Love and achievement motives in women's and men's suicide notes

Their final words: An analysis of suicide notes from the United States

The present study sought to explore motivations (affective, relationships, life events, injury/medical diagnosis) in suicide notes (N = 49) from the U.S. Authors ranged in age from 18 to 74 years and were majority male (73.5%). Four raters analyzed the notes and, through a series of meetings, came to a consensus on the motives behind each note writers' suicide in terms of the broader motivational themes and the narrower second-level themes. All notes were primarily affectional in nature, with some gender and age differences. For example, suicide notes from males frequently refer to financial hardships whereas suicide notes from females were more focused on lowered self-worth and notes written by younger persons focused more on affect and relationships, while notes written by older adults focused on life events and marriage difficulties and separation. Findings illuminate the varied nature of suicide motivations but also highlight important patterns across groups.

Refuting Six Misconceptions about Romantic Love

Scientific research on romantic love has been relatively sparse but is becoming more prevalent, as it should. Unfortunately, several misconceptions about romantic love are becoming entrenched in the popular media and/or the scientific community, which hampers progress. Therefore, I refute six misconceptions about romantic love in this article. I explain why (1) romantic love is not necessarily dyadic, social, or interpersonal, (2) love is not an emotion, (3) romantic love does not just have positive effects, (4) romantic love is not uncontrollable, (5) there is no dedicated love brain region, neurotransmitter, or hormone, and (6) pharmacological manipulation of romantic love is not near. To increase progress in our scientific understanding of romantic love, I recommend that we study the intrapersonal aspects of romantic love including the intensity of love, that we focus our research questions and designs using a component process model of romantic love, and that we distinguish hypotheses and suggestions from empirical findings when citing previous work.

Understanding complex causes of suicidal behaviour among graduates in Bangladesh

This study utilizes both fieldwork and desk-based discourse analysis of newspaper reports to investigate the concerning number of suicides among graduates in Bangladesh. According to some reports, a majority of suicide cases involve young adults who are either currently studying at university or have recently completed their degree (between the ages of 20 and 32). This research contends that patriarchal social expectations in Bangladesh place significant pressure on young adults to secure well-paying jobs to support their families and uphold their family's status, which can have a negative impact on their mental health. Furthermore, this article identifies additional risk factors that contribute to the high suicide rates among graduates in Bangladesh. These factors include unemployment, poverty, relationship problems, drug addiction, political marginalization, and the stigma of shame, all of which can cause low self-esteem and suicidal thoughts. Moreover, the research suggests that families in Bangladesh have not been providing adequate support to their young members when facing challenges in life. On the contrary, families have added to the pressure on young adults, which can be attributed to joiner's theory of the effect of industrialization on family norms and values.

Electrophysiological Correlates of Romantic Love: A Review of EEG and ERP Studies with Beloved-Related Stimuli

Science is starting to unravel the neural basis of romantic love. The goal of this literature review was to identify and interpret the electrophysiological correlates of romantic love. Electroencephalography (EEG) and event-related potential (ERP) studies with a design that elicits romantic love feelings were included. The methods of previous EEG studies are too heterogeneous to draw conclusions. Multiple ERP studies, however, have shown that beloved stimuli elicit an enhanced late positive potential (LPP/P3/P300), which is not due to familiarity, positive valence, or objective beauty. This effect occurs in Western and Eastern cultures and for pictorial and verbal information, and results from bottom-up rather than top-down factors. Studies have also shown that beloved stimuli elicit an early posterior negativity (EPN), which also does not seem to be due to familiarity or positive valence. Data on earlier ERP components (P1, N1, P2, N170/VPP, N2) is scarce and mixed. Of course, the enhanced LPP and EPN are not specific to romantic love. Instead, they suggest that the beloved captures early attention, within 200–300 ms after stimulus onset that is relatively resource-independent, and subsequently receives sustained motivated attention. Future research would benefit from employing cognitive tasks and testing participants who are in love regardless of relationship status.

