Suicide and the media. Part III: Theoretical issues

Third Molar Comparison in Class I and II Extraction and Non-extraction Orthodontic Treatment: A Retrospective Longitudinal Study

Objective

This study compared third molar angulation and eruption status in Class I and II malocclusions after orthodontic treatment with and without first premolar extractions.

Methods

The sample comprised 93 patients divided into four groups: Group 1, Class I malocclusion treated with first premolar extractions; Group 2, Class I malocclusion treated without extractions; Group 3, Class II malocclusion treated with first premolar extractions; and Group 4, Class II malocclusion treated without extractions. Panoramic radiographs were used to evaluate the third molar mesiodistal angulations at T1 (pretreatment), T2 (posttreatment), and T3 (long-term posttreatment). Third molar eruption status was assessed in dental casts. Intergroup angulations and eruption status comparisons were performed using one-way analysis of variance (ANOVA), followed by Tukey's test and Kruskal-Wallis test, respectively.

Results

Significantly greater mesial angulation and percentage of erupted right maxillary third molars were observed in the Class I extraction group. Significantly greater eruption status of the right mandibular third molars was observed in the Class I and Class II malocclusion extraction groups.

Conclusion

Class I and II malocclusion extraction treatment exhibited more favorable angulations and a greater number of erupted third molars than non-extraction treatment. The non-extraction groups exhibited a greater percentage of unerupted third molars.

Predicting Sensationalism in Suicide Story Headlines

Objective: Suicide is a leading cause of death in the United States, and media publicity plays a role in suicide rates. The United States offers guidelines for the reporting of suicide. This study evaluated guideline adherence in newspaper and newswire publications covering celebrity suicide deaths. The research also assessed whether the sensationalism of article headlines could be predicted by variables reflecting nonadherent reporting. Method: Publications from 2013 to 2018 reporting on nine celebrity suicides were evaluated via content analysis. Adherence was assessed in a two-step hierarchical linear regression to determine which variables predicted sensationalism in headlines. Results: Overall adherence to reporting guidelines was moderate. Newspaper disclosure of suicide method only, suicide method and location, and note contents significantly predicted headline sensationalism in the first regression model, R2 = 22%. The sensationalism in the body of the article and other variables additionally predicted headline sensationalism in the second regression model, R2 = 55%. Limitations: This study is limited to celebrity suicide reporting and may not reflect media reporting trends of noncelebrity suicide deaths. Conclusion: Findings reveal that sensationalism in the body of the article and other variables uniquely contributed to sensationalism in newspaper headlines. This suggests that the public could be at risk for reading harmful content not consistent with reporting recommendations about suicide because of the initial attraction to sensational headlines.

The Association Between Media Exposure to Non Suicidal Self-Injury and Emergency Department Visits for Self-Harm

OBJECTIVE

This study aimed to evaluate the association between media exposure to non suicidal self-injury (NSSI) and emergency department (ED) visits due to self-harm in Korea, specifically before and after the initial broadcast of the song Barcode, which has an explicit focus on NSSI.

METHOD

We used the national emergency department information system to obtain data related to ED visits due to self-harm between January 1, 2014, and December 31, 2018. Using interrupted time series regression analysis, we assessed the monthly ED visits due to self-harm before and after the media exposure to NSSI on March 30, 2018. In addition, self-harm methods were assessed.

RESULTS

A total of 35,928,834 visits to ED were identified, of which 115,647 were due to self-harm. ED visits due to self-harm showed a significant step increase in the 10- to 14-year-old (β = 0.883, p = .001), 15- to 19-year-old (β = 2.941, p < .001), 20- to 24-year-old (β = 1.997, p = 0.002), and 25- to 29-year-old (β = 1.438, p = .029) age groups, before and after the media exposure to NSSI. The most pronounced increase was observed in male participants aged 20 to 24 years (β = 1.790, p = .012) and female participants aged 15 to 19 years (β = 5.158, p < .001). Self-harm by cutting has increased significantly in participants aged 10 to 29 years, and self-harm by poisoning has also increased significantly in participants aged 10 to 19 and 25 to 29 years.

CONCLUSION

ED visits due to self-harm increased significantly, especially in adolescents and young adults, following the exposure to NSSI. Responsible media reporting on NSSI and appropriate guidelines would help prevent a further increase in self-harm.

DIVERSITY & INCLUSION STATEMENT

We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.

