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Abstract

In most Western countries females have higher rates of suicidal ideation and behavior than males, yet mortality from suicide is typically lower for females than for males. This article explores the gender paradox of suicidal behavior, examines its validity, and critically examines some of the explanations, concluding that the gender paradox of suicidal behavior is a real phenomenon and not a mere artifact of data collection. At the same time, the gender paradox in suicide is a more culture-bound phenomenon than has been traditionally assumed; cultural expectations about gender and suicidal behavior strongly determine its existence. Evidence from the United States and Canada suggests that the gender gap may be more prominent in communities where different suicidal behaviors are expected of females and males. These divergent expectations may affect the scenarios chosen by females and males, once suicide becomes a possibility, as well as the interpretations of those who are charged with determining whether a particular behavior is suicidal (e.g., coroners). The realization that cultural influences play an important role in the gender paradox of suicidal behaviors holds important implications for research and for public policy.
... According to the gender paradox in suicidology, an important sex difference has been reported for suicidal behavior. Females have higher rates of suicide ideation and suicide attempts than males, while fatal suicide acts are typically higher for males than for females [8][9][10][11][12]. The lethality of suicidal behavior in females is lower, most likely because males choose more violent suicide methods [8,13,14]. ...
... Females have higher rates of suicide ideation and suicide attempts than males, while fatal suicide acts are typically higher for males than for females [8][9][10][11][12]. The lethality of suicidal behavior in females is lower, most likely because males choose more violent suicide methods [8,13,14]. However, the reason why males and females choose different suicide methods is still controversial. ...
... One hypothesis is that men tend to gravitate toward more lethal methods than females because they have higher suicide intent [15][16][17][18]. Canetto et al. [8] proposed that women and men use different suicide methods as a result of the sex roles in their culture. ...
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According to the gender paradox in suicidology, an important sex difference has been reported with a preponderance of females in nonfatal suicidal behavior and a preponderance of males in completed suicide. Furthermore, females and males present different risk factors for suicide. The present study explored possible clinical differences between male and female psychiatric inpatients who had recently attempted suicide. The study included 177 adult inpatients hospitalized following a suicide attempt at the University Psychiatric Clinic, Sant’Andrea Hospital, Sapienza University of Rome. Clinical features assessed included psychiatric diagnosis, method and lethality of suicide attempts using the Risk/Rescue Rating Scale, the history of suicide attempts, age at onset of psychiatric illness, the presence of substance or alcohol use, and the length of stay. The results found that males and females differed in the method used for the suicide attempt, the scores for risk and rescue, and the length of hospitalization post-suicide attempt. In conclusion, identifying gender characteristics of patients at higher risk of suicide is important for implementing specific suicide prevention strategies and reducing the risk of future suicidal behavior in psychiatric inpatients.
... More simply, subjects may have been following an encultured script. Particularly in the West (less so in south and west Asia), suicide is characterized by a "gender paradox": women account for most attempts, but men account for most deaths (Canetto & Sakinofsky, 1998). Men's attempts are more decisively lethal, probably in large part because help-seeking behavior is deemed incompatible with a male stereotype (Mergl et al., 2015). ...
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We offer a commentary on Gaffney, Adams, Syme, and Hagen (2022; Depression and suicidality as evolved credible signals of need in social conflicts. Evolution and Human Behavior, 43, 242-256). Gaffney et al. argue that suicidality and other depressive behaviors evolved as mechanisms by which otherwise powerless individuals obtain concessions from others, and these authors present experimental data to support their argument. While applauding their goals and their study's strengths, we present reservations and counter-arguments: that the target behaviors to be explained are inadequately defined; that there is insufficient evidence of ancestral fitness benefits arising from them; and that both depression and suicidality lack the evidence of special design required to support an adaptationist explanation. In the light of anomalies noted in Gaffney et al.'s "signaling" stance, we propose a new theoretical project-towards a comprehensive theory of human mental health and wellbeing.
... The finding that, controlling for other predictors, the addition of the risk of suicidality and self-harm reverses the relationship between sex and inpatient mental health admissions may be explained by the "gender paradox" [77]. Namely, it suggests that suicide attempts and suicidal thoughts are greater in females, but suicide death rates are greater in males. ...