Dying in a foreign land: A study of completed suicides among foreign workers in Singapore

Suicide is a public health issue that impacts a nation's resident and non-resident populations alike. Singapore has one of the largest non-resident (work permit holder) populations in the world, yet very little attention has been given to examining suicide in this population. The current study examined the case materials of all 303 non-resident completed suicides in Singapore in the period January 2011 to December 2014. Their basic profiles were compared with that of the 1,507 resident cases in the same period. A sample of 30 death notes written by non-residents were randomly selected and thematically analyzed to supplement the descriptive findings and discussion. Results showed that suicides were highest among males, those aged 21-35 years old, and South Asians. Most non-resident suicide cases did not have known physical or mental health issues, prior suicide attempts, or suicide notes. Suicide decedents from South Asia and Europe most frequently used hanging, while jumping was most common among decedents from other regions. Relationship and health problems emerged as the top two suspected triggers for suicide based on our analysis of the suicide notes. The unique situation of working abroad may increase non-residents' vulnerability in general, while adverse life events such as relationship and health issues may be too overwhelming to bear, especially when support services are not readily available and accessible. The results have implications for suicide prevention among this neglected group of people who choose to work in foreign lands.

Language, culture, gender, and intersectionalities in suicide theory, research, and prevention: Challenges and changes

Over the decades suicidology has experienced many challenges and changes. Language, culture, gender, and intersectionalities of experience have been domains of challenge and change. In this article I document my contributions to suicidology's transformation in these domains. These contributions include challenging stigmatizing and biased suicide-language (e.g., expressions like "successful" and "failed" suicide); questioning gender myths of suicidal behaviors (e.g., the myth that women and men are opposites in terms of suicide motives); the gender-paradox-of-suicide idea; and suicide-scripts theory and research. I then describe the evolution of suicide-scripts theory. Suicide-scripts theory builds on evidence that in each culture there are unique situations when suicidal behavior is expected from specific people, using specific methods, and with specific social consequences. The theory posits that these scripts contribute to variations in suicidality across cultures, and within cultures, across sociodemographic groups, intersectionally. Studies using a diversity of methodologies and focusing on a diversity of sociodemographic groups and cultures point to the role of suicide scripts in suicidality. The article concludes with a discussion of the implications, for suicide prevention, of suicide-scripts theory and evidence.

A Quantitative and Qualitative Study of Notes Left by Youth Who Died by Suicide in Quebec from 1895 to 1985

The study of suicide notes and the evolution of their content could contribute to a better understanding of reasons conducive to suicide mortality and offer further prevention strategies. From 1895 to 1985, 706 coroner's inquests of individuals who died by suicide and were 20 years old or younger were found in the province of Quebec. Quantitative analysis compared those who left notes (n = 47) to those who did not leave notes (n = 659). Furthermore, notes were subjected to inductive thematic analysis. Sociodemographic characteristics of the deceased individuals did not change over time. Qualitative analysis revealed four superordinate themes: (1) last wishes, (2) to those I leave behind, (3) about me and how and why I did it, and (4) self-positioning in the world. Only the last theme evolved over the time period considered. Suicide notes shed light on the psychological state of the majority of young note leavers and suggest the persistent feelings of distress and entrapment before the suicide, which may be important factors for caregivers and family members to monitor.

Measuring the Capacity to Love: Development of the CTL-Inventory

Objective: The individual capacity to love (CTL) has been linked to various mental health parameters and is considered to be an important outcome parameter of psychotherapeutic treatment. However, empirical examinations of the concept have not been conducted up to now. The aim of this study was to develop a valid and reliable instrument for the assessment of CTL [Capacity to Love Inventory (CTL-I)] as a trait of personality, which is shown to be related to clinically relevant symptoms and conditions.

Method: Four independent healthy samples in Austria (n = 547, n = 174, and n = 85) and Poland (n = 240) were assessed by a prototype of the CTL-I and its final shorter version in a confirmatory factor analysis (CFA). Internal consistency of the total questionnaire and each subscale was assessed by Cronbach alpha. External validity was measured against Beck Depression Inventory, Quality of Relationship Inventory, Sociosexual Orientation Inventory, Pathological Narcissism Inventory, and Narcissistic Personality Inventory according to the theoretical framework of the CTL concept. Further test–retest reliability was assessed.

