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Choi WS, Roh BR, Jon DI, Ryu V, Oh Y, Hong HJ. An exploratory study on spatiotemporal clustering of suicide in Korean adolescents. Child Adolesc Psychiatry Ment Health 2024; 18:54. [PMID: 38730504 PMCID: PMC11088016 DOI: 10.1186/s13034-024-00745-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 05/01/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Adolescent suicides are more likely to form clusters than those of other age groups. However, the definition of a cluster in the space-time dimension has not been established, neither are the factors contributing to it well known. Therefore, this study aimed to identify space-time clusters in adolescent suicides in Korea and to examine the differences between clustered and non-clustered cases using novel statistical methods. METHODS From 2016 to 2020, the dates and locations, including specific addresses from which the latitude and longitude of all student suicides (aged 9-18 years) in Korea were obtained through student suicide reports. Sociodemographic characteristics of the adolescents who died by suicide were collected, and the individual characteristics of each student who died by suicide were reported by teachers using the Strengths and Difficulties Questionnaire (SDQ). Density-Based Spatial Clustering of Applications with Noise (DBSCAN) analysis was used to assess the clustering of suicides. RESULTS We identified 23 clusters through the data analysis of 652 adolescent suicides using DBSCAN. By comparing the size of each cluster, we identified 63 (9.7%) spatiotemporally clustered suicides among adolescents, and the temporal range of these clusters was 7-59 days. The suicide cluster group had a lower economic status than the non-clustered group. There were no significant differences in other characteristics between the two groups. CONCLUSION This study has defined the space-time cluster of suicides using a novel statistical method. Our findings suggest that when an adolescent suicide occurs, close monitoring and intervention for approximately 2 months are needed to prevent subsequent suicides. Future research using DBSCAN needs to involve a larger sample of adolescents from various countries to further corroborate these findings.
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Affiliation(s)
- Won-Seok Choi
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Beop-Rae Roh
- Department of Social Welfare, Pukyong National University, Busan, Republic of Korea
| | - Duk-In Jon
- Department of Psychiatry, Hallym University Sacred Heart Hospital, Hallym University, 22, Gwanpyeong-ro 170Beon-gil, Dongan-gu, Anyang, Gyeonggi-do, Republic of Korea
| | - Vin Ryu
- Department of Psychiatry, Hallym University Sacred Heart Hospital, Hallym University, 22, Gwanpyeong-ro 170Beon-gil, Dongan-gu, Anyang, Gyeonggi-do, Republic of Korea
| | - Yunhye Oh
- Department of Psychiatry, Hallym University Sacred Heart Hospital, Hallym University, 22, Gwanpyeong-ro 170Beon-gil, Dongan-gu, Anyang, Gyeonggi-do, Republic of Korea
| | - Hyun Ju Hong
- Department of Psychiatry, Hallym University Sacred Heart Hospital, Hallym University, 22, Gwanpyeong-ro 170Beon-gil, Dongan-gu, Anyang, Gyeonggi-do, Republic of Korea.
- Hallym University Suicide and School Mental Health Institute, Anyang, Republic of Korea.
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Lee SC, Rouquette OY, Hawton K, Cleobury L, Spencer S, Lloyd K, Gunnell D, Scourfield J, John A. Understanding Suicide Clusters Through Exploring Self-Harm Behaviors. CRISIS 2024; 45:180-186. [PMID: 37904497 DOI: 10.1027/0227-5910/a000930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/01/2023]
Abstract
Background: There is little information about characteristics and long-term outcomes of individuals who self-harm during a suicide cluster. Aims: To compare characteristics of individuals who self-harmed during a suicide cluster in South Wales (∼10 deaths between December 2007 and March 2008) with others who self-harmed prior to the cluster and to evaluate 10-year self-harm and mortality outcomes. Method: Using records from the hospital serving the catchment area of the suicide cluster, enhanced by national routinely collected linked data, we created the following two groups: individuals who self-harmed (a) during the suicide cluster and (b) 1 year before. We compared individuals' characteristics and performed logistic regression to compute odds ratios of 10-year self-harm and mortality outcomes. Results: Individuals who self-harmed during the cluster were less likely to be hospitalized or have a mental health history than those who self-harmed prior to the cluster. No significant group differences were found for 10-year self-harm outcomes, but all-cause mortality was higher for males. Limitations: Sample size was small, and data were lacking on psychological and social proximity to individuals who died during the suicide cluster. Conclusion: Our findings highlight the importance of long-term healthcare follow-up of those who self-harm during a suicide cluster, particularly males.
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Affiliation(s)
- Sze Chim Lee
- Population Data Science, Swansea University Medical School, Swansea, UK
| | | | - Keith Hawton
- Centre for Suicide Research, University of Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Louise Cleobury
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Sarah Spencer
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Keith Lloyd
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - David Gunnell
- Population Health Sciences, Bristol Medical School, University of Bristol, UK
- National Institute of Health and Care Research Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, UK
| | - Jonathan Scourfield
- Children's Social Care Research and Development Centre (CASCADE), School of Social Sciences, Cardiff University, UK
| | - Ann John
- Population Data Science, Swansea University Medical School, Swansea, UK
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Robison M, Robertson L, Joiner TE. Why did peri-pandemic suicide death rates decrease among non-Hispanic white people while increasing among most people of color? Suicide Life Threat Behav 2024. [PMID: 38676429 DOI: 10.1111/sltb.13088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 04/15/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024]
Abstract
INTRODUCTION While suicides in the United States decreased during the COVID-19 pandemic, statistically significant decreases have been limited to White people throughout a large portion of 2020. METHODS This paper outlines possible explanations for racial/ethnic differences in suicidality in the early pandemic phases. RESULTS We propose both distal (i.e., tele-mental health usage, internet and technology access, employment protections, and economic security) and proximal (cultural beliefs, coping strategies, clustering, pulling together, and embracing life) factors that may have helped build and foster community and mental wellness. However, this paper argues these factors did not extend, or did not extend as much, to many communities of color. CONCLUSIONS We argue that these disparities are due to the myriad effects of discrimination and systemic racism, encapsulated broadly by the minority stress theory, and provide suggestions for relief and research.
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Affiliation(s)
- Morgan Robison
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Lee Robertson
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - T E Joiner
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
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Brockie T, Kahn-John M, Mata Lopez L, Bell E, Brockie T, Brockie T, Decker E, Glass N, Has Eagle H, Helgeson K, Main NJ, Kazemi M, Perez-Monteau R, Myrick A, Nelson KE, Ricker A, Rider T, Roberts T, Wilson DH, Yazzie K, Perrin N. A mixed-methods study protocol on factors contributing to suicide clusters among Native American youth in a northern plains reservation. Front Public Health 2024; 11:1281109. [PMID: 38259800 PMCID: PMC10800579 DOI: 10.3389/fpubh.2023.1281109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 12/12/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction Suicide and suicide clusters within Native American Reservation communities are devastating to the entire community and increase individuals' risk for suicide over the lifespan. The objective of this paper is to describe the Indigenous community-based participatory research protocol implemented in partnership with the Fort Belknap Indian Community in Montana, United States. The study protocol was developed to understand suicide risk and protective factors, and community-derived solutions, in a reservation community with history of a suicide cluster and high rates of youth suicide. Methods In this mixed-methods study, qualitative data from youth, adults, and service providers and quantitative data from 200 adolescents and young adults (aged 14-24 years) were collected in Fort Belknap, Montana from May - December of 2022. Qualitative data were collected first via in-depth interviews and focus groups. Survey questions included validated and pre-tested measures of factors youth experience across socio-ecological levels. Thematic analysis was applied to the qualitative data; and logistic regression models were used to examine relationships within the quantitative data. Discussion This study will add a multi-dimensional perspective to our current understanding of (1) risk and protective factors for suicide, community-derived postvention solutions, and insights on community assets, and (2) the current health and psychosocial status of youth in the Fort Belknap community. This study may serve as an exemplar of co-created, culturally safe solutions designed to address mental health resource gaps. Next steps include development of a suicide crisis response tool kit and a culturally aligned postvention intervention that will enhance individual, family, and community survivance.
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Affiliation(s)
- Teresa Brockie
- Johns Hopkins School of Nursing, Baltimore, MD, United States
| | | | | | - Eleesha Bell
- Johns Hopkins School of Nursing, Baltimore, MD, United States
- Fort Belknap Reservation Community, Agency, MT, United States
| | - Truth Brockie
- Johns Hopkins School of Nursing, Baltimore, MD, United States
- Fort Belknap Reservation Community, Agency, MT, United States
| | - Terry Brockie
- Fort Belknap Reservation Community, Agency, MT, United States
| | - Ellie Decker
- Johns Hopkins School of Nursing, Baltimore, MD, United States
| | - Nancy Glass
- Johns Hopkins School of Nursing, Baltimore, MD, United States
| | | | | | - Nona J. Main
- Montana Family Planning, Bozeman, MT, United States
| | - Mina Kazemi
- Johns Hopkins School of Nursing, Baltimore, MD, United States
| | | | - Alicia Myrick
- Johns Hopkins School of Nursing, Baltimore, MD, United States
- Fort Belknap Reservation Community, Agency, MT, United States
| | - Katie E. Nelson
- Johns Hopkins School of Nursing, Baltimore, MD, United States
| | - Adriann Ricker
- Johns Hopkins School of Nursing, Baltimore, MD, United States
| | - Tammy Rider
- Fort Belknap Tribal Health Department, Harlem, MT, United States
| | - Teeah Roberts
- Johns Hopkins School of Nursing, Baltimore, MD, United States
- Fort Belknap Reservation Community, Agency, MT, United States
| | - Deborah H. Wilson
- Johns Hopkins School of Nursing, Baltimore, MD, United States
- Auckland University of Technology, Auckland, New Zealand
| | - Karen Yazzie
- Fort Belknap Tribal Health Department, Harlem, MT, United States
| | - Nancy Perrin
- Johns Hopkins School of Nursing, Baltimore, MD, United States
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Clayton MG, Pollak OH, Prinstein MJ. Why Suicide? Suicide Propinquity and Adolescent Risk for Suicidal Thoughts and Behaviors. Clin Child Fam Psychol Rev 2023; 26:904-918. [PMID: 37801188 DOI: 10.1007/s10567-023-00456-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2023] [Indexed: 10/07/2023]
Abstract
Suicide represents an international public health concern, and for adolescents aged 14 to 18 in the United States, is the third leading cause of death (Centers for Disease Control and Prevention. 2021 Youth Risk Behavior Survey Data. Available at: www.cdc.gov/yrbs . Accessed on August 30, 2023.). In response to this alarming rate, as well as the relative lack of meaningful progress in the prediction and prevention of suicidal thoughts and behaviors (STB) over the past decades (see Franklin et al., 2017), recent reviews of the suicide literature have advocated for the adoption of novel frameworks and theoretical reexamination of the processes that confer risk for suicide. Currently, the majority of suicide theories emphasize distal factors associated with suicide risk, but these factors also generalize to other types of psychopathology and do not answer the fundamental question of "why suicide?" vs. other maladaptive outcomes. In an effort to address this gap and build off existing theoretical and empirical science from various disciplines, the current theoretical paper will explore the concept of suicide propinquity, the degree of closeness and identification with STB, as a potential moderator of the link between psychological distress and suicide. Specifically, this paper: (1) provides context within the existing theories of suicide, highlighting gaps that might otherwise be explained by propinquity; (2) discusses historical and scientific evidence of suicide phenomena that support the existence of propinquity; (3) explores potential processes of how propinquity may confer risk for STB in adolescence; and (4) suggests future directions for research to examine adolescent suicide from a propinquity perspective.
