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Antoon A. Leenaars

Antoon A. Leenaars
Independent Researcher

Doctor of Philosophy

About

247
Publications
49,357
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Introduction
Dr. Antoon A. Leenaars is a registered psychologist in private practice in mental health, public health, and forensic sciences in Windsor, Canada. He was Senior Advisor with the Norwegian Institute of Public Health, Division of Mental Health, Norway, member (Researcher) of the Faculty (Dept. of Clinical and Health Psychology) at the University of Leiden, The Netherlands, and member (Adjunct Lecturer) of the Faculty (Dept. of Public Health Sciences) at the Karolinska Institutet, Sweden.

Publications

Publications (247)
Article
Full-text available
Secrecy kills. What can we learn about the most dangerous aspect of the suicidal mind? A psychological autopsy was undertaken. We interviewed 120 survivors of people who died by suicide. Like in suicide notes, we found the mask, (self)deception, dissembling, camouflaging, whatever you may call it, in almost 80%! That is risk! We learn from the surv...
Article
Full-text available
Abstract Public health organizations have recommended restricted access and safe storage practices as means to reduce firearms injuries and deaths, most specifically, suicide, homicide and accidental deaths. We aimed to present the effects of three firearms restrictions on suicide in Canada. Canada’s Criminal Amendment Act in 1977 (Bill C-51) manda...
Chapter
Full-text available
Abstract Public health organizations have recommended restricted access and safe storage practices as means to reduce firearms injuries and deaths, most specifically, suicide, homicide and accidental deaths. We aimed to present the effects of three firearms restrictions on suicide in Canada. Canada’s Criminal Amendment Act in 1977 (Bill C-51) manda...
Chapter
Full-text available
Article
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Background: Theory is the foundation of science; this is true in suicidology. Over decades of studies of suicide notes, Leenaars developed a multidimensional model of suicide, with international (crosscultural) studies and independent verification. Aim: To corroborate Leenaars's theory with a psychological autopsy (PA) study, examining age and s...
Article
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Chile exhibits an alarming increase in the number of suicides among both the general population and the prison community, this being a matter of concern for justice and health authorities. Objective: the analysis of suicides committed by prisoners in Chilean jails during years 2006-2015 in order to obtain the profile of both the suicide acts and pe...
Article
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Previous research using small samples and subjective judgments has failed to identify reliable sex differences in the suicide notes. Suicide notes written by 166 women and 513 men collected by Edwin Shneidman were analyzed by the Linguistic Inquiry and Word Count computer program. Six significant different and four trends were identified. The suici...
Article
Full-text available
Chile exhibits an alarming increase in the number of suicides among both the general population and the prison community, this being a matter of concern for justice and health authorities. Objective: the analysis of suicides committed by prisoners in Chilean jails during years 2006-2015 in order to obtain the profile of both the suicide acts and pe...
Article
Full-text available
This study explores self-esteem in suicide among young males with no earlier history of suicide attempt(s) or treatment in mental health services. The data come from an ongoing psychological autopsy study; 10 cases of young men aged 18 to 30, were selected to generate a phenomenologically based understanding of the psychological mechanisms and proc...
Article
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Introduction: Public health organizations have recommended restricted access and safe storage practices as means to reduce firearm injuries and deaths. We aimed to assess the effect of four firearm restrictions on firearm deaths in Norway 1969-2009. Methods: All deaths due to firearm discharge were included (5,660 deaths, both sexes). The statis...
Article
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Serial killers have always fascinated society. A serial killer is typically defined as a perpetrator who murders three or more people over a period of time. Most reported cases of serial killers come from the United States and Canada. In India, there are few reported cases. We present, to the best of our knowledge, the first Indian case in the lite...
Article
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One of the most established "truths" in suicidology is that almost all (90% or more) of those who kill themselves suffer from one or more mental disorders, and a causal link between the two is implied. Psychological autopsy (PA) studies constitute one main evidence base for this conclusion. However, there has been little reflection on the reliabili...
