The role of gender and suicide precipitant in attitudes toward nonfatal suicide behavior

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.

Suicidal Behaviour among School-Going Adolescents in Saint Lucia: Analysis of Prevalence and Associated Factors

Suicide poses a debilitating threat to adolescents' lives worldwide. Although suicide prevention efforts are evident globally, there is limited evidence on the prevalence and correlations of suicidal behaviour among school-going adolescents in Saint Lucia. We used a dataset from the 2018 Global School-based Student Health Survey to examine the prevalence and associated factors of suicidal behaviour among 1864 students from schools in Saint Lucia. Prevalence rates of 25.5%, 22.1%, and 17.5% were found for suicidal ideation, suicide plan, and suicide attempt, respectively. After adjusting for other factors, being male and having understanding parents were protective against suicidal behaviour. However, suicidal ideation was predicted by being physically attacked and bullied, parental guidance, tobacco use, loneliness, and worry. Moreover, being a victim of physical attacks and bullying, having close friends, being lonely, and worrying were predictive of making suicidal plans among adolescents. Attempting suicide was predicted by cigarette smoking, current use of tobacco and related products, bullying, having close friends, being lonely, and worrying. School-based preventive interventions are required to help address triggers of suicidal behaviour among adolescents in Saint Lucia and to help attain the targets for suicide prevention in the global Sustainable Development Goals.

Psychosocial factors that distinguish between men and women who have suicidal thoughts and attempt suicide: findings from a national probability sample of adults

BACKGROUND

Previous research has highlighted the importance of understanding which psychosocial factors distinguish between those with suicide thoughts compared to those who attempt suicide. This study aims to investigate these distinguishing factors further within an ideation-to-action framework and to explore sex differences in suicide risk.

METHODS

Participants (n = 7546, aged 16+) were from the cross-sectional Adult Psychiatric Morbidity Survey (APMS; 2014) of England. Face-to-face and self-completion questionnaires assessed lifetime suicidal ideation, lifetime suicide attempts, demographic characteristics, life experiences, social support, health and mental illness. Multinomial logistic regression examined factors differentiating between those with suicidal ideation only and suicide attempt histories (with or without suicidal ideation) in men and women.

RESULTS

Overall men were less likely to report suicidal thoughts and attempts, compared to females. More factors differentiated between suicidal thoughts and attempts in women compared to in men; these included hospital admission for mental illness, below degree level qualifications, being single and childhood adversity. In men, factors which significantly differentiated between suicidal thoughts and attempts included self-report of professional diagnosis of mental illness and childhood adversity. Higher levels of social support were associated with being in the suicidal thoughts group v. in the attempts group in men.

CONCLUSION

This study identified some key differences between men and women in factors associated with suicide attempts compared to suicidal thoughts. The findings support the use of the ideation-to-action framework to investigate sex differences in suicidal behaviour. Future research should examine the extent to which these factors are associated with suicide risk over time.

Psychiatric euthanasia, suicide and the role of gender

The preponderance of women among persons who request and receive euthanasia and assisted suicide based on a psychiatric condition, as shown by data from The Netherlands and Belgium, is virtually unexplored. We provide a critical discussion of this gender gap, and propose that it can inform a key debate point in the controversy over the practice, namely its conflict with suicide prevention.

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.

Negative Life Events and Suicide in the National Violent Death Reporting System

Negative life events may be a major precipitating factor for suicide and may differ across sociodemographic groups. We used data from the National Violent Death Reporting System (NVDRS) to explore whether age, gender, current mental illness, and disclosure around suicide predicted adult decedents' precipitants for suicide. Method: An NVDRS data set was used that included 58,247 adults who died by suicide between 2005 and 2010. Multivariate logistic regression was used to explore the relationship between sociodemographic characteristics and precipitating factors while controlling for the impact of other factors. Results: Age group (18-34, 35-64, or ≥ 65), sex, current mental illness, and disclosure around suicide significantly predicted various precipitants. Males were more likely than females to have most precipitating factors, particularly a criminal legal problem (odds ratio [OR]: 2.76), job problem (OR: 1.97), or financial problem (OR: 1.42). While younger decedents had more crises and intimate partner problems, middle-aged decedents had more loss of housing (OR: 1.87) and financial (OR: 1.81) and job-related (OR: 1.35) precipitants than the younger group. The odds of a physical health issue increased successively with each age group. Identified mental illness was associated most strongly with a job (OR: 1.43) or physical health problem (OR: 1.35). Individuals who disclosed suicidal ideation had a higher incidence of all precipitants. Conclusions: The precipitants to suicide appear to vary according to individuals' demographic factors, current mental illness, and disclosure of intent. Our understanding of suicide may be enhanced by exploring the causal pathway behind these relationships.

