Sociocultural determinants of suicide ideation: a comparison between American and Ghanaian college samples

The effectiveness of a vignette approach to teaching suicide risk factors: an Omani perspective

This within subjects study assessed the effectiveness of a previously published vignettes approach to the teaching of suicide risk factors in a cohort of students in an Omani medical school. As part of their learning, students were asked to rank four case descriptions for suicide risk, after which there was a specific discussion of the cases and of suicide risk assessment. A previous study had shown significant and dramatic improvement in students from a US university. However the students in this study showed a very different profile of learning about suicide risk from this activity. They had particular difficulty in weighing risk and protective factors when determining relative risk. The impact of cultural and religious context on the effectiveness of this learning activity is discussed. It is clear that there is a continuing need for evaluation and research as to the efficacy of developments in medical education as they are applied in international medical schools with students of different cultural and religious backgrounds.

Spirituality, religion and suicidal behavior in a nationally representative sample

BACKGROUND

Studies show that religion and spirituality are associated with decreased rates of mental illness. Some studies show decreased rates of suicide in religious populations, but the association between religion, spirituality and suicidal behaviors in people with mental illness are understudied. Few studies have examined the influence of social supports in these relationships.

METHODS

Data were drawn from the Canadian Community Health Survey 1.2. Logistic regression was used to examine the relationship between spiritual values and religious worship attendance with twelve-month suicidal ideation and attempts. Regressions were adjusted for sociodemographic factors and social supports. Interaction variables were then tested to examine possible effect modification by presence of a mental disorder.

RESULTS

Identifying oneself as spiritual was associated with decreased odds of suicide attempt (adjusted odds ratio-1 [AOR-1]=0.65, CI: 0.44-0.96) but was not significant after adjusting for social supports. Religious attendance was associated with decreased odds of suicidal ideation (AOR-1=0.64, 95% CI: 0.53-0.77) but not after adjusting for social supports. Religious attendance was associated with decreased odds of suicide attempt and remained significant after adjusting for social supports (AOR-2=0.38, 95% CI: 0.17-0.89). No significant interaction effects were observed between any of the tested mental disorders and religion, spirituality and suicidal behavior.

LIMITATIONS

This was a cross-sectional survey and causality of relationships cannot be inferred.

CONCLUSIONS

Results suggest that religious attendance is associated with decreased suicide attempts in the general population and in those with a mental illness independent of the effects of social supports.

Building models for the relationship between attitudes toward suicide and suicidal behavior: based on data from general population surveys in Sweden, Norway, and Russia

Our aim was to build a model delineating the relationship between attitudes toward suicide and suicidal behavior and to assess equivalence by applying the model on data from different countries. Representative samples from the general population were approached in Sweden, Norway, and Russia with the Attitudes Toward Suicide (ATTS) questionnaire. Data on experience of suicidal behavior among significant others and self-reported suicidal expressions were also collected. Structural equation modeling resulted in gender and country specific models where experience of suicidal behavior among significant others and self-reported suicidal expressions earlier in life predicted attitudes, and attitudes predicted current suicidal expressions. The models included the attitude factors acceptance of suicide, condemnation, and preventability; age and level of education were also incorporated. The different models reveal possible ways to better understand gender and culture-specific paths between attitudes and suicidal behaviors, and their relevance in a suicide prevention context is considered.

Self-reported suicidal behavior and attitudes toward suicide and suicide prevention among psychology students in Ghana, Uganda, and Norway

Self-reported suicidal behavior and attitudes toward suicide in psychology students are reported and compared in Ghana, Uganda, and Norway. Small differences only were found in own suicidal behavior. However, experience of suicidal behavior in the surroundings was more common in Uganda than in Ghana and Norway. Although differences were found between the three countries in attitudes toward suicide, which emphasizes the need for culture-sensitive research and prevention, many of the differences were not as big as expected. The most pronounced difference was that the Norwegian students were more reluctant to take a stand on these questions compared to their African counterparts. Some differences were also found between the two African countries. The implications of the results for suicide prevention in Africa are discussed.

Religion and spirituality along the suicidal path

The inner experience of spiritual and religious feelings is an integral part of the everyday lives of many individuals. For over 100 years the role of religion as a deterrent to suicidal behavior has been studied in various disciplines. We attempt to systematize the existing literature investigating the relationship between religion/spirituality and suicide in this paper. After an overview of the attitudes of the dominant religions (e.g., Catholicism, Islam, and Buddhism) toward suicide, the three main theories that have speculated regarding the link between religion and suicide are presented: "integration theory" (Durkheim, 1897/1997), "religious commitment theory" (Stack, 1983a; Stark, 1983), and "network theory" (Pescosolido & Georgianna, 1989). Subsequent to this theoretical introduction, we report on studies on religion/spirituality keeping the suicidal path as a reference: from suicidal ideation to nonlethal suicidal behavior to lethal suicidal behavior. Studies presenting indications of religious beliefs as a possible risk factor for suicidal behavior are also presented. The last section reviews possible intervention strategies for suicidal patients and suicide survivors. Indications for future research, such as more studies on nonreligious forms of spirituality and the use of qualitative methodology to achieve a better and deeper understanding of the spiritual dimension of suicidal behavior and treatment, are offered.