Chapter
Suicide is strongly forbidden in India. The Dharmashastras (a book on the codes of living in ancient India) is explicit in the condemnation of suicide (Thakur, 1963). In India, assisting suicide is a punishable offence under the legal code (Leenaars, et al., 2001). There are strong taboos toward suicide in India, even toward research into suicide....
Article
Too often ethical boards delay or stop research projects with vulnerable populations, influenced by presumed rather than empirically documented vulnerability. The article investigates how participation is experienced by those bereaved by suicide. Experiences are divided into 3 groups: (a) overall positive (62%), (b) unproblematic (10%), and (c) pos...
Article
Edwin S. Shneidman (DOB: 1918-05-13; DOD: 2009-05-15) is a father of contemporary suicidology. His work reflects the intensive study of lives lived and deaths, especially suicides, and is the mirror to his mind. His contributions can be represented by five categories: psychological assessment, logic, Melville and Murray, suicide, and death. His wor...
Article
A 28-year-old man, Surinder Koli, from a Nithari village adjoining Delhi, India committed serial murder. This case was of paramount importance in medico-legal investigations, as it was a landmark case of a serial killer reported from India. The skeletal remains (627 pieces) including skull/skull portions (19) were recovered from the nearby sewer dr...
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Suicide is the second leading cause of death among 25–34 year olds and the third leading cause of death among 15–25 year olds in the United States. In the Emergency Department, where suicidal patients often present, estimating the risk of repeated attempts is generally left to clinical judgment. This paper presents our second attempt to determine t...
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En el año 2003 el suicidio se declaró como un problema de salud pública por la World Health Organization (WHO), y por tanto la Organización de las Naciones Unidas (ONU), junto con la Asociación Internacional de Prevención de Suicidio (IASP), declararon al 10 de septiembre como el «Día Mundial de la Prevención del Suicidio». Esto fue posible gracias...
Article
Full-text available
Edwin S. Shneidman (13-05-1918 - 15-05-2009) is known as the father of contemporary suicidology. His work reflects the intensive study of lives and deaths, especially suicides, and is the mirror to his mind. Few people, like doctor Edwin S. Shneidman, are vouchsafed the rare opportunity to create a new discipline, to name it, to shape it, to contri...
Article
Of the 800,000 suicides worldwide every year, a small number fall under Emile Durkheim's term of altruistic suicides. Study on martyrdom has been limited. There has to date, for example, been no systematic empirical study of martyr letters. We examined 33 letters of Korean self-immolators, compared with 33 suicide notes of a matched sample of more...
Article
Suicide is a global concern, hence, cross-cultural research ought to be important; yet, there is a paucity of cross-cultural study in suicidology. This study sought to investigate suicide notes drawn from India and the United States, as these countries have similar suicide rates but markedly different cultures. A thematic or theoretical-conceptual...
Article
Suicide is a global concern, hence, cross-cultural research ought to be central; yet, there is a paucity of cross-cultural study in suicidology. A thematic or theoretical-conceptual analysis of 60 suicide notes drawn from Turkey and the United States, matched for age and sex, was undertaken, based on Leenaars’s empirical-based multidimensional mode...
Article
Full-text available
Edwin S. Shneidman (DOB: 1918-05-13; DOD: 2009-05-25) is a father of contemporary suicidology.His work reflected the intensive study of suicide. His contributions on suicide are some of the essential studies in the field. The works on suicide can be divided into five parts: Definitional and Theoretical, Suicide Notes, Administrative and Programmati...
Article
Few studies directly address vulnerable populations' motivation for participating in research. Often motives are expressed spontaneously and typically given post-interview. This article investigates motivation for research participation among informants who have been bereaved by suicide. Informants were specifically asked for their motivation eithe...
