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Abstract

The prevailing view that the vast majority of those who complete suicide have an underlying psychiatric disorder has been recently challenged by research on the contribution of "predicaments", in the absence of mental illness, to suicide. In this paper, we sought data to support the notion that forced marriage may lead to suicide without the presence of psychiatric disorder. Historical records, newspapers, and the electronic media were searched for examples. Two examples from ancient times and six from the last hundred years were located and described. These cases suggest that forced marriage may lead to suicide and complements earlier findings that loss of fortune, health, liberty, and reputation may lead to suicide in the absence of mental disorder.
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Original Article
Suicide and Forced Marriage
Saxby Pridmore
1
, Garry Walter
2
1
Discipline of Psychiatry, University of Tasmania, Hobart, Tasmania,
Australia
2
Discipline of Psychiatry, University of Sydney, and Child and Adolescent
Mental Health Services, Northern Sydney Local Health District, Sydney,
NSW, Australia
Submitted: 3 Jun 2012
Accepted: 31 Jul 2012
Abstract
Background:Theprevailingviewthatthevastmajorityofthosewhocompletesuicidehave
anunderlyingpsychiatricdisorderhasbeenrecentlychallengedbyresearchonthecontributionof
“predicaments”,intheabsenceofmentalillness,tosuicide.Inthispaper,wesoughtdatatosupport
thenotionthatforcedmarriagemayleadtosuicidewithoutthepresenceofpsychiatricdisorder.
Method: Historical records, newspapers, and the electronic media were searched for
examples.
Results: Twoexamplesfromancienttimesandsixfromthelasthundredyearswerelocated
anddescribed.
Conclusion:Thesecasessuggestthatforcedmarriagemayleadtosuicideandcomplements
earlierndingsthatlossoffortune,health,liberty,andreputationmayleadtosuicideintheabsence
ofmentaldisorder.
Keywords: marriage, social condition suicide, prevention
Introduction
The conventional and dominant medical
wisdom is that all (1) or almost all (2) suicide is
the result of mental disorder.
Our group has developed the concept of
“predicament suicide” (3), according to which
suicide is viewed as a response to intolerable
circumstances. These predicaments are of two
main types; one is intractable or untreated
mental disorder, and the other entails social or
environmental stressors. Of course, individual
cases may manifest both types simultaneously.
Our contribution to the literature has been
to strengthen the argument that, at times, social/
environmental factors (in the absence of mental
disorder) may lead to suicide. To this end, we
have used accounts of suicide on the public
record (from mythology, history, and press). We
have described suicide by apparently mentally
healthy individuals who have suffered damage
to reputation (4), in particular, as a result of
having been revealed as pedophiles (5), people
in other forms of moral dilemma (6), people with
intractable illness (7), and people having lost life
savings (8). We have also examined suicide pacts,
in which the most common factor was the loss of
health of one or both members (9).
The circumstances in the above paragraph
are predominantly loss, and it appears that
these suicides are a means to escape the pain of
the loss. In the current paper, we are concerned
with suicide associated with forced marriage.
There is an important distinction to be made
between “arranged” and “forced” marriage.
In the former, the choice of whether to accept
the offer remains with the two central gures,
notwithstanding the uncertainty or “pressure”
that they may feel regarding the arrangement.
In contrast, in forced marriage, one or both
individuals are non-consenting and coercion is
used to ensure compliance.
In the forced marriage setting, suicide
may represent a means of avoiding potentially
distressing events, entrapment, control by others
or as a loss of a keenly anticipated, positive
future. The aim in this paper is to present
examples from the public record (from mythical
times to the current day) of suicide associated
with forced marriage in apparently mentally
healthy individuals as a means of increasing our
understanding of suicide.
Quantitative studies of the relationship
between forced marriage and suicide are not
yet available. However, in China, the most
common negative life events leading to suicide
have been identied as “those related to family
relations, love affairs, and marital issues” (10).
In India, death from burns (which could be
murder or suicide) are frequently associated
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Malays J Med Sci. Mar-May 2013; 20(2): 47-51
with “dowry and family quarrels and marital
disharmony” (11). In Turkey, the suicide rate
of is higher in young women (15–24 year olds)
than young men, and the causative factors for
young women include forced marriage, young
marriage age and low literacy (12). Although our
focus is on forced marriages, we acknowledge
that, depending on circumstances, any marriage
forced or otherwise can be stressful for the
individuals and the couple, culminating in a
range of adverse psychiatric outcomes.