Effect of suicide prevention law and media guidelines on copycat suicide of general population following celebrity suicides in South Korea, 2005-2017

OBJECTIVE

To prevent copycat suicides following media reporting of celebrity suicides, the South Korean government enacted a 'suicide prevention law' in 2012 and revised the media guidelines for suicide reporting in 2013. This study examined how these two regulatory measures affected suicide trends among the general population in South Korea.

METHODS

We analyzed the individual effect estimates for the general population within 30 days following the media report of 24 celebrity suicides using multivariate negative binomial regression. We performed a meta-analysis to compute the pooled rate ratios of the two regulations. We examined the trends in daily suicides by month during three time intervals before and after enactment using an autoregressive model and tested their significance using a piecewise linear regression.

RESULTS

Total suicides increased by 6.27 daily during the 30-day period after celebrity suicides. Compared with the 30 days prior to the reports on the suicide of 24 celebrities, the number of suicidal deaths in the general population increased by 13% during the 30 days after the reports were announced (pooled rate ratio 1.13, 95% confidence interval: 0.06-0.18; p < 0.001). There was a significant downward trend in the average daily suicide deaths, and no significant increase in suicide rates, after the enactment of the suicide prevention law (p < 0.001) and revision of the media guidelines (p = 0.014).

CONCLUSIONS

Suicide prevention and media guidelines were effective in reducing the effect of celebrity suicides. In addition to regulating media reporting of celebrity suicide, measures are needed to address viral republication on social media and to prevent suicide among entertainers.

The Werther Effect, the Papageno Effect or No Effect? A Literature Review

This paper examines the association between media reporting on suicides and the subsequent suicides. Scientific papers from two online bibliographic sources Medline (PubMed) and PsycINFO were searched. The sample included 108 research papers examining the impact of different types of media stories on suicides. The review revealed that although the media can be a double-edged sword and serve both as a risk and a protective factor, the vast majority of research suggests that the relationship between the media reporting and the actual suicide rates is causal and real. Moreover, both the quantity and the quality of media reporting may trigger additional suicides in society. Simultaneously, research suggests that especially non-fictional presentations of celebrities’ suicides in newspapers and on television news have the biggest influence on the subsequent suicides. Additionally, a strong modelling effect of media reporting on suicide is based on nationality, age, and gender. However, research shows that because a negative reporting style can be modifiable and improved, the media can also have an educative or preventive effect and can reduce the risk of contagion. Consequently, it is important to monitor the implementation of media recommendations for the reporting of suicide, and continuous education of reporters is needed.

The Werther Effect, the Papageno Effect or No Effect? A Literature Review

This paper examines the association between media reporting on suicides and the subsequent suicides. Scientific papers from two online bibliographic sources Medline (PubMed) and PsycINFO were searched. The sample included 108 research papers examining the impact of different types of media stories on suicides. The review revealed that although the media can be a double-edged sword and serve both as a risk and a protective factor, the vast majority of research suggests that the relationship between the media reporting and the actual suicide rates is causal and real. Moreover, both the quantity and the quality of media reporting may trigger additional suicides in society. Simultaneously, research suggests that especially non-fictional presentations of celebrities’ suicides in newspapers and on television news have the biggest influence on the subsequent suicides. Additionally, a strong modelling effect of media reporting on suicide is based on nationality, age, and gender. However, research shows that because a negative reporting style can be modifiable and improved, the media can also have an educative or preventive effect and can reduce the risk of contagion. Consequently, it is important to monitor the implementation of media recommendations for the reporting of suicide, and continuous education of reporters is needed.

Suicide Coverage in the Digital Press Media: Adherence to World Health Organization Guidelines and Effectiveness of Different Interventions Aimed at Media Professionals

This study evaluated the characteristics of suicide news articles in the digital press, their adherence to World Health Organization (WHO) recommendations, and the effectiveness of interventions. We assessed adherence, avoidability, frequency and typology of suicide news over a six-month period in the four main digital media outlets of the Canary Islands (Spain). A brief training and information package intervention to the Canary Islands media outlets was carried out. We compared the quality of media reporting at both the pre-intervention and post-intervention timepoints, and compared the quality of reporting at the post-intervention timepoint in Victoria (Australia), where media interventions have been well-resourced and running for several years. We evaluated 339 suicide news articles: 38 from the pre-intervention period, 64 from the post-intervention period, and 237 from Victoria. News articles showed a very low degree of adherence to WHO recommendations, especially to those recommendations thought to have a protective effect. Post-intervention news articles showed better adherence than pre-intervention ones, but lower than those of Victoria, where constant interventions have been developed for years. We conclude that adherence to WHO recommendations is low. Simple interventions aimed at media professionals can improve adherence. However, constant and complex interventions seem to be more effective.

