Suicide and Life-Threatening Behavior

Published by Wiley
Online ISSN: 1943-278X
Publications
Article
Epidemiological trends in national suicide rates were identified, including a slowdown in the 1980s in the suicide rates of nations with the highest rates and a rising male suicide rate worldwide. A review of theories of national differences in suicide rates permitted selection of a small set of predictor variables, which were quite successful in predicting the suicide rates of 17 industrialized nations.
 
Article
Suicide rates may be affected by world news. Our objective was to investigate the possible impact of the terrorist attacks of September 11, 2001, on suicidal behavior in the Netherlands. There was evidence of an increase in rates of suicide and deliberate self-harm in the weeks immediately following the attacks. These findings contrast with Durkheim's (1897) original suggestion that suicide rates decline in times of war and outside threat but are in line with findings of increases in suicidal behavior after media coverage of lethal violence.
 
Article
A case of the attempted suicide of a 66-year-old female is presented. Comment based on the chapters in this volume is presented. Specific topics of demographics, psychiatric-psychological, object relations, the attempt, and concluding comments provide an idiographic illustration of suicidal behavior in an older adult.
 
Article
There is substantial evidence of detrimental psychological sequelae following disasters, including terrorist attacks. The effect of these events on extreme responses such as suicide, however, is unclear. We tested competing hypotheses about such effects by employing autoregressive integrated moving average techniques to model the impact of September 11 and the Oklahoma City bombing on monthly suicide counts at the local, state, and national level. Unlike prior studies that provided conflicting evidence, rigorous time series techniques revealed no support for an increase or decrease in suicides following these events. We conclude that while terrorist attacks produce subsequent psychological morbidity and may affect self and collective efficacy well beyond their immediate impact, these effects are not strong enough to influence levels of suicide mortality.
 
Article
In many European countries, suicidal behavior constitutes a major public and mental health problem. In most countries, the number of suicides is significantly higher than the number of deaths due to traffic accidents. According to official figures, the suicide rates among European countries differ widely; for example, Hungary has the highest rates. Suicide attempt rates, based on data from the WHO/Euro Multicentre project on Parasuicide, equally show variation; for example, the highest average rate of suicide attempts is for Helsinki, Finland. This paper outlines the epidemiological findings and then presents some hypotheses (e.g., age, ethnic difference) to explain the differences.
 
Article
To determine changes in rates of drug ingestions in 10-14 year old children in our country, a retrospective chart review of 10-14 year olds hospitalized for drug ingestion between 1993-1995 and 2000-2004 was performed. Odds ratios and Chi-square were used for analyses. From 1993-1995 there were 92.8 ingestions/100,000 children/year; from 2000-2004 there were 63.3 ingestions/100,000 children/year. More males ingested in 2000-2004 than 1993-1995 (26.3% vs.14.2% O.R. 2.15 [1.19, 3.92]). More patients took psychiatric medications in 2000-2004 than 1993-1995 (38.9% vs. 27.0%, O.R. 1.72 [1.06, 2.80]). More patients ingested SSRIs in 2000-2004 than 1993-1995; fewer ingested tricyclics. Hospitalization rates for drug ingestions have decreased. There has been a change in drug ingested, and more males are ingesting drugs.
 
Article
Fatal and nonfatal injuries due to suicidal behavior among younger adolescents are of growing concern for many communities. We examined the incidence and patterns of these injuries among persons aged 10-14 years using three databases, two national and a third from Oregon. Suffocation and firearm gunshot were the leading external causes of suicide; poisoning and cutting/piercing were the leading causes of nonfatal self-harm injuries. The most common psychosocial factors associated with those treated in emergency departments for self-harm injuries were psychological conditions; drug/alcohol involvement; and adverse circumstances, including family discord, school problems, and physical/sexual abuse. Analysis of population-based data from these databases are part of the public health approach and can help direct much needed research and prevention efforts that address self-harming behavior in these younger adolescents.
 