Methods
An extensive search was made of historical
texts, newspapers, and the electronic media.
Factiva (media), PsycInfo, Medline, general
internet, and manual searches were conducted.
These tools were used to identify both ancient
texts and cases from the last 100 years.
Results
Eight cases (two from ancient texts and
six from the last hundred years) were located
and are presented. Many reports, including one
from Yakin Erturk, Special Rapporteur of the
United Nations Commission on Human Rights
(13), make clear that forced marriage not
infrequently leads to suicide, but do not provide
individual examples.
Daphne
In Greek mythology, Daphne was a minor
nature deity and Apollo (son of Zeus) was a major
Olympian deity. In The Metamorphoses, Ovid
(14) reports that Cupid shot both with arrows.
The one which hit Daphne (a sworn virgin) didn’t
have the expected outcome, but the one which
hit Apollo had a profound effect. He chased her
across the countryside. When she was about to be
caught, she called to the Gods, “cover with green
earth/This body I wear too well” (page 19), and
was immediately transformed into a (laurel) tree.
Thus, Daphne chose to cease living as a human
rather than marry or participate in physical
intimacy.
Aino
Aino is a beautiful young woman in the
Finnish national epic poem, “The Kalevala” (15),
which records events from ancient times up until
about 900 CE. She was promised by her brother to
an old man, Vainamoinen, with magical powers.
Rather than marry Vainamoinen, Aino drowned
herself in a river.
Aino has been celebrated in paintings and
an opera by Finnish artists. Aino was the most
popular name for girls in Finland in 2006 and
2007.
Miss Chao (died, 1919)
Chao Wu-chieh of Changsha, China, was
engaged to marry Wu Feng-lin of Kantzuyuan,
China. The marriage had been arranged. The
couple had met on a couple of ceremonial
occasions. Miss Chao disliked her husband-to-
be, but her parents insisted that the marriage go
ahead. When she was raised up in the bridal chair,
to be carried shoulder-high to her husband-to-
be’s home, she drew a dagger and cut her throat,
killing herself.
We know about her death because Mao
Tse-tung (16) wrote on the events several times.
Interestingly, he stated, “A person's suicide
is entirely determined by circumstances”. He
railed against the culture of the time and the lack
of individual rights, and recommended social
change.
Gul Rukh (died, 1976)
In the vast majority of cases of forced
marriage leading to suicide, the bride is decades
younger than her husband. In this Afghani case,
the reverse was the situation (17).
The Gul and Malang families were related.
When Rukh was 1 year old, a boy was born into
the Malang family. When he was 1 month old,
the families arranged their marriage and an
engagement was celebrated according to local
custom. However, the boy died at 2. When Rukh
was 5 years old, another son was born to the
Malang family, and she was again promised in
marriage. When the husband-to-be was 17, he was
killed by accident, during wedding preparations.
Rukh was then promised to the youngest Malang
family son, Khan (aged 5 years).
Kahn was teased at school for being engaged
to an “old woman”, and he protested that he did
not want to marry Rukh. Nevertheless, they were
married when Rukh was 37 and Khan was 20
years. He rejected her and the following year she
died by self-immolation.
Fariba (died 2007)
Fariba was 18 years of age and lived in the
Kapisa province of Afghanistan. She had been
pleased to become engaged to Mujahid, aged 22,
3 years earlier. However, Mujahid had gone
to work in Iran, and when he returned he was
addicted to drugs. In these circumstances, Fariba
was adamant that she did not want to marry him
Original Article | Suicide and forced marriage
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49
(18). As pressure to marry increased, and she
could not persuade her parents otherwise, she
completed suicide by shooting.
Adyru Begum (died, 2010)
Adyru Begum was 12 years of age, a grade 5
student living in Rangpur, Bangladesh. Against
her will, her father arranged her marriage to an
adult man (Enamul Haque). After the marriage
ceremony, and during the wedding feast, Aduri
completed suicide by taking poison (19).
Mitu Molla and Soud Sheikh (died, 2012)
Mitu Molla (16 years) and Soud Sheikh
(17 years) lived in neighboring villages in
Gopalganj district, Bangladesh. After their affair
became public, Molla’s mother took her to a town
200k from her village and married her against
her will, to a man twice her age. At this point,
Sheikh was at high school in the capital Dhaka.
