An empirical test of a mediation model of the impact of the traditional male gender role on suicidal behavior in men

The association between social relationships and self-harm: a case-control study in Taiwan

BACKGROUND

Although suicide has been postulated as a result of social breakdown, relatively little attention has been paid to the association between social relationships and non-fatal self-harm. We sought to investigate the extent to which social factors correlate with self-harm in this case-control study.

METHODS

The primary outcome was self-harm with hospital presentation. Cases of self-harm from the Emergency Department in a general hospital in Northern Taiwan were recruited, and individually age-and-gender-matched control participants were recruited from non-psychiatric outpatient clinics at the same hospital. The Close Persons Questionnaire was administered and its social support and social network subscales were used to measure social relationships in the 12 months prior to the interview. Other covariates, comprising sociodemographic factors, major life events, physical and mental health, were adjusted in conditional logistic regression models.

RESULTS

A total of 124 case-control pairs were recruited. The mean (standard deviation) age of the case group was 34.7 (12.8) years and 80.6% were female. Higher social isolation score remained significantly associated with self-harm after adjustment (adjusted odds ratio per standard deviation increase 2.92, 95% confidence interval 1.44-5.95) and household size was negatively associated with the outcome (adjusted odds ratio per unit increase 0.54, 95% CI 0.32-0.94).

CONCLUSIONS

More limited social networks were associated with self-harm after adjustment for potential confounders. Enhancing social structure and effective networking of people with self-harm to community resources may be important for self-harm management in Asian societies and elsewhere.

Suicídio de idosos sob a perspectiva de gênero

Este estudo explora a relação entre suicídio e envelhecimento na perspectiva de gênero, analisando as demarcações socialmente impostas de masculinidade e feminilidade na vida de idosos que cometeram suicídio. Trata-se de estudo qualitativo no qual foram consideradas 50 autópsias psicossociais realizadas com familiares de idosos, pertencentes a 10 municípios brasileiros, nas regiões Norte, Sul, Nordeste e Centro-Oeste. Neste artigo foram identificadas situações referentes a vulnerabilidades de gênero na vida de 13 pessoas que se suicidaram: 10 homens e três mulheres, selecionados pelo seu caráter de exemplaridade. Duas categorias principais foram elencadas: a primeira refere-se às feminilidades, incluindo o "destino de gênero" vivido por mulheres idosas que se suicidam quando não podem mais cuidar e trabalhar. A segunda refere-se a crises nas masculinidades hegemônicas, em que homens idosos morrem após mudanças nos papeis de provedores, ocasionadas pela aposentadoria ou doença. Ressalta-se que as normas de gênero, os códigos de honra, as desigualdades de poder e estereótipos afetam tanto as mulheres quanto os homens em relação à vulnerabilidade para comportamentos suicidas.

Taking it like a man: masculine role norms as moderators of the racial discrimination-depressive symptoms association among African American men

OBJECTIVES

I examined the association between everyday racial discrimination and depressive symptoms and explored the moderating role of 2 dimensions of masculine role norms, restrictive emotionality and self-reliance.

METHODS

Cross-sectional survey data from 674 African American men aged 18 years and older recruited primarily from barbershops in 4 US regions (2003-2010) were used. Direct and moderated associations were assessed with multivariate linear regression analyses for the overall sample and different age groups. Models were adjusted for recruitment site, sociodemographics, masculine role norms salience, and general social stress.

RESULTS

Everyday racial discrimination was associated with more depressive symptoms across all age groups. Higher restrictive emotionality was associated with more depressive symptoms among men aged 18 to 29 and 30 to 39 years. Self-reliance was associated with fewer depressive symptoms among men aged 18 to 29 years and 40 years and older. The positive association between everyday racial discrimination and depressive symptoms was stronger among men with high restrictive emotionality, but this moderated effect was limited to men older than 30 years.

CONCLUSIONS

Interventions designed to reduce African American men's depression instigated by racism should be life-course specific and address masculine role norms that encourage emotion restriction.

Lifetime Risk of Suicidal Behaviors and Communication to a Health Professional About Suicidal Ideation

Background: There is presently a lack of information on the role of healthcare in suicidal ideation in adults. Aims: To assess the frequencies, patterns, and factors associated with the communication of suicidal ideation toward a health professional. Methods: Participants stem from a French cross-sectional survey of 22,133 randomly selected adults. Lifetime suicidal behaviors and 12-month mental disorder patterns were assessed using the short form of the Composite International Diagnostic Interview. Participants with suicidal ideation were asked whether they had talked about it and, if they had, to whom. Results: Around 20% of people with suicidal ideation had talked about this distress to a health professional. It was more frequent for people with more severe suicidal behaviors (plan or a prior attempt), among women, those aged 30 or more, those suffering from major depressive episode, panic disorder, or drug use disorder. Above all, it was more frequent among those who had also talked to friends or relatives. Conclusions: Prevention strategies that encourage suicidal persons to seek help for their distress, whoever that is, may be the more important strategies to develop.