Article
There have been numerous papers focusing on culture and suicide, but it seems that they have often emphasized cultural differences excessively, thus running the risk of increasing prejudice toward different cultures and reinforcing overgeneralizations. From my albeit limited knowledge and experience, it appears that there are more similarities than differences in suicide among various cultures. Most cases of suicide reflect complex human factors that are found universally among cultures. Despite the fact that some cultural differences in suicide admittedly exist in different societies and that these are important, they cannot explain every aspect of suicide. This article explains how I, as a Japanese psychiatrist, diagnose and treat suicidal patients against the backgrounds of Japanese culture by presenting my way of thinking in daily practice in order to show similarities and differences that exist in Japanese suicide, treatment, and prevention.
 
Article
Among affectively ill patients followed naturalistically for up to 14 years, 36 committed suicide, 120 attempted suicide, and 373 had no recorded suicide attempt. Comparing these three groups on clinical and intake personality revealed that suicide completed within 12 months was predicted by clinical but not personality variables, and suicide beyond 12 months was predicted by newly derived temperament factors, not clinical variables. Attempters and completers shared core characteristics: previous attempts, impulsivity, substance abuse, and psychic turmoil within a cycling/mixed bipolar disorder. Such temperament attributes as impulsivity and assertiveness were the best prospective predictors of completed suicides beyond 12 months with a sensitivity level of 74% and specificity level of 82%.
 
Article
This paper presents a survey of suicide in Denmark from the time when statistics were first kept 100 years ago, up to the present. The remarkable high suicide rate at the start is discussed. The belief that suicide rate is influenced by several factors outside the individual, factors which to some extent can be influenced, is supported by the great variability of the suicide index during the last 100-150 years, being 29.9 in 1861, 12.8 in 1918 and 26 in 1976. The distribution according to sex and age today compared have helped many elements of the population, especially the youngest and the eldest, and especially the men. However, among women 35 to 70 years old and especially those between 45 and 55 the suicide rate has increased. One possible explanation is today's greater number of divorces with all the troubles that follow. Finally, the changing of suicide methods is discussed.
 
Article
In this study indicators associated with suicidal ideation and suicide attempts in a nationwide representative sample (N=3184) of Danes aged 16-35 years were examined. The study was cross-sectional and had three aims: (1) to draw a profile of persons with and without suicidal tendency established on a combined quartered variable on current suicidal thoughts and/or ever attempted suicide; (2) to explore whether the different suicidal tendencies constitute a severity continuum; and (3) to identify factors of significance for suicidal tendency. Factors included were demographic characteristics, living conditions, social network, external health risks, lifestyle, health-related quality of life, symptoms, morbidity, and illness behavior. A continuum hypothesis was not supported, as the multiple logistic regression analysis showed no clear gradient in the different forms of suicidal tendency. Cohabitation status (single, p < 0.0001), exposure to violent threats (p < 0.0001), exposure to sexual abuse (p < 0.0001), being a daily smoker (p < 0.0001), doing nothing to stay healthy (p < 0.0004), poor mental health (p < 0.0001), mental symptoms within the past 2 weeks (p = 0.0003), contact with psychologist (p < 0.0001), and absence from work due to illness (p = 0.005) were indicators significantly related to suicidal tendency.
 
Article
The prevalence of suicidal ideation/behavior in 1983 or 1987 and its association with future mental health in 2001 were evaluated in a provincially representative sample of Canadian adolescents (n = 1,248) aged 12 to 16 years. Approximately 13.3% (95% CI = 11.5-15.3) of adolescents self-reported suicidal ideation/behavior. Adolescent agreement with parent (κ = .07) and teacher (κ = .05) reports at baseline was low because adults identified so few subjects. In adulthood, the associations between adolescent self-reports of suicidal behavior/ideation and major depression and other mental health indicators were explained by respondent sex and adolescent emotional problems reported in 1983/1987. Adolescents with suicidal behavior/ideation often are not recognized by their parents and teachers and may be at risk for persistent psychiatric problems attributable to coexisting mental health problems early-on.
 
Article
This study presents the changes in the overall and firearm suicide rates for Québec (Canada) before and after Bill C-17, which was implemented to secure safe storage of firearms. It covers 20,009 suicide cases reported to the coroner's office. Interrupted time series analysis is used to compare suicide rates in the two periods. Firearm suicide rates have dropped among males and females, but the downward trends were not significant when compared to those prior to the law. Hanging suicide rates have risen considerably among men and women, but those upward trends did not increase significantly when compared with those preceding the law. The decline in suicide rates involving firearms has not resulted in a parallel decline in overall suicide rates. The analyses suggest that Bill C-17 neither improved the downward trend in firearm suicide, which had already begun before the enactment of the law, nor reduced the upward trend of the overall suicide rate. Correlation analyses between firearm suicide, hanging suicide, and the overall suicide rate suggest that firearm suicide is replaced by hanging suicide among males.
 