Two months later, when Molla went home
to visit her parents, Sheikh left Dhaka and
met her in her village. On Valentine’s Day, they
tied their hands together and jumped to their
deaths from a mobile phone tower. Sheikh had
earlier telephoned his brother to say that they
planned to die on Valentine’s Day “to stay together
forever” (20).
Amina Filali (died, 2012)
Amina was 15 years of age when she was
raped, in Morocco, by a man 10 years her senior.
The matter went to court and the judge ordered or
recommended (depending on reporting source)
that the couple marry. By this mechanism, her
honor would be restored and her rapist could
avoid a lengthy jail sentence. In Morocco, the age
of consent to marry is 18 years, but this can be
varied in special circumstances (21).
Amina married her rapist and lived at his
family home. Her mother (Zohra) reports that he
beat her severely, and shortly afterwards, Amina
completed suicide by ingesting rat poison.
Discussion
Our aim was to seek information as to whether
forced marriage might lead to suicide. At least one
epidemiological study (12) and anecdotal report
(13) support the notion of a causal relationship.
We found two stories from ancient times (one
Greek and one Finnish) and six stories from the
past hundred years in which death was preferred
to an unacceptable marriage–substantiating
the above-mentioned material. Whether these
ancient people (Daphne and Aino) ever existed, or
behaved as described, is not critical - the point is
that myths and legends advise us about the range
of possible human responses and, in many cases,
the responses that are recommended.
The details of the six stories from the
last hundred years are limited, as might be
expected, emanating as they do from isolated,
disadvantaged regions. The story of Miss Chao
was recounted a number of times by Mao Tse-
tung, and could perhaps have been distorted for
political purposes, but subsequent scholars (22)
have conrmed the events. The story of Amina
Filali (who died in 2012), whose marriage to her
rapist was ordered/recommended by a court, has
received international attention, and the facts are
probably substantially correct.
We have sought to extend understanding
of suicide. The “one-size-ts-all” notion that all
or almost all suicide is attributable to mental
disorder is unhelpful, and has recently been
called into question by other researchers (23).
Adherence to the belief places responsibility for
suicide with psychiatry. It puts clinicians in peril
during Coroners’ Court hearings, and denies the
possibly of non-psychiatric interventions which
may have benecial outcomes. Notwithstanding
these issues, psychiatrists and other mental
health professionals retain a role in identifying,
understanding and ameliorating psychosocial
risk factors that might play a part in suicide in
those without mental illness.
In our earlier work, we have acknowledged
that environmental/social events such as loss of
fortune, health and reputation may not only lead
to psychiatric illness, such as depression, anxiety,
and adjustment disorder, but we have also
suggested that those events may lead to suicide
in the absence of mental disorder. Here, without
discounting situations where forced marriage may
lead to suicide and simultaneously be associated
with psychiatric disorder, we are proposing that
forced marriage may, alone, lead to suicide. The
use of qualitative methodology, whose value
in psychiatric research is being increasingly
recognized (24), facilitated our understanding of
the potential motivations to suicide in the cases
described. The motivation may be to escape the
attention of a disliked individual, the loss of an
ideal future, a feeling of entrapment or similar
unacceptable circumstances. The Gul Rukh case
is somewhat atypical in that the association of
forced marriage and suicide appeared to relate
to rejection, shame and narcissistic humiliation;
in this case, too, however, there was an apparent
lack of mental disorder.
50
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Malays J Med Sci. Mar-May 2013; 20(2): 47-51
Acknowledgement
We thank Dr Nerissa Soh for her assistance.
Conict of interest
Nil.
Funds
Nil.
Authors’ Contributions
Conception and design, analysis and interpretation
of the data, drafting of the article, critical revision
of the article for the important intellectual
content, nal approval of the article, provision of
study materials or patient, statistical expertise,
obtaining of funding, administrative, technical
or logistic support and collection and assembly of
data: SP, GW
Correspondence
Professor Garry Walter
MBBS (UNSW), BMedSc (UNSW), PhD (USyd),
FRANZCP, Cert Child Psych (RANZCP)
Coral Tree Family Service
PO Box 142, North Ryde
NSW, 1670, Australia
Tel: +612-9887 5830
Fax: +612-9887 2941
Email: gwalter@mail.usyd.edu.au
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... However, Abel and colleagues did not examine suicide and marriage and so the discourse on the correlation between marriage and suicide is yet to be investigated in Jamaica. Another study revealed that direct correlation between suicide and marriage, but this was among women who are married against their will, forced marriages (Pridmore & Waller, 2013). In some forced marriages, women commit suicide as an option out of these marital arrangements and suicide increases in such instances (Arango, 2012). ...