Article
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OBJECTIVE: This study sought to investigate suicide notes drawn from Mexico and the United States (US) as these countries share geographical proximity, but markedly different cultures and suicide rates. MATERIAL AND METHODS: A theoretical conceptual analysis of 102 suicide notes drawn from these countries, matched for age and sex, was undertaken ba...
Article
Full-text available
This study sought to investigate suicide notes drawn from Mexico and the United States (US) as these countries share geographical proximity, but markedly different cultures and suicide rates. A theoretical conceptual analysis of 102 suicide notes drawn from these countries, matched for age and sex, was undertaken based on a thematic model of suicid...
Article
Previous research, albeit limited, has reported mixed findings on the impact of menstruation cycle on suicidal behavior. The contribution of menstruation to completed suicide is also controversial; the studies are, in fact, very limited and are not carefully designed. To examine whether the menstruation cycle impacts on suicide. In order to explore...
Article
Full-text available
The usual clinical practice When clinicians are called to see a patient who has attempted suicide, they usually try to assess the risk of further suicidal behaviour by interviewing the patient in their search for clinical risk factors, particularly for signs of a psychiatric disorder, such as depression, substance abuse, severe personality disorder...
Article
The objective of this study was to identify the impact of a patient's suicide on psychiatrists in Thailand. A confidential coded postal questionnaire survey was sent to 320 eligible psychiatrists; with a response rate of 52.18%). The results showed that 94 (56.28%) of responding psychiatrists had a patient die by suicide, consistent with high rates...
Article
The villain for the would-be suicide attempter is pain; clinicians need something to fight that pain, an anodyne. Psychotherapy is such; yet, to assuage the pain, the clinician primarily needs to know what he/she is treating. This paper, thus, first offers an empirical, cross-cultural perspective on that ‘what,’ illustrated with the writings of Wil...
Chapter
Reconsideration of CluesYoung AdulthoodResearch on Suicide in Young AdultsIdiographic ApproachThe Case: IntakeThe Case: The ProcessPrediction and AssessmentUnderstanding SuicideThe Case: InterpretationRichard Cory: ReconsideredConcluding Remarks
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A Developmental Perspective of Late AdulthoodJoe: An IntroductionFirst VisitJoe's DespairConsultationThe Subsequent VisitsThe Latter VisitsConcluding RemarksWhat Have we Learned From This Case?
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Prediction Versus AssessmentLethality and PerturbationTests to Predict SuicideUnderstanding Suicide as Assessment and PredictionA Theory of SuicideA Few Notes on Transference and Countertransference in AssessmentCase Illustration: Vince Foster JRAssessment of Suicide Risk: A Prologue
Chapter
I Patient DataII Suicidal ExperienceIII Referral DataIV Interview SituationV InterpretationsVI RemarksInstructions
Chapter
Middle AdulthoodPeter and Rita: RevisitedPeter'S ChaosConsultationRejection-aggressionPeter'S HistoryPeter's NeedsThe Mother's DeathRita Goes on and onRelationshipsUnderstanding the ChaosSuicide in AlcoholismAccepting the UnacceptableIntrojectsThe Latter VisitsCoping With Life's DemandsWhat Have we Learned From This Case?
Chapter
The Case: An ExaminationThe Case: The ProcessCase Discussion: Preliminary ConsiderationsA Developmental PerspectiveA Few Preliminary ConceptsA Psychological Theory of SuicideUnconscious ProcessesTreatment: A Few ObservationsConcluding Remarks
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Definition of SuicideEpidemiology of SuicideHistory of SuicideContemporary Developments in SuicidologySuicide Facts and MythsAttempted SuicidePartial Death and Substitutes for SuicidePsychological Theories of SuicideTheoretical/Clinical ObservationsBehavioural CluesGenderA Life-Span Perspective of SuicideCultural VariationSuicide PreventionRational...