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Affiliation(s)
- Matthew G Clayton
- Department of Psychology and Neuroscience, University of North Carolina, Davie Hall, Campus, Box 3270, Chapel Hill, NC, USA.
| | - Olivia H Pollak
- Department of Psychology and Neuroscience, University of North Carolina, Davie Hall, Campus, Box 3270, Chapel Hill, NC, USA
| | - Mitchell J Prinstein
- Department of Psychology and Neuroscience, University of North Carolina, Davie Hall, Campus, Box 3270, Chapel Hill, NC, USA
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Mitsuhashi T. Assessing Vulnerability to Surges in Suicide-Related Tweets Using Japan Census Data: Case-Only Study. JMIR Form Res 2023; 7:e47798. [PMID: 37561553 PMCID: PMC10450538 DOI: 10.2196/47798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 06/30/2023] [Accepted: 07/07/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND As the use of social media becomes more widespread, its impact on health cannot be ignored. However, limited research has been conducted on the relationship between social media and suicide. Little is known about individuals' vulnerable to suicide, especially when social media suicide information is extremely prevalent. OBJECTIVE This study aims to identify the characteristics underlying individuals' vulnerability to suicide brought about by an increase in suicide-related tweets, thereby contributing to public health. METHODS A case-only design was used to investigate vulnerability to suicide using individual data of people who died by suicide and tweet data from January 1, 2011, through December 31, 2014. Mortality data were obtained from Japanese government statistics, and tweet data were provided by a commercial service. Tweet data identified the days when suicide-related tweets surged, and the date-keyed merging was performed by considering 3 and 7 lag days. For the merged data set for analysis, the logistic regression model was fitted with one of the personal characteristics of interest as a dependent variable and the dichotomous exposure variable. This analysis was performed to estimate the interaction between the surges in suicide-related tweets and personal characteristics of the suicide victims as case-only odds ratios (ORs) with 95% CIs. For the sensitivity analysis, unexpected deaths other than suicide were considered. RESULTS During the study period, there were 159,490 suicides and 115,072 unexpected deaths, and the number of suicide-related tweets was 2,804,999. Following the 3-day lag of a highly tweeted day, there were significant interactions for those who were aged 40 years or younger (OR 1.09, 95% CI 1.03-1.15), male (OR 1.12, 95% CI 1.07-1.18), divorced (OR 1.11, 95% CI 1.03 1.19), unemployed (OR 1.12, 95% CI 1.02-1.22), and living in urban areas (OR 1.26, 95% CI 1.17 1.35). By contrast, widowed individuals had significantly lower interactions (OR 0.83, 95% CI 0.77-0.89). Except for unemployment, significant relationships were also observed for the 7-day lag. For the sensitivity analysis, no significant interactions were observed for other unexpected deaths in the 3-day lag, and only the widowed had a significantly larger interaction than those who were married (OR 1.08, 95% CI 1.02-1.15) in the 7-day lag. CONCLUSIONS This study revealed the interactions of personal characteristics associated with susceptibility to suicide-related tweets. In addition, a few significant relationships were observed in the sensitivity analysis, suggesting that such an interaction is specific to suicide deaths. In other words, individuals with these characteristics, such as being young, male, unemployed, and divorced, may be vulnerable to surges in suicide-related tweets. Thus, minimizing public health strain by identifying people who are vulnerable and susceptible to a surge in suicide-related information on the internet is necessary.
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Affiliation(s)
- Toshiharu Mitsuhashi
- Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan
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Leveau CM, Alazraqui M. [Geographies of suicide in Argentina: a spatial ecological study during 1999-2003 and 2008-2012 periods]. Rev Salud Publica (Bogota) 2023; 22:14-26. [PMID: 36753135 DOI: 10.15446/rsap.v22n1.75841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 09/16/2019] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE The aim of this study was to describe the geographical distribution and the role of sociodemographic factors on mortality by suicides, according to sex and age groups, in Argentina during the periods 1999-2003 and 2008-2012. METHODS The role of sociodemographic factors on mortality by suicides and their geographical distribution were analyzed by means of multiple spatial regressions. Three independent variables were included: an index of social fragmentation, a poverty index and population density, as an indicator of the level of rurality. RESULTS Social fragmentation and suicide were directly related in men 10-59 years old and women 10-29 years old during 1999-2003. During 2008-2012, the risk of suicide was higher in areas of low population density, except for women aged 10-29 years. CONCLUSIONS The results obtained in this study support the hypothesis of social fragmentation as a phenomenon associated with the risk of suicide in departments of Argentina, but also support the hypothesis of an increased risk of suicide in rural areas. Suicide prevention measures could focus on policies that promote social integration, especially in the young population, as well as greater cohesion of rural areas.
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Affiliation(s)
- Carlos Marcelo Leveau
- CL: Lic. Geografía. M. Sc. Epidemiología, Gestión y Políticas de Salud. Ph. D. Geografía. Instituto de Salud Colectiva, Universidad Nacional de Lanús. Remedios de Escalada, Lanús, Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Argentina.
| | - Marcio Alazraqui
- MA: MD. M. Sc.; Ph. D. Salud Colectiva. Instituto de Salud Colectiva, Universidad Nacional de Lanús. Remedios de Escalada. Lanús, Argentina.
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Lundahl A, Helgesson G, Juth N. Hospital staff at most psychiatric clinics in Stockholm experience that patients who self-harm have too long hospital stays, with ensuing detrimental effects. Nord J Psychiatry 2022; 76:287-294. [PMID: 34428119 DOI: 10.1080/08039488.2021.1965213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Previous research on patients who self-harm has indicated potential negative effects from long hospital stays. Yet, such care has been reported to occur regularly. We conducted this questionnaire study to investigate how hospital staff, who treat self-harming patients, experience the relation between lengths of stay and self-harm behaviour, and the motives for non-beneficial hospital stays. METHODS The respondents of the questionnaire were nurses and mental health workers employed at public inpatient wards in Stockholm, treating patients who self-harm. The questionnaire contained questions with fixed answers and room for comments. A total of 304 questionnaires were distributed to 13 wards at five clinics, and the response rate was 63%. The data were analysed with descriptive statistics and qualitative descriptive content analysis. RESULTS The results show that most staff experienced that more than a week's stay either increased (57%) or had no effect (33%) on self-harm behaviour. Most respondents at most clinics considered the stays to be too long at their wards, and that the stays could be reduced. The respondents recognized several reasons for non-beneficial hospital stays, like fear of suicidal behaviour and doctors' fear of complaints. Patients appearing as demanding or fragile were thought to be given more care than others. The respondents' comments confirmed the majority's experience of detrimental effects from longer hospital stays. CONCLUSIONS A majority of the health care staff experienced that patients who self-harm often receive too long hospital stays, with detrimental effects, and they had experienced several non-medical reasons for such care.
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Affiliation(s)
- Antoinette Lundahl
- Stockholm Centre for Healthcare Ethics, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Gert Helgesson
- Stockholm Centre for Healthcare Ethics, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Niklas Juth
- Stockholm Centre for Healthcare Ethics, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
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Benson R, Rigby J, Brunsdon C, Cully G, Too LS, Arensman E. Quantitative Methods to Detect Suicide and Self-Harm Clusters: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095313. [PMID: 35564710 PMCID: PMC9099648 DOI: 10.3390/ijerph19095313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/20/2022] [Accepted: 04/23/2022] [Indexed: 11/16/2022]
Abstract
Suicide and self-harm clusters exist in various forms, including point, mass, and echo clusters. The early identification of clusters is important to mitigate contagion and allocate timely interventions. A systematic review was conducted to synthesize existing evidence of quantitative analyses of suicide and self-harm clusters. Electronic databases including Medline, Embase, Web of Science, and Scopus were searched from date of inception to December 2020 for studies that statistically analyzed the presence of suicide or self-harm clusters. Extracted data were narratively synthesized due to heterogeneity among the statistical methods applied. Of 7268 identified studies, 79 were eligible for narrative synthesis. Most studies quantitatively verified the presence of suicide and self-harm clusters based on the scale of the data and type of cluster. A Poisson-based scan statistical model was found to be effective in accurately detecting point and echo clusters. Mass clusters are typically detected by a time-series regression model, although limitations exist. Recently, the statistical analysis of suicide and self-harm clusters has progressed due to advances in quantitative methods and geospatial analytical techniques, most notably spatial scanning software. The application of such techniques to real-time surveillance data could effectively detect emerging clusters and provide timely intervention.
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Affiliation(s)
- Ruth Benson
- School of Public Health, College of Medicine and Health, University College Cork, Western Gateway Building, T12 XF62 Cork, Ireland; (G.C.); (E.A.)
- National Suicide Research Foundation, University College Cork, 4.28 Western Gateway Building, T12 XF62 Cork, Ireland
- Correspondence:
| | - Jan Rigby
- National Centre for Geocomputation, Maynooth University, W23 F2H6 Maynooth, Ireland; (J.R.); (C.B.)
| | - Christopher Brunsdon
- National Centre for Geocomputation, Maynooth University, W23 F2H6 Maynooth, Ireland; (J.R.); (C.B.)
| | - Grace Cully
- School of Public Health, College of Medicine and Health, University College Cork, Western Gateway Building, T12 XF62 Cork, Ireland; (G.C.); (E.A.)