... In some forced marriages, women commit suicide as an option out of these marital arrangements and suicide increases in such instances (Arango, 2012). Such situations occurred in Iraq, India and other nations (Mayer & Ziaian, 2002;Pridmore & Waller, 2013;Arango, 2012), and cannot be used as the norm to establish a contradiction to Durkheim's work and therefore a study of suicide in non-arranged marriages is still outstanding. ...
... The small number of absolute suicide in Jamaica (Thompson, 2014) is not enough evidence to warrant the absence of an investigation into the matter of suicide and marital status, particularly from the perspective of the gap in the literature on the matter. With Pridmore & Waller's (2013) work indicating that most of those who commit suicide have some underlying psychiatric disorders, a few people who commit suicide are sufficient numbers to enquire into the matter, particularly among those who are married, as this will affect the children as well as society. Marriage is believed to confer psychiatric benefits (Ueker, 2012;Butterworth & Rodger, 2008) and this among other positives account for few studies that would have examined marriage and suicide. ...
Research
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Introduction: Suicide is an indication of psychiatric disorder, which is more associated with marital discord than marital unions. Despite the widely held view that suicide is not usually associated with maritial union, there is empirical evidence linking suicides to marriages. Objective: This study seeks to evaluate the current gaps by way of examining suicide and marriage using 44 years of datapoints. This includes the role of the exchange rate in suicide and marriage rates discourse, determining absolute suicide as a per cent of absolute marriage, and likely correlations between suicide, marriage and the exchange rate. Materials and Methods: The data for this study were taken from various Jamaica Government Publications including the Demographic Statistics. The period for this work is from 1970 through to 2013. Data were recorded, stored and retrieved using the Statistical Packages for the Social Sciences (SPSS) for Windows, Version 21.0. The level of significance that is used to determine statistical significance is less than 5% (0.05) at the 2-tailed level of significance. Ordinary least square (OLS) regressions were used to determine models or factors of suicide rate. Findings: For the studied period, the average marriage rate was 64.0 ± 21.4 per 10,000 (95% CI: 57.2-70.7) and 1.2 ± 0.8 per 100,000 for the suicide rate. The average marriage rate and suicide rate for the studied decades have been increasing constantly from the 1970s to 2000s. The largest percentage annual increase for both the suicide rate (220%) and marriage rate (70.1%) occurred in the 1990s over the 1980s. There was also a 25% and 20.1% rise in suicide and marriage rates respectively in the 2000s over 1990s. Furthermore, on average, 42 persons are married daily in Jamaica and approximately 3 persons commit suicide monthly. Conclusion: The psychiatric and psychological disturbances in marriages are overlooked because of the established theories on the benefits of marriages. Suicide is an expression of marital discords which are allowed to fester for too long until divorce proceedings commence. Frequently, these unresolved issues often culminate with one party committing suicide.
... В поэме «Нарспи» интерес представляет связь неравного брака, домашнего насилия и массивного стресса с совершением ПГСУ. Указанные факторы достаточно подробно изучались учёными и представлены в научной литературе [44,45]. Поэма переведена на английский язык профессором Эдинбургского университета Питером Франсом и издана в 2018 г. ...
... In the "Narspi" poem, the interest is in the connection of unequal marriage, domestic violence and massive stress with the commission of PHS. These factors have been studied in sufficient detail by scientists and are presented in the scientific literature [44,45]. The poem was translated into English by a professor at the University of Edinburgh, Peter France and published in 2018.The opera was staged in two acts with the libretto by G. Khirby, different productions of the play have been performed from the mid-50s of the last century to the present in the Chuvash language (at the Chuvash State Opera and Ballet Theater in Cheboksary). ...
