Risk and Resiliency Factors Influencing Suicidality Among Urban African American and Latino Youth

For decades, suicide rates among minority African American and Latino young people have been stable and, when compared with Whites, relatively low. This is no longer the case, underscoring the need for documenting and understanding the problem of suicidality in this population. We report on the prevalence and predictors of suicidality among 879 urban adolescents in the Reach for Health study. All youth resided in economically disadvantaged neighborhoods; 69% were African American, 16% Latino, and 15% reported mixed or other ethnicity. In the past year, 15% had seriously considered suicide; 13% had made a suicide plan, 11% had attempted suicide at least once, and 4% reported multiple attempts. Risk factors significantly related to suicidal ideation are being female, having basic needs unmet, engaging in same-gender sex, and depression. Resiliency factors include family closeness and, marginally, religiosity. Risk factors related to reports of suicide attempts are being female, being Hispanic, and depression; family closeness is strong resiliency factor. Family composition, ethnic identity, coping style, peer support, and school attachment are not significant correlates of suicidal ideation or attempts.     

The Clustering and Contagion of Suicide

Two general types of suicide cluster have been discussed in the literature; roughly, these can be classified as mass clusters and point clusters. Mass clusters are media related, and the evidence for them is equivocal; point clusters are local phenomena, and these do appear to occur. Contagion has not been conceptually well developed nor empirically well supported as an explanation for suicide clusters. An alternative explanation for why suicides sometimes cluster is articulated: People who are vulnerable to suicide may cluster well before the occurrence of any overt suicidal stimulus, and when they experience severe negative events, including but not limited to the suicidal behavior of one member of the cluster, all members of the cluster are at increased risk for suicidality (a risk that may be offset by good social support).     

Natural death and the work of perfection.

The historic or traditional Christian view of pain (suffering) and death, especially as preserved by the Christians East (i.e., the Orthodox), is radically opposed to the modern secular obsession with avoidance of pain. Everything about this life has its goal or aim in a mystical reality, the Kingdom of Heaven, for which earthly life is a preparation. While neither illness nor health are seen as ends in themselves, both are viewed as proceeding from the will of God for our benefit and have no ultimate meaning or purpose outside of eternal life. Death may be a relief or an ending of suffering, but in itself it is not "good" but evil. Because they are the embodiment of lived theology, saints' lives can be a sure guide to understanding how to die as a traditional Christian. To illustrate this, I have chosen some examples from the lives of relatively recent saints. I myself am from the Russian Orthodox spiritual tradition, so all but one of my examples come from pre-Revolutionary Russia. The question is not so much whether or not a traditional Christian can countenance physician-assisted suicide, but rather, what is the meaning or purpose of pain and suffering in general. Is it part of the "work of perfection" required of those who wish to enter the Kingdom of Heaven and therefore not to be completely denied?     

Fewer reasons for staying alive when you are thinking of killing yourself: The brief reasons for living inventory

The Linehan Reasons for Living Inventory is a 48-item scale on which respondents rate how important each item would be for living if suicide were contemplated. The inventory possesses good psychometric properties and can distinguish suicidal from nonsuicidal people among shoppers, psychiatric inpatients, college students, and adolescents. As its length limits its utility in many institutional and screening settings, the purpose of this study was (1) to develop a brief form of the Reasons for Living Inventory appropriate for clinical use and (2) to examine the predictive validity of this brief measure, named the Brief Reasons for Living Inventory (BRFL), to distinguish suicidal from nonsuicidal prison inmates. Results indicate that the brief form was as good as either the Beck Depression Inventory or the Beck Hopelessness Scale at predicting suicidality in this population. Further study is needed to validate the BRFL with different institutionalized and other populations as well as to assess its ability to discriminate suicide ideators from those engaging in overt suicidal behavior.Support for this project was provided in part by the New York State Office of Mental Health Bureau of Forensic Services and the New York State Department of Correctional Services.     