Variables Affecting Attitudes Toward Suicide Among the Adolescent Population

Past research has supported the positive association between prosuicide attitudes and suicidal behavior. The aim of the present study was to determine the factor structure of adolescents' attitudes toward suicide and to explore correlates associated with their attitudes. A questionnaire was distributed to 1292 adolescents at eight middle schools to assess their demographic information, clinical variables, and attitudes toward suicide. After factor analysis, we reached a four-factor solution of the attitudes toward suicide. Significantly more females, nonreligious adolescents, those with a lower socioeconomic status, those with higher levels of depressive symptoms, and those with a history of suicidal ideation/plans had more understanding attitudes toward suicide. Depressive adolescents were also more permissive and believed that suicides were unpreventable and that loneliness led to suicide. In conclusion, adolescents' attitudes toward suicide were significantly associated with not only various sociodemographic correlates but also the severity of depressive symptoms and their own experiences of suicidality.

Individual and social stress, social capital, and depressive symptoms as predictors of adolescent suicide in South Korea: A mediated moderation model

This study examined the interactive effects of strain induced by individual and social stress and social capital on suicide, highlighting depressive symptoms as mediator in these relationships. This study used data from 5000 adolescents aged 14-18 years. Strain due to individual stress was found to have a direct effect on suicide, but strain due to social stress did not have a direct effect on suicide. The interactive effect of strain and social capital significantly predicted depressive symptoms and suicide. In the relationship between strain and suicide, the interactive effect of strain and social capital was mediated by depressive symptoms.

The Role of Masculinity and Depressive Symptoms in Predicting Suicidal Ideation in Homeless Men

Men's suicide rates may be influenced by difficulties recognizing externalizing depressive symptoms in men that adhere to hegemonic masculine gender role norms. The purpose of this study was to investigate the ability of externalizing depressive symptoms, internalizing depressive symptoms, and hegemonic masculinity in predicting the existence and severity of suicidal ideation. Homeless men (n = 94) completed questionnaires at a resource center in the Rocky Mountain Western United States. Internalizing symptoms predicted the existence of suicidal ideation, and both externalizing and internalizing symptoms predicted increased severity of suicidal ideation. The masculine norms violence and playboy were correlated with men's suicidal ideation. An externalizing-internalizing model of predicting suicide in men and men's adherence to certain masculine gender role norms may be valuable to further efforts in suicide assessment and prevention.

Preventing suicide; nurse education and the occluded issue of gender

Suicide prevention training recommended as part of national suicidal strategies across the UK has contributed to a reduction in suicide. Previous studies have found suicide prevention training changes attitude and increases confidence in ability to utilise suicide prevention strategies. There is limited evidence relating to the different responses to suicide prevention training by females and males. As the majority of nurses are female it is important to know if they report the same increases in confidence after suicide prevention training. An exploratory study utilising a survey design and repeated measures was used to investigate the effect of SafeTALK training on the level of general perceived self-efficacy (GPSE) in student nurses and to observe for any gender-related differences. A sample (N = 128) of first year student nurses were asked to complete a GPSE assessment pre and post SafeTALK training. Males reported higher scores on both total pre and post-training scores of GPSE and on mean scores per question compared to females. An effect of time (F (1, 118) = 20.07, p = .001) but no effect of gender (F (1, 118) = 3.53, p = .06) was found. A post-hoc sample size calculation revealed that a replication of the current investigation with a sample size of N = 15 (males), N = 155 (females), would be likely to find a statistically significant difference between genders in GPSE scores. It may be prudent to consider joint facilitation, with both male and female facilitators of SafeTALK training sessions. Specific pedagogical strategies can also be used to promote an increase in self-efficacy in those people undertaking SafeTALK training.

Permissive beliefs and attitudes about older adult suicide: a suicide enabling script?

OBJECTIVES

In the United States, suicide rates are highest among European American older adults. This phenomenon calls attention to cultural factors, specifically, the suicide beliefs and attitudes of European Americans. Beliefs and attitudes matter in the vulnerability to suicide. As predicted by cultural scripts of suicide theory, suicide is most likely among individuals and in communities where it is expected and is most acceptable. This study examined beliefs about the precipitants of, and protectors against older adult suicide, as well as suicide attitudes, in a predominantly European American community.