Article
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The mental health system is impacted by extreme delays in the provision of care, even in the face of suicidal behaviour. The failure to address mental health issues in a timely fashion result in a dependence on acute mental health services. Improvement to the mental health care system is impacted by the paucity of information surrounding client profiles admitted to inpatient settings. Using archival data from 10,865 adolescents 12–18 years of age (Mage = 14.87, SDage = 1.77), this study aimed to examine the characteristics of adolescents admitted to psychiatric inpatient services in Ontario, Canada. Multivariate binary logistic regression revealed that adolescents reporting interpersonal polyvictimization, greater family dysfunction and higher risk of suicide and self-harm had a greater likelihood of an inpatient mental health admission. The interRAI Child and Youth Mental Health assessment can be used for care planning and early intervention to support adolescents and their families before suicide risk is imminent.
... About one out of five male decedents and one out of six female decedents age 45-64 had JFH. This sex difference in JFH-precipitated suicides may reflect cultural expectations related to gender (Canetto, 2021;Canetto & Sakinofsky, 1998). Men, especially middle-aged men with family, have been expected to be the primary breadwinner, which may also explain the higher proportion of married individuals among male than female decedents with JFH. ...
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Previous research has shown that job loss, financial strain, and/or loss of housing (JFH) in midlife elevate suicide risk. In this study based on the 2017–2019 National Violent Death Reporting System, we examined other suicide precipitants and contributors of decedents whose suicide was in part precipitated by JFH and the circumstances under which they died. First, we examined all adult decedents (N = 94,454; 74,042 males [78.4%] and 20,412 females [21.6%]) and then focused on decedents age 45–64 (N = 34,208; 25,640 males [75%] and 8568 females [25.0%]). The 45–64 age group had the highest rate of JFH (22.0% for males and 15.1% for females) as a suicide precipitant. The results of generalized linear models for all adult suicide decedents of both sexes showed that the 45–64 age group (IRR = 2.02, 95% CI = 1.89–2.16), compared to 65+ age group, and relationship problems, mental disorders, and alcohol problems were associated with significantly higher risk of JFH-precipitated suicide. In male decedents age 45–64, JFH was positively associated with depressed mood (IRR = 1.95, 95% CI = 1.85–2.06), alcohol problems (IRR = 1.14, 95% CI = 1.07–1.21), and number of crises (IRR = 1.48, 95% CI = 1.43–1.53). In female decedents age 45–64, JFH was positively associated with relationship problems (IRR = 1.19, 95% CI = 1.05–1.35), legal problems (IRR = 1.27, 95% CI = 1.06–1.54), depressed mood (IRR = 1.78, 95% CI = 1.59–1.99), and number of crises (IRR = 1.58, 95% CI = 1.48–1.68). In both sexes, the risk of JFH was also positively associated with a college education. In female decedents, JFH risk was higher among divorced or never-married individuals. Coroner/medical examiner and law enforcement agency reports show that some experienced depression and started misusing alcohol and/or other substances following a job loss, but others had these problems throughout life, which caused/contributed to JFH. These findings show the significance of suicide prevention approaches at both systemic (generous unemployment insurance, housing subsidies) and individual (treatment of depression and alcohol/substance misuse problems and social support/connection) levels.
... It is pertinent to maintain that failure in relationship, unemployment and forced retirement is the other challenging factors to the Male Myth of Power and falls into the basket of committing suicide (Moscicki, 1999;Farrel, 1993;Stellrechtet al., 2006). With female failure to cope with self-definition in terms of dependence and failure in love, yet another contributing factor to suicide (Canetto, 1998). ...
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The present study was conducted in District Swat, Pakistan with the sole aim to assessing the root cause of committing suicide i.e. mate selection and their impacts on left behind families. A sample size of 204 households were selected randomly through structured interview schedule. The collected data was further analyzed through descriptive (univaraite/ frequency and percentage) and inferential (cross tabulation and indexation through chi square test with amalgamation of multivariate analysis) statistics. At bivariate analysis through associational measure between dependent variable(effects of suicide) and independent variable (mate selection) findings, a significant association was found between effects of suicide and violence at home on women (P=0.021), infertility (p=0.001) and love marriage(p=0.022) is the major determinants towards committing suicide. Awareness pertaining to this important dys-functionalism in the institutional framework could easily be encountered provided media is vibrated through participation and endorsement from religious scholars, while highlighting religious values pertaining to gender, division of labor and integration of family in light of allocation of rules for either gender were put forwarded some of the recommendations in light of the present study.
