Soldier Background and Postinvestigative Events Associated With Timing of Suicide Following Deployment of U.S. Army National Guard Soldiers

The present study examined the timing of suicide and its associated soldier background and postinvestigative events among deployed Army National Guard (ARNG) soldiers from calendar years 2007 through 2014. Suicide deaths were nearly equally distributed between soldiers who had been deployed and those who had not. Among those deployed, however, suicides occurred mostly 1 year or more after having returned from deployment. Soldier background and postsuicide investigative events were associated with the timing of suicide. Having more years of military service, more previous deployments, and being married were associated with in-theater suicides. Soldiers younger in age (17–24 years), single, nonprior service, and lower in rank, in addition to having parent-family conflicts, full-time employment problems, and military transition problems were associated with suicides that had occurred 1–120 days and 120–365 days since return from deployment. Soldiers aged (24–29 years), married, and higher in rank, along with more reported problems including past behavioral health conditions, postdeployment behavior health referrals, criminal behaviors, and military performance were associated with suicides that had occurred 1 year or more after return. Findings likely represent time periods of suicide vulnerability for identifiable groups of soldiers, based on soldier background and events surrounding the suicide. Practical and theoretical implications of the findings are discussed.     

Suicidal ideation,affective lability,and religion in depressed adults

Suicidal ideation is a strong precursor to suicidal acts and like depression is complex with many risk and protective factors. The purpose of this study is to determine if affect lability, positive and negative religion/spirituality (RS) are related to suicidal ideation and if RS mediates the relationship between affect lability and suicidal ideation. RS are used synonymously to reflect a multidimensional construct. In this cross-sectional study of 183 depressed psychiatric patients, we confirm that depression and affective lability both contribute to suicidal ideation. Positive RS is associated with lower suicidal ideation. Negative RS is associated with higher suicidal ideation; however, this occurs through its association with affective lability. Affective lability and negative aspects of RS are two factors related to suicide ideation that could be addressed in the treatment of depressed patients.     

‘Between the bridge and the brook’

Abstract

That suicide was a damnable sin in Reformation England has been emphasized so far in the historiography of self-killing, but in practice the clergy were equivocal over the question of whether all self-killers were damned. This article re-examines English Protestant beliefs about suicide and salvation from the mid-sixteenth to the mid-seventeenth century. It suggests that clerical statements about the damnableness of suicide need to be understood in the context of the threat posed by Stoic philosophy. Religious writers rejected the notion of noble suicide and reiterated Augustinian theology that premeditated self-killing was a form of murder. However, the harsh rhetoric was mitigated by a number of factors that brought into question the idea that all suicides were destined for Hell. These included changing medical opinion about mental states, evidence of the good character of many suicides, belief in the overpowering influence of demonic forces and basic Christian charity and compassion.     

Introduction

Abstract

Managed health care policy has created dramatic changes in current clinical practice, and all too frequently, impacts the overall treatment plan. Clinicians making referrals for emergency hospitalizations can no longer rely on an in-patient, safe, holding environment. Rather the hospital's relationship and stance with managed care insurance providers determines the length of the hospitalization and the case management plan for patients, instead of the patient's need.     

The Moral Foundations of Equipoise and Its Role in International Research

This article reviews the Dutch societal debate on euthanasia/assisted suicide in dementia cases, specifically Alzheimer's disease. It discusses the ethical and practical dilemmas created by euthanasia requests in advance directives and the related inconsistencies in the Dutch legal regulations regarding euthanasia/assisted suicide. After an initial focus on euthanasia in advanced dementia, the actual debate concentrates on making euthanasia/assisted suicide possible in the very early stages of dementia. A review of the few known cases of assisted suicide of people with so-called early dementia raises the question why requests for euthanasia/assisted suicide from patients in the early stage of (late onset) Alzheimer's disease are virtually non-existent. In response to this question two explanations are offered. It is concluded that, in addition to a moral discussion on the limits of anticipatory choices, there is an urgent need to develop research into the patient's perspective with regard to medical treatment and care-giving in dementia, including end-of-life care.     

