The Definition and Epidemiology of Clusters of Suicidal Behavior: A Systematic Review

Suicide clusters are a rare and underresearched phenomenon which attract wide media attention and result in heightened concern in the communities where they occur. We conducted a systematic literature review covering the definition and epidemiology of the time–space clustering of suicidal behavior. Of the 890 articles identified by electronic searching, 82 were selected for inclusion and the extracted data were analyzed by narrative synthesis. Less than a third of studies included a definition of a suicide cluster, and definitions varied considerably. Clusters occurred in various settings, including psychiatric hospitals, schools, prisons, indigenous communities, and among the general population. Most clusters involved young people. The proportion of all episodes that occurred in clusters varied considerably between studies and partly depended on study methodology (e.g., a larger proportion was found in studies of specific clusters compared with general population studies). Future studies should aim to combine the statistical analysis of time–space clustering with a case study of events, which examines potential links between individuals and the wider environmental context.     

Lifetime and 12‐Month Nonsuicidal Self‐Injury and Academic Performance in College Freshmen

We examined whether nonsuicidal self‐injury (NSSI) is associated with academic performance in college freshmen, using census‐based web surveys (N = 7,527; response = 65.4%). NSSI was assessed with items from the Self‐Injurious Thoughts and Behaviors Interview and subsequently linked with the administratively recorded academic year percentage (AYP). Freshmen with lifetime and 12‐month NSSI showed a reduction in AYP of 3.4% and 5.9%, respectively. The college environment was found to moderate the effect of 12‐month NSSI, with more strongly reduced AYPs in departments with higher‐than‐average mean departmental AYPs. The findings suggest that overall stress and test anxiety are underlying processes between NSSI membership and academic performance.     

Preventing Suicide at Suicide Hotspots: A Case Study from Australia

The Gap Park Self‐Harm Minimisation Masterplan project is a collaborative attempt to address jumping suicides at Sydney's Gap Park through means restriction, encouraging help‐seeking, and increasing the likelihood of third‐party intervention. We used various data sources to describe the Masterplan project's processes, impacts, and outcomes. There have been reductions in reported jumps and confirmed suicides, although the trends are not statistically significant. There has been a significant increase in police call‐outs to intervene with suicidal people who have not yet reached the cliff's edge. The collaborative nature of the Masterplan project and its multifaceted approach appear to be reaping benefits.     

Development of a Scale to Assess Knowledge about Suicide Postvention using Item Response Theory

Knowledge about suicide postvention (KSPV) is an important distal outcome in the evaluation of suicide prevention programs that focus on the bereaved. However, most scales are specifically tailored to the evaluation study in question and psychometric properties are often unsatisfactory. Therefore, we developed the KSPV scale. Scale properties were investigated with Rasch trees, a newly developed method in the framework of item response theory. Additionally, we provide cues for convergent validity. In summary, the scale shows satisfactory properties for assessing KSPV and could be used to evaluate suicide postvention programs more effectively.     

Encountering the Body at the Site of the Suicide: A Population‐Based Survey in Sweden

Encountering the body of a child who died by suicide at the site of death is believed to be especially harmful for bereaved parents. We investigated the association between encountering the body at the site of the suicide and psychological distress in 666 suicide‐bereaved parents. Parents who had encountered their child's body at the site of the suicide (n = 147) did not have a higher risk of nightmares (relative risk [RR] 0.95, 95% confidence interval [CI] 0.67–1.35), intrusive memories (RR 0.97, 95% CI 0.84–1.13), avoidance of thoughts (RR 0.97, 95% CI 0.74–1.27), avoidance of places or things (RR 0.91, 95% CI 0.66–1.25), anxiety (RR 0.93, 95% CI 0.64–1.33), or depression (RR 0.94, 95% CI 0.63–1.42) compared with parents who had not encountered the body (n = 512). Our results suggest that losing a child by suicide is sufficiently disastrous by itself to elicit posttraumatic responses or psychiatric morbidity whether or not the parent has encountered the deceased child at the site of death.