Results: The CFA confirmed 41 items in six dimensions: Interest in the life project of the other, Basic trust, Humility and gratitude, Common ego ideal, Permanence of sexual passion, and Acceptance of loss/jealousy/mourning. The Cronbach alphas of the total CTL-I and its subscales ranged between 0.67 and 0.90 in all samples, suggesting a valid construct. The CTL-I was moderately positively associated with quality of relationship (Support r = 0.63, Conflict r = -0.66, and Depth r = 0.66) and inversely associated with symptoms of depression (r = -0.37), pathological narcissism (r = -0.29) and promiscuity (r = -0.42). The test–retest reliability of the total CTL-I was high with r = 0.81, suggesting the stability of answers over time.

Conclusion: The proposed 41-item version of the CTL-I is a psychometrically sound and validated instrument measuring six dimensions of the concept of the CTL. The reported negative associations with clinically relevant parameters such as depression, pathological narcissism and promiscuity as well as associations with relationship qualities such as conflicts, support, and depth warrant its future use in burdened populations including couples in clinical settings.

Assessing Suicide Risk and Emotional Distress in Chinese Social Media: A Text Mining and Machine Learning Study

BACKGROUND

Early identification and intervention are imperative for suicide prevention. However, at-risk people often neither seek help nor take professional assessment. A tool to automatically assess their risk levels in natural settings can increase the opportunity for early intervention.

OBJECTIVE

The aim of this study was to explore whether computerized language analysis methods can be utilized to assess one's suicide risk and emotional distress in Chinese social media.

METHODS

A Web-based survey of Chinese social media (ie, Weibo) users was conducted to measure their suicide risk factors including suicide probability, Weibo suicide communication (WSC), depression, anxiety, and stress levels. Participants' Weibo posts published in the public domain were also downloaded with their consent. The Weibo posts were parsed and fitted into Simplified Chinese-Linguistic Inquiry and Word Count (SC-LIWC) categories. The associations between SC-LIWC features and the 5 suicide risk factors were examined by logistic regression. Furthermore, the support vector machine (SVM) model was applied based on the language features to automatically classify whether a Weibo user exhibited any of the 5 risk factors.

RESULTS

A total of 974 Weibo users participated in the survey. Those with high suicide probability were marked by a higher usage of pronoun (odds ratio, OR=1.18, P=.001), prepend words (OR=1.49, P=.02), multifunction words (OR=1.12, P=.04), a lower usage of verb (OR=0.78, P<.001), and a greater total word count (OR=1.007, P=.008). Second-person plural was positively associated with severe depression (OR=8.36, P=.01) and stress (OR=11, P=.005), whereas work-related words were negatively associated with WSC (OR=0.71, P=.008), severe depression (OR=0.56, P=.005), and anxiety (OR=0.77, P=.02). Inconsistently, third-person plural was found to be negatively associated with WSC (OR=0.02, P=.047) but positively with severe stress (OR=41.3, P=.04). Achievement-related words were positively associated with depression (OR=1.68, P=.003), whereas health- (OR=2.36, P=.004) and death-related (OR=2.60, P=.01) words positively associated with stress. The machine classifiers did not achieve satisfying performance in the full sample set but could classify high suicide probability (area under the curve, AUC=0.61, P=.04) and severe anxiety (AUC=0.75, P<.001) among those who have exhibited WSC.

CONCLUSIONS

SC-LIWC is useful to examine language markers of suicide risk and emotional distress in Chinese social media and can identify characteristics different from previous findings in the English literature. Some findings are leading to new hypotheses for future verification. Machine classifiers based on SC-LIWC features are promising but still require further optimization for application in real life.