Article
Drug poisoning is the leading method of suicide-related deaths among females and third among males in the United States. Alcohol can increase the severity of drug poisonings, yet the prevalence of alcohol overdoses in suicide-related drug poisonings (SRDP) remains unclear. Data from the Nationwide Inpatient Sample was examined to determine rates of inpatient hospital stays for SRDP and co-occurring alcohol overdoses in adolescents (ages 12-17) and young adults (ages 18-24) between 1999 and 2008. Among adolescents, there were 14,615 hospitalizations for drug poisonings in 2008, of which 72% (10,462) were suicide-related at a cost of $43 million. Rates of SRDP in this age group decreased between 1999 and 2008. The prevalence of co-occurring alcohol overdoses increased from 5% in 1999 to 7% in 2008. Among young adults, there were 32,471 hospitalizations for drug poisonings in 2008, of which 64% (20,746) were suicide-related at a cost of $110 million. Rates of SRDP did not change significantly between 1999 and 2008. The prevalence of co-occurring alcohol overdoses increased from 14% in 1999 to 20% in 2008. Thus, while rates of SRDP decreased for adolescents and remained unchanged for young adults, the prevalence of co-occurring alcohol overdoses increased for both age groups. Such hospitalizations provide important opportunities to employ intervention techniques to prevent further suicide attempts.
 
Article
The rate of suicide in young adults has more than doubled since 1950. This paper presents some explanations for this rise and analyzes the diagnoses and population groups whose high rates of suicide contribute most of this increase. The factors leading to suicide are presented for each group, and preventative interventions are developed from the analyses. Groups that can be readily affected by suicide reduction measures are discussed, and methods for reducing their suicide rates are proposed.
 
Article
Within the contexts of both the American Association of Suicidology's (AAS's) history and the history of associating suicidologists, an integrative identity based on the tenets of science is urged for the AAS. Two propositions are made: first, that we must promote and adopt more discriminative, standardized terminology; second, that we must promote and implement standards of informational competency for professionals and paraprofessionals alike.
 
Article
Little is known about accurate prevalence and associated factors of deliberate self-harm (DSH) among adolescents in Asian countries. In this study, the prevalence and associated factors of DSH among adolescents in Japan were examined. Data were derived from a cross-sectional survey using an anonymous self-report questionnaire and enrolling 8,620 adolescents aged 12-15 and 9,484 aged 15-18. DSH in the previous 12 months was reported by 3.3% (95% CI, 2.9-3.7) of junior and 4.3% (3.9%-4.7%) of senior high school respondents. The prevalence was more than four times as high among girls as among boys for both age groups. DSH was further strongly associated with having suicidal thoughts, having depression/anxiety symptoms, and having used recreational drugs. These associated factors were similar for both sexes and for both older and younger teenagers. A substantial minority of adolescents present with DSH, even among those aged 12-15. The prevalence of DSH in Japan was in the lower ranges of those reported for Western countries. The identified associated factors were not dissimilar from those reported in the West.
 
Article
The epidemiology of adolescent suicide is summarized with particular emphasis on temporal trends by age and gender. "First-generation" prevention programs, as reviewed and critiqued by the Centers for Disease Control and Prevention, are then examined. In the absence of compelling empirically based behavioral outcome data, selective targeted "second-generation" prevention efforts are then described across the primary-secondary-tertiary continuum. These efforts are focused toward targets of individual predisposition, the social milieu, or proximal agents associated with high risk for suicidal behaviors. Finally, with an eye toward the future, current obstacles and unanswered questions are explored as they relate to opportunities and hopes for change in effecting reduced rates of these behaviors.
 