- National Suicide Research Foundation, University College Cork, 4.28 Western Gateway Building, T12 XF62 Cork, Ireland
| | - Lay San Too
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3053, Australia;
| | - Ella Arensman
- School of Public Health, College of Medicine and Health, University College Cork, Western Gateway Building, T12 XF62 Cork, Ireland; (G.C.); (E.A.)
- National Suicide Research Foundation, University College Cork, 4.28 Western Gateway Building, T12 XF62 Cork, Ireland
- Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane, QLD 4122, Australia
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What is Known About the Role of Friendship in Adolescent Self-Harm? A Review and Thematic Synthesis. CHILD & YOUTH CARE FORUM 2022. [DOI: 10.1007/s10566-022-09686-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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John A, Marchant A, Hawton K, Gunnell D, Cleobury L, Thomson S, Spencer S, Dennis M, Lloyd K, Scourfield J. Understanding suicide clusters through exploring self-harm: Semi-structured interviews with individuals presenting with near-fatal self-harm during a suicide cluster. Soc Sci Med 2021; 292:114566. [PMID: 34814023 DOI: 10.1016/j.socscimed.2021.114566] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 10/26/2021] [Accepted: 11/12/2021] [Indexed: 11/19/2022]
Abstract
There was a highly publicised cluster of at least ten suicides in South Wales, United Kingdom, in 2007-2008. We carried out a qualitative descriptive study using cross-case thematic analysis to investigate the experiences and narratives of eight individuals who lived in the area where the cluster occurred and who survived an episode of near-fatal self-harm at the time of the cluster. Interviews were conducted from 01.01.2015 to 31.12.2015. All interviewees denied that the other deaths in the area had affected their own suicidal behaviour. However, in other sections of the interviews they spoke about the cluster contributing to difficulties they were experiencing at the time, including damage to social relationships, feelings of loss and being out of control. When asked about support, the interviewees emphasized the importance of counselling, which they would have found helpful but in most cases did not receive, even in the case of close contacts of individuals who had died. The findings suggest that effective prevention messaging must be subtle, since those affected may not be explicitly aware of or acknowledge the imitative aspects of their behaviour. This could be related to stigma attached to suicidal behaviour in a cluster context. Lessons for prevention include changing the message from asking if people 'have been affected by' the suicide deaths to emphasising the preventability of suicide, and directly reaching out to individuals rather than relying on people to come forward.
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Affiliation(s)
- Ann John
- Swansea University Medical School, Swansea University, UK.
| | | | - Keith Hawton
- Centre for Suicide Research, University of Oxford, UK
| | - David Gunnell
- Department of Population Health Sciences, University of Bristol, UK
| | | | - Susan Thomson
- Swansea University Medical School, Swansea University, UK
| | - Sarah Spencer
- Swansea University Medical School, Swansea University, UK
| | - Michael Dennis
- Swansea University Medical School, Swansea University, UK
| | - Keith Lloyd
- Swansea University Medical School, Swansea University, UK
| | - Jonathan Scourfield
- Children's Social Care Research and Development Centre (CASCADE), School of Social Sciences, Cardiff University, UK
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Renkiewicz GK, Hubble MW. Secondary Traumatic Stress in Emergency Services Systems (STRESS) Project: Quantifying and Predicting Compassion Fatigue in Emergency Medical Services Personnel. PREHOSP EMERG CARE 2021; 26:652-663. [PMID: 34128453 DOI: 10.1080/10903127.2021.1943578] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introduction: Compassion fatigue (CF) is defined as the acute or gradual loss of benevolence that occurs after exposure to critical incident stress. Colloquially referred to as the "cost of caring," CF can affect an individual's future response to stressful situations and is unhealthy for caregivers.Objective: To identify the prevalence and predictors of CF in EMS professionals.Methods: This was a cross-sectional survey of EMS personnel using one-stage area sampling. Nine EMS agencies recruited based on location and geographic region provided data on service area and call mix. Respondents were surveyed in-person during monthly training. The survey evaluated the relationship between CF and psychosocial factors using the Professional Quality of Life Scale (ProQOL). Parametric and non-parametric tests were used where appropriate for the univariate analysis. Those factors significant in the univariate analysis were included in the multivariable analysis. A logistic regression was conducted to determine predictors of CF while controlling for potential confounders.Results: A total of 686 EMS personnel completed the survey. Altogether, 48% had CF, of which 50.8% were male and 14% were minorities. Compared to those without CF, more than 4 times as many respondents with CF (n = 28[8.6%] v. 7[2.0%]) self-reported as currently in counseling and over a third (n = 109[33.1%]) had considered suicide. Irrespective of the presence of CF, one in two knew another EMS professional who had completed suicide. African-American EMS professionals were 3 times more likely to have CF (OR:3.1;p = 0.009). Mean scores on the ProQOL CF subscale were 10 points higher in those with CF compared to those without (27.1[±4.34] v. 17.04[±2.9]). EMS personnel were 48% more likely to have CF if they knew an EMS provider who completed suicide (p = 0.047). Additionally, those with concomitant traumatic stress syndromes, such as vicarious trauma and burnout, were 4.61 and 3.35 times more likely to have CF, respectively.Conclusions: CF is a considerable concern for EMS professionals and there are several modifiable factors that may reduce the prevalence of this cumulative stress syndrome. Additional research should focus on causal factors and mitigation strategies, as well as the individual and agency impact of CF on the prehospital work environment.
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Keyes KM, Kandula S, Olfson M, Gould MS, Martínez-Alés G, Rutherford C, Shaman J. Suicide and the agent-host-environment triad: leveraging surveillance sources to inform prevention. Psychol Med 2021; 51:529-537. [PMID: 33663629 PMCID: PMC8020492 DOI: 10.1017/s003329172000536x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 12/14/2020] [Accepted: 01/06/2021] [Indexed: 12/11/2022]
Abstract
Suicide in the US has increased in the last decade, across virtually every age and demographic group. Parallel increases have occurred in non-fatal self-harm as well. Research on suicide across the world has consistently demonstrated that suicide shares many properties with a communicable disease, including person-to-person transmission and point-source outbreaks. This essay illustrates the communicable nature of suicide through analogy to basic infectious disease principles, including evidence for transmission and vulnerability through the agent-host-environment triad. We describe how mathematical modeling, a suite of epidemiological methods, which the COVID-19 pandemic has brought into renewed focus, can and should be applied to suicide in order to understand the dynamics of transmission and to forecast emerging risk areas. We describe how new and innovative sources of data, including social media and search engine data, can be used to augment traditional suicide surveillance, as well as the opportunities and challenges for modeling suicide as a communicable disease process in an effort to guide clinical and public health suicide prevention efforts.
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Affiliation(s)
| | - Sasikiran Kandula
- Department of Environmental Health Sciences, Columbia University, New York, NY, USA
| | - Mark Olfson
- Department of Epidemiology, Columbia University, New York, NY, USA
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Madelyn S. Gould
- Department of Epidemiology, Columbia University, New York, NY, USA
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Gonzalo Martínez-Alés
- Department of Epidemiology, Columbia University, New York, NY, USA
- Universidad Autónoma de Madrid School of Medicine, Madrid, Spain
| | | | - Jeffrey Shaman
- Department of Environmental Health Sciences, Columbia University, New York, NY, USA
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14
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Athey A, Overholser JC, Beale EE. Depressed adolescents' exposure to suicide attempts and suicide loss. DEATH STUDIES 2021; 46:1862-1869. [PMID: 33439771 DOI: 10.1080/07481187.2020.1864063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This study explored depressed adolescent inpatients' (N = 158) experiences of exposure to friends' and family members' suicidal behaviors. Most of the participants (n = 102, 64.6%) reported exposure to suicide-related behavior. Teens exposed to suicide were more likely than non-exposed peers to report experiencing physical abuse, sexual abuse, and suicide attempts. No differences were observed between those exposed to only suicide attempts and those exposed to both suicide attempts and deaths in clinical characteristics or suicidal behaviors. Exposure to any form of suicide-related behavior may be associated with multiple forms of adversity in childhood.
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Affiliation(s)
- A Athey
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - J C Overholser
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - E E Beale
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, Ohio, USA
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15
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Hill NT, Spittal MJ, Pirkis J, Torok M, Robinson J. Risk factors associated with suicide clusters in Australian youth: Identifying who is at risk and the mechanisms associated with cluster membership. EClinicalMedicine 2020; 29-30:100631. [PMID: 33294825 PMCID: PMC7691728 DOI: 10.1016/j.eclinm.2020.100631] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/18/2020] [Accepted: 10/27/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND It is unclear who is at risk of being involved in a suicide cluster and whether suicide clusters are influenced by the social transmission of suicidal behaviour, assortative relating, or a combination of both. METHODS Suicide clusters involving two or more young people were identified from the free text of electronic police and coroners reports in Australia's National Coronial Information System in a nationwide cross-sectional study. The duration of survival among exposed cases were estimated using time-to-event methods. The casewise concordance of demographic, social and clinical characteristics and circumstances of death were examined among index and exposed cases. FINDINGS We identified links between 117 young people (51 suicide clusters). 50% of young people died within 90 days of the index suicide. Individuals exposed to railway suicide had an 80% probability of dying by the same method. Those exposed to the suicide of a person aged 10-18 years had an 86% probability of being from the same age group. Young people had a 67% and 60% probability of sharing the same characteristics as the index suicide when the index suicide resided in a remote community or was of Aboriginal and Torres Strait Islander descent. INTERPRETATION Suicide clusters may be associated with both the social transmission of suicidal behaviour and assortative relating. Individuals who were close to the deceased should be provided with access to postvention support, particularly within the first 90 days of exposure to an index suicide. FUNDING Australian Rotary Health, National Health and Medical Research Council.
