management services and followed up on suicide attempt cases for 6 months. The salient factors for repeat suicide attempts were estimated using a logistic regression analysis. The results showed that multiple factors, including a “willingness to receive mental health services during a crisis,” “social support,” “a history of mental disorders,” and “a history of suicide,” could predict repeat suicide attempts with hazard ratios (0.58, 0.54, 3.84, 1.51) and 95% confidence interval (0.39–0.86, 0.36–0.83, 2.41–6.10, 1.03–2.21). The four factors mentioned above were the most accurate predictors of subsequent suicidality when case management services were utilized after 6 months of follow‐up. The findings of our study could help clarify future strategies for suicide prevention.     

Decomposing implicit associations about life and death improves our understanding of suicidal behavior

The Death/Suicide Implicit Association Test (IAT) is effective at detecting and prospectively predicting suicidal thoughts and behaviors. However, traditional IAT scoring procedures used in all prior studies (i.e., D-scores) provide an aggregate score that is inherently relative, obfuscating the separate associations (i.e., “Me = Death/Suicide,” “Me = Life”) that might be most relevant for understanding suicide-related implicit cognition. Here, we decompose the D-scores and validate a new analytic technique called the Decomposed D-scores (“DD-scores”) that creates separate scores for each category (“Me,” “Not Me”) in the IAT. Across large online volunteer samples (N > 12,000), results consistently showed that a weakened association between “Me = Life” is more strongly predictive of having a history of suicidal attempts than is a stronger association between “Me = Death/Suicide.” These findings replicated across three different versions of the IAT and were observed when calculated using both reaction times and error rates. However, among those who previously attempted suicide, a strengthened association between “Me = Death” is more strongly predictive of the recency of a suicide attempt. These results suggest that decomposing traditional IAT D-scores can offer new insights into the mental associations that may underlie clinical phenomena and may help to improve the prediction, and ultimately the prevention, of these clinical outcomes.     

Suicide Prediction Revisited

Data from a 1983 prospective study of suicide in a cohort of 4800 psychiatric inpatients were reanalyzed using logistic regression, which is more appropriate for a binary outcome. The results were the same as in the previous study: too few of the subsequent suicides were identified and there were too many false positives to make this procedure useful. Several additional “artificial” logistic regression analyses were done: one series randomly removed increasing numbers of nonsuicide cases to increase the base rates; another series added an increasingly powerful hypothetical “test.” Both of these maneuvers helped, but fell well short of perfection.     

The Effect of the Media on Suicide: Evidence From Japan, 1955–1985

Research on media impacts on suicide has been largely restricted to the United States, a Christian nation marked by moral aversion to suicide. The present study extends the analysis to an Eastern nation, Japan, where people are less critical of those who suicide. Such a cultural definition of suicide might multiply imitative effects. Yule-Walker times series estimates indicate that the imitative effect is restricted to stories concerning Japanese victims. Further, the increase is similar in magnitude to that reported in the American cultural context. The Japanese audience may not be as predisposed to media effects, given a lower divorce rate, low couple centeredness, and a high level of extended family social support. These factors may offset a potentially very high “Werther effect.” The model explains 88% of the variance in monthly Japanese suicide rates.     

Changing the Direction of Suicide Prevention in the United States

It is axiomatic that the goal of suicide prevention is the prevention of suicide. Yet in spite of significant efforts to this end since the middle of the last century, and most notably in the last decade, the rate of suicide in the U.S. has not declined; rather, it has increased. To address this issue, Suicide Awareness Voices of Education (SAVE) brought together leading prevention specialists from other public health problems where successes have been achieved, representatives from countries where suicide rates have declined, and U.S. based suicide prevention researchers and program directors, to “think outside the box” and propose innovative, scalable approaches that might better drive success in achieving desired results from U.S. suicide prevention efforts. The recommendations should challenge our preconceptions and force us outside our own mental constraints to broaden our perspectives and suggest catalysts for real change in suicide prevention.     

An explication of rational suicide: Its definitions,implications, and complications

Abstract

Logical analysis of arguments in favor of “rational suicide” reveals eleven commonly encountered premises. Most of the premises are unclear on close scrutiny, and six are ethical propositions that although acceptable to some will not be acceptable to others. The “rational suicide” literature appears to be an effort to legitimize certain kinds of suicide, largely by appeal to a consensus of experts. This kind of argument is criticized on historical grounds; it has led to moral and social disasters in the past.     

Systematic innovation and social philosophy

Corbett's “Europe and the Social Order”; makes two claims: that industrial societies are marked by “systematic innovation”; and that, as a consequence, our inherited social doctrines are obsolete and must be replaced. The first claim is true, but the second is false: it is not the case that social doctrines are “consistent”; only with certain kinds of social order: we cannot therefore say that innovating societies either preclude or compel any particular social doctrines. They do not invalidate a priori doctrine, though they undermine belief in it. It is therefore less important to attack such doctrine than to study innovation empirically.