Gender roles, suicidal ideation, and self-harming in young adults

This study investigates whether positive and negative conventional gender roles relate to suicidal ideation and self-harming in different ways among young adults. Participants completed an online survey about previous self-harm, recent suicidal ideation, and positive and negative aspects of conventional masculinity and femininity. Logistic regression analyses showed that negative femininity positively predicted self-harm and recent suicidal ideation status. Positive femininity was unrelated. Positive masculinity was negatively related to suicidal ideation and self-harming while negative masculinity was negatively related to self-harming only. The findings suggest that it is not the conventional feminine gender role per se that is associated with suicidality but specific negatively evaluated aspects. Conceptualizing gender as a multivariate construct may be useful in the gender socialization theory of suicidal behavior.

[The sociology of gender: an original perspective for a better understanding of suicide in men]

There is a general consensus that suicide is a social problem. But what exactly is the contribution of sociology to research on suicide? This paper proposes a brief overview of the historical bases of the sociology of suicide and its evolution through the study of deviance and exclusion. On the level of application, the sociology of gender contributed to better understand how some aspects of male socialisation, such as the rigid relations with norms of the male role, may act as suicide risk factors or as a path to recovery.

Preference of lethal methods is not the only cause for higher suicide rates in males

BACKGROUND

In most countries worldwide suicide rates are higher for males whereas attempted suicide rates are higher for females. The aim is to investigate if the choice of more lethal methods by males explains gender differences in suicide rates.

METHODS

Data on completed and attempted suicides were collected (n=3235, Nuremberg and Wuerzburg, years 2000-2004). The research question was analyzed by comparing the method-specific case fatality (= completed suicides/completed+attempted suicides) for males and females.

RESULTS

Among the events captured, men chose high-risk methods like hanging significantly more often than women (φ=-0.27; p<0.001). However, except for drowning, case fatalities were higher for males than for females within each method. This was most apparent in "hanging" (men 83.5%, women 55.3%; φ=-0.28; p<0.001) and "poisoning by drugs" (men 7.2%, women 3.4%; φ=-0.09; p<0.001).

LIMITATIONS

The sample size (n=3235) was not enough for comparing method and gender specific case fatalities with a fine-meshed stratification regarding age.

CONCLUSIONS

Higher suicide rates in males not only result from the choice of more lethal methods. Other factors have to be considered.

Depression and anxiety in the reindeer-herding Sami population of Sweden

OBJECTIVES

The objective of this study was to investigate symptoms and predicting factors of depression and anxiety among reindeer-herding Sami in Sweden.

STUDY DESIGN

A total of 319 reindeer-herding Sami (168 men, 151 women) were compared with urban and rural reference populations comprising 1,393 persons (662 men, 731 women).

METHODS

A cross-sectional questionnaire study on mental health, which included the Hospital Anxiety and Depression Scale (HADS). Data were analysed with regard to population, gender, age group, education and work-related stress.

RESULTS

The Sami population disclosed higher mean values for both depression and anxiety than the reference groups, with Sami men reporting the highest rates. Work-related stress was associated with anxiety and depression in the Sami group.

CONCLUSIONS

By comparing Sami men and women with reference groups of men and women living in urban and rural areas in northern Sweden, this study identified that reindeer-herding Sami men require special attention with regard to mental health problems.

"You feel like you can't live anymore": suicide from the perspectives of Canadian men who experience depression

Severe depression is a known risk factor for suicide, yet worldwide men's suicide rates continue to outnumber reported rates of men's depression. While acknowledging that the pathways to suicide are diverse, and being mindful of the complex challenges inherent to studying suicide, we interviewed men who experienced depression as a means to better understanding the processes they used to counter and contemplate suicide. This novel qualitative study provides insights on how masculine roles, identities and relations mediate depression-related suicidal ideation in a cohort of 38 men in Canada, ranging in age from 24 to 50 years-old. Constant comparative analyses yielded the core category of reconciling despair in which men responded to severe depression and suicidal ideation by following two pathways. To counter suicide actions, connecting with family, peers and health care professionals and/or drawing on religious and moral beliefs were important interim steps for quelling thoughts about suicide and eventually dislocating depression from self-harm. This pathway revealed how connecting with family through masculine protector and father roles enabled men to avoid suicide while positioning help-seeking as a wise, rational action in re-establishing self-control. The other pathway, contemplating escape, rendered men socially isolated and the overuse of alcohol and other drugs were often employed to relieve emotional, mental and physical pain. Rather than providing respite, these risky practices were the gateway to men's heightened vulnerability for nonfatal suicidal behaviour. Men on this pathway embodied solitary and/or risk taker identities synonymous with masculine ideals but juxtaposed nonfatal suicidal behaviours as feminine terrain.

Parental divorce, parental depression, and gender differences in adult offspring suicide attempt

Research suggests parental divorce during childhood increases risk of suicide attempt for male but not female offspring. The negative impact on offspring associated with parental divorce may be better explained by parental psychopathology, such as depression. We examined whether adult offspring of parental divorce experience elevated risk of suicide attempt, controlling for parental history of depression, and whether the risk varies by the gender of the offspring. Using the 2001 to 2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), the sample consists of respondents who experienced parental divorce (N = 4895). Multivariable regressions controlled for age, race/ethnicity, income, marital status, and parental history of depression. Females living with their fathers were significantly more likely to report lifetime suicide attempts than females living with their mothers, even after controlling for parental depression. Findings suggest that childhood/adolescent parental divorce may have a stronger impact on suicide attempt risk in female offspring than previously recognized.