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Affiliation(s)
- Nicole T.M. Hill
- Telethon Kids Institute, 15 Hospital Ave, Nedlands, Perth, WA 6008, Australia
- Orygen, Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Matthew J. Spittal
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Michelle Torok
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Jo Robinson
- Orygen, Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
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16
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Syed S, Kingsbury M, Bennett K, Manion I, Colman I. Adolescents' knowledge of a peer's non-suicidal self-injury and own non-suicidal self-injury and suicidality. Acta Psychiatr Scand 2020; 142:366-373. [PMID: 32885408 DOI: 10.1111/acps.13229] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/25/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Some research suggests that suicidal ideation and attempt among adolescents may be contagious - that is adolescents who are exposed to peers' suicidal behaviour are more likely to experience suicidal ideation or attempt suicide themselves. Less is known about the potential contagion effect of non-suicidal self-injury (NSSI). Our objective was to determine whether knowledge of a friend's NSSI is associated with adolescent's own non-suicidal self-injury and suicidal behaviours. METHODS Data from 1483 youth ages 14-17 years were obtained from the 2014 Ontario Child Health Study, a cross-sectional population-based survey of children and adolescents in Ontario, Canada. Logistic regression models were used to examine associations between knowledge of a friend's NSSI and adolescents' own self-reported self-injurious and suicidal behaviours. Interactions with gender, age group and presence of a mental disorder were investigated. RESULTS Knowledge of a friend's non-suicidal self-injury was significantly associated with the adolescent's own non-suicidal self-injury (OR = 2.03, 95% CI 1.05-3.90), suicidal ideation (OR = 3.08, 95% CI 1.50-6.30) and suicide attempt (OR = 2.87, 95% CI 1.20-6.87). CONCLUSION These findings suggest an apparent contagion effect for non-suicidal self-injury. Awareness of a friend's self-injurious behaviours is associated with an adolescent's own self-injury and suicidality. Interventions aimed at preventing NSSI and suicidality should consider prevention of possible contagion at the school and/or community level.
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Affiliation(s)
- S Syed
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - M Kingsbury
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - K Bennett
- Department of Health Research Methods, Evidence and Impact (formerly Clinical Epidemiology and Biostatistics) and the Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
| | - I Manion
- University of Ottawa Institute of Mental Health Research, Ottawa, Ontario, Canada
| | - I Colman
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.,Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
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17
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Conrad RC, Brendel RW. Structural Deprioritization and Stigmatization of Mental Health Concerns in the Educational Setting. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2020; 20:67-69. [PMID: 33016823 DOI: 10.1080/15265161.2020.1806389] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Rachel C Conrad
- Harvard Medical School Center for Bioethics
- Brigham and Women's Hospital
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18
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Gordon E, Kenny M, O'Reilly A, Eynan R. You feel it was written about you: client acceptability of a group intervention for repeat suicide attempts. J Ment Health 2020; 31:479-486. [PMID: 32935603 DOI: 10.1080/09638237.2020.1818705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Repeat attempts increase risk of death by suicide. The Psychosocial/psychoeducational Intervention for People with recurrent Suicide Attempts (PISA)/Skills for Safer Living (SfSL) is a group intervention targeting repeat attempts. AIMS To evaluate the acceptability of PISA/SfSL to clients and identify key model components influencing this. METHODS This exploratory mixed-methods study involved adults who completed PISA/SfSL (N = 16). Participants completed semi-structured interviews and a satisfaction questionnaire post-intervention, and self-report outcome measures of population specific challenges pre and post-intervention and at 6-month follow-up. RESULTS Qualitative themes illuminate three interrelated response processes; connection with each other and the model, taking control of life, and gaining a sense of value. Quantitative outcome measures indicated positive trends in suicidality, hopelessness, alexithymia, and problem-solving. High satisfaction levels indicated its quality, relevancy, applicability and helpfulness. Key components influencing responses were PISA/SfSL's; psychosocial group format and processes, psychoeducational and skill development content, and ethos. Results suggest PISA/SfSL was acceptable to those with repeat suicide attempts. CONCLUSIONS The study highlights the usefulness of group work and the importance of consistency with guidelines in suicide intervention. It supports the view that recovery in suicidality and engagement in treatment are complex processes. It adds to previous research demonstrating acceptability among facilitators.
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Affiliation(s)
- Evelyn Gordon
- School of Nursing, Psychotherapy and Community Health, Dublin City University (DCU), Dublin, Ireland
| | - Maeve Kenny
- Psychology Department, St Vincent's Hospital Fairview, Dublin, Ireland
| | - Aileen O'Reilly
- School of Nursing and Human Sciences, Dublin City University (DCU), Dublin, Ireland
| | - Rahel Eynan
- Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Canada
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19
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Sy KTL, Shaman J, Kandula S, Pei S, Gould M, Keyes KM. Spatiotemporal clustering of suicides in the US from 1999 to 2016: a spatial epidemiological approach. Soc Psychiatry Psychiatr Epidemiol 2019; 54:1471-1482. [PMID: 31177308 PMCID: PMC6858930 DOI: 10.1007/s00127-019-01736-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 06/03/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE This study aims to describe and characterize the spatial and temporal clustering patterns of suicide in the ten states with the greatest suicide burden in the United States from 1999 to 2016. METHODS All suicide deaths from January 1, 1999 to December 31, 2016 in the United States were identified using data from the Wide-ranging Online Data for Epidemiologic Research (WONDER) dataset. The ten states with the highest age-adjusted suicide rates were Montana, Alaska, Wyoming, New Mexico, Nevada, Utah, Idaho, Colorado, Arizona, and Oklahoma. A spatiotemporal scan statistic using a discrete Poisson model was employed to retrospectively detect spatiotemporal suicide clusters. RESULTS From 1999 to 2016, a total of 649,843 suicides were recorded in the United States. Nineteen statistically significant spatiotemporal suicide mortality clusters were identified in the states with the greatest suicide rates, and 13.53% of the suicide cases within these states clustered spatiotemporally. The risk ratio of the clusters ranged from 1.45 to 3.64 (p < 0.001). All states had at least one cluster, with three clusters spanning multiple states, and four clusters were found in Arizona. While there was no clear secular trend in the average size of suicide clusters, the number of clusters increased from 1999 to 2016. CONCLUSIONS Hot spots for suicidal behavior in the United States warrant public health intervention and continued surveillance. As suicide rates in the US continue to increase annually, public health efforts could be maximized by focusing on regions with substantial clustering.
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Affiliation(s)
- Karla Therese L. Sy
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Jeffrey Shaman
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Sasikiran Kandula
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Sen Pei
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Madelyn Gould
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA,Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, USA
| | - Katherine M. Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
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20
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Yi H, Hwang J, Bae HJ, Kim N. Age and sex subgroups vulnerable to copycat suicide: evaluation of nationwide data in South Korea. Sci Rep 2019; 9:17253. [PMID: 31754190 PMCID: PMC6872728 DOI: 10.1038/s41598-019-53833-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 11/06/2019] [Indexed: 12/30/2022] Open
Abstract
Media reports of a celebrity’s suicide may be followed by copycat suicides, and the impact may vary in different age and sex subgroups. We proposed a quantitative framework to assess the vulnerability of age and sex subgroups to copycat suicide and used this method to investigate copycat suicides in relation to the suicides of 10 celebrities in South Korea from 1993 to 2013. By applying a detrending model to control for annual and seasonal fluctuations, we estimated the expected number of suicides within a copycat suicide period. The copycat effect was assessed in two ways: the magnitude of copycat suicide by dividing the observed by the expected number of suicides, and the mortality rate by subtracting the expected from the observed number of suicides. Females aged 20–29 years were the most vulnerable subgroup according to both the magnitude of the copycat effect (2.31-fold increase over baseline) and the mortality rate from copycat suicide (22.7-increase). Males aged 50–59 years were the second most vulnerable subgroup according to the copycat suicide mortality rate (20.5- increase). We hope that the proposed quantitative framework will be used to identify vulnerable subgroups to copycat effect, thereby helping devise strategies for prevention.
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Affiliation(s)
- Hahn Yi
- Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea
| | - Jeongeun Hwang
- Department of Medicine, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hyun-Jin Bae
- Department of Medicine, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Namkug Kim
- Department of Convergence Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea. .,Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
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21
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Notredame CE, Morgiève M, Morel F, Berrouiguet S, Azé J, Vaiva G. Distress, Suicidality, and Affective Disorders at the Time of Social Networks. Curr Psychiatry Rep 2019; 21:98. [PMID: 31522268 DOI: 10.1007/s11920-019-1087-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE OF REVIEW We reviewed how scholars recently addressed the complex relationship that binds distress, affective disorders, and suicidal behaviors on the one hand and social networking on the other. We considered the latest machine learning performances in detecting affective-related outcomes from social media data, and reviewed understandings of how, why, and with what consequences distressed individuals use social network sites. Finally, we examined how these insights may concretely instantiate on the individual level with a qualitative case series. RECENT FINDINGS Machine learning classifiers are progressively stabilizing with moderate to high performances in detecting affective-related diagnosis, symptoms, and risks from social media linguistic markers. Qualitatively, such markers appear to translate ambivalent and socially constrained motivations such as self-disclosure, passive support seeking, and connectedness reinforcement. Binding data science and psychosocial research appears as the unique condition to ground a translational web-clinic for treating and preventing affective-related issues on social media.
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Affiliation(s)
- Charles-Edouard Notredame
- Psychiatry Department, CHU Lille, 2 rue André Verhaeghe, F-59000, Lille, France. .,SCALab, CNRS UMR9193, F-59000, Lille, France. .,Groupement d'Étude et de Prévention du Suicide, Saint-Benoît, France. .,Papageno Program, Lille, France.
| | - M Morgiève
- Groupement d'Étude et de Prévention du Suicide, Saint-Benoît, France.,Papageno Program, Lille, France.,Centre de Recherche Médecine, Sciences, Santé, Santé Mentale, Société (CERMES3), UMR CNRS 8211-Unité Inserm 988-EHESS-Université Paris Descartes, 75006, Paris, France.,Hôpital de la Pitié-Salpêtrière, ICM - Brain and Spine Institute, 47-83, boulevard de l'hôpital, 75013, Paris, France
| | - F Morel
- Psychiatry Department, CHU Lille, 2 rue André Verhaeghe, F-59000, Lille, France
| | - S Berrouiguet
- Groupement d'Étude et de Prévention du Suicide, Saint-Benoît, France.,Centre Hospitalier Régional Universitaire de Brest à Bohars, Pôle de psychiatrie, 29820, Bohars, France
| | - J Azé
- LIRMM, UMR 5506, Montpellier University/CNRS, 860 rue de St Priest, 34095, Montpellier Cedex 5, France
| | - G Vaiva
- Psychiatry Department, CHU Lille, 2 rue André Verhaeghe, F-59000, Lille, France.,SCALab, CNRS UMR9193, F-59000, Lille, France.,Groupement d'Étude et de Prévention du Suicide, Saint-Benoît, France
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22
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Lai CCS, Law YW, Shum AKY, Ip FWL, Yip PSF. A Community-Based Response to a Suicide Cluster. CRISIS 2019; 41:163-171. [PMID: 31418310 DOI: 10.1027/0227-5910/a000616] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: A 45-month community-based suicide prevention program was launched in response to the emergence of a suicide cluster in 2010 in Hong Kong. Aims: This study aimed to evaluate the effectiveness of the program, document the implementation and outcomes of the project, and identify factors that contribute to the outcomes. Method: The program was delivered following the five key components of the public health approach: (a) community consensus building; (b) surveillance and monitoring; (c) development of coordinated action strategies; (d) interventions development and implementation at the universal, selective, and indicated levels; and (d) program evaluation. Results: A significant decreasing trend of suicide was found in the study site during the intervention period, whereas no changes were found in the three control sites. Spatial analysis also showed that the suicide cluster subsided after the intervention. Three impacts and one challenge of the program were identified from the qualitative feedback of the program stakeholders. Limitations: More investigations should be made to assess the sustainability of this community-based suicide prevention effort in the long run. Conclusion: A community-based suicide prevention program was successfully implemented to address the suicide cluster. A reduction in the suicide rate was observed after the intervention.