Validating Machine Learning Algorithms for Twitter Data Against Established Measures of Suicidality

BACKGROUND

One of the leading causes of death in the United States (US) is suicide and new methods of assessment are needed to track its risk in real time.

OBJECTIVE

Our objective is to validate the use of machine learning algorithms for Twitter data against empirically validated measures of suicidality in the US population.

METHODS

Using a machine learning algorithm, the Twitter feeds of 135 Mechanical Turk (MTurk) participants were compared with validated, self-report measures of suicide risk.

RESULTS

Our findings show that people who are at high suicidal risk can be easily differentiated from those who are not by machine learning algorithms, which accurately identify the clinically significant suicidal rate in 92% of cases (sensitivity: 53%, specificity: 97%, positive predictive value: 75%, negative predictive value: 93%).

CONCLUSIONS

Machine learning algorithms are efficient in differentiating people who are at a suicidal risk from those who are not. Evidence for suicidality can be measured in nonclinical populations using social media data.

Predictors of intimate partner problem-related suicides among suicide decedents in Kentucky

BACKGROUND

Suicide is the 10th leading cause of death in the United States. Furthermore, intimate partner problems are amid the top precipitating circumstances among suicide decedents. The aim of this study was to determine circumstantial associations of intimate partner problem-related suicides in suicide decedents in Kentucky.

METHODS

All suicides that were reported to the Kentucky Violent Death Reporting System between 2005 and 2012 were eligible for this study. Multiple logistic regression was used to explore predictors (precipitating health-related problems, life stressors, and criminal/legal issues) of intimate partner problem-related suicides.

RESULTS

Of the 4,754 suicides, included in this study, approximately 17% had intimate partner problems prior to suicide. In the adjusted analysis, mental health issues, alcohol problems, history of suicides attempts, suicides precipitated by another crime, and other legal problems increased the odds of having an intimate partner-related suicide. However, having physical health problems, prior to the suicide, decreased the odds of intimate partner-related suicide.

CONCLUSIONS

These results provide insight for the development of suicide interventions for individuals with intimate partner problems by targeting risk factors that are prevalent among this population. Moreover, these results may help marriage/relationship and/or family/divorce court representatives identify individuals with intimate partner problems more at risk for suicide and alleviate the influence these suicide risk factors have on individuals experiencing Intimate partner problems.

The impact of intimate partner relationships on suicidal thoughts and behaviours: A systematic review

BACKGROUND

A systematic review was conducted to identify the impact of intimate partner relationships on suicidality. The aim of the review was to identify factors within intimate partner relationships that influence suicidal ideation, attempts and completion.

METHOD

Fifty-one articles were identified through Scopus, PubMed and PsycINFO databases. Due to the high heterogeneity of the included studies, a narrative data synthesis was conducted.

RESULTS

The research drew attention to specific contingents of the population, for example examining suicide risk in individuals under the age of 35 or lesbian, gay, bisexual and transgender (LGBT) individuals who are experiencing relationship discord, and in males who have recently separated.

LIMITATIONS

Interpretation of these findings is constrained by methodological limitations prevalent in much of the literature. Limitations of the existing literature and corresponding directions for future research are discussed.

CONCLUSIONS

Relationship separation and poor quality relationships are likely to be important risk factors for suicidal thoughts and behaviours and are frequent triggers for a suicide attempt. This review highlights intimate partner relationships as a significant component in a suicide risk assessment, regardless of the clinical setting. Consequently, clinicians should be aware that individuals reporting relationship problems are likely to be at increased risk of suicidal thoughts and behaviours.

