Showing papers in "Archives of Suicide Research in 2006"
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TL;DR: Suicide rates do appear to be lower in Muslims than in those of other religions, even in countries which have populations belonging to several religious groups.
Abstract: Much of the research on suicidal behavior in Muslim countries has been simple descriptive studies of samples of completed and attempted suicides. Despite this, and despite the possible under-reporting of suicidal behavior in countries where such behavior is illegal, suicide rates do appear to be lower in Muslims than in those of other religions, even in countries which have populations belonging to several religious groups. Rates of attempted suicide, on the other hand, do not appear to be lower in Muslims as compared to non-Muslims. Research into this topic has been quite poor, failing to take into account the ethnic background and the Islamic sect to which the suicidal subjects belonged. Reasons for the low rate of completed suicide in Muslims are reviewed, including differences in values and socio-economic status.
173 citations
TL;DR: Drug use was the strongest correlate of suicidal ideation, and both enculturation and perceived discrimination emerged as important culturally specific variables and it was suggested that suicide prevention programs should draw on the strengths of American Indian culture.
Abstract: This study examined correlates of suicidal ideation among 212 American Indian youth who lived on or near three reservations in the upper Midwestern United States. The youths were, on average, 12 years old, and 9.5% reported current thoughts about killing themselves. Females were over 2 times more likely than males to think about suicide. Multivariate logistic regression results indicated that gender, enculturation, negative life events, perceived discrimination, self-esteem, and drug use were related to the likelihood of thinking about suicide. Drug use was the strongest correlate of suicidal ideation, and both enculturation and perceived discrimination emerged as important culturally specific variables. It was suggested that suicide prevention programs should draw on the strengths of American Indian culture.
123 citations
TL;DR: The authors socially and historically contextualize changes in Aboriginal and Torres Strait Islander suicide, identifying the causal frameworks adopted in developing interventions, and present an explanation in narrative and pictorial form that draws on critical family-centered trauma.
Abstract: Aboriginal and Torres Strait Islander suicide has been an issue of national public health and mental health concern for only one decade, having increased dramatically from levels that were very low in the late 1980s to levels of young adult male suicide that are now substantially higher than for the non-indigenous population. In this review the authors socially and historically contextualize these changes, identifying the causal frameworks adopted in developing interventions, and present an explanation in narrative and pictorial form that draws on critical family-centered trauma.
118 citations
TL;DR: The program of research outlined here—work that explores the relation between markers of self- and cultural continuity, and suicidal behaviors in both culturally mainstream and Canadian Aboriginal youth—provides evidence that personal persistence and persistent peoples have low or absent rates of youth suicide, while individuals and communities lacking a requisite sense of continuity regularly suffer suicides in epidemic numbers.
Abstract: What does it mean to somehow override change and to count one's self as one and the same individual, continuous in time? What does "continuity" mean for whole cultural groups? How might disruptions to a sense of personal or cultural persistence deprive us of a past, and a connection to our as yet unrealized futures? Why is it that the bulk of us who succeed in knitting up our raveled sleeves of care choose for life, while those who loose the thread of their continuous existence so frequently make the opposite choice? The program of research outlined here--work that explores the relation between markers of self- and cultural continuity, and suicidal behaviors in both culturally mainstream and Canadian Aboriginal youth--provides evidence that personal persistence and persistent peoples have low or absent rates of youth suicide, while individuals and communities lacking a requisite sense of continuity regularly suffer suicides in epidemic numbers.
105 citations
TL;DR: Analysis of official data from the New Zealand Health Information Service reveals patterns of suicide and attempted suicide among the indigenous (Māori) population of New Zealand using official data, and examines approaches to effective intervention to reduce rates of suicide in young Māori.