DESIGN AND METHODS

Two hundred and fifty-five older adults (86% European American) and 281 younger adults (81% European American) indicated what they thought were the most likely older adult suicide precipitants and protectors, and their opinion about older adult suicide, depending on precipitant.

RESULTS

Health problems were the most endorsed older adult suicide precipitants. Suicide precipitated by health problems was also rated most positively (e.g., rational, courageous). Older adults, persons with more education, and persons who did not identify with a religion expressed the most favorable attitudes about older adult suicide, across suicide precipitants. Men viewed older adult suicide as more admissible, and women, with more sympathy. Perceived suicide protectors included religiosity among older adults, and supportive relationships among younger adults.

CONCLUSIONS

The belief, in this study's predominantly European American community, that older adult suicide is triggered by health problems, together with favorable attitudes about older adult suicide, suggest an enabling older adult suicide script, with implications for suicide risk and prevention.

Stigma in Male Depression and Suicide: A Canadian Sex Comparison Study

Stigma in men's depression and suicide can restrict help-seeking, reduce treatment compliance and deter individuals from confiding in friends and family. In this article we report sex comparison findings from a national survey of English-speaking adult Canadians about stigmatized beliefs concerning male depression and suicide. Among respondents without direct experience of depression or suicide (n = 541) more than a third endorsed the view that men with depression are unpredictable. Overall, a greater proportion of males endorsed stigmatizing views about male depression compared to female respondents. A greater proportion of female respondents endorsed items indicating that men who suicide are disconnected, lost and lonely. Male and female respondents with direct personal experience of depression or suicide (n = 360) strongly endorsed stigmatizing attitudes toward themselves and a greater proportion of male respondents indicated that they would be embarrassed about seeking help for depression.

Gender Differences Related to Attitudes Toward Suicide and Suicidal Behavior

This descriptive study examined gender differences related to attitudes toward suicide among randomly selected urban residents. Data was collected using a standardized questionnaire through face-to-face interview. Our findings revealed that men hold more pro preventive attitudes to help persons with suicidal thoughts (80.3 %, p = 0.05) and agreed that suicidal attempts are impulsive (78.6 %, p = 0.01). However, they hold permissive attitude to help persons with incurable diseases and expressing death wishes to die (66 %, p = 0.05). A majority of men (78.6 %) than women agreed that "suicidal attempt is essentially a cry for help" (χ (2) = 11.798, p = 0.05). These gender differences need to be taken into consideration when developing appropriate programs to prevent suicide. Further, decriminalizing the law, high-quality research and raising awareness about suicide prevention among the general population is crucial in developing countries like India.

The Body as a Site of Gender-Related Distress: Ethical Considerations for Gender Variant Youth in Clinical Settings

The present article maps out understandings about embodied distress among gender-nonconforming youth. Feminist bioethics and queer-inflected clinical perspectives are used to inform thinking about ethical, nonpathologizing health care in the case of gender-related distress. Specific attention is directed at self-harming among gender variant and trans youth. This is contextualized in relation to the role that self-harm plays for some LGBT youth, where it may be seen as a rite of passage or as reasonable and inevitable way of coping. The particular complexities of self-harm among trans youth seeking clinical intervention are examined. Queer bioethics is proposed as potentially facilitating productive uncertainty with regard to the diverse imagined futures of gender variant and trans youth.

I Would Rather Just Go Through With It Than Be Called a Wussy: An Exploration of How a Group of Young South African Men Think and Talk About Suicide

Worldwide suicide is a deeply gendered phenomenon. In South Africa, approximately 80% of suicide completers are male. This study aimed to investigate how a group of young South African men understand and think about suicidal behavior. In-depth semistructured interviews and thematic analysis using a grounded theory approach revealed that this group of young South African men had permissive attitudes to suicide and viewed suicide as a morally defensible alternative in specific situations. They spoke of suicide as a goal-directed behavior that provides a means of regaining control, asserting power, communicating, and rendering oneself visible. From this perspective, suicide was understood as a brave act requiring strength and determination. These data have congruence with the Theory of Gender and Health, which proposes that constructions of masculinity may be implicated in the attitudes and beliefs young men in South Africa hold toward suicide.

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.

Acceptance of suicide in Moscow

PURPOSE

Attitudes concerning the acceptability of suicide have been emphasized as being important for understanding why levels of suicide mortality vary in different societies across the world. While Russian suicide mortality levels are among the highest in the world, not much is known about attitudes to suicide in Russia. This study aims to obtain a greater understanding about the levels and correlates of suicide acceptance in Russia.