Article
Police suicide research has yielded inconsistent results. An opportunity presented to survey Queensland police suicides in a historical context and add to the existing literature; the study describes changes in police suicide over time, the associated characteristics, and opportunities for intervention. Suicides were examined from the origins of police in Queensland in 1843 up to 1992. Suicide rates were higher earlier, around 60 per 100,000, declining to around 20 per 100,000 recently. The recent rate is lower than most other police studies but the same as the general community (employed). Most suicides were associated with psychological and physical ill health, alcohol abuse, and domestic problems, in keeping with general community surveys. However, occupational problems were more evident than is generally the case. The proximity in time of disciplinary events and suicides was striking. Future studies should explore the interactions between these factors.
 
Article
A bibliography of suicide notes, arranged chronologically, from 1856 to the present (1979) is presented without comment.
 
Article
This paper analyzes trends in the male-female suicide ratio in Australia, using data for the period 1901-1985. The main finding of the paper is that modernization, as measured by an index composed of the female participation rate in the labor force and the urbanization rate, is positively related to the male-female suicide ratio. This is contrary to an earlier finding by Stack and Danigelis (1985), who reported an inverse relationship between these two variables. This finding is shown to be due to the fact that no correction was made for trend. When the data series are corrected for trend, a significant positive relationship is found between modernization and the male-female suicide ratio in Australia. Another finding of the paper is that the female suicide rate in Australia has been falling significantly since the mid-1960s. This is also at variance with Stack and Danigelis's hypothesis that as modernization proceeds, the female suicide rate rises. We discuss reasons for this in the Australian context.
 
Article
The paper utilizes a natural experiment approach to estimate the impact of exogenous social and political events on suicide behavior in the United States between 1910 and 1920. The study is concerned with determining the impact of World War I, the great Influenza Epidemic, and the prohibition experiment on suicide. Estimating the monthly population in the United States registration area from 1910 to 1920, monthly suicide and mortality rates are computed. A time-series model is postulated, and second-order autoregressive estimates are used to determine the impact of the independent variables in the model. It is concluded that World War I did not influence suicide; the Great Influenza Epidemic caused it to increase; and the continuing decline in alcohol consumption between 1910 and 1920 depressed national suicide rates. Further individual-level aggregate studies are needed to confirm the findings of the study.
 
Article
The literature of the impact of publicized suicide stories on suicide has neglected the influence of social contexts. In the present study, the context of a popular war was inspected. A Durkheimian perspective was tested, wherein the context of war would lower suicide through promoting social integration. Suicide stories in such times should have less of an impact than in times of peace. Data were collected on widely publicized suicide stories during the World War I decade. A Cochrane-Orcutt iteractive time series analysis found that publicized suicide stories during war had no impact on suicide. In contrast, peacetime suicide stories were associated with an increase of 48 suicides. This is significant, since the electronic media were nonexistent and hence could not reinforce the publicity in the printed media, as they do today. Further analysis of the relationship found similar results for New York City.
 
Article
In recent years many suicidologists have based their epidemiological studies on suicide on theories assuming that people born within the same period of time will follow the same suicidal patterns throughout their lives, and that variations in the annual rate of suicide will, therefore, reflect systematic differences between cohorts. Cohort analysis carried out on Danish data showed, however, that although some differences could be found as to the course of events during the life span of the cohorts and also when the material was adjusted for sex, no significant differences could be found between various birth cohorts in the total rates of suicide. The authors argue that the reason for this is that a cohort effect is only one of three dimensions of an analytical tool, namely, Age-Period-Cohort (APC) analysis, and that the balance between the three effects changes over time.
 
Article
Depression-era bank suspensions and failures are conceptualized as products of the first part of what Polanyi (1994) called "The Great Transformation," which involved an imbalanced institutional arrangement in which the economy dominated other institutions. Relying on Durkheim (1897/1951) and Merton (1938, 1968), it is argued that these banking problems accentuated the type of chronic anomie that Durkheim theorized would create normative deregulation and elevated suicide rates over the long-term. Results from county-level analyses are supportive as the 1930 bank suspension rate is positively related to the 2000 suicide rate, controlling for contemporary and historical factors. The mediating roles of integration and chronic anomie are considered, with the latter measured using data from the geocoded General Social Survey.
 