Abstract: This article describes patterns of suicide and attempted suicide among the indigenous (Māori) population of New Zealand using official data from the New Zealand Health Information Service (NZHIS). The majority of Māori suicides (75%) occurr in young people aged <35 years. Rates of suicide are higher among Māori males and females aged <25 than in their non-Māori peers. Rates of hospitalization for attempted suicides are higher amongst Māori males aged 15–24, compared to non-M[abar]ori. In contrast, suicide is virtually unknown amongst older M[abar]ori (60 years). This article reviews explanations for the observed rates of suicide in M[abar]ori, and examines approaches to effective intervention to reduce rates of suicide in young Māori.
75 citations
TL;DR: A special issue of Archives of Suicide Research (ASR) is an attempt to heed this call; this special issue as discussed by the authors presents data from the Arctic, Canada, Australia, New Zealand, Brazil, and other regions.
Abstract: Indigenous people around the world have the highest suicide risk of any identifiable cultural (or ethnic) group. It is a youth epidemic. The World Health Organization (WHO) has called for action; this special issue of Archives of Suicide Research (ASR) is an attempt to heed this call. Scholars, indigenous and non-indigenous, present data from the Arctic, Canada, Australia, New Zealand, Brazil, and other regions. It is concluded that not only data, but also explanations are needed. Suicide is multi determined. Colonialism and its associated genocide are, however, cited as a common factor. Yet, much greater cooperative international efforts are needed to not only understand, but also predict and control the epidemic.
73 citations
TL;DR: The results of this study are compatible with two recent epidemiological cohort studies showing a positive association between cholesterol and completed suicide.
Abstract: Low cholesterol concentrations and cholesterol-lowering therapies have been suggested to be associated with increased suicidality. This article examined the association of cholesterol, triglycerides, and body-mass index (BMI) with suicidal ideation and suicide attempts. Findings are based on a nationally representative community sample of n = 4,181 subjects (18-65 years) examined with a standardized diagnostic interview (CIDI) for (DSM-IV) mental disorders. Controlling for age and gender the study revealed a moderate positive association between cholesterol, triglycerides, BMI, and suicide attempts in subjects with depressive symptoms during the past 12 months (n = 1,205). The results of this study are compatible with two recent epidemiological cohort studies showing a positive association between cholesterol and completed suicide.
63 citations
TL;DR: The incidence of youth suicides has increased dramatically among the Inuit in Greenland since the modernization started in the 1950s and there is a definite correlation with several aspects of the modernization process but it is hard to pinpoint causal relationships.
Abstract: The incidence of youth suicides has increased dramatically among the Inuit in Greenland since the modernization started in the 1950s. Suicides currently peak at age 15-24 Men: 400-500, Women: 100-150 per 100,000 person-years. The methods are drastic: shooting or hanging. An early peak was seen in the capital, a later peak in the rest of West Greenland, and high and increasing rates in remote East Greenland. Suicidal thoughts occur more often in young people who grew up in homes with a poor emotional environment, alcohol problems and violence. There is a definite correlation with several aspects of the modernization process but it is hard to pinpoint causal relationships. It is rather the "modernization package" that should be regarded as risk factors for suicides.
57 citations
TL;DR: This study examined whether the hypothesized association between country of birth and suicide rates remains after adjustment for age, marital status, socioeconomic status, and hospitalization due to psychiatric disorders or substance abuse.
Abstract: The aim of this study was to examine whether the hypothesized association between country of birth and suicide rates remains after adjustment for age, marital status, socioeconomic status, and hospitalization due to psychiatric disorders or substance abuse. A Swedish cohort of 4.4 million individuals aged 25–64 years was followed from January 1, 1994, to December 31, 1999 for suicide. Suicide rates varied according to country of birth. Among men the highest risk of suicide was found among men from Finland. Among women the highest risk of suicide was found among women from Finland, Poland, and Eastern Europe. Key factors to prevent suicide include early detection and treatment of psychiatric disorders and/or substance abuse, especially among certain population groups.
55 citations
TL;DR: Excessive motivation to excel in the army, and the tendency to be autonomous and independent, may account for suicide among combatant S-soldiers, whereas personality weaknesses may have an impact on suicide among non-combatants.