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Affiliation(s)
- Carmen C S Lai
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong SAR
| | - Yik Wa Law
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong SAR.,Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR
| | - Angie K Y Shum
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong SAR
| | - Flora W L Ip
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong SAR
| | - Paul S F Yip
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong SAR.,Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR
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23
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Edwards AC, Ohlsson H, Mościcki EK, Sundquist J, Sundquist K, Kendler KS. Geographic proximity is associated with transmission of suicidal behaviour among siblings. Acta Psychiatr Scand 2019; 140:30-38. [PMID: 31102549 PMCID: PMC6667185 DOI: 10.1111/acps.13040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/13/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The aim of this study was to clarify the role of 'contagion', or social transmission, in risk of suicidal behaviour (SB) among siblings. METHODS We followed Swedish sibling pairs until one of them (S1; N = 111,848) was registered for a suicide attempt or completion. We tested the effect of geographic proximity between siblings on risk of a first SB registration of S1's sibling (S2). To control for familial confounding, we conducted complementary analyses of sibling trios (N = 701), comparing risk in different siblings as a function of their respective proximity to S1. RESULTS The best-fitting model across sibling pairs included an effect of distance between siblings (HR = 0.96, 95% CI = 0.93-0.99). Hazard ratios declined quickly up to 25 km and largely stabilized beyond 150 km. Across all pairs, a larger age difference between siblings was associated with reduced SB risk (HR = 0.96 95% CI = 0.93-0.98). Findings were consistent within the sibling trios. CONCLUSIONS Consistent with the concept of suicide contagion, risk of suicidal behaviour subsequent to a sibling's suicide completion or attempt is higher as a function of sibling closeness. These findings are robust to potentially confounding familial factors.
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Affiliation(s)
- Alexis C. Edwards
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Henrik Ohlsson
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Eve K. Mościcki
- Department of Epidemiology and Biostatistics, Temple University, Philadelphia, PA, USA
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Functional Pathology, School of Medicine, Center for Community-based Healthcare Research and Education (CoHRE), Shimane University, Matsue, Japan
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Functional Pathology, School of Medicine, Center for Community-based Healthcare Research and Education (CoHRE), Shimane University, Matsue, Japan
| | - Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA
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24
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Miklin S, Mueller AS, Abrutyn S, Ordonez K. What does it mean to be exposed to suicide?: Suicide exposure, suicide risk, and the importance of meaning-making. Soc Sci Med 2019; 233:21-27. [PMID: 31153084 DOI: 10.1016/j.socscimed.2019.05.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 05/09/2019] [Accepted: 05/16/2019] [Indexed: 10/26/2022]
Abstract
Current research indicates that exposure to suicide is a risk factor for suicidality; however, we know little about the mechanisms through which exposure confers this risk. In this study, we address this gap by examining the role of meaning-making after a suicide death in moderating individual's vulnerability to suicide. We draw on interview data with suicide bereaved individuals in the USA (N = 48), the majority of whom engaged in intense meaning-making processes after their loss. Many reported an increased awareness of suicide as a 'something that actually happens,' a realization that impacted their lives and relationships with others (N = 37). For 7 participants, all women, their loss appeared to trigger increased suicidality, as they not only felt overwhelmed by grief, but also came to see suicide as something they, too, could do. However, for 19 participants, witnessing the profound impact of suicide on others made them feel that suicide was something they could never do. Thus, in our data, how exposure impacted vulnerability was tied to how individuals made sense of and experienced their loss. For some, suicide was re-framed as more of an option, while for others it was re-framed as not just the killing-of-oneself, but as the harming-of-others through grief and trauma, which in turn diminished their view of suicide's acceptability. Collectively, our findings suggest that exposure to suicide itself is not inherently risky, though it may be inherently distressing; instead, whether it results in increased vulnerability depends on the meaning an individual makes of the experience and likely the context surrounding the death. We discuss the implications of our findings for theories of suicide contagion, suicide itself, and suicide prevention.
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Abstract
Suicide is the second leading cause of death worldwide for adolescents. Despite decades of research on correlates and risk factors for adolescent suicide, we know little about why suicidal ideation and behavior frequently emerge in adolescence and how to predict, and ultimately prevent, suicidal behavior among youths. In this review, we first discuss knowledge regarding correlates, risk factors, and theories of suicide. We then review why adolescence is a period of unique vulnerability, given changing biology and social network reorganization. Next, we present a conceptual model through which to interpret emerging findings in adolescent suicide research. We suggest that a promising area for future research is to examine adolescent suicide as a failure of biological responses to acute stress in the proximal moments of a suicidal crisis. After reviewing initial evidence for this conceptualization, we review future directions for studies on adolescent suicide.
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Affiliation(s)
- Adam Bryant Miller
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA; ,
| | - Mitchell J Prinstein
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA; ,
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Roden-Foreman JW, Foreman ML, Funk GA, Powers MB. Driver see, driver crash: Associations between televised stock car races' audience size and the incidence of speed-related motor vehicle collisions in the United States. Proc AMIA Symp 2019; 32:37-42. [PMID: 30956578 PMCID: PMC6442903 DOI: 10.1080/08998280.2018.1512275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 08/06/2018] [Accepted: 08/13/2018] [Indexed: 10/27/2022] Open
Abstract
Several studies have examined road rage, but few studies have examined other psychosocial factors that may contribute to the number of motor vehicle collisions (MVCs). One study found increases in MVCs in West Virginia following televised NASCAR races but did not account for audience size. This study examined associations between NASCAR's television viewership ratings and the incidence of speed-related MVCs in the USA using generalized estimating equations that controlled for seasonal effects, intoxication, road surface conditions, and lighting conditions. A 1% increase in the number of US households watching NASCAR races per month was associated with a 6.3% (95% confidence interval [CI], 3.0% to 9.7%; P < 0.001) increase in the incidence of speed-related MVCs-approximately 4911 (95% CI, 2353 to 7470) speed-related MVCs per month or one speed-related MVC per 595 (95% CI, 382 to 1354) viewers. As expected, similar results were not found for the total number of MVCs. These data suggest that televised NASCAR races may be associated with substantial increases in the incidence of speed-related MVCs. Making drivers aware of psychological factors that may increase risky driving behaviors could prove beneficial because self-monitoring can result in safer driving.
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Affiliation(s)
- Jacob W. Roden-Foreman
- Division of Trauma, Critical Care, and Acute Care Surgery, Baylor University Medical Center at DallasDallasTexas
| | - Michael L. Foreman
- Division of Trauma, Critical Care, and Acute Care Surgery, Baylor University Medical Center at DallasDallasTexas
| | - Geoffrey A. Funk
- Division of Trauma, Critical Care, and Acute Care Surgery, Baylor University Medical Center at DallasDallasTexas
| | - Mark B. Powers
- Division of Trauma, Critical Care, and Acute Care Surgery, Baylor University Medical Center at DallasDallasTexas
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Wang Z, Yu G, Tian X. Exploring Behavior of People with Suicidal Ideation in a Chinese Online Suicidal Community. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 16:ijerph16010054. [PMID: 30587805 PMCID: PMC6339245 DOI: 10.3390/ijerph16010054] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 12/23/2018] [Accepted: 12/24/2018] [Indexed: 12/19/2022]
Abstract
People with suicidal ideation (PSI) are increasingly using social media to express suicidal feelings. Researchers have found that their internet-based communication may lead to the spread of suicidal ideation, which presents a set of challenges for suicide prevention. To develop effective prevention and intervention strategies that can be efficiently applied in online communities, we need to understand the behavior of PSI in internet-based communities. However, to date there have been no studies that specifically focus on the behavior of PSI in Chinese online communities. A total of 4489 postings in which users explicitly expressed their suicidal ideation were labeled from 560,000 postings in an internet-based suicidal community on Weibo (one of the biggest social media platforms in China) to explore their behavior. The results reveal that PSI are significantly more active than other users in the community. With the use of social network analysis, we also found that the more frequently users communicate with PSI, the more likely that users would become suicidal. In addition, Chinese women may be more likely to be at risk of suicide than men in the community. This study enriches our knowledge of PSI’s behavior in online communities, which may contribute to detecting and assisting PSI on social media.
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Affiliation(s)
- Zheng Wang
- School of Management, Harbin Institute of Technology, Harbin 150001, China.
| | - Guang Yu
- School of Management, Harbin Institute of Technology, Harbin 150001, China.
| | - Xianyun Tian
- School of Management, Harbin Institute of Technology, Harbin 150001, China.
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Lankford A, Tomek S. Mass Killings in the United States from 2006 to 2013: Social Contagion or Random Clusters? Suicide Life Threat Behav 2018; 48:459-467. [PMID: 28726336 DOI: 10.1111/sltb.12366] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 04/19/2017] [Indexed: 11/29/2022]
Abstract
In line with previous research on suicide and social contagion, there has been widespread speculation that mass killings-which often involve suicidal offenders-are socially contagious for up to 14 days. This study tested these claims by making comparisons (i) between observed chronological clusters of mass killings in the United States from 2006 to 2013 and clusters in 500 simulations containing 116,000 randomly generated dates, and then (ii) between observed mass killings receiving varying levels of public attention. No evidence of short-term contagion was found, although longer term copycat effects may exist. Further scholarly and policy implications are discussed.