... This represents a significant gap in the literature, as the gender paradox in suicide (i.e., women tend to attempt suicide more often, while men tend to die by suicide more often) is wellknown. The gender paradox in suicide is a culture-bound phenomenon, meaning that cultural expectations about gender and suicide strongly determine both its existence and magnitude [84,85]. As such it is likely that the risk factors predictive of suicidal thoughts and behaviors will be different for men and women. ...
Preprint
BACKGROUND Machine learning is a promising tool in the area of suicide prevention due to its ability to combine the effects of multiple risk factors and complex interactions. The power of machine learning has led to an influx of studies on suicide prediction, as well as a few recent reviews. However, the existing systematic reviews did not differentiate between data sources, and have largely failed to summarize the most important risk factors. OBJECTIVE The objective of our study was to assess the degree to which machine learning techniques capture incidents of suicidal thoughts and behaviors, and ascertain the most important predictors of suicidal thoughts and behaviors identified via machine learning. METHODS A systematic literature search of PubMed,‎ Medline, Embase, PsycINFO, Web of Science,‎ Cumulative Index to Nursing and Allied Health Literature‎ (CINAHL)‎, and Allied and Complementary Medicine Database (AMED) to identify all studies that have used machine learning to predict suicidal thoughts and behaviors using administrative or survey data‎ was performed. The search was conducted for articles published between January 1, 2019 and May 11, 2022. In addition, all articles identified in three recently published systematic reviews (the last of which included studies up until January 1, 2019) were retained, if they met our inclusion criteria. To evaluate the predictive power of machine learning methods in predicting suicidal thoughts and behaviors box plots were used to summarize the distribution of the area under the receiver operating characteristic curve (AUC) values by suicide outcome (i.e., suicidal thoughts, suicide attempt, and death by suicide, as well as all suicide outcomes combined) and machine learning method. Mean AUCs with 95% confidence intervals (CIs) were computed for each suicide outcome by study design, study data source, total sample size, and sample size of cases, and machine learning methods employed. The most important risk factors identified were summarized. RESULTS The search strategy identified a total of 2,200 unique records, of which 104 articles met the inclusion criteria. Machine learning algorithms achieved good prediction of suicidal thoughts and behaviors (i.e., an AUC between 0.80 and 0.89); however, their predictive power appears to differ across suicide outcomes. The AUCs for boosting algorithms achieved good prediction of suicidal thoughts, death by suicide, and all suicide outcomes combined, while neural network algorithm achieved good prediction of suicide attempt. The risk factors for suicidal thoughts and behaviors differed depending on the data source and the population under study. CONCLUSIONS The predictive utility of machine learning for suicidal thoughts and behaviors is largely dependent on the approach used. The findings of the current review should prove helpful in preparing future machine learning models. CLINICALTRIAL N/A
... As other research finds that suicide in Germany is a predominantly male phenomenon, 9 this supports the 'gender paradox in suicide' in which women experience higher rates of suicidal ideation whereas men die from suicide more frequently. 10 While existing research finds that suicide in Germany is a declining phenomenon, 11 the survey data behind this brief suggests a considerable increase in suicidal thoughts between 2016 (16%) and 2022 (24%), most likely linked to the pandemic. However, the vast majority of those who have considered suicide have done so before the pandemic (80%). ...