"It's a battle for eyeballs and suicide is clickbait": The media experience of suicide reporting in India

Introduction

Suicide rates in India are among the highest in the world, equating to over 200,000 suicide deaths annually. Crime reports of suicide incidents routinely feature in the Indian mass media, with minimal coverage of suicide as a broader public health issue. To supplement our recently published content analysis study, we undertook qualitative interviews to examine media professionals' perspectives and experiences in relation to media reporting of suicide-related news in India.

Materials and methods

In 2017–18, semi-structured qualitative interviews with twenty-eight print media and television media professionals with experience reporting on suicide-related news were undertaken across north (New Delhi and Chandigarh) and south (Chennai) India. A semi-structured interview guide was designed to initiate discussions around; 1) perspectives on why suicide incidents are regularly reported on by mass media in India, 2) a description of experiences and processes of covering suicide incidents on the crime beat; and 3) perspectives on the emergence of health reporter coverage of suicide. Interviews were digitally audio-recorded and transcribed. A deductive and inductive thematic analytic approach was used, supported by the use of NVivo.

Results

Suicides were typically seen as being highly newsworthy and of interest to the audience, particularly the suicides of high-status people and those who somewhat matched the middle-class profile of the core audience. Socio-cultural factors played a major role in determining the newsworthiness of a particular incident. The capacity to link a suicide incident to compelling social narratives, potentially detrimental social/policy issues, and placing the suicide as a form of protest/martyrdom increased newsworthiness. Reporters on the crime beat worked in close partnership with police to produce routine and simplified incident report-style coverage of suicide incidents, with the process influenced by: informal police contacts supporting the crime beat, the speed of breaking news, extremely tight word limits and a deeply fraught engagement with bereaved family members. It was articulated that a public health and/or mental health framing of suicide was an emerging perspective, which sought to focus more on broader trends and suicide prevention programs rather than individual incidents. Important challenges were identified around the complexity of adopting a mental health framing of suicide, given the perceived pervasive influence of socioeconomic and cultural issues (rather than individual psychopathology) on suicide in India.

Conclusions

Our findings delve into the complexity of reporting on suicide in India and can be used to support constructive partnerships between media professionals and suicide prevention experts in India. Policymakers need to acknowledge the socio-cultural context of suicide reporting in India when adapting international guidelines for the Indian media.

Association Between the Release of Netflix's 13 Reasons Why and Suicide Rates in the United States: An Interrupted Time Series Analysis

OBJECTIVE

To estimate the association between the release of the Netflix series 13 Reasons Why and suicide rates in the United States.

METHOD

Using segmented quasi-Poisson regression and Holt-Winters forecasting models, we assessed monthly rates of suicide among individuals aged 10 to 64 years grouped into 3 age categories (10-17, 18-29, and 30-64 years) between January 1, 2013, and December 31, 2017, before and after the release of 13 Reasons Why on March 31, 2017. We also assessed the impact of the show's release on a control outcome, homicide deaths.

RESULTS

After accounting for seasonal effects and an underlying increasing trend in monthly suicide rates, the overall suicide rate among 10- to 17-year-olds increased significantly in the month immediately following the release of 13 Reasons Why (incidence rate ratio [IRR], 1.29; 95% CI, 1.09-1.53); Holt-Winters forecasting revealed elevated observed suicide rates in the month after release and in two subsequent months, relative to corresponding forecasted rates. Contrary to expectations, these associations were restricted to boys. Among 18- to 29-year-olds and 30- to 64-year-olds, we found no significant change in level or trend of suicide after the show's release, both overall and by sex. The show's release had no apparent impact in the control analyses of homicide deaths within any age group.

CONCLUSION

The release of 13 Reasons Why was associated with a significant increase in monthly suicide rates among US youth aged 10 to 17 years. Caution regarding the exposure of children and adolescents to the series is warranted.