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Affiliation(s)
- Adam Lankford
- Department of Criminology & Criminal Justice, The University of Alabama, Tuscaloosa, AL, US
| | - Sara Tomek
- Department of Educational Studies in Psychology, Research Methodology and Counseling, The University of Alabama, Tuscaloosa, AL, US
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Williams CL, Witte TK. Media Reporting on Suicide: Evaluating the Effects of Including Preventative Resources and Psychoeducational Information on Suicide Risk, Attitudes, Knowledge, and Help-Seeking Behaviors. Suicide Life Threat Behav 2018; 48:253-270. [PMID: 28504315 DOI: 10.1111/sltb.12355] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 01/10/2017] [Indexed: 11/29/2022]
Abstract
We evaluated the effects of exposure to a suicide news article on a variety of outcome variables and whether adhering to one specific media guideline (i.e., including psychoeducational information and preventative resources) buffered any of the negative effects of exposure. Participants were randomly assigned to read one of three articles and then asked to complete a battery of self-report questionnaires. Overall, we found no effect of exposure to a suicide news article, regardless of the inclusion of resources and information, with a few minor exceptions. Although researchers have demonstrated the effectiveness of media guidelines in the aggregate at reducing imitative suicidal behavior, it remains unclear which guidelines in particular are responsible for this effect.
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Affiliation(s)
| | - Tracy K Witte
- Department of Psychology, Auburn University, Auburn, AL, USA
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Cha CB, Franz PJ, Guzmán EM, Glenn CR, Kleiman EM, Nock MK. Annual Research Review: Suicide among youth - epidemiology, (potential) etiology, and treatment. J Child Psychol Psychiatry 2018; 59:460-482. [PMID: 29090457 PMCID: PMC5867204 DOI: 10.1111/jcpp.12831] [Citation(s) in RCA: 276] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/11/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Suicide is a leading cause of death and a complex clinical outcome. Here, we summarize the current state of research pertaining to suicidal thoughts and behaviors in youth. We review their definitions/measurement and phenomenology, epidemiology, potential etiological mechanisms, and psychological treatment and prevention efforts. RESULTS We identify key patterns and gaps in knowledge that should guide future work. Regarding epidemiology, the prevalence of suicidal thoughts and behaviors among youth varies across countries and sociodemographic populations. Despite this, studies are rarely conducted cross-nationally and do not uniformly account for high-risk populations. Regarding etiology, the majority of risk factors have been identified within the realm of environmental and psychological factors (notably negative affect-related processes), and most frequently using self-report measures. Little research has spanned across additional units of analyses including behavior, physiology, molecules, cells, and genes. Finally, there has been growing evidence in support of select psychotherapeutic treatment and prevention strategies, and preliminary evidence for technology-based interventions. CONCLUSIONS There is much work to be done to better understand suicidal thoughts and behaviors among youth. We strongly encourage future research to: (1) continue improving the conceptualization and operationalization of suicidal thoughts and behaviors; (2) improve etiological understanding by focusing on individual (preferably malleable) mechanisms; (3) improve etiological understanding also by integrating findings across multiple units of analyses and developing short-term prediction models; (4) demonstrate greater developmental sensitivity overall; and (5) account for diverse high-risk populations via sampling and reporting of sample characteristics. These serve as initial steps to improve the scientific approach, knowledge base, and ultimately prevention of suicidal thoughts and behaviors among youth.
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Affiliation(s)
- Christine B. Cha
- Department of Counseling and Clinical Psychology, Teachers College, Columbia
University
| | | | - Eleonora M. Guzmán
- Department of Counseling and Clinical Psychology, Teachers College, Columbia
University
| | - Catherine R. Glenn
- Department of Clinical and Social Sciences in Psychology, University of
Rochester
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Van Meter AR, Algorta GP, Youngstrom EA, Lechtman Y, Youngstrom JK, Feeny NC, Findling RL. Assessing for suicidal behavior in youth using the Achenbach System of Empirically Based Assessment. Eur Child Adolesc Psychiatry 2018; 27:159-169. [PMID: 28748484 PMCID: PMC5785572 DOI: 10.1007/s00787-017-1030-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 07/19/2017] [Indexed: 02/06/2023]
Abstract
This study investigated the clinical utility of the Achenbach System of Empirically Based Assessment (ASEBA) for identifying youth at risk for suicide. Specifically, we investigated how well the Total Problems scores and the sum of two suicide-related items (#18 "Deliberately harms self or attempts suicide" and #91 "Talks about killing self") were able to distinguish youth with a history of suicidal behavior. Youth (N = 1117) aged 5-18 were recruited for two studies of mental illness. History of suicidal behavior was assessed by semi-structured interviews (K-SADS) with youth and caregivers. Youth, caregivers, and a primary teacher each completed the appropriate form (YSR, CBCL, and TRF, respectively) of the ASEBA. Areas under the curve (AUCs) from ROC analyses and diagnostic likelihood ratios (DLRs) were used to measure the ability of both Total Problems T scores, as well as the summed score of two suicide-related items, to identify youth with a history of suicidal behavior. The Suicide Items from the CBCL and YSR performed well (AUCs = 0.85 and 0.70, respectively). The TRF Suicide Items did not perform better than chance, AUC = 0.45. The AUCs for the Total Problems scores were poor-to-fair (0.33-0.65). The CBCL Suicide Items outperformed all other scores (ps = 0.04 to <0.0005). Combining the CBCL and YSR items did not lead to incremental improvement in prediction over the CBCL alone. The sum of two questions from a commonly used assessment tool can offer important information about a youth's risk for suicidal behavior. The low burden of this approach could facilitate wide-spread screening for suicide in an increasingly at-risk population.
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Affiliation(s)
- Anna R Van Meter
- Ferkauf Graduate School, Yeshiva University, 1165 Morris Park Avenue, Rousso Building, Bronx, NY, 10461, USA.
| | | | | | - Yana Lechtman
- Ferkauf Graduate School, Yeshiva University, 1165 Morris Park Avenue, Rousso Building, Bronx, NY, 10461, USA
| | | | | | - Robert L Findling
- Johns Hopkins University/Kennedy Krieger Institute, Baltimore, MD, USA
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Abstract
Suicide is a leading cause of global mortality. Suicide clusters have recently been identified among peer networks in high-income countries. This study investigates dynamics of suicide clustering within social networks of young Kenya men (n = 532; 18-34 years). We found a strong, statistically significant association between reported number of friends who previously attempted suicide and present suicide ideation (odds ratio = 1.9; 95% confidence interval (1.42, 2.54); p < 0.001). This association was mediated by lower collective self-esteem (23% of total effect). Meaning in life further mediated the association between collective self-esteem and suicide ideation. Survivors of peer suicide should be evaluated for suicide risk.
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Too LS, Pirkis J, Milner A, Spittal MJ. Clusters of suicides and suicide attempts: detection, proximity and correlates. Epidemiol Psychiatr Sci 2017; 26:491-500. [PMID: 27278418 PMCID: PMC6998993 DOI: 10.1017/s2045796016000391] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 05/12/2016] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND A suicide cluster is defined as a higher number of observed cases occurring in space and/or time than would typically be expected. Previous research has largely focused on identifying clusters of suicides, while there has been comparatively limited research on clusters of suicide attempts. We sought to identify clusters of both types of behaviour, and having done that, identify the factors that distinguish suicide attempts inside a cluster from those that were outside a cluster. METHODS We used data from Western Australia from 2000 to 2011. We defined suicide attempts as admissions to hospital for deliberate self-harm and suicides as deaths due to deliberate self-harm. Using an analytic strategy that accounted for the repetition of attempted suicide within a cluster, we performed spatial-temporal analysis using Poisson discrete scan statistics to detect clusters of suicide attempts and clusters of suicides. Logistic regression was then used to compare clustered attempts with non-clustered attempts to identify risk factors for an attempt being in a cluster. RESULTS We detected 350 (1%) suicide attempts occurring within seven spatial-temporal clusters and 12 (0.6%) suicides occurring within two spatial-temporal clusters. Both of the suicide clusters were located within a larger but later suicide attempt cluster. In multivariate analysis, suicide attempts by individuals who lived in areas of low socioeconomic status had higher odds of being in a cluster than those living in areas of high socioeconomic status [odds ratio (OR) = 29.1, 95% confidence interval (CI) = 6.3-135.5]. A one percentage-point increase in the proportion of people who had changed address in the last year was associated with a 60% increase in the odds of the attempt being within a cluster (OR = 1.60, 95% CI = 1.29-1.98) and a one percentage-point increase in the proportion of Indigenous people in the area was associated with a 7% increase in the suicide being within a cluster (OR = 1.07, 95% CI = 1.00-1.13). Age, sex, marital status, employment status, method of harm, remoteness, percentage of people in rented accommodation and percentage of unmarried people were not associated with the odds of being in a suicide attempt cluster. CONCLUSIONS Early identification of and responding to suicide clusters may reduce the likelihood of subsequent clusters forming. The mechanisms, however, that underlie clusters forming is poorly understood.
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Affiliation(s)
- L. S. Too
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - J. Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - A. Milner
- Deakin Population Health SRC, School of Health and Social Development, Deakin University, Victoria, Australia
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - M. J. Spittal
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
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Maple M, Cerel J, Sanford R, Pearce T, Jordan J. Is Exposure to Suicide Beyond Kin Associated with Risk for Suicidal Behavior? A Systematic Review of the Evidence. Suicide Life Threat Behav 2017; 47:461-474. [PMID: 27786372 DOI: 10.1111/sltb.12308] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 06/09/2016] [Indexed: 01/01/2023]
Abstract
Suicide bereavement and postvention literature often espouses risk for subsequent suicidal behavior among those previously exposed to a suicide death. Most often risk is discussed in relation to kin; however, many more individuals are exposed to suicide, and the impact of this exposure is important to understand in relation to targeting postvention. This review examined the research literature (1990-2014) to determine the evidence base for risk among those exposed to suicide. The findings demonstrate that risk of suicidal behaviors among those exposed to the suicide is significantly higher than those unexposed. These results are discussed within the context of current research in the field of postvention, and suggestions for future research are suggested.