Research
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This brief presents new survey data on suicidal thoughts in Germany before and during the COVID-19 pandemic. It finds that suicidal thoughts were more prevalent amongst younger people and women and that COVID-19 increased feelings of depression, primarily amongst those under 35 years of age. It further finds that suicidal thoughts are at least descriptively speaking associated with inequalities and poor working conditions, as people with low incomes and those experiencing harassment, unemployment, and burnout are particularly affected. Effects of teleworking are not entirely clear, although the data hints that it can have beneficial mental health effects if context conditions are favourable. In light of the specific characteristics of the German healthcare system, this brief makes several policy recommendations. First, is proposes increasing the number of psychotherapists who are allowed to bill public insurers (‘Kassensitze’). Second, it recommends funding more low-threshold support for those affected by suicidal thoughts, including friends and family. Third, more funding is needed for research, education, and information campaigns. Fourth, these measures should be accompanied by limiting access to means of suicide. Fifth, associated issues such as poverty and burnout need to be tackled in general, for example by making minimum income schemes less stigmatising, reducing work hours at full wage compensation, giving workers a right to choose whether they want to telework, and exploring basic income policies. Finally, field-specific policies against burnout should be implemented, for example improving conditions in the care sector, normalising permanent contracts in academia (including for young people), and socially protecting freelancers and platform workers.
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Introduction: As children become adolescents and young adults (AYA), their risk for attempting suicide increases dramatically, with chronic health conditions an important risk factor. This study examined correlates of suicidality across development in AYA living with perinatally acquired HIV (AYALPHIV) and those perinatally HIV-exposed but uninfected (AYAPHEU). Methods: Data come from an ongoing longitudinal New York City-based study (N = 339) with AYALPHIV and AYAPHEU interviewed every 12-18 months from 2003 to 2019 (mean enrolment age = 12 years; current mean age = 27 years). The Diagnostic Interview Schedule for Children (adolescent or young adult version) assessed psychiatric disorders and first-reported suicide attempt. Generalized estimating equations were used to examine associations between first-reported suicide attempt and socio-demographic, contextual and psychosocial correlates measured concurrently across six timepoints. Results: At enrolment, 51% of participants were female, 72% heterosexual, 60% Black and 50% Latinx. Attempted suicide was significantly higher among AYALPHIV (27%, CI 21-33%) compared to AYAPHEU (16%, CI 10-22%), with an OR of 1.74 (CI 1.04-2.92) in a model adjusting for age. For AYALPHIV, anxiety (OR 2.66, CI 1.46-4.85), mood (OR 3.62, CI 1.49-8.81) and behaviour disorders (OR 5.05, CI 2.15-11.87) and past-year arrest (OR 3.05, CI 1.26-7.4), negative life events (OR 1.27, CI 1.11-1.46), city stress (OR 2.28, CI 1.46-3.57), pregnancy (OR 2.28, CI 1.08-4.81) and HIV stigma (OR 2.46, CI 1.27-4.75) were associated with increased odds of attempted suicide, while identifying as heterosexual (OR 0.27, CI 0.14-0.52), higher personal (OR 0.45, CI 0.26-0.80) and family self-concept (OR 0.36, CI 0.22-0.57) were protective. Interactions by HIV status and age were found: substance use was more strongly associated with attempted suicide among AYAPHEU than AYALPHIV, while negative life events and higher religiosity were more strongly associated with increased odds of attempted suicide among AYA ≥ 19 versus ≤ 18 years. Conclusions: AYALPHIV compared to AYAPHEU faced unique risks for attempted suicide as they age into adulthood, with the highest risk among AYALPHIV experiencing HIV stigma or pregnancy and the highest risk among AYAPHEU with substance use. Assessing for suicide risk and correlates with attention to ageing can inform preventive interventions tailored to meet AYALPHIV and AYAPHEU needs.
Article
It is important to understand the role of social determinants, such as gender, in suicidal ideation. This study examined whether conformity to specific masculine norms, particularly high self-reliance and emotional self-control, moderated the relationship between psychological distress and suicidal ideation for men. The other norms explored were those pertaining to behavioral–emotional or social hierarchy status aspects of masculinity, and whether they moderated the psychological distress–suicidal ideation relationship for men and women. The Conformity to Masculine Norms Inventory, the Kessler Psychological Distress Scale, and the Suicidal Ideation Attributes Scale were administered to an Australian community sample in an online survey ( n = 486). As predicted, higher psychological distress was associated with higher suicidal ideation. Self-reliance enhanced the relationship and was the only moderator among men. High self-reliance levels might be an important indicator of risk, which can be used when assessing and working with men who are hesitant to openly discuss suicidal ideation with clinicians. For female participants, higher endorsement of behavioral–emotional norms and lower conformity to social hierarchy status norms appear to increase suicide risk in the presence of psychological distress. Our findings suggest that high self-reliance is of particular concern for men experiencing psychological distress. It is also important to consider the roles of masculine norm endorsement in the psychological distress–suicidal ideation relationship among women.