Article
This study employed multiple classification analysis to examine the impact of age, period, and cohort effects on U.S. white male suicide rates between 1933 and 1978. Previous studies of cohort effects with regard to suicide behavior have been descriptive in nature, and have failed to consider the interaction of the three effects. Drawing on a study of pulmonary tuberculosis mortality by W.M. Mason and Smith (1985), the work specified seven models. The Shazam ordinary-least-squares computer package was employed to estimate the logit coefficients for the seven models. Period effects were found to be weaker than age and cohort effects for explaining shifts in white male suicide patterns. In this study all of the three effects were measured indirectly, and this fact limits the validity of the findings. Causal analysis, which directly measures at least one of the effects, would have improved the robustness of the findings.
 
Article
Changes in the age patterns of U.S. male and female suicide rates from 1934 to 1983 are examined, using official suicide data. Among whites, the age patterns of male and female suicide rates have become less concordant since about 1960. In contrast, the age patterns of nonwhite male and female suicide rates have become more concordant since the mid-1950s. A review of sociological theories of suicide identifies problems in accounting for such changes--problems stemming in part from what has been a theoretical emphasis on cross-sectional relations.
 
Article
Recent clusters of teenage suicides in Texas suburban communities have focused national attention on the rise in teenage suicidal behavior. This study sought to clarify the teenage suicide phenomenon by using a cohort method of data analysis. Beginning with suicide rates for white males aged 15-19 in 1945, suicide rates were calculated and plotted for each 5-year age cohort entering the late teenage years, when suicide risk factors dramatically increase. Our analysis of these cohort patterns confirmed the ever-rising risk factor associated with the ages of 15-19. This trend is consistent with many studies suggesting that teenage suicide is a function of socioeconomic and psychological factors operating across community and national boundaries. In addition, our study revealed that as white males 15-19 years of age in 1945 aged, their suicide rates also increased, confirming earlier findings that the suicide risk factor increases with age. In fact, Texas data for 1980 revealed that older persons, not teenagers, had the highest suicide rates-a finding that confirms other studies' results. Finally, Texas cohort patterns for suicide revealed the recent curvilinearity tendencies of older adult male suicide rates. By 1980 Texas data revealed a bimodal distribution of high suicide risk, with white males in their late 20s and ages 55 and over having the highest rates.
 
Article
The World Health Organization (WHO) provides annual mortality statistics from 1950 onward based on the International Classification of Diseases (ICD). In this paper we evaluate the effects of ICD form revisions on suicide rates for 71 countries. The changes between ICD-6, ICD-7, ICD-8, and ICD-9 did not have an overall effect on reported suicide rates. The transitions to ICD-8 and ICD-9 were, however, associated with country-specific changes in the suicide rate in some countries. The change from ICD-9 to ICD-10 was associated with an overall change of -.73 suicides per 100,000 inhabitants. It is recommended that researchers using the WHO mortality data for longitudinal cross-national studies control for the ICD form used at different time points.
 
Article
Using Census data covering the 29 year period starting in 1950 this study tests the hypothesis that (1)#female labor force participation may result in more married women committing suicide due to the strain of household and outside working responsibilities and the (2) female labor force participation may also be associated with higher rates of male suicide due to the fact that it represents apparent failure of the husband as sole breadwinner (Stack, 1978). Results show that during the 1950's male suicide was not associated with growth in the female labor force, but female suicide was. During the 1960s male suicide was negatively associated with female labor force participation, but the opposite was true for females. It is argued that working women represented a weakening of norms concerning sex roles. Apparently as more and more women entered the labor force, role conflict did ensue, but contrary to the above hypothesis it only increased female suicide potential. These results are discussed in terms of different normative sex role contexts of the 1950s and the 1960s.
 
Article
The aim of this paper was to estimate how suicide rates in the United States are affected by changes in per capita consumption during the postwar period. The analysis included Annual suicide rates and per capita alcohol consumption data (total and beverage specific) for the period 1950-2002. Gender- and age-specific models were estimated using the Box-Jenkins technique for time series analysis. No significant estimate was found for males. For females the total alcohol estimate (0.059) was significant at the 10% level whereas the spirits estimate was significant with an effect of 0.152. The results imply that a change in U.S. per capita consumption would result in a change in female suicide rates, whereas the male rates would not be affected.
 