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Posthomicidal suicide (PHSU) is a rare occurrence in life. Despite this, it is presented in cultural works, in particular, there are works describing the PHSU in sculpture and opera performances. The purpose of the study is to find cases of PHSU in Russian-language fiction and to conduct a comparative analysis with scientific publications. Materials and methods. Considered 10 literary texts published in Russian in 1880-2013 (novels – 6, stories – 2, narrative – 1, poem – 1); in nine cases it was a completed PHSU, in one it was an attempt. Results. Most often, PHSU met in detective novels by famous foreign writers (A. Christie, J. Simenon, R. Stout), translated into Russian, although it was the subject of investigation in three works (in two cases as corpus delicti and in one as a possible plot). In the domestic literature, PHSU was described extremely rarely, despite the mass of modern research on artistic thanatology in Russia. According to our data, the most informative of the Russian authors are the works of F.M. Dostoevsky, who can rightfully be considered not only an outstanding psychopathologist among writers, but also an unsurpassed suicidologist. According to the classification, nine texts usually described spousal (partnership) or family PHSUs, the death toll, as a rule, is two. The time criteria of the PHSU (24-72 hours) met in seven cases out of nine. The connection between murder and suicide allowed us to qualify two more PHSUs as post-murder suicides. The aggressors were more often younger than their victims, possibly due to the absence of children's PHSUs, in four cases out of nine they were committed by women and they occurred outside the home. The most common methods of murder and suicide were firearms (pistols), their coincidence was found in five cases. Four aggressors (psychosis, epilepsy, depression, alcohol abuse) and three victims (psychosis, two cases of alcohol abuse) suffered from mental disorders, four murderers had suicidal thoughts and intentions; in alcoholic intoxication were respectively - two and four heroes of the works. In literary texts, many topical scientific and practical issues are raised: a rare way of PHSU (car accident of an aggressor and victim), tragic death of loved ones, unequal marriage and domestic violence as factors of murder and suicide, stigmatization (selfstigmatization) and post-traumatic stress disorders in children of participants of PHSU, motives PHSU in adolescents and their prevention; "Perfect kill" and "perfect way to kill". Conclusion. PHSU in the literature is described quite realistically, which can be used for scientific, practical and educational purposes. Keywords: post-homicidal suicide (criteria, factors, motives, age and gender groups, place and weapon of murder / suicide), works of fiction, prevention
... In the former, suicide as a channel of evading potentially agonizing events including tolerating the consent violators, sexual confrontation, unwilling consummation, entrapment and bereavement of an eagerly aspired, desirable prospect. 10 In unforced arranged marriages, the spouses submit their liberty to orthodoxy, which negates or avoids most of the above distasteful encounters, and hence suicide ideations are infrequent from interpersonal conflicts. Spousal selection is matched with social factors like employment, place of residence and position of acceptance within their social strata, apart from religion, ethnicity, and the choice of parents and influential family members. ...
... Suicidal ideation lures the falling self-esteem to deceive harassments by gifting oneself vindication without having to fight out the perpetrating impediments. People turn suicidal when having suffered damage to reputation, 10,30 and guilt and pain from recent or past abuses, affairs 31 and intractable illnesses. 32 In suicide pacts, common causes were debts, and loss of health of one or both the couples or of their children. ...
Article
BACKGROUND Even as marriage tends to protect many from suicidal thoughts and attempts, by cushioning the mind from extrinsic stressful events, it also brings into play an inherent set of additional stressors. Interpersonal conflicts including disjointed and disdainful behaviour, emotional and cultural duress, spousal and substance abuse, financial demands, and an occasional conjugal jealousy may cause significant psychiatric morbidity. This coupled with impulsive traits increase suicidal risk, which can be countered by a satisfactory and well-adjusted marriage. We wanted to estimate the intricate variables like impulsiveness, couple satisfaction, adjustment, and their impact on suicidal intent in arranged and love marriages. METHODS A cross-sectional observational study with 39 and 41 suicidal attempters with arranged and love marriage respectively using sociodemographic profile and Barratt's impulsiveness scale, presumptive life events scale and Beck's suicide intent scale, along with couple satisfaction and adjustment scales. RESULTS In this South Indian study, both the groups showed preponderance in suicidal attempts of males, those marrying earlier, went high school or above, from rural and nuclear families, of low socioeconomic group, from alcohol-related quarrels, but minimal correlation with life events. Children did not have significant effect in both groups. The love group had 86% more unemployed and skilled workers, slightly (7%) more impulsiveness, 43% more borderline traits, 66% more attempts before the first anniversary. Spouses from arranged group had 14% lesser couple satisfaction, 7% lesser adjustment, were 26% more depressed, responded 19% more to acute suicidal ideation, had 36% more frequent attempts, along with significantly higher intent. CONCLUSIONS With respect to intent and recurrence, couple satisfaction and parental support were found to be more protective in the arranged group. Adjustment was better with higher satisfaction in the love group. It has been reiterated that focus on marital quality constructs can save both the marriage and the lives, through community-based programs.