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Affiliation(s)
- Myfanwy Maple
- School of Health, University of New England, Armidale, NSW, Australia
| | - Julie Cerel
- College of Social Work, University of Kentucky, Lexington, KY, USA
| | | | - Tania Pearce
- School of Health, University of New England, Armidale, NSW, Australia
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Briggs S, Slater T, Bowley J. Practitioners' experiences of adolescent suicidal behaviour in peer groups. J Psychiatr Ment Health Nurs 2017; 24:293-301. [PMID: 28321968 DOI: 10.1111/jpm.12388] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/16/2017] [Indexed: 11/29/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: Group suicidal behaviour can be devastating for all concerned. There is an absence of research on adolescent suicidal group behaviour. The perspectives of practitioners' experiences of these groups are largely lacking from research literature. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Practitioners work regularly with suicidal behaviour in adolescent peer groups. Practitioners identify peer relationships in groups as complex, including elements that are both suicide encouraging and preventing. Practitioners identify a range of ways in which young people become involved in suicidal behaviour in groups, including indirectly through risk taking and care-seeking as well as directly suicidal or self-harming. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Assessments of young people should routinely include a focus on the qualities of peer relations, including those in the online/digital realm. Assessments and interventions need to consider the complexity of group relationships and roles, and the multiplicity of factors that can contribute to suicidal behaviour in groups. Interventions that sustain therapeutic connectedness are helpful for taking dynamic/fluctuating risks into account. ABSTRACT Introduction Group suicidal behaviour by young people can have harmful effects; it may be increasing, influenced by online media and reported increasing self-harm rates; new knowledge and understanding to inform interventions is required. Aim To explore how practitioners experience group suicidal behaviour amongst adolescents, how they assess risks/needs, and how these insights inform understanding about these groups. Method Ten practitioners, including Mental Health Nurses, were interviewed in one multidisciplinary CAMHS, in England. Data analysis was by Thematic Analysis (Braun & Clarke 2006). Results Participants described frequently working with suicidal groups. Roles in groups include suicide encouraging and preventing. Practitioners identify risky and protective connections between young people, online and offline. Clinical tensions include living with suicidal risks, emotional and positional challenges, and getting to grips with digital media. Discussion Peer groups appear to have a larger role in adolescent suicide than recognized to date. Practitioners need to assess young people's roles in groups, their diverse motivations and to understand constantly changing digital media. Implications for practice Assessments of suicide risk for young people should routinely include focus on peer relations including the online/digital realm. Maintaining relationships with vulnerable young people facilitates managing fluctuating risks and understanding different group dynamics.
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Affiliation(s)
- S Briggs
- Department of Social Work, University of East London, London, UK
| | - T Slater
- Department of Social Work, University of Cardiff, Cardiff, UK
| | - J Bowley
- Barnet Enfield and Haringey Mental Health NHS Trust, London, UK
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Hom MA, Stanley IH, Gutierrez PM, Joiner TE. Exploring the association between exposure to suicide and suicide risk among military service members and veterans. J Affect Disord 2017; 207:327-335. [PMID: 27743535 DOI: 10.1016/j.jad.2016.09.043] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 09/01/2016] [Accepted: 09/27/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Past research suggests that suicide has a profound impact on surviving family members and friends; yet, little is known about experiences with suicide bereavement among military populations. This study aimed to characterize experiences with suicide exposure and their associations with lifetime and current psychiatric symptoms among military service members and veterans. METHODS A sample of 1753 United States military service members and veterans completed self-report questionnaires assessing experiences with suicide exposure, lifetime history of suicidal thoughts and behaviors, current suicidal symptoms, and perceived likelihood of making a future suicide attempt. RESULTS The majority of participants (57.3%) reported knowing someone who had died by suicide, and of these individuals, most (53.1%) reported having lost a friend to suicide. Chi-square tests, one-way ANOVAs, and logistic regression analyses revealed that those who reported knowing a suicide decedent were more likely to report more severe current suicidal symptoms and a history of suicidal thoughts and behaviors compared to those who did not know a suicide decedent. Hierarchical linear regression analyses indicated that greater self-reported interpersonal closeness to a suicide decedent predicted greater self-reported likelihood of a future suicide attempt, even after controlling for current suicidal symptoms and prior suicidal thoughts and behaviors. LIMITATIONS This study utilized cross-sectional data, and information regarding degree of exposure to suicide was not collected. CONCLUSIONS Military personnel and veterans who have been bereaved by suicide may themselves be at elevated risk for suicidal thoughts and behaviors. Additional work is needed to delineate the relationship between these experiences.
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Affiliation(s)
- Melanie A Hom
- Department of Psychology, Florida State University, United States.
| | - Ian H Stanley
- Department of Psychology, Florida State University, United States
| | - Peter M Gutierrez
- Rocky Mountain Mental Illness Research, Education and Clinical Center, Denver Veterans Affairs Medical Center, United States; Department of Psychiatry, University of Colorado School of Medicine, United States
| | - Thomas E Joiner
- Department of Psychology, Florida State University, United States
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Too LS, Pirkis J, Milner A, Bugeja L, Spittal MJ. Railway suicide clusters: how common are they and what predicts them? Inj Prev 2016; 23:328-333. [PMID: 27864309 DOI: 10.1136/injuryprev-2016-042029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 10/09/2016] [Accepted: 10/27/2016] [Indexed: 11/04/2022]
Abstract
BACKGROUND A growing number of studies have sought to detect clusters of all suicides, but few have sought to identify clusters of method-specific suicides. METHODS Data on railway suicides occurring in Victoria, Australia, between 2001 and 2012 were obtained from the National Coronial Information System. We used the Poisson discrete scan statistic to identify railway suicides that occurred close together in space and/or time. We then used a case-control design to compare clustered railway suicides with non-clustered railway suicides on a range of individual and neighbourhood factors. RESULTS We detected four spatial clusters that accounted for 35% of all railway suicides. Railway suicides by individuals who were hospitalised for mental illness had nearly double the odds of being in a cluster compared with those individuals who had never been hospitalised (OR 1.80, 95% CI 1.02 to 3.18). Higher frequency train services were associated with increased odds of being in a cluster (OR 1.11, 95% CI 1.03 to 1.19). No other predictors were associated with being in a cluster. CONCLUSIONS Railway suicides that occur in clusters warrant particular attention because of the ripple effect they can have for communities and the risk that they may lead to copycat acts. Railway suicide prevention strategies should consider the fact that these suicides can occur in clusters, particularly among individuals who had previous hospitalisations for mental illness or live in areas with high-frequency train services.
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Affiliation(s)
- Lay San Too
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Allison Milner
- Deakin Population Health Strategic Research Centre, School of Health and Social Development, Deakin University, Burwood, Victoria, Australia.,Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lyndal Bugeja
- Department of Forensic Medicine, School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - Matthew J Spittal
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
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Rezaeian M, Zarghami M. Algorithm Characterization of Suicide: Introducing an Informative Categorization System. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2016; 10:e4544. [PMID: 27822281 PMCID: PMC5097447 DOI: 10.17795/ijpbs-4544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 04/11/2015] [Accepted: 10/29/2015] [Indexed: 11/25/2022]
Affiliation(s)
- Mohsen Rezaeian
- Epidemiology and Biostatistics Department, Occupational Environmental Research Center, Rafsanjan Medical School, Rafsanjan University of Medical Sciences, Rafsanjan, IR Iran
| | - Mehran Zarghami
- Department of Psychiatry, School of Medicine, Mazandaran University of Medical Sciences, Mazandaran, Sari, IR Iran; Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Mazandaran, Sari, IR Iran
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40
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Logan JE, Fowler KA, Patel NP, Holland KM. Suicide Among Military Personnel and Veterans Aged 18-35 Years by County-16 States. Am J Prev Med 2016; 51:S197-S208. [PMID: 27745608 PMCID: PMC6046215 DOI: 10.1016/j.amepre.2016.06.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 04/18/2016] [Accepted: 06/03/2016] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Suicide among military personnel and young Veterans remains a health concern. This study examined stateside distribution of suicides by U.S. county to help focus prevention efforts. METHODS Using 2005-2012 National Violent Death Reporting System data from 16 states (963 counties, or county-equivalent entities), this study mapped the county-level distribution of suicides among current military and Veteran decedents aged 18-35 years. This study also compared incident circumstances of death between decedents in high-density counties (i.e., counties with the highest proportion of deaths) versus those in medium/low-density counties to better understand the precipitators of suicide in counties most affected. Last, this study identified potential military and Veteran Health Administration intervention sites. All analyses were conducted in 2015. RESULTS Within the National Violent Death Reporting System participating states, an estimated 262 (33%) current military suicides occurred in just ten (1.0%) counties, and 391 (33%) Veteran suicides occurred in 33 (3.4%) counties. Mental health and intimate partner problems were common precipitating circumstances, and some circumstances differed between cases in high- versus those in medium/low-density counties. Multiple potential intervention sites were identified in high-density counties. CONCLUSIONS These findings suggest that military and Veteran suicides are concentrated in a small number of counties. Increased efforts at these locales might be beneficial.
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Affiliation(s)
- Joseph E Logan
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Violence Prevention, Atlanta, Georgia.
| | - Katherine A Fowler
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Violence Prevention, Atlanta, Georgia
| | - Nimeshkumar P Patel
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Analysis, Research and Practice Integration, Atlanta, Georgia
| | - Kristin M Holland
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Violence Prevention, Atlanta, Georgia
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41
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Hasking P, Whitlock J, Voon D, Rose A. A cognitive-emotional model of NSSI: using emotion regulation and cognitive processes to explain why people self-injure. Cogn Emot 2016; 31:1543-1556. [DOI: 10.1080/02699931.2016.1241219] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Penelope Hasking
- School of Psychology and Speech Pathology, Curtin University, Perth, Australia
| | - Janis Whitlock
- College of Human Ecology, Cornell University, New York, NY, USA
| | - David Voon
- School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Alyssa Rose
- School of Psychology and Speech Pathology, Curtin University, Perth, Australia
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Guillaume Grandazzi. Familles et communautés face aux « grappes localisées » de suicides de jeunes : deux exemples en populations québécoise et autochtone. ENFANCES, FAMILLES, GÉNÉRATIONS 2016. [DOI: 10.7202/1038115ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
À partir d’entretiens réalisés dans deux localités au Québec, dont une en milieu autochtone, touchées par des grappes localisées de suicide de jeunes, les représentations et les répercussions de ces évènements sont interrogées. L’objectivation d’une série de suicides dans un temps et un lieu donnés ne suffit pas à qualifier le phénomène, qui renvoie à une réalité à la fois physique et sociale, et qui fait l’objet d’un processus de construction sociale. Celui-ci va contribuer ou non à transformer plusieurs tragédies individuelles et familiales en enjeu collectif qui concerne et interpelle l’ensemble de la collectivité affectée. Au-delà de la proximité temporelle et géographique des cas de suicides, c’est le fait que le phénomène atteigne des adolescents et des jeunes adultes, dans des proportions parfois importantes, qui interpelle profondément les communautés concernées et qui oblige les adultes à se questionner sur les raisons pour lesquelles une partie de la jeunesse manifeste, au travers de l’acte suicidaire, une grande vulnérabilité qui ébranle les fondements de la vie sociale et de la transmission intergénérationnelle.