Abstract: The present study compared characteristics of combatant and non-combatant Israeli soldiers (ages 18-21), who committed suicide (N = 429) with others who did not commit suicide (N = 499). Measures of pre-military psychological characteristics and data reflecting adjustment to service were culled from army records. Findings indicated that, in comparison to non-suicide soldiers (NS-soldiers), soldiers who committed suicide (S-soldiers) had greater behavioral adjustment and motivation to serve. In addition, as compared to non-combatant S-soldiers, combatant S-soldiers had fewer referrals for psychological evaluation, higher sense of duty and autonomy scores and fewer unit changes. Excessive motivation to excel in the army, and the tendency to be autonomous and independent, may account for suicide among combatant S-soldiers, whereas personality weaknesses may have an impact on suicide among non-combatants. Practical implications for the disclosure of suicide risk and for preventive efforts in both groups are discussed.
50 citations
TL;DR: In this article, the authors explored the accuracy of prevalence estimations for suicide attempts and found that suicide attempters are at least 1.6 times more likely to drop out than subjects with no suicide attempts or suicidal ideas.
Abstract: This study explores the accuracy of prevalence estimations for suicide attempts. Data came from the Early Developmental Stages of Psychopathology (EDSP) Study, a prospective community study (mean follow-up period was 42 months) of 3,021 respondents aged 14 to 24 years at the outset of the study. Suicide attempters are at least 1.6 times more likely to drop out than subjects with no suicide attempts and suicidal ideas. A total of 8% of all suicide attempters answered in the negative the depression-related gate questions of all surveys. One-third of all baseline suicide attempters did not report their suicide attempt again at the four years later assessment. In particular, 80% of all nonreporters were female, and almost 60% were aged 14-17 at baseline.
TL;DR: In accordance with previous research into suicidal processes, repatriation probably reflects an event causing severe damage to peacekeepers' self-esteem, which combined with vulnerability and lack of protection could increase suicide risk.
Abstract: This psychological autopsy study focused on suicide risk factors in veterans of peacekeeping, specifically, a representative sample of Norwegian peacekeepers. A multivariate analysis yielded three dimensions with a unique impact on suicide risk: Involuntary repatriation from peacekeeping service, negative life-events before peacekeeping and marital status. In accordance with previous research into suicidal processes, repatriation probably reflects an event causing severe damage to peacekeepers' self-esteem, which combined with vulnerability and lack of protection could increase suicide risk. Preventive measures should focus on careful personnel selection and follow-up of repatriated individuals.
TL;DR: It was found that psychological citizen factors, like home satisfaction and happiness, mediated the impact of societal variables, like the sex ratio, in predicting suicide rates.
Abstract: Suicide is usually conceptualized as arising either because of social phenomena or individual dynamics. In this study, these approaches were combined by analyzing suicide rates of younger people aged 15-24 and elderly aged 65-74 from 54 nations using societal variables in conjunction with psychological measures of citizen characteristics as mediators. A mediated analysis showed that psychological citizen factors, like home satisfaction and happiness, mediated the impact of societal variables, like the sex ratio, in predicting suicide rates. We found different psychological and societal predictors for young and elderly suicides, with elderly suicide rates being much more predictable. An age-responsive Durkheimian framework focusing on the dynamics of social integration at different ages was used to interpret these results.
TL;DR: Both exploratory and confirmatory factor analyses showed different factor structures in the two countries, possibly due to different latent variables indicating differences in meaning(s) of suicidal behavior between the two country or lack of reliability and/or validity of the instrument.
Abstract: The main purposes of this study was to test the psychometric properties of a questionnaire on attitudes towards suicide in a cross-cultural setting, and to discuss the value of cross-cultural studies in the search of meaning(s) of suicidal behavior as well as the methodological challenges encountered in such studies. Data on attitudes towards suicide among health and social science students from Norway and Uganda were employed to illustrate the points made. Both exploratory and confirmatory factor analyses showed different factor structures in the two countries. Whether this result is due to different latent variables indicating differences in meaning(s) of suicidal behavior between the two countries or lack of reliability and/or validity of the instrument is discussed.