Chapter
The UnconsciousA Serendipitous FindingA Study: An IntroductionSpeculations on the UnconsciousA Case IllustrationConcluding Remarks
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A New StudyA Discussion: What we Learn From This StudySummaryAppendix 20.1 Thematic Guide For Suicide Prediction: Form 2
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MedicationHospitalizationEnvironmental ControlConcluding Remarks
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The ReferralBackground Early VisitsConsultationThe ConfusionsThink Before You ActSummer HolidaysProtective FactorsThe Mother's SuicideWhat Have We Learned from this Case'
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Suicide NotesPsychotherapy ProtocolsConcluding Remarks
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Back to the PrefaceImplications for ResponseConcluding RemarksAppendix 12.1 Shneidman Psychological Distress Questionnaire
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The Next VisitsDanKonradDan RevisitedGoodbye to KonradThe FatherBenSex DifferencesThe Father ContinuedTerminationAnd then her Father Killed HimselfConsultationSurvivorshipLearning to Live AgainSaying GoodbyeGoodbyeWhat have We Learned from this Case?PostscriptAppendix 16.1 Shneidman Psychological Distress Questionnaire (PDQ)
Chapter
Cognition, Communication, and NotesConsiderations Preliminary to PredictionReview of the LiteratureSuicide NotesThematic Guide for Suicide PredictionConcluding Remarks
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Background RapportCommunity ApproachFirst ContactsThe Subsequent VisitsThe DeathCalculated Risk-TakingWhat Have We Learned from this Case?Concluding RemarksAppendix 14.1 Thematic Guide for Suicide Prediction
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A CaseThe ModelA Few Notes on Transference and Countertransference in InterventionConcluding Remarks
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Suicide NotesA Theory of SuicideSome ObservationsAn Idiographic SummaryConcluding Remarks
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scream with suicide;suicidal pain;inner turmoil of deep anguish;munch's mind;history of depression
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Suicide Notes and Other Personal DocumentsOther Personal DocumentsThe Suicidal PoemSylvia PlathPlath's Processes to DeathConcluding Remarks
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Laws on Suicide, Assisted Suicide and EuthanasiaStandards of Care and LiabilityFurther Ethical and Professional ConcernsConcluding Remarks
Chapter
HistoryA NoteThe ArrestThe Analysis of the NoteLimitations of a NoteThe Psychological AutopsyShneidman's Perspective on the Psychological AutopsyThe InterviewsAn AutobiographyA Few Pre-Trial DocumentsCherrylle and ScottA Newspaper's StoryCourt TestimonyMy TestimonyThe Verdict
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Half TitleTitleCopyrightContentsAbout the AuthorPrefaceAcknowledgements
Chapter
Full-text available
IntroductionSuicide and Attempted SuicideEuthanasia and Assisted SuicideStandards of Reasonable and Prudent CareResponsibility of CareFailure in CareLiability and MalpracticeConclusion References
Article
Full-text available
Shneidman's Psychological Pain Assessment Scale (PPAS; 1999) was administered to 88 psychiatric patients. Both current and worst-ever psychache were significantly higher in those patients judged by a psychiatrist, on the basis of a structured clinical interview, to be at risk of suicide. However, current and worst-ever psychache were not associated...
Article
There has been limited study of suicide in Islamic countries. This paper marks the first study of suicide notes in Turkey, an Islamic country. Using a classification scheme, 49 suicide notes (a rate of 34.5%) were studied. The results show that note writers do not differ greatly from other suicides. Further analysis of younger (<40) and older (>40)...
Article
Suicide is a multifaceted event that is open to study from multiple points of view. In this chapter, I offer a psychological/psychiatric perspective with diverse ethnic and racial applications. I do so because I agree with Shneidman (1985) that the psychological dimensions of suicide are the "trunk" of suicide. This is true regardless of the cultur...