Mutual influences between partners' hormones shape conflict dialog and relationship duration at the initiation of romantic love

Early-stage romantic love involves reorganization of neurohormonal systems and behavioral patterns marked by mutual influences between the partners' physiology and behavior. Guided by the biobehavioral synchrony conceptual frame, we tested bidirectional influences between the partners' hormones and conflict behavior at the initiation of romantic love. Participants included 120 new lovers (60 couples) and 40 singles. Plasma levels of five affiliation and stress-related hormones were assessed: oxytocin (OT), prolactin (PRL), testosterone (T), cortisol (CT), and dehydroepiandrosterone sulfate (DHEAS). Couples were observed in conflict interaction coded for empathy and hostility. CT and DHEAS showed direct actor effects: higher CT and DHEAS predicted greater hostility. OT showed direct partner effects: individuals whose partners had higher OT showed greater empathy. T and CT showed combined actor-partner effects. High T predicted greater hostility only when partner also had high T, but lower hostility when partner had low T. Similarly, CT predicted low empathy only in the context of high partner's CT. Mediational analysis indicated that combined high CT in both partners was associated with relationship breakup as mediated by decrease in empathy. Findings demonstrate the mutual influences between hormones and behavior within an attachment bond and underscore the dynamic, co-regulated, and systemic nature of pair-bond formation in humans.

Love and suicide: the structure of the Affective Intensity Rating Scale (AIRS) and its relation to suicidal behavior

BACKGROUND

Suicide has been linked to intense negative affect. However, little is known about the range of affects experienced by suicidal persons, or the separate effects of affect valence and intensity. We examine a novel self-report scale, the 17-item Affective Intensity Rating Scale (AIRS), and its relation to suicidality in a high-risk sample.

METHODOLOGY/PRINCIPAL FINDINGS

Patients presenting with suicidality were recruited from the Emergency Department in a large urban hospital, and completed a battery of assessments there. Structure of the AIRS was assessed using Maximum Likelihood Factor Analysis with Oblimin rotation. Convergent and divergent validity were assessed by regressing AIRS subscales against Brief Symptom Inventory subscales. Relation to suicidality was assessed by regression of suicide attempt status against scale and subscale scores, and individual items and two-way item interactions, along with significant clinical and demographic factors. 176 subjects were included in analyses. Three reliable subscales were identified within the AIRS measure: positive feelings towards self, negative feelings towards self, and negative feelings towards other. Only individual AIRS items associated significantly with suicide attempt status; strong 'feelings of love' associated positively with actual suicide attempt, while 'feelings of calm' and 'positive feelings towards self' associated negatively. Interaction analyses suggest 'calm' moderates the association of 'love' with suicide attempt.

CONCLUSIONS/SIGNIFICANCE

Factor analysis of the AIRS is consistent with a circumplex model of affect. Affective dimensions did not predict suicidal behavior, but intense feelings of love, particularly in the absence of protective feelings of calm or positive self-view associated with current attempt.

Oxytocin during the initial stages of romantic attachment: relations to couples' interactive reciprocity

Romantic relationships can have a profound effect on adults' health and well-being whereas the inability to maintain intimate bonds has been associated with physical and emotional distress. Studies in monogamous mammalian species underscore the central role of oxytocin (OT) in pair-bonding and human imaging studies implicate OT-rich brain areas in early romantic love. To assess the role of OT in romantic attachment, we examined plasma OT in 163 young adults: 120 new lovers (60 couples) three months after the initiation of their romantic relationship and 43 non-attached singles. Twenty-five of the 36 couples who stayed together were seen again six months later. Couples were observed in dyadic interactions and were each interviewed regarding relationship-related thoughts and behaviors. OT was significantly higher in new lovers compared to singles, F(1,152)=109.33, p<.001, which may suggest increased activity of the oxytocinergic system during the early stages of romantic attachment. These high levels of OT among new lovers did not decrease six months later and showed high individual stability. OT correlated with the couples' interactive reciprocity, including social focus, positive affect, affectionate touch, and synchronized dyadic states, and with anxieties and worries regarding the partner and the relationship, findings which parallel those described for parent-infant bonding. OT levels at the first assessment differentiated couples who stayed together six months later from those who separated during this period. Regression analysis showed that OT predicted interactive reciprocity independent of sex, relationship duration, and the partner's OT. Findings suggest that OT may play an important role at the first stages of romantic attachment and lend support to evolutionary models suggesting that parental and romantic attachment share underlying bio-behavioral mechanisms.