TL;DR: This review article outlines the research basis for an effective approach to psychotherapy with suicidal people and concludes that one has to be person-centered (or patient centered): You have to know whom you are treating.
Abstract: This review article outlines the research basis for an effective approach to psychotherapy with suicidal people. It answers the question, “Is psychotherapy effective with suicidal people?” Based on the notable historical publications and the most recent (Lambert, 2004), it is shown that psychotherapy works, largely because there are commonalities (i.e., common factors) that may be the overriding important factor in all forms of psychotherapy. The therapeutic relationship is primary; this and other common factors are illustrated with suicidal people. Patient qualities, therapist qualities, and a multi-modal or multi-component approach are reviewed. On an empirical basis, it is concluded that one has to be person-centered (or patient centered): You have to know whom you are treating.
TL;DR: Three explanations of lower married than not married suicide rates are tested: 1) Gibbs and Martin's marital status integration hypothesis; 2) marital status differences in norms regarding the acceptability of suicide; and 3) Durkheim's societal integration theory.
Abstract: Male suicide rates, circa 1960, specific to age and marital status for 12 developed countries show married men with lower suicide rates than not married men. This results in differences in the age structures of married and not married suicide rates. We test three explanations of lower married than not married suicide rates: 1) Gibbs and Martin's (1964) marital status integration hypothesis; 2) marital status differences in norms regarding the acceptability of suicide; and 3) Durkheim's societal integration theory. All three explanations are supported by multivariate regressions. The strongest support is for societal integration. The models explain over 80% of the variance in both married and not married male age-specific suicide rates. These regression equations generate predicted suicide rates and these predicted rates are then used to see if they account for the observed age structures of married and not married men. They do in 19 of 24 tests.
TL;DR: Findings in this report were remarkable: the rates of suicide among these communities appear higher than the national average; suicide deaths disproportionately affect adolescents and young adults; and suicide rates among young males appear to be increasing.
Abstract: Information on morbidity and mortality are critical for developing appropriate prevention and health promotion programs. This study summarizes data on the Guarani (Kaiowa and Nandeva) communities in Mato Grosso do Sul, Brazil, about which little addressing suicide has been documented. Epidemiologic and anthropological data were used to examine suicidal behavior in these indigenous communities. Several findings in this report about the Guarani Kaiowa and Nandeva communities were remarkable: the rates of suicide among these communities appear higher than the national average; suicide deaths disproportionately affect adolescents and young adults; and suicide rates among young males appear to be increasing. Data in this report highlight the need for health information data specific to a community in order to identify emerging health problems.
TL;DR: Patients with a family history of suicidal behavior and who had themselves attempted suicide had significantly higher BIS scores for both impulsivity and risk taking than patients who had never attempted suicide.
Abstract: A family history of suicide indicates a raised risk for suicidal behavior; this liability might be familially transmitted as an impulsive-aggression trait. To examine the impulsivity factor, data from 258 abstinent drug dependent patients who were interviewed about their family history of suicidal behavior and who completed the Barratt Impulsivity Scale (BIS) were examined. The results showed that patients with a family history of suicidal behavior had significantly higher BIS scores for risk taking than patients without a family history of suicidal behavior. Also, patients with a family history of suicidal behavior who had themselves attempted suicide had significantly higher BIS scores for both impulsivity and risk taking than patients with a family history of suicidal behavior who had never attempted suicide.
TL;DR: It is concluded that noncompliance with medication is associated with suicidal ideation and this increase was significantly greater in noncompliant Subjects with lower insight scores at discharge.
Abstract: Discharged psychiatric inpatients are at a greater risk of suicide in the three months following discharge. However, risk factors for this group are not clear. In this study 69 psychiatric inpatients were recruited and suicidal ideation, insight and compliance scores were measured at discharge and 12 weeks post-discharge. There were clinically significant rates of suicidal ideation (52%) and deliberate self harm (28%) in the post-discharge period. Over half of patients (52%) became noncompliant with medication. Subjects with lower insight scores at discharge were significantly more likely to become noncompliant. Suicidal ideation scores increased irrespective of compliance from discharge to follow-up and this increase was significantly greater in noncompliant subjects. We conclude that noncompliance with medication is associated with suicidal ideation.