... They had no choice about what they like to do or even whom they want to marry, which deteriorated even more after they got pregnant. A study found that forced marriage led to suicide even without psychological problems [26]. Suicide attempts resulting from forced and early marriage were also reported in two separate studies in Turkey and Sri Lanka [27,28]. ...
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Background Suicide-attempts have increased across the world and have become higher among females. There has been a high prevalence of self-immolation in Iran, mostly young married women admitted to the burn centers. This study aimed to explore the factors and experiences of self-immolation in Iranian married women to develop prevention strategies to prevent the personal, social, and economic impacts of suicide and suicide attempts. Methods A qualitative descriptive approach using open-ended, in-depth, face-to-face interviews was conducted in a purposive sample of 16 married Iranian women aged 16–40 years in the burn centers in Urmia city, a place in northwest Iran. Conventional content analysis was used to analyze the data. Results Three themes emerged from the data, including (1) antecedents of self-immolation, (2) suicidal ideation method, and (3) pathway to recovery. Each of these themes is supported by sub-themes. Conclusions The study highlights the demand for health professionals to support self-immolation survivors to continue their normal lives. According to survivors’ needs, a comprehensive supportive program is recommended to support their pathways to recovery in all its complexities. Health professionals should also not forget that the survivors’ family also will need help to overcome this trauma. A family counseling program may also be provided.
... According to the results, most of the participants who attempted self-immolation were married, which is consistent with the results obtained by some other studies. 11,18,19 Differences in interests, violence and the undue strictness of the husband and family were some of the main complains of the participants for their self-immolation attempts that pertained to the two first categories of the research which were not having control over personal life and marital conflicts. They expressed their disappointment and anger about always being ordered around by their husbands and family and having to comply without saying a word and not being respected by their husbands and family for their opinions. ...
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Background: Suicide is a major psychiatric emergency that has always been a topic of great interest to researchers. Self-immolation is a heinous suicide method that is common in Eastern societies. The present study was conducted to explore probable issues which might lead to self-immolation in young Kurdish Iraqi women. Methods: The present qualitative study was conducted in Soran, Erbil Governorate in Iraq, and the surrounding villages of Soran District (March 2015 to May 2016). Using purposive sampling, we conducted 24 in-depth interviews with women who had done self-immolation. The obtained data were analyzed using conventional content analysis. Results: The analysis of the data obtained from the interviews led to the extraction of five categories which seems to be related to self-immolation attempts, including not having control over personal life, marital conflicts, seeking attention, instilling guilt in the family members, and resentment towards male dominant community. Conclusion: Self-immolation is a multidimensional phenomenon that has not come to exist overnight and is rooted in various factors that join to encourage self-immolation attempts by women in critical situations. Comprehensive preventive strategies, such as cultural changes, along with education are required to help lower the rate of self-immolation.
... Forced and arranged marriages are not made exclusively for economic reasons, but often to restore family honor. This is the case of Amina, a Moroccan girl who, after being raped was married to her assailant in order "to save her honor" following string pressure from the Prosecutor's Office and the family judge in charge of the proceedings (Pridmore & Walter, 2013). ...
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Arranged marriages are traditional in Africa, South-east Asia, The Middle East and Latin America. Due to migration the practice has been extended today to western world countries. Many families choose their daughters’ husbands according to wealth, so converting the woman into a tradable good.
... The deaths were classified as suicide (57%) and murder (43%). Pridmore and Walter (2013) have documented suicides in Asia in women after a forced marriage. ...
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The field of suicide postvention remains relatively immature in terms of the current knowledge base. This manuscript examines the existing knowledge regarding suicide bereavement and describes the limitations of the suicide bereavement knowledge base using a critical review of the literature specifically relating to suicide bereavement published in the previous 10 years. Six limitations are identified in the literature: concern about samples used in research, sampling only people who have been help-seeking, women being overrepresented in studies, additional design issues including limitations by research ethics boards, definitional problems in who is suicide bereaved, and determining the size of the population bereaved by suicides. This is followed by a discussion of the need to define the suicide bereaved population, as well as understand the effect of suicide bereavement. The paper closes with suggestions for future directions that are required in the field of suicide bereavement in order to best understand and help those people left behind in the wake of suicide deaths.