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Background: Adolescent suicide can have serious consequences for individuals, families and society, so we should pay attention to it. As social media becomes a platform for adolescents to share their daily lives and express their emotions, online identification and intervention of adolescent suicide problems become possible. In order to find the suicide mechanism path of high-suicide-risk adolescents, we explore the factors that influence is, especially the relations between psychological pain, hopelessness and suicide stages. Methods: We identified high-suicide-risk adolescents through machine learning model identification and manual identification, and used the Weibo text analysis method to explore the suicide mechanism path of high-suicide-risk adolescents. Results: Qualitative analysis showed that 36.2% of high-suicide-risk adolescents suffered from mental illness, and depression accounted for 76.3% of all mental illnesses. The mediating effect analysis showed that hopelessness played a complete mediating role between psychological pain and suicide stages. In addition, hopelessness was significantly negatively correlated with suicide stages. Conclusion: mental illness (especially depression) in high-suicide-risk adolescents is closely related to suicide stages, the later the suicide stage, the higher the diagnosis rate of mental illness. The suicide mechanism path in high-suicide-risk adolescents is: psychological pain→ hopelessness → suicide stages, indicating that psychological pain mainly affects suicide risk through hopelessness. Adolescents who are later in the suicide stages have fewer expressions of hopelessness in the traditional sense.
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Epidemiological studies have long reported that, in North America, patterns of suicidal behavior differ by gender: women “attempt” suicide; men “complete” suicide. Theories of suicidal behavior also differ according to gender. Traditionally, women are said to be suicidal for love; men, for pride and performance. Are these gender differences “real?” Are women's attempts “failed” suicides? Do suicidal men “succeed” when they kill themselves? Is women's self-definition dependent on love? Is men's dependent on performance? Evidence currently available does not support traditional theories of gender and suicidal behavior. As culturally shared assumptions, however, traditional theories may influence the suicidal choices of women and men, as well as the assumptions and research methods of suicidologists.
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Historically, the literature on the treatment of suicidal behavior has not given explicit consideration to gender issues. There are, however, several important reasons for considering the influence of gender in the treatment of suicidal individuals. First, women's patterns of suicidal behavior are different, from those of men. Second, reasons for suicidal behavior are often assumed to vary by gender Third, gender has been recognized as having an impact on the dynamics of psychotherapy. This article focuses on gender dynamics relevant to psychotherapy with suicidal adults. Specifically, it reviews the literature on the relationships between gender and (a) the epidemiology of suicidal ideation and behaviors, (b) the reasons for suicidal behavior, and (c) the initiation and goals of psychological treatment for the suicidal individual.
Further to the work of Broverman et al. (1972) and others, this study explored whether different attitudes exist toward female as opposed to male suicidal behaviours, and, in turn, whether these conceptions would vary according to one's professional discipline. Psychologists (N = 38), social workers (N = 45), registered nurses (N = 43), and 42 lay persons completed the Suicide Opinion Questionnaire (Domino et al., 1982). Half of each group's questionnaires referred to a female target person, and half referred to a male. Judged seriousness of behaviour for males vs. females was significantly different on 22 items, and significant differences between professional groups appeared on 36 items. Some female suicide behaviours were perceived as less serious than were the same behaviors when performed by a male. Further analyses, and implications for theory and practice in the community, are outlined.
Article
In order to find possible factors predicting suicide among psychiatric patients, a prospective study of 2,184 in- and outpatients treated at the Department of Psychiatry, Linköping, Sweden, during 1976 was made. Information was obtained by semi-structured interview covering demographics, diagnosis, symptomatology, life events and received treatment, supplemented by officially registered information about annual income, public assistance, sick-leave and cause of death. During the period of observation (1–2 years), 34 patients had committed suicide. These were matched according to age, sex, diagnosis and in- or outpatient status with controls from the original census. The findings suggest that psychiatric patients who commit suicide, often are drug and alcohol abusers and neurotics with symptoms of depression. They often have made suicide attempts earlier in their lives, are often widowed and have suffered loss of key persons by death. After the initial contact they receive less outpatient treatment than controls. Their method of committing suicide is mainly by intoxication.