TL;DR: Results failed to show any significant relationship between serum cholesterol levels and either total Beck Depression Inventory (BDI) scores or BDI scores on the item measuring current suicidal ideation.
Abstract: Low serum cholesterol has been associated with suicidal behavior. Depression has been postulated to be a mediating factor between low serum cholesterol and suicidal behavior. Therefore, this possibility was examined in a large group of 459 diabetic patients that had blood drawn for serum cholesterol levels on the same day that they completed the Beck Depression Inventory. The results failed to show any significant relationship between serum cholesterol levels and either total Beck Depression Inventory (BDI) scores or BDI scores on the item measuring current suicidal ideation. The limitations of the study are discussed.
TL;DR: The data show a very high rate in the young, especially males, of suicide in American Indians and Alaskan Natives (AI/AN), and it is concluded that much greater effort is needed.
Abstract: Suicide is the second leading cause of death in young Indian people. USA's Indian Health Service is responsible for the health of the people; a structured system and services are provided. These services include surveillance and suicide investigation, to allow for better understanding. This article presents the current epidemiology on suicide for American Indians and Alaskan Natives (AI/AN). The data show a very high rate in the young, especially males. Beyond the general, the article offers a unique look into a suicidal AI/AN young person, through the psychological autopsy. A case illustration, E.S., a 16-year-old male who died by suicide, is outlined. Discussion, the author's words, and current efforts of Indian Health Services are presented, but it is concluded that much greater effort is needed.
TL;DR: The epidemiology of suicide in Serbia and Montenegro from 1989 to 2003, a period of civil war, is presented, with findings consistent with Durkheim's classical hypothesis concerning suicide and unpopular wars.
Abstract: The epidemiology of suicide in Serbia and Montenegro from 1989 to 2003, a period of civil war, is presented. Following the break-up of former Yugoslavia, Serbia and Montenegro underwent a period of war from 1991–1994 and another in 1999. During the war years, the number of suicides increased, reaching its peak in 1993. Male suicides outnumbered female suicides by a ratio of 2:1. Male suicides decreased slightly after the war of 1991–1994 only to rise in 1997 and continue at this higher level throughout the nineties. In Serbia alone, male suicide reached its peak in 2002 (nearly 29/100,000). The methods of suicide changed significantly, with the use of firearms doubling during and after the war years. Speculations are offered about the findings, many consistent with Durkheim's classical hypothesis concerning suicide and unpopular wars.
TL;DR: The study of suicide in indigenous peoples is explored in different nations, both within nations containing many types of indigenous peoples and also across cultures.
Abstract: The study of suicide in indigenous peoples is explored in different nations, both within nations containing many types of indigenous peoples and also across cultures. Some illustrations are given of how studies of indigenous peoples can be used both to test existing theories of suicide and generate new theories of suicide.
TL;DR: The results indicate that suicide attempters with low CSF 5-HIAA in this sample tended to experience more discomfort and pain during self-inspection, which raises questions whether shame may be involved in the psychobiology of suicide.
Abstract: Two independent measures, 5-HIAA and the Rorschach Suicide Constellation (S-CON), both related to suicide, were studied in an attempt to explore any relationship between the two. Lumbar puncture and the Rorschach were performed in standardized manner on 38 consecutive psychiatric inpatients, who had made a recent suicide attempt. Low CSF 5-HIAA was significantly related to the S-CON (rs = −.517, p = .033) and the Vista variable in the S-CON appeared to play an important role for the correlation. The results indicate that suicide attempters with low CSF 5-HIAA in this sample tended to experience more discomfort and pain during self-inspection. These results raise questions whether shame may be involved in the psychobiology of suicide.
TL;DR: The diary left by Cesare Pavese covering the 15 years prior to his suicide is examined, finding that mention of failure with women was immediately followed in his diary by denigration of his literary work.