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The article aims to explore the phenomenon of suicide in relation to honour based violence (HBV). Although HBV is explored in depth in relation to honour killing, forced marriage and female genital mutilation, its link and manifestation in the form of suicide has not been discussed in existing literature. This article examines how suicide can manifest itself in honour based patriarchal communities as either honour suicide or forced suicide. Although both forms of suicide are carried out as a result of HBV, there is a crucial difference between them and this needs be identified and distinguished to hold perpetrators accountable before the law. Honour suicide and forced suicide both occur in honour based patriarchal communities and such practices spread around the world via immigration; hence the UK is not immune from this. Due to the complexity of the incidents and vulnerability of the victims, honour suicide and forced suicide are likely to be unreported and unrecognised by the legal system. Therefore, the discussion in this article will look at the national law in England and Wales related to suicide and critically examine whether it can address instances of honour suicide and forced suicide if they occur under its jurisdiction. Accordingly, it will suggest law reforms to address effectively the issue of suicide committed as a result of HBV and abuse.
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Suicide is a multi-disciplinary subject where interdisciplinary research and practice is still insufficient. This book covers the most relevant scientific approaches to suicide as well as lived-experience social movements. Through an interdisciplinary approach, actual suicide rates in lifting and the strength sports are discussed, and suicide protective as well as suicide conducive factors are identified. Suggestions and guidelines to promote positive trends are offered. The objective is to contribute towards community-centered preventive and postventive actions.
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Current clinical wisdom is that the vast majority of those who complete suicide suffer from a mental disorder. Uncritical adherence to this belief may limit our understanding and restrict the full range of prevention activities. We aimed to examine the public record for accounts of suicide by men who had been, or were about to be, investigated or apprehended for "sex only" child sex offences, with a view to presenting a collection of case histories, and identifying examples of suicide in the apparent absence of mental disorder other than pedophilia. The public record (hard and electronic copy) was examined. Twenty case histories were identified of men with no apparent mental disorder (other than pedophilia) who completed suicide shortly after exposure or threatened public exposure and/or early or potential legal punishment. This evidence strongly suggests that exposure or threatened public exposure of pedophilia and/or early or potential legal punishment creates a predicament, which may lead to completed suicide.
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The current Western psychiatric wisdom states that suicide is always or almost always associated with mental disorder. Careful Asian studies are casting doubt on this conclusion. Using information from the public record (newspapers, coroner's reports, and various web-based sources), we sought evidence that, in the absence of mental disorder, suicide may be associated with major financial loss. Reports of 15 individuals who completed suicide following major financial loss were identified, thus an association between these events is supported.
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Suicides among tinnitus sufferers are rare. Indeed, on examining the public record (newspapers and the Web), the authors identified only 4 cases in the past 10 years that had been examined by a coroner. Nevertheless, the deaths of Rick Tharp, Dietrich Hectors, William Morris, and Robert McIndoe prompt reconsideration of the association between tinnitus and suicide that appears to be weak. The article also draws attention to a subject that is receiving attention in the medical literature--namely, the role of "precipitants" (in this case, tinnitus) in completed suicide and the need to screen some cases of severe, disabling tinnitus for the presence or absence of coinciding psychopathology, which is very amenable to treatment.
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This study compares youth (<24 years) suicide rates in Turkey and the United States; a demographic and cross-cultural comparison and exploration of possible causative factors. Publicly available data were compared for children, adolescents, and young adults for years 1992-2004. The mean general population suicide rate in Turkey (per 100,000) was, male = 3.53 and female = 2.31 (for the US, males = 18.37, females = 4.31); for ages below 15 years the rate was, males = 0.28 and females = 0.39 (for the US, males = 1.09 and females = 0.38); while for aged 15-24 years the rate was, males = 4.58 and females = 5.22 (for the US, males = 18.84 and females = 3.36). The patterns for Turkey are: (a) Female youth had a higher suicide rate than male youth; this was the reverse of the U.S. pattern, (b) Youth suicide increased during the time period in Turkey, whereas it was relatively stable in the US, (c) However, suicide rates in Turkey were generally lower than the US, (d) Fifty percent of all female suicide victims in Turkey were under the age of 24 years (versus 11% in the US). Possible psychosocial causative factors may include (a) negative social status of females (forced marriage, young marriage age, low literacy, honor killings); (b) substantial rural to urban migration which disrupts ties and exposes migrants to a less traditional cultural system; (c) shortage of mental health services; (d) and possibly, reduced religious education enrollment may be an additional factor.