Anxiety disorders and suicidal behaviour: an update

PURPOSE OF REVIEW

The primary aim of this review is to present the main findings from the literature published between January 2006 and May 2007 on anxiety and suicidal behaviour. The secondary aim is to present critical comments on methodological issues, highlighting areas for future research.

RECENT FINDINGS

Traditionally, anxiety disorders have not been viewed as independent risk factors for suicidal behaviour, and therefore assessment of anxiety disorders has not been particularly emphasized in clinical enquiries and suicide screening tools. This review identifies evidence suggesting that specific anxiety disorders (e.g. generalized anxiety disorder, panic disorder and obsessive-compulsive disorder) may be independently associated with suicidality, to which they particularly contribute when they are co-morbid with bipolar disorder, depression, schizophrenia, or post-traumatic stress disorder, in both child/adolescent and adult populations.

SUMMARY

Despite methodological issues preventing firm conclusions from being drawn in most cases, these findings should prompt clinicians to evaluate more specifically the impact of anxiety disorders on suicidal behaviour, particularly when they are co-morbid. Further research into treatment of anxiety disorders in relation to preventing suicide is required.

Ethnocultural aspects of suicide in young people: a systematic literature review part 1: Rates and methods of youth suicide

The study of ethnocultural aspects of suicidal behaviour is, at the moment, still a neglected area. The relatively few studies available are mainly on adults; young people usually are not examined separately. The authors reviewed 82 publications on youth suicide that have addressed, to different degrees, the ethnicity/culture of the population studied. Following a description of the main characteristics shared by these researches (e.g., predominance of studies on Blacks, Whites, and Hispanics; lack of qualitative methodology, etc.), the rates and methods of youth suicide, from a cross-cultural perspective are discussed.

Ethnocultural aspects of suicide in young people: a systematic literature review part 2: Risk factors, precipitating agents, and attitudes toward suicide

Different scholars have expressed the same regret for the lack of research on ethnocultural differences in youth suicide behavior and the need to conduct more comparative studies, necessary to develop culturally responsive prevention and intervention strategies. The authors reviewed 82 publications on youth suicide that have considered, to different degrees, the ethnicity/culture of the population studied. Part 1 of this article explored youth suicide rates and methods (SLTB, this issue), while the present paper examines risk and precipitating factors and attitudes toward suicide in young people from a cross-cultural perspective.

Analysis of a national toll free suicide crisis line in South Africa

The first national toll free suicide crisis line for South Africa was launched in October 2003 with the aim of providing a service dedicated to the prevention of suicide in this country. The intervention was motivated by South Africa's suicide rate which had risen higher than the global suicide rate, with the majority of attempted suicides occurring among people younger than 35 years of age (WHO, 2002). Demographic characteristics of callers were identified to evaluate the perceived helpfulness of this crisis line, so as to inform planning and implementation of future suicide prevention programs. Results showed that the majority of callers were female; between the ages of 16 and 18 years; and lived in the provinces of Gauteng, North West, or KwaZulu Natal. Callers were more likely to be from urban than rural areas; were still at school, unemployed, or studying at a tertiary institution; and had not previously attempted suicide. The majority of participants did perceive the crisis line as helpful. The continued collection of demographic data from the crisis line is recommended so that South Africa can create an updated database of areas and sectors of the population that require suicide intervention, and for planning and implementing suicide prevention programs in this country.

Acculturation and suicide attitudes: a study of perceptions about suicide among a sample of Ghanaian immigrants in the United States

To investigate whether a relationship exists between acculturation and attitudes about suicide, 81 Ghanaian immigrants living in the U.S. who responded to a mail inquiry were selected to participate in the current study. This particular immigrant sample was chosen because although they represent a rapidly growing group in the U.S., they have been rarely studied. Respondents consisted of 42 women and 36 men (3 did not identify their sex), with a mean age of 29.5 yr. (SD = 10.6). Participants completed measures of acculturation and attitudes about suicide. Results indicated significant correlations between length of residency in the United States and negative suicide attitudes, and also between psychological acculturation and negative suicide attitudes. No significant relationship was found between behavioral acculturation and suicide attitudes. Furthermore, length of residency was a stronger predictor of suicide attitudes than other subjective measures of acculturation. Implications and suggestions for further research are discussed.

Young peoples' opinions about the causes of, and solutions to, New Zealand's high youth suicide rate

In response to an open-ended question about the causes of New Zealand's high youth suicide rate, 384 young adults most commonly cited pressure to conform and perform, followed by financial worries, abuse and neglect, problems with alcohol or drugs, and boredom. Depression was cited by 5 percent and mental illness by only 1 percent. Recommended solutions included crisis support services located in schools and youth centers, youth activities, educational programs to assist young people to discuss feelings and to bolster self-esteem, and financial aid. Neither increasing mental health services, nor reducing media coverage of suicides, was considered to be a solution.