Abstract: The diary left by Cesare Pavese covering the 15 years prior to his suicide is examined. The noteworthy pattern is that mention of failure with women was immediately followed in his diary by denigration of his literary work. Other features of his life, such as the loss of his father when he was six, are also discussed.
TL;DR: An evaluation of Slovene suicide and meteorological data confirm a significant fluctuation of suicide incidence between the same months of consecutive years from 1985 to 1993 and the lack of significant correlation between the Meteorological data and suicide incidence starting in 1994 may be interpreted as a decreasing meteorological influence on suicide incidence due to increase in antidepressant use.
Abstract: The fluctuating rate of suicide associated with seasonal changes is present throughout the world. An evaluation of Slovene suicide and meteorological data confirm a significant fluctuation of suicide incidence between the same months of consecutive years from 1985 to 1993. This phenomenon has been observed in all months of the year, but especially during the spring months. The research results confirm a significant correlation between suicide incidence and temperature and suicide incidence and the number of sunny hours for 1985 to 1993. The lack of significant correlation between the meteorological data and suicide incidence starting in 1994 may be interpreted as a decreasing meteorological influence on suicide incidence due to increase in antidepressant use.
TL;DR: A highly significant association between the two items from HoNOS and CPRS and the validated scale, InterSePT exists and appears to be strong indicators of suicidality in this patient population.
Abstract: The use of general scales such as the Health of the Nation Outcome Scale (HoNOS) and the Comprehensive Psychopathological Rating Scale (CPRS) are widespread. Both scales contain non-validated items on suicidality. This study aimed to establish whether an association between these suicidality items and the validated scale, InterSePT exists. Forty patients with a diagnosis of schizophrenia or schizo-affective disorder were assessed using the three scales. A highly significant association between the two items and the validated scale was found. The suicidality items from HoNOS and CPRS appear to be strong indicators of suicidality in this patient population. The findings allow for use of the suicidality items in clinical assessments and re-investigation of suicidality of other studies where these general rating scales have been used.
TL;DR: A CD-ROM on suicide prevention was evaluated in an Inuit hamlet to examine if knowledge is acquired after viewing this multi-media format of education and showed knowledge increased after viewing.
Abstract: A CD-ROM on suicide prevention was evaluated in an Inuit hamlet to examine if knowledge is acquired after viewing this multi-media format of education Twenty-four respondents showed knowledge increased after viewing Forty six percent had never used a computer yet 95% felt the technology could train counselors Such technology may improve knowledge and skills in this cultural setting and perhaps may be useful in other cross-cultural environments
TL;DR: The inner world of bipolar patients as it relates to their suicidality, along with the appropriate psychoanalytically oriented approach to treatment, are highlighted.
Abstract: This paper gives an overview of psychoanalytic contributions to the understanding of suicidal behavior in bipolar patients. Although little specific literature is available, many authors have contributed to the understanding of these patients' psychodynamics and suicidality in various papers. Different points of emphasis are described, among these are defensive strategies, narcissistic personality structure, and dealing with intense feelings such as object loss. Using detailed case descriptions, the inner world of bipolar patients as it relates to their suicidality, along with the appropriate psychoanalytically oriented approach to treatment, are highlighted.
TL;DR: Almost all adolescents indicated that they learned something helpful in the suicide prevention group that would keep them from attempting suicide in the future, and some differences did emerge as a function of history of prior suicidal behavior.
Abstract: The purpose of this study was to present a psychoeducational suicide prevention group for psychiatrically hospitalized suicidal adolescents, and explore participant perceptions of the strengths and weaknesses of this group therapy experience using archival data. Over the course of approximately three years, 250 adolescents admitted to a psychiatric inpatient unit attended the suicide prevention group. Almost all adolescents indicated that they learned something helpful in the group that would keep them from attempting suicide in the future. The creation of a "Reasons To Live List" was reported as most helpful by adolescents while the creation of a "Safety List" was deemed least helpful. However, some differences did emerge as a function of history of prior suicidal behavior. Recommendations for future treatment research with suicidal adolescent psychiatric inpatients are offered.