Book
Almost a million people die by suicide every year (WHO estimate) The sheer numbers have made suicide prevention a major health target, but effective prevention is not straightforward. Suicide is a complex event, more complex than most of us imagine, calling for an equally complex response. Psychotherapy with Suicidal People provides a multi-compone...
Article
Full-text available
Previous research has reported mixed findings on the effect of the menstrual cycle on suicidal behavior. The contribution of menstruation to completed suicide is also controversial, though the studies are very limited and have not been carefully designed. To explore the relationship, 217 autopsies on completed suicides were performed, matched to a...
Article
Full-text available
Previous research has reported mixed findings on the effect of the menstrual cycle on suicidal behavior. The contribution of menstruation to completed suicide is also controversial, though the studies are very limited and have not been carefully designed. To explore the relationship, 217 autopsies on completed suicides were performed, matched to a...
Article
Gun control is the prototypical example of controlling the environment for the means of suicide, an effective public health approach to suicide prevention. Canada's Criminal Law Amendment Act of 1977 (Bill C-51) provides an excellent opportunity to illustrate the effects of legislative gun-control laws and the impact on suicide. The research in Can...
Article
According to international and Mexican official statistics, there is a dramatic rise in suicide in Mexico; however, research in this area is severely limited. This is the first study of suicide notes from Mexico in the international literature. From a population of 747 registered suicides, a sample of 106 note-writers and 106 non-note writers was e...
Article
One of the oldest methods of preventing death is by environmental control. Removing the sword from the defeated soldier in battle, for example, is an environmental act of prevention. Suicide, homicide, and accidental deaths can be so prevented. It has been empirically established across the globe that availability of a potential dangerous lethal me...
Article
People who have committed a certain sin ought to be dead; I am a person who has committed that sin; therefore, I ought to be dead. Thus is the logic of a suicidal mind. Lester, Szaz, and others argue the 'sinner' should always be allowed to kill him/herself. Shneidman, Leenaars and others do not agree. Once one knows the suicidal mind, it is easy t...
Article
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, 200437. Lambert , M. , Bergin , A. , & Garfield , S. (2004). Introduction and histo...
Article
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 fem...
Article
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 A...
Article
Full-text available
Suicidal thought is a risk factor and a stage in the suicidal process from planning to attempting and dying by suicide. To date, studies on suicidal thought in the general population, especially in Asian communities, have been limited. The WHO SUPRE-MISS (the multisite intervention study on suicidal behaviours) community survey questionnaire was fi...
Article
Full-text available
Shneidman's Psychological Pain Assessment Scale (PPAS) was explored for its validity and reliability. The test-retest reliability of the measures was quite modest for a 28-day interval. In a sample of undergraduate students, measures of psychache were significantly associated with prior suicidality; yet, the PPAS had only a modest degree of validit...
Article
The epidemiology of suicide in Thailand from 1977-2002 was presented. In the years 1977 and 2002, the suicide rates were 5.9 and 7.8 per 100,000 population. This is low compared to nearby Asian countries. The highest suicide rate was 8.6 per 100,000 in the year 1999, a time of economic crisis. The ratio of male to female suicide rate was 1.14:1 in...
Article
HIV/AIDS is an alarming illness worldwide. It is known to have a significant association to suicide, despite a lack of in depth study. Early studies suggested suicide risk 20 to 36 times higher than the general population, but more recent trends in America show a decline. This is not true in Africa, including the region of Eastern Province, South A...
Article
Full-text available
Although the existence of mood disorders was identified centuries ago, the present state of knowledge is unsatisfactory. This special issue of Archives of Suicide Research (ASR), the official journal of the International Academy for Suicide Research, presents the state of the science and collects new empirical data. Different aspects of suicidality...
Article
Object: Suicide is a multi-dimensional event. A report by the World Health Organization (WHO) isolated a series of effective public health tactics in preventing suicide. Method: This paper presents a selective review of research-based examples. Results: Public education about suicide has been controversial, but today the preponderance of studies ha...

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