METHODS

Data from a survey of 1,190 Muscovites were analysed using logistic regression techniques. Suicide acceptance was examined among respondents in relation to social, economic and demographic factors as well as in relation to attitudes towards other moral questions.

RESULTS

The majority of interviewees (80%) expressed condemnatory attitudes towards suicide, although men were slightly less condemning. The young, the higher educated, and the non-religious were more accepting of suicide (OR > 2). However, the two first-mentioned effects disappeared when controlling for tolerance, while a positive effect of lower education on suicide acceptance appeared. When controlling for other independent variables, no significant effects were found on suicide attitudes by gender, one's current family situation, or by health-related or economic problems.

CONCLUSIONS

The most important determinants of the respondents' attitudes towards suicide were their tolerance regarding other moral questions and their religiosity. More tolerant views, in general, also seemed to explain the more accepting views towards suicide among the young and the higher educated. Differences in suicide attitudes between the sexes seemed to be dependent on differences in other factors rather than on gender per se. Suicide attitudes also seemed to be more affected by one's earlier experiences in terms of upbringing and socialization than by events and processes later in life.

Effects of race and precipitating event on suicide versus nonsuicide death classification in a college sample

Race group differences in suicide death classification in a sample of 109 Black and White university students were examined. Participants were randomly assigned to read three vignettes for which the vignette subjects' race (only) varied. The vignettes each described a circumstance (terminal illness, academic failure, or relationship difficulties) that preceded the vignette subject's ambiguously premature death. Participants were asked to describe "what happened." Black participants were significantly less likely than White participants to attribute a vignette target's death to suicide and also less likely to report that suicide is acceptable. Implications for future research and prevention efforts are discussed.

Suicide attempts among women during low estradiol/low progesterone states

The relationship between the menstrual cycle and risk for suicidal behaviors is not clear. The aim of this study is to determine whether perimenstrual phases in fertile women are associated with acute risk for suicide attempt and explore whether risk is elevated during low estradiol/low progesterone states. Women (N=431) recruited within 24h of a suicide attempt were assessed for psychopathology, suicidal behavior and LH, FSH, estradiol and progesterone blood levels. Among fertile women (N=281/431), suicide attempts were more likely to occur during menses (26%, 72/281 observed vs. 15%, 43/281 expected attempts; p<0.001). Compared to women whose attempts occurred during other phases, women who attempted suicide during low estradiol/low progesterone states (menstrual phase, amenorrhea and menopause) reported severe suicide intent, a measure that may be predictive of eventual suicide death. Suicide attempts among women are more likely when estrogen and progesterone levels are low and attempts made under these conditions are associated with greater severity. Low gonadal hormone levels may constitute a key factor in the neurobiological basis of suicidal behavior among women, suggesting a novel, testable hypothesis regarding the underpinnings of suicidal acts.

Attitudes Toward Suicide in the Adolescent Population

Background: Only few studies have so far confirmed the clear connection of attitudes toward suicide with prevalence of suicidal behavior, and there are several contradictory findings on the balance of this relationship. Slovenia has long had a very high suicide rate, including in the population of adolescents. Aims: To examine attitudes of Slovene adolescents toward suicide and their connection to different suicide risk factors. Methods: A questionnaire on attitudes toward suicide was given to 423 high school students from three regions based on the different regional suicide rates. Results: The results proved our expectation of girls having more permissive attitudes toward suicide than boys. Also, a permissive attitude was positively associated with the majority of suicide risk factors. Conclusions: In the light of certain limitations of the study we discuss the implications of the main finding, namely, that permissive attitudes toward suicide are more likely a risk than a safety factor for suicidal behavior.

Suicidal behavior in young women

This article provides an update on suicidal behaviors in young women. The rates of completed suicide and suicide attempts among young women are reviewed, and the impact of race and ethnicity on these rates is described. The risk and protective factors associated with suicidal behaviors in young women are discussed, including stressful life events, mental disorders, and hormonal factors. Finally, some considerations for treating suicidal young women are included.

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

BACKGROUND

Men die by suicide three to four times more often than women in Western countries. The adverse impact of the traditional male gender role as well as men's reluctance to seek help are possible explanations of this gender gap, but these hypotheses have not been well documented empirically.

METHODS

This study compares two groups of men who experienced comparable severely stressful life events during the preceding 12 months: 40 men admitted to hospital emergency following suicide attempts, and 40 men with no history of suicide attempts. Structured interviews were conducted to measure adherence to the traditional male gender role, help seeking behaviour, social support, suicide acceptability and mental health.