Article
The cross-country differences and the trends of suicide rates in 71 countries from 1950 to 2004 are described. The data are from the World Health Organization's Mortality Database. It shows that suicide rates vary greatly across countries, even within the same region or at similar levels of development. Random-effect models were used to examine the between-country and within-country stabilities in suicide rates. The results show that more than 90% of the variance in suicide rates is due to between-country differences, suggesting suicide rates display a strong temporal stability.
 
Article
This investigation examines the deterrence hypothesis of an inverse relationship between state execution rates and homicides. Although this question has received some attention in recent studies, the findings of these investigations are mixed. Cross-sectional analyses of states have typically shown execution and homicide rates to be positively associated, while at least two national time-series studies report support for the deterrence hypothesis. To test whether these divergent findings are result of the two different methodologies employed (cross-sectional vs. time-series), a methodology that combines the strengths of each is used in the present study. For the period 1950 to 1960, we examine cross-sectionally for states the relationship between changes in execution rates and changes in murder rates. This analysis does not find support for the deterrence argument for the certainty of the death penalty when a number of models of the execution rate--murder rate relationship are considered, and when a variety of imprisonment and socio-demographic factors are considered as control variables.
 
Article
This study examines whether the purported tripling in teenage suicides since the 1950s represents a real increase or is simply an artifact of the increased skill of medical examiners in distinguishing youth suicides from fatal accidents. This study examines firearms and poisoning deaths, which together account for 75% of all certified youth suicides, from 1953 through 1987, and concludes: (a) a past undercount of youth suicides is likely, (b) the increase in youth suicide that has occurred is less dramatic than reported and resembles increases in adult suicide, and (c) the suicide increase indicated among youths and adults occurred from 1964 to 1971 and has since stabilized.
 
Article
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.
 
Article
National data on firearm suicides and accidental firearm deaths for persons aged 15-19 from 1955 to 1979 were examined to test hypotheses of increases in reported suicide rates as resulting from (1) improved accuracy in the determination and certification of suicide in equivocal firearm deaths; (2) actual increases in the rate of firearm suicides among teens; or (3) some combination of these factors. Data presented support the hypothesis of certification changes as the primary factor influencing suicide rates during the first 12-year segment, but suggest a period of actual growth combined with continued certification change from 1967 to 1979.
 
Article
We examined New Mexico vital statistics data for suicides and homicides among the state's Hispanics, Native Americans, and non-Hispanic whites collected from 1958 to 1987. We found high age-adjusted rates for both suicides and homicides among Hispanic and Native American males, in comparison with rates for non-Hispanic white males. Suicide rates among Native American women were comparatively low, contrasting with their high homicide rates. Homicide rates for males in all three ethnic groups increased substantially over the 30-year study period. We conclude that death from violent causes, both suicide and homicide, is a major public health problem in New Mexico, and disproportionately affects minority males.
 
Article
A review was carried out on empirical studies on the classification of attempted suicide over the period 1963-1993. Our aim was to investigate whether there is research evidence for a valid classification of homogeneous subgroups of suicide attempters. After assessment of the research quality, 32 studies were selected for comparison. Although there is lack of consistency among the studies, indications were found for two clearly distinguished subgroups characterized by mild and severe suicide attempts, which constitute the opposite poles of a one-dimensional concept of severity.
 
Article
The declining English and Welsh suicide rates are associated with increased Samaritan efforts and detoxification of household gas during the pre-1972 era. The resulting debate has been heuristic. The author reviewed annual rates of new callers, volunteers and suicidal deaths between 1965 and 1977 and computed ratios of new clients to high risk people. This reveals an asymptotic progression towards 27 percent since 1972. Similarly, the ratio of new clients to volunteers has been constant at 11 for the same period. These consistencies help to explain the constant suicide rate at eight per 100,000 live people after 1972 despite increasing Samaritan efforts. The author recommends an effort to increase the percentage of high risk served as a test for the hypothesis of Samaritan causality in explaining the reduced English suicide rates.
 
Article
The traditional view that modernization is likely to increase male vulnerability to suicide while protecting females from such self-destruction was offered by Durkheim (1951). This implies a theory of divergence of suicide rates such that the male-female suicide ratio should increase with modernization. Contemporary researchers have questioned whether modernization has had such an impact. We conducted a time series analysis of male and female suicide data to determine the impact on the suicide ratio for India for the years 1967 to 1997. We developed a modernization index comprised of urbanization, female literacy, and female work participation rates. Moreover, to improve methodological efficacy, we controlled for the passage of time. However, we found that there is no significant relationship between modernization and the male-female suicide ratio. Our conclusion is that using national male-female suicide ratios to determine modernization effects may mask significant regional gender and age differences, particularly in developing countries such as India.
 