Article
The present study examined whether attitudes toward suicide vary as a function of the age and gender of the suicide victim, the gender of the evaluator, and the type of illness that precipitates the suicide. The participants in the study were 780 college students who were administered a questionnaire consisting of one of twelve scenarios describing a fictitious individual who has decided to commit suicide, as well as a series of evaluative scales and questions about the individual and his/her decision. The scenarios varied in terms of the age of the victim (i.e., forty-five vs. seventy), the gender of the victim, and the precipitating illness (i.e., chronic depression, chronic physical pain, or terminal bone cancer). Evaluations of suicide tended to be significantly more favorable when the evaluators were male, when male victims were being judged, when elderly victims were being evaluated, or when terminal cancer was the precipitating illness.
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Two objective measures of the lethality of 11 suicidal methods were defined: Mean Seriousness of suicidal incidents involving the method, and Probability of Death resulting from use of the method. The measures were found to be essentially interchangeable. Fourteen judges were asked to rank the same 11 methods according to the “probability of death resulting from use of the method in a suicide attempt.” The judges' subjective estimates of lethality corresponded well with objective measures. The relationship between lethality and risk, or the probability of suicide at some future date, was examined. The two variables were clearly distinct. Rank correlation between lethality of, and risk associated with, the 11 suicidal methods was not significant Moreover, when all incidents within a given lethality category were collapsed, and then risk associated with each lethality category evaluated, the most lethal attempts had a significantly lower risk of future suicide than the least lethal attempts.
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This study compares female and male reactions to troubled female and male target figures. The results replicate the findings of four earlier studies that showed that females are move sympathetic than males toward suicidal target figures. Unlike previous studies, however, by using a non-suicidal comparison condition, this study also shows that female sympathy ratings were not influenced by whether or not target figures were suicidal. Male ratings did show such an influence: males were most sympathetic to non-suicidal male targets and least sympathetic to suicidal male targets. Results are discussed in the light of sex-role stereotyping of males.
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Data on 674 patients, admitted between 1986 and 1990 to a medical intensive care unit with acute poisoning (8.8% of total admissions), were analysed retrospectively. Females slightly predominated (53.4%); the age distribution peaked in the third decade of life. Attempted suicide made up 68.7 of all cases (64.8% in females), while 30% of intoxications were accidental (70.8% in males). Alcohol was the most common form of poison (41.4%), followed by benzodiazepines (27%) and psychoactive drugs (24.5%), more than one drug having been taken in 36.1% of cases. Artificial ventilation was needed in 14.2% of cases, while resuscitation was necessary in 1.6%. Forms of detoxication were: gastric lavage (58%), forced diuresis (6.4%), haemoperfusion (10.1%), haemodialysis (3.4%). An anticholinergic syndrome developed in 8% of cases, pneumonia in 3%, acute renal failure in 1.2%. Rhabdomyolysis occurred in 2.5%. The death rate was 1.2%. Language: de
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In this chapter, the author summarizes the evidence on Asian American women. She also highlights the differences among various Asian American populations (e.g., Koreans, Chinese, Japanese) and describes how their different immigration and political histories in the United States have affected gender roles and relations within each community. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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This paper describes experiences with suicidality among college students. Of 140 students in two samples who responded to questionnaires, all but 13 reported contact with peers who expressed suicidal intentions or attempted suicide, and/or expressed suicidal feelings or attempted suicide themselves. These verbalizations of suicidal feelings and attempts are described, and a model of the effectiveness of prevention of suicide by means of appropriate peer reactions is presented. This model is based upon results of multivariate log-linear analysis of qualitative data by the method of maximum likelihood. The model, replicated in the second sample, suggests that an open response of discussing suicidal feelings is generally perceived as helpful, bu is less likely to be effective when the suicidal ideation follows the loss of a significant person. Implications for prevention are discussed.