RESULTS

ANOVAS indicated that attempters are more likely to adhere to the traditional masculine gender role and regression analysis revealed that this relationship persists even when the presence of mental disorders is statistically controlled. Sequential regression analysis support the mediation model and show that the effects of the traditional male gender role on suicidal behavior are mediated through protective and risk factors for suicide, namely mental state, help seeking and social support.

CONCLUSIONS

The traditional male gender role appears to increase the risk of suicidal behavior in men by undermining their mental state and by inhibiting the protective factors of help seeking and social support. This study underscores the importance of encouraging men to seek help.

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.

Young adults' reactions to gay and lesbian peers who became suicidal following "coming out" to their parents

Rates of nonfatal suicidal behavior among gay and lesbian youth surpass those recorded among their heterosexual peers. A frequently cited precipitant of gay and lesbian nonfatal suicidal behavior is the turmoil associated with coming out to one's family. This study investigated young adults' attitudes toward peers who engaged in suicidal behavior after coming out and being rejected by their parents, and compared them with attitudes toward persons who had become suicidal in response to other stressors (a physical illness, a relationship loss, or an academic failure). Our goal was to explore whether young persons hold beliefs that may encourage lesbian and gay suicidal behavior. We found that gays and lesbians who engaged in suicidal behavior following coming out were not viewed in particularly forgiving or empathic ways, as was the case for persons who became suicidal following an incurable illness. All suicidal persons were perceived as relatively feminine. At the same time, suicidal males were rated as more masculine if they engaged in suicidal behavior because of an academic failure or a physical illness, while suicidal females were viewed as more masculine only if their suicidal behavior followed an academic failure. Finally, we found that both respondent sex and respondent gender-identity influenced evaluations of suicidal persons. Building on these findings, future research should explore attitudes toward the permissibility of a suicidal decision by lesbian and gay persons.

Comparative study of suicide potential among Pakistani and American psychiatric patients

This study compared suicide potential and suicide attempts in 50 Pakistani and 50 American psychiatric patients all of whom reported a positive history of suicide attempts during the past 1-5 years. It further explored the role of nationality, gender, diagnosis, and marital status in respondents' potential for suicide and suicide attempts. The American sample reported a higher degree of suicide potential on the Firestone Assessment of Self-Destructive Thoughts (FAST), more suicide attempts, and a larger number of suicide precipitants (family conflicts, work pressure, wish for death, loneliness, financial problems, and mental disorders/drug withdrawal) than did the Pakistani sample. For suicide attempts, effects of 3-way interaction for gender, marital status and nationality were found significant. However, these effects were non-significant for respondent's potential for suicide. In addition, the FAST was found to have a significantly high correlation with suicide attempts. Thus, it may be inferred that the FAST can be used as a valuable screening instrument for the identification of patients at risk for suicide in diverse cultural settings. However, more prospective validity studies are needed to enhance our cross-cultural understanding of suicide; identification of psychiatric patients at risk for suicide by the FAST; and for effective treatment and prevention programs for Eastern and Western societies.

The determinants of attempted suicide in a general hospital setting in Fiji Islands: a gender-specific study

The objective of the study was to examine the sociodemographic and clinical factors influencing gender-specific attempted suicide. Suicide attempters, 40 males and 88 females, seen on a consultation-liaison psychiatric service over a period of 42 months (from January 1, 1999 to June 30, 2002) were compared on sociodemographic and clinical variables. The female attempters [22.99 years (SD 8.1)] were younger than their male counterparts [25.15 years (SD 9.5)] [P = 0.0002]. A higher proportion of the male attempters were engaged in outside occupations, compared with their female counterparts who were mainly full-time housewives or engaged in domestic duties [P = 0.003]. Alcohol misuse was more associated with male suicide attempts [P = 0.001]. Ninety percent of male attempters and 54.6% of the female attempters had the intention to die [P = 0.001]. Although depressive episode was the most common psychiatric disorder in male attempters, followed by neurotic and stress-related disorders, while neurotic and stress-related disorders ranked first in female attempters followed closely by depressive episode, the difference was not significant. However, significantly more male attempters required pharmacotherapy and psychological intervention than their female counterparts [P = 0.002]. More females had marital difficulties, although comparing the two groups on social difficulties did not yield a significant difference. Method used, personality disorders, previous attempt, repeat attempt, race, religion, and marital status were not significant distinguishing factors. Younger age, lack of employment outside home, marital problems, and nondeath motives were more influential in female attempted suicide, while alcohol misuse and severe psychiatric morbidity were more frequently associated with male attempted suicide. The findings support gender-specific preventive and interventional strategies.