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The aim of this article is to describe the circumstances surrounding the suicide of Adam Czerniakow during the Holocaust. Examination of Czerniakow's (translated) diary and other Holocaust literature. Head of the "Judenrat" (Jewish Council) in the Warsaw ghetto, Czerniakow had the impossible task of obeying oppressive German orders, while trying to serve and protect his people. Following instruction to have ready for deportation from the ghetto several thousand Jews each day, Czerniakow took his life. Although Czerniakow may not have known the precise destination of those deported (they were sent to death camps), he is believed to have held grave fears for their fate. Suicide in the context of avoiding having to perform an unacceptable task is not commonly recorded, but may have applied in Czerniakow's case and was not infrequent among Judenrat members.
Article
There was nothing particularly out of the ordinary about the facts of Miss Chao's suicide. It happened this way. Miss Chao Wu-chieh, of Nanyang Street, Changsha, was engaged to marry Wu Feng-lin, of Kantzuyuan, on November 14, 1919. As a matter of course the match had been arranged by her parents and the matchmaker. Although Miss Chao had had only the brief ritual encounters with the fiancé, she disliked him intensely and was unwilling to marry him. Her parents refused both to undo the match and to postpone the wedding date. On the day of the wedding, as Miss Chao was being raised aloft in the bridal chair to be delivered to the home of the groom, she drew out a dagger which she had previously concealed in the chair and slit her throat.
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Previous studies on the Chinese suicide found some life events prior to the suicide different from those in the West, but there is a lack of summary of the Chinese life event patterns to better understand the effects of the social structure on Chinese suicide. We tried to identify the life events that precede the Chinese rural youth suicides and compare them with what are found in the West, so as to find the patterns that are particularly true in the Chinese culture contexts. Suicide cases were investigated with a psychological autopsy study in rural China, and local community living controls were also interviewed with the same protocol. We collapsed 64 negative life events into six categories: (1) Marriage/Love, (2) Family/Home, (3) Work/Business, (4) Health/Hospital, (5) Law/Legal, (6) Friend/Relationship. About 92.3% of the suicides studied had experienced at least one type of negative life events. The three most common negative life events categories in the past one year were Family/Home (60.7%), Health/Hospital (53.8%) and Marriage/Love (51.3%) in the rural young suicide victims. Among the negative life events, those related to family relations, love affairs, and marital issues were most likely to precede a suicide of rural suicides in China, and it is especially true of rural young women. Family is an important social institution in rural China for suicide prevention efforts.
Article
Background While numerous past reviews of psychological autopsy (PA) studies have examined the relationship between mental disorder and suicide, there has been little systematic investigation of suicide occurring in the absence of any identifiable psychiatric condition. Aim This article reviews available literature on the topic by considering Axis I, sub-threshold, mild disorders and personality disorders. Method We conducted a systematic review of PA studies from 2000 onwards. Studies included in the review had to clearly describe the proportion of suicide cases without a classifiable mental disorder or sub-threshold condition. Results Up to 66.7% of suicide cases remained without diagnosis in those studies that only examined Axis I disorders ( n = 14). Approximately 37.1% of suicide cases had no psychiatric condition in research papers that assessed personality and Axis I disorders ( n = 9), and 37% of suicides had no Axis I, sub-threshold/mild conditions ( n = 6). In general, areas in China and India had a higher proportion of suicides without a diagnosis than studies based in Europe, North America or Canada. Conclusion Variation in the proportion of suicide cases without a psychiatric condition may reflect cultural specificities in the conceptualization and diagnosis of mental disorder, as well as methodological and design-related differences between studies.
Article
Objective: The aim of this paper was to examine accounts on the public record of suicide by couples, with a view to extending our clinical understanding of such events. Method: A collection of print reports was examined and a web search was conducted. Cases were generally only accepted when the names, ages, locations and method of death of the individuals were provided, along with sufficient detail to convey the rudiments of the social and physical setting. Cases were then arranged into groups and classified using a typology of suicide. Results: Twelve cases were identified which provide valuable insights into the lives of couples who suicide. We found 11 married female-male couples and one female-female couple. A large group (seven couples) was characterized by severe or terminal illness in one or both partners. A small group (three couples) was characterized by serious legal problems. One couple was grieving the loss of an only child, and one example involved a psychotic individual, folie a deux and consequent social stressors. The terminal illness group, the legal difficulties group and the bereaved couple could be classified as 'Type 3 suicide' according to the first author's suicide classification. The case involving the psychotic individual and consequent social stressors could be classified as a combination of Type 1 and Type 3 suicide. Conclusion: Reports on the public record of suicide by couples provide valuable insights into the lives of participants, and their suicides could be grouped (terminal illness, legal difficulties, other) and classified using a typology.