The problem-solving diathesis in depression,hopelessness, and suicide ideation: A longitudinal analysis

The problem-solving deficit (PSD) diathesis-stress model of suicide behavior proposed by Clum, Patsiokas, and Luscomb (1979) and expanded by Schotte and Clum (1982, 1987) was examined in a short-term longitudinal test. The present study assessed the relationship between problem-solving deficits at Time 1—prior to the stressor (a D or F on a midterm examination)—and adjustment at Time 2—after the Stressor. Evidence was found for an additive predictive relationship for stress and problem-solving deficits to Time 2 measures of depressive symptoms, hopelessness, and suicide ideation. Evidence was also found that PSD × Stress interactions uniquely predicted the three criteria. The results of this study were taken as evidence of problem-solving deficits functioning as a diathesis for depression, hopelessness, and suicide ideation.     

Culturally grounded strategies for suicide and alcohol risk prevention delivered by rural Alaska Native communities: A dynamic wait-listed design evaluation of the Qungasvik intervention

We examined the effectiveness of the Qungasvik (Tools for Life) intervention in enhancing protective factors as a universal suicide and alcohol prevention strategy for young people ages 12−18 living in highly affected rural Alaska Native communities. Four communities were assigned to immediate intervention or to a dynamic wait list. Outcomes were analyzed for 239 young people at four time points over two years of community intervention. Outcomes assessed two ultimate variable protective factors buffering suicide and alcohol risk, and three intermediate variable protective factors at the individual, family, and community level. Dose dependent intervention effects were associated with growth in ultimate but not intermediate variables. This evaluation of the Qungasvik intervention provides support for the effectiveness of its Indigenous strategies for suicide and alcohol misuse prevention in this rural Alaska Native setting. Though findings did not provide support for a theory of change where growth in ultimate variables is occasioned through effects on intermediate variables, research designs focused on young people who enter intervention at lower levels of preexisting protection hold promise for better understanding of intervention change processes. The Qungasvik intervention is responsive to an acute public health need for effective rural Alaska Native suicide and alcohol risk prevention strategies.     

Epidemiology,Risk Factors,and Prevention of Suicidal Thoughts and Behaviour in Prisons: A Literature Review

Suicide is a global public health concern that affects all echelons of society, albeit not equally so. Compared with adults in the general population, incarcerated offenders are at increased risk to consider, attempt, and die by suicide, which represents a substantial burden of morbidity and mortality in prisons worldwide. This review synthesises recent literature pertaining to the epidemiology, risk factors, and prevention of suicidal thoughts and behaviour among prisoners, and outlines a framework which emphasises the interplay between individuals (importation) and their surroundings (deprivation). The available evidence suggests that prison-specific stressors may exacerbate risk of suicide in an already vulnerable population characterised by complex health and social care needs. Emerging data point to differential mechanisms through which prisoners come to think about suicide and subsequently progress to suicidal behaviour. As risk of suicide is determined by a complex web of synergistically interacting factors, its management and prevention demands a cross-sectoral policy and service response that includes targeted interventions aimed at high-risk prisoners in combination with population strategies that promote the health and wellbeing of all people in prison.     

Suicide and self-inflicted injuries

The present study addressed itself to the problem of self-inflicted injuries (SII) in the Israeli army, and to the wider question whether non-fatal self injuries and suicide are part of the same phenomenon. The findings show that in some cases SII is an unsucessful suicide while in others SII is anything but a reflection of a death wish. It appears that the modus operandi is a major indication as to the intentions of the actor. The study also demonstrates the difference between the population of the suiciders and that of the SII victims. While suiciders seem to score higher on the Performance Prediction Score (PPS) and Combat Suitability Scale, the SII population seems to be overly represented in the lower parts of the PPS and the Combat Suitability Scale. The study used a data set that represents a 5 year period, and followed the consequences of the SII in terms of medical status and occupational assignment of the actors. The findings yielded some possible policy implications, in terms of a better classification of the relevant populations, and a possible attribution of a more refined meaning to the behavior. © 1994 Wiley-Liss, Inc.     

The Relative Contribution of Diagnostic and Psychosocial Variables to Severity of Suicidal Ideation

The present study examined the relative contribution of diagnostic and psychosocial factors to the prediction of severity of suicidal ideation in a sample of 78 college students. Using hierarchical regression analyses to control for each set of factors, psychosocial variables were found to consistently predict level of suicidal ideation. In contrast, diagnostic variables including diagnosis of substance abuse and composite scores for depression and anxiety were unrelated to level of suicidality. An examination of individual diagnoses revealed no predictable relationships with severity of suicidality in this population. The results were discussed from several methodological viewpoints.