An inquiry into relationship suicides and reciprocity

Few theories on suicide have been grounded in the norm of reciprocity. There is literature on suicide, however, describing motivations such as retaliation and retreat which can be interpreted as modes of adaptation to the norm of reciprocity. We propose a reciprocity-based theory to explain suicides associated with relationship problems. Employing a content analysis of suicide notes, we tested the theory, finding evidence of exploitation, exploiter guilt, retaliation, and retreat as motives for committing relationship-based suicide. Reciprocity-based note writers were more likely to have used alcohol or drugs in the hours prior to committing suicide, and they were also more likely to have made their intentions known beforehand. Implications for future research as well as for suicide prevention are discussed.

The interpersonal nature of suicide: a qualitative investigation of suicide notes

Prior investigations of suicide notes typically focus on verifying psychological theories about suicide motives. Fewer concern the interpersonal nature of suicide. This research investigated broad interpersonal themes related to suicide as revealed through suicide notes. This study was a qualitative investigation of suicide notes written by 138 individuals who completed suicide. Grounded theory analysis revealed seven interpersonal themes: 1) instructions; 2) positive relationships; 3) explanations; 4) relationship reconciliation/maintenance; 5) concern for others; 6) negative relationships; and 7) acknowledging end of relationship. These themes suggest that suicidal individuals consider positive and negative aspects of relationships in their notes, and they attempt to maintain and reconcile relationships even in the face of death.

Suizidologie: Abschiedsbriefe und ihre Themen

BACKGROUND

The study of suicide notes has a long tradition. It is important to integrate this study into psychological autopsy and to make contact with the bereaved. For the first time, we present an Austrian-German study and its themes.

MATERIAL AND METHODS

A consecutive series of suicides, investigated at the Department for Forensic Medicine in Vienna from Mai 2002 until April 2005, was examined for the presence of suicide notes. Suicide notes and demographic variables were integrated in an Access databank.

RESULTS

A total of 29% of the those committing suicide left notes, however, the bereaved of only about a quarter allowed these to be studied. The major part was hand written, addressed to the general public or family, and shorter than 150 words. Frequent themes were specific instructions, emotions, themes regarding the environment such as the family, occupation and leisure time, and themes regarding stations of life and illness.

Beliefs about gender differences in methods and causes of suicide

Forty undergraduate students (20 males, 20 females) made judgments about the relationship between an individual's gender and the method of suicide most likely to be chosen by that individual. The perceived relationship between different precipitating events for suicide and the method of suicide were also examined, as were the participants' judgments about the moral justification of suicide in response to different traumatic situations. The results indicated clear and consistent beliefs about the relationship between the gender of the potential suicide victim, the method of suicide likely to be chosen, and whether or not the cause of the suicide was judged harshly or sympathetically. Understanding how the gender of an at-risk individual interacts with an observer's beliefs and moral perspective should help us predict when suicide threats will be taken seriously and what form of intervention will take place.

Comparative Study about Methods of Suicide between Japan and the United States

BACKGROUND: Suicide is one of the most important public health issues in both Japan and the United States. This study is to clarify the differences in methods of suicide between the two countries, among various races within the United States, and between genders and age-groups.

METHODS: Vital statistics mortality data and the estimated population in 1999 in Japan and in the United States were used. Age-adjusted mortality rates were calculated using the age-specific total population of Japan and the United States as a standard population. In addition, the proportionate distribution of suicide methods was calculated.

RESULTS: Age-adjusted mortality rates from suicide in Japan were about 2 times higher for males and 3 times higher for females compared with the United States. The most common method among both genders in Japan was hanging, followed by jumping from a high place. In the United States, it was firearms among both genders, followed by hanging among males and drugs among females. For Asians in the United States, hanging was the method of choice for about half among both genders; hanging was the most common method for the age group of 40 years or more among males and for all age groups among females. Firearms were the method of choice for the 20-39 age group among males.

CONCLUSIONS: Although the overall suicide rates among Asians in the United States were lower than Japan, the methods were similar to those in Japan.