Article
Unlike previous work, the present investigation tests a nonadditive model of the suggestion/imitation. Suicide stories are predicted to have the greatest effect on suicide in times of high suicidogenic conditions. The latter are measured in terms of unemployment. Data on the American monthly suicide rate are analyzed using Cochrane Orcutt techniques. While support was found for the nonadditive model based on an interaction effect between media stories and the rate of unemployment, it did not prove more powerful than an additive model. Future work is needed, however, for a systematic testing of the nonadditive thesis.
 
Article
A study of 104 homicide-followed-by-suicide events in Los Angeles during 1970-1979 are reported and compared, in part, to the findings of D.J. West for Wales and England, 1954-1961. Variables discussed are age, ethnicity, sex distribution of both offenders and victims, relationship between them, methods by which victims were killed, alcohol content in victims and offenders, suicide notes, depression, and physical illness.
 
Article
From 1970 to 1990 California experienced a 32% decline in suicide, which was particularly pronounced among women, non-whites, the young, and urban dwellers. Suicide declines of over 50% were recorded in San Francisco and Los Angeles, and large decreases occurred in other coastal counties. Additionally, California was the only one of 51 states to show a consistent decline in teenage and young-adult suicide (accompanied by an 88% decrease in teenage drug and other poisoning deaths). Initial investigation of death certification, accident and homicide trends, economic measures, and prevention efforts did not produce an explanation for a suicide decrease of California's magnitude. However, the state does display anomalous trends in certain social measures (reduced divorce, rising non-White population, and rising homicide) that point to multifactorial hypotheses including demographic changes and changed attitudes toward violence. Review of the accuracy of past suicide certification procedures nationally is also indicated.
 
Article
The effect of seasons on suicides has been suggested repeatedly. In order to reveal a true seasonal pattern, an appropriate statistical technique, which is sensitive to a specific type of cyclic variation in the data, must be chosen. This study is a review of the use of statistical techniques for seasonality and of some important characteristics of study samples that were evaluated from 46 original suicide seasonality articles published in major psychiatric journals. The results showed that statistical techniques were applied in a majority of articles, but they were commonly lacking regarding analyses, which compared seasonal patterns among subgroups of a population. In recent studies more sophisticated statistical techniques were utilized for seasonality, like spectral analyses, as compared with earlier studies, in which the emphasis was on chi-square tests. Lack of reporting essential features of the data, such as the sample size and monthly values of suicides, were frequent. The calendar effect was adjusted only in 11 studies. Some recommendations concerning the methodological and reporting issues are summarized for future articles on the seasonal affect on suicides.
 
Article
The decade of the 70's has been reviewed with the document Suicide Prevention in the 70's serving as a guide. Twenty-one goals put forward in the report were reviewed in light of subsequent progress in the field. Although progress was noted on many fronts, four areas were outstanding in the sense that envisioned goals were met or exceeded. These involved the areas of promulgation of information about suicide, establishment of standards and certification procedures, development of regional organizations to forward training and program development, and education of the public to improve awareness of suicide as a public problem. This analysis also identified areas where little or no progress has been made. From this there developed four recommendations: 1. The funding and establishment of a national case file using a standard nomenclature and a standard data base to improve epidemiologic knowledge, and to provide pooled data appropriate for more sophisticated research analyses. 2. The establishment of a task force to study the application of program evaluation methods to suicide prevention efforts. 3. The development of new programs at local levels to try to reach known high-risk groups and to provide relevant programs of suicide prevention for them. 4. Making creative efforts toward elaboration of a comprehensive theory of life-threatening behavior and exploration of developmental corrolates of such behavior.
 
Top-cited authors
Patrick W. O'Carroll
  • University of Washington Seattle
Morton M Silverman
  • Medical College of Wisconsin
Alan L Berman
  • American Astronomical Society
Nels D Sanddal
  • Consultant, EMS and Trauma Systems
E David Klonsky
  • University of British Columbia - Vancouver