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Stanley IH, Hom MA, Rogers ML, Hagan CR, Joiner TE. Understanding suicide among older adults: a review of psychological and sociological theories of suicide. Aging Ment Health 2016; 20:113-22. [PMID: 25693646 DOI: 10.1080/13607863.2015.1012045] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Older adults die by suicide at a higher rate than any other age group in nearly every country globally. Suicide among older adults has been an intractable clinical and epidemiological problem for decades, due in part to an incomplete understanding of the causes of suicide, as well as imprecision in the prediction and prevention of suicidal thoughts and behaviors in later life. Theory-driven investigations hold promise in addressing these gaps by systematically identifying testable, and thus falsifiable, mechanisms that may better explain this phenomenon and also point to specific interventions. METHOD In this article, we comprehensively review key extant psychological and sociological theories of suicide and discuss each theory's applicability to the understanding and prevention of suicide among older adults. RESULTS Despite a modest number of theories of suicide, few have undergone extensive empirical investigation and scrutiny, and even fewer have been applied specifically to older adults. CONCLUSION To advance the science and contribute findings with a measurable clinical and public health impact, future research in this area, from conceptual to applied, must draw from and integrate theory.
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Affiliation(s)
- Ian H Stanley
- a Department of Psychology , Florida State University , Tallahassee , FL , USA
| | - Melanie A Hom
- a Department of Psychology , Florida State University , Tallahassee , FL , USA
| | - Megan L Rogers
- a Department of Psychology , Florida State University , Tallahassee , FL , USA
| | - Christopher R Hagan
- a Department of Psychology , Florida State University , Tallahassee , FL , USA
| | - Thomas E Joiner
- a Department of Psychology , Florida State University , Tallahassee , FL , USA
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44
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A Preliminary Application of Social Cognitive Theory to Nonsuicidal Self-Injury. J Youth Adolesc 2016; 45:1560-74. [DOI: 10.1007/s10964-016-0449-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 02/19/2016] [Indexed: 10/22/2022]
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Contagion from peer suicidal behavior in a representative sample of American adolescents. J Affect Disord 2015; 186:219-25. [PMID: 26253902 DOI: 10.1016/j.jad.2015.07.001] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 06/29/2015] [Accepted: 07/03/2015] [Indexed: 01/30/2023]
Abstract
BACKGROUND Assortative relating is a proposed explanation for the increased occurrence of suicidal behavior among those exposed to suicidal peers. This explanation proposes that high-risk individuals associate with each other, and shared risk factors explain the effect. METHODS Data were obtained from the ADDhealth longitudinal survey waves I and II (n=4834 school attending adolescents). People who reported peer suicidal behavior in the first wave were identified and classified as the exposure group. Potentially confounding variables were identified, and propensity scores were calculated for the exposure variable using logistic regression. Inverse-probability-of-treatment weighted regression estimated the effect of exposure on the risk for a suicide attempt during the first two waves. RESULTS Weighted analysis showed that the group exposed to a friend's suicide attempt had a higher occurrence of suicide attempts in both waves. Exposure to peer suicide attempts was associated with increased suicide attempts at baseline (RR=1.93; 95%CI= 1.23-3.04) and 1-year follow-up (RR=1.70; 95%CI= 1.12-2.60). LIMITATION Only two consecutive years of data are provided. Misclassification and recall bias are possible due to the use of self-report. The outcome may be misclassified due to respondent misunderstanding of what constitutes a suicide attempts, versus non-suicidal self-injury. Non-response and trimming reduced the sample size significantly. CONCLUSIONS Assortative relating did not account for all the variance and is currently not sufficient to explain the increased risk after exposure to peer suicidal behavior. Clinicians should assess for exposure to suicidal behaviors in their patients.
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Jacob N, Scourfield J, Evans R. Suicide prevention via the Internet: a descriptive review. CRISIS 2015; 35:261-7. [PMID: 24984890 DOI: 10.1027/0227-5910/a000254] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND While concerns abound regarding the impact of the Internet on suicidal behaviors, its role as a medium for suicide prevention remains underexplored. AIMS The study examines what is currently known about the operation and effectiveness of Internet programs for suicide and self-harm prevention that are run by professionals. METHOD Systematic searches of scholarly databases and suicide-related academic journals yielded 15 studies that presented online prevention strategies. RESULTS No professional programs with a sole focus on nonsuicidal self-harm were identified, thus all studies reviewed focused on suicide prevention. Studies were predominantly descriptive and summarized the nature of the strategy and the target audience. There was no formal evaluation of program effectiveness in preventing suicide. Studies either presented strategies that supported individuals at risk of suicide (n = 8), supported professionals working with those at risk (n = 6), or attempted to improve website quality (n = 1). CONCLUSION Although the Internet increasingly serves as an important medium for suicidal individuals, and there is concern about websites that both promote and encourage suicidal activity, there is lack of published evidence about online prevention strategies. More attention is needed in the development and evaluation of such preventative approaches.
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Affiliation(s)
- Nina Jacob
- DECIPHer, School of Social Sciences, Cardiff University, UK
| | | | - Rhiannon Evans
- DECIPHer, School of Social Sciences, Cardiff University, UK
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Abstract
The object of this article is to review the past decade of research on teenage suicide, with a particular emphasis on epidemiologic trends by age, gender and indigenous ethnicity. As such, a review of research literature from 2003 to 2014 was conducted via a comprehensive search of relevant psychological and medical databases. Wide gaps in our knowledge base exist concerning the true extent of teenage suicide due to lack of data, particularly in developing countries, resulting in a Western bias. The gender paradox of elevated suicidality in females with higher completed suicide rates in males is observed in teenage populations worldwide, with the notable exceptions of China and India. Native and indigenous ethnic minority teens are at significantly increased risk of suicide in comparison to general population peers. Often those with the highest need for mental health care (such as the suicidal adolescent) have least access to therapeutic support.Globally, suicide in teenagers remains a major public health concern. Further focused research concerning completed suicides of youth below the age of 18 is required across countries and cultures to understand more about risk as children progress through adolescence. Gender and ethnic variations in suicidality are embedded within cultural, historical, psychological, relational and socio-economic domains. Worldwide, the absence of child/adolescent-specific mental health policies may delay the development of care and suicide prevention. Overall, it is vital that clinicians adopt a holistic approach that incorporates an awareness of age and gender influences, and that cultural competency informs tailored and evaluated intervention programmes.
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Affiliation(s)
- A B McLoughlin
- From the Department of Psychiatry, Psychotherapy & Mental Health Research, St. Vincent's University Hospital and School of Medicine & Medical Science, University College Dublin, Elm Park, Dublin 4, Ireland and
| | - M S Gould
- Division of Child and Adolescent Psychiatry, Department of Epidemiology, College of Physicians and Surgeons, Columbia University/New York State Psychiatric Institute, Riverside Drive, New York, NY 10035, USA
| | - K M Malone
- From the Department of Psychiatry, Psychotherapy & Mental Health Research, St. Vincent's University Hospital and School of Medicine & Medical Science, University College Dublin, Elm Park, Dublin 4, Ireland and
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O'Connor RC, Portzky G. The association between goth subculture identification, depression, and self-harm. Lancet Psychiatry 2015; 2:766-7. [PMID: 26321234 DOI: 10.1016/s2215-0366(15)00211-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 04/21/2015] [Indexed: 10/23/2022]
Affiliation(s)
- Rory C O'Connor
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, Glasgow G12 0XH, UK.
| | - Gwendolyn Portzky
- Unit for Suicide Research and Flemish Suicide Prevention Centre, Ghent University, Ghent, Belgium
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The Aftermath of a Suicide Cluster in the Age of Online Social Networking: a Qualitative Analysis of Adolescent Grief Reactions. ACTA ACUST UNITED AC 2015. [DOI: 10.1007/s40688-015-0060-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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O'Toole BI, Orreal-Scarborough T, Johnston D, Catts SV, Outram S. Suicidality in Australian Vietnam veterans and their partners. J Psychiatr Res 2015; 65:30-6. [PMID: 25914085 DOI: 10.1016/j.jpsychires.2015.02.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Revised: 12/30/2014] [Accepted: 02/06/2015] [Indexed: 11/30/2022]
Abstract
Lifetime suicidality was assessed in a cohort of 448 ageing Australian Vietnam veterans and 237 female partners during in-person structured psychiatric interviews that permitted direct comparison with age-sex matched Australian population statistics. Relative risks for suicidal ideation, planning and attempts were 7.9, 9.7 and 13.8 times higher for veterans compared with the Australian population and for partners were 6.2, 3.5 and 6.0 times higher. Odds ratios between psychiatric diagnoses and suicidality were computed using multivariate logistic regression, and suicidality severity scores were assigned from ideation, planning and attempt, and analysed using ordinal regression. PTSD, depression alcohol disorders, phobia and agoraphobia were prominent predictors of ideation, attempts and suicidal severity among veterans, while depression, PTSD, social phobia and panic disorder were prominent predictors among partners. For veterans and their partners, PTSD is a risk factor for suicidality even in the presence of other psychiatric disorders, and is stronger in Vietnam veterans than their partners.
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Affiliation(s)
- Brian I O'Toole
- University of Sydney Brain & Mind Research Institute, Sydney, Australia.
| | | | - Deborah Johnston
- University of Sydney Brain & Mind Research Institute, Sydney, Australia
| | - Stanley V Catts
- University of Sydney Brain & Mind Research Institute, Sydney, Australia; University of Queensland, Centre for Mental Health, Royal Brisbane and Women's Hospital, Brisbane, Australia.
| | - Sue Outram
- School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, Newcastle, Australia.
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