Suicide is Neither Rational nor Irrational

Richard Brandt, following Hume, famously argued that suicide could be rational. In this he was going against a common ‘absolutist’ view that suicide is irrational almost by definition. Arguments to the effect that suicide is morally permissible or prohibited tend to follow from one’s position on this first issue of rationality. I want to argue that the concept of rationality is not appropriately ascribed – or withheld – to the victim or the act or the desire to commit the act. To support this, I explore how the concept is ascribed and withheld in ordinary situations, and show that it is essentially future-oriented. Since the suicide victim has no future, it makes no sense to call his act rational or irrational. The more appropriate reaction to a declared desire for suicide, or to the news of a successful suicide, is horror and pity, and these are absent from Brandt’s account, as is a humble acknowledgement of the profound mystery at the heart of any suicide.

The Interplay Among Risk Factors for Suicidal Ideation and Suicide: The Role of Depression, Poor Health, and Loved Ones' Messages of Support and Criticism

When individuals who receive social support are in poor physical or mental health and are criticized or made to feel unwanted, they may perceive themselves as a burden. Poor physical health and depression were hypothesized to exacerbate the harmful effects on suicidal ideation of receiving critical negative messages and of receiving social support. These hypotheses were tested using secondary analyses of data from a sample of 533 unemployed married individuals who were assessed shortly after job loss, and 6 months later. The results of our analyses supported the hypotheses and demonstrated that for participants with poor health or high level of depressive symptoms an increase in critical messages and social support (from Time 1 to Time 2) predicted increased suicidal ideation. This relationship was not observed for non- depressed participants in good health. The results are discussed in terms of their implications for suicide prevention.     

Worst-point suicidal plans: a dimension of suicidality predictive of past suicide attempts and eventual death by suicide

Among 440 psychiatric outpatients with current suicidal ideation, we examined the empirical distinction between the “plans” vs. “desire” dimensions of suicidality, focusing for conceptual and empirical reasons on a worst-point assessment strategy. Factor analyses were consistent with the distinction, but more importantly, among the current ideators included in this study, the worst-point “plans” dimension was the only predictor significantly related to both of two important indices, history of past attempt and eventual suicide. These findings bear on the trajectory of suicidal behavior over time, as well as inform the clinical assessment of suicidal patients.     

Validity and reactivity of a system of self-monitoring suicide ideation

The present study describes the rationale and validation of a self-monitoring approach for suicide ideation. A sample of 49 severely ideating 18- to 24-year-old college students volunteering for a treatment study for chronic ideators served as subjects. A three-item self-monitoring scale designed to assess the strength, duration, and level of control relative to suicide ideation was designed and utilized. Positive correlations with previously validated measures of suicide ideation support the validity of the use of self-monitoring. In addition, positive relationships with measures of depression and hopelessness provide evidence of concurrent validity. There was no evidence that self-monitoring and concomitant increased attention to ideation increased suicidality. In fact, decreases were noted in measures of suicide ideation following a 2-week period of self-monitoring. Together these findings support the addition of self-monitoring to the list of dependent measures for addressing suicidal behavior.     

Cross‐national comparisons of attitudes towards suicide and suicidal persons in university students from 12 countries

This paper reports the results of a comparative investigation of attitudes to suicide and suicidal persons in 5,572 university students from 12 countries. Participants filled out two scales measuring attitudes towards suicide and suicidal persons, a measure of psychological distress together with the questions about suicidal behavior. Results showed that the highest suicide acceptance scores were observed in Austrian, UK, Japanese and Saudi Arabian samples and the lowest scores were noted in Tunisian, Turkish, Iranian and Palestinian samples. While the highest social acceptance scores for a suicidal friend were noted in Turkish, US, Italian and Tunisian samples, the lowest scores were seen in Japanese, Saudi Arabian, Palestinian and Jordanian samples. Compared to participants with a suicidal past, those who were never suicidal displayed more internal barriers against suicidal behavior. Men were more accepting of suicide than women but women were more willing to help an imagined suicidal peer. Participants with accepting attitudes towards suicide but rejecting attitudes towards suicidal persons reported more suicidal behavior and psychological distress, and were more often from high suicide rate countries and samples than their counterparts. They are considered to be caught in a fatal trap in which most predominant feelings of suicidality such as hopelessness or helplessness are likely to occur. We conclude that in some societies such as Japan and Saudi Arabia it might be difficult for suicidal individuals to activate and make use of social support systems.