Clustering of suicides in children and adolescents

Suicide is one of the major causes of death in young people, in whom suicide can occur in clusters. In this Review, we have investigated definitions and epidemiology of such clusters, the factors associated with them, mechanisms by which they occur, and means of intervening and preventing them. Clustering of suicidal behaviour is more common in young people (<25 years) than adults. Suicide clusters can occur as a greater number of episodes than expected at a specific location, including in institutions (eg, schools, universities, psychiatric units, and youth offender units). They might also involve linked episodes spread out geographically. Locations exposed to clusters can be at risk for future clusters. Mechanisms involved in clusters include social transmission (particularly via person-to-person transmission and the media), perception that suicidal behaviour is widespread, susceptible young people being likely to socialise with others at risk of suicidal behaviour, and social cohesion contributing to the diffusion of ideas and attitudes. The internet and social media might have particularly important roles in spreading suicidal behaviour. The effect of suicide clusters on communities and institutions is usually profound. Experience of intervening in clusters has resulted in best practice guidance. This guidance includes preparation for occurrence of clusters in both community and institutional settings. Identification of clusters in the community requires real-time monitoring of suicidal behaviour. Effective intervention is more likely if a cluster response group is established than if no such group exists. The response should include bereavement support, provision of help for susceptible individuals, proactive engagement with media interest, and population-based approaches to support and prevention. Social media can provide a powerful means for disseminating information and reaching young people at risk.

The Effect of Media Coverage of Celebrities with Panic Disorder on the Health Behaviors of the Public

Although having a mental illness has become common, many people tend to hide their illness and avoid seeking treatment. One of the reasons for not seeking treatment is the stigma of mental illness. Celebrity confessions about their experiences of mental illness can reduce such stigma, because the public obtains more knowledge about the illness and becomes more familiar with it. However, little research has been conducted on the influence of a celebrity's confession about mental illness on the public's health behaviors related to the illness. The present study examined the effects of the media coverage of celebrities with panic disorder on information-seeking, providing information about the illness, and the number of people who visited a psychiatrist in South Korea. For this, we collected all the news articles on celebrities' confessions regarding their panic disorder, search frequency of panic disorder, the number of questions on a Questions & Answers (Q&A) Website, a number of blog posts about panic disorder, and the number of people that visited a psychiatrist for panic disorder between 2010 and 2015. We found that there were positive correlations between the media's coverage of celebrities with panic disorder with other variables. In addition, the search frequency and the number of questions on the Q&A Website were also positively associated with the number of people who visited a psychiatrist. Regression analysis showed that the search frequency was the most significant predictor of the increase in the number of people who visited a psychiatrist for panic disorder.

Media Reporting on Suicide: Evaluating the Effects of Including Preventative Resources and Psychoeducational Information on Suicide Risk, Attitudes, Knowledge, and Help-Seeking Behaviors

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.

Supporting Reporting: On the Positive Effects of Text- and Video-Based Awareness Material on Responsible Journalistic Suicide News Writing

Suicide is a global public health problem. Media impact on suicide is well confirmed and there are several recommendations on how media should and should not report on suicide to minimize the risk of copycat behavior. Those media guidelines have been developed to improve responsible reporting on suicide (RRS). Although such guidelines are used in several countries, we lack empirical evidence on their causal effect on actual journalistic news writing. We conducted an experiment with journalism students (N = 78) in Germany in which we tested whether exposure to awareness material promoting RRS influences news writing. As a supplement to the widely used text-based material, we tested the impact of a video in which a suicide expert presents the guidelines. A video was used as a supplement to text partly due to its potential benefit for prevention efforts over the Internet. We chose a low-budget production process allowing easy reproduction in different countries by local suicide experts. In the experiment, participants were either exposed to written, audio-visual, or no awareness material. Afterwards, participants read numerous facts of an ostensible suicide event and were asked to write a factual suicide news story based on these facts. Analyses indicate that awareness material exposure helped to improve RRS with the awareness video showing the strongest effects. We recommend that suicide prevention should use instructive awareness videos about RRS complementary to text-based awareness material.

Effects of Suicide Awareness Material on Implicit Suicide Cognition: A Laboratory Experiment

In spite of the increasing adoption of suicide awareness campaigns to prevent suicide, little is known about the effective construction of awareness messages used and on their impact on suicidal cognition. We hypothesized that media reporting on an individual overcoming a suicidal crisis increases the automatic association between "life" and self. University students (N = 112) were randomly allocated to one of three groups in a laboratory experiment. Participants allocated to treatment group 1 or group 2 read awareness material about a person coping with suicidal ideation by getting professional help. The only difference between the two groups was the amount of social similarity (low vs. high) between the protagonist and the participants. The control group read an article unrelated to suicide. Awareness material increased implicit cognition in terms of a strengthening of self-life associations. This effect was restricted to participants scoring low on wishful identification with the suicidal protagonist. This finding suggests that only individuals who do not wishfully identify with a protagonist going through difficult life circumstances benefit from the awareness material in terms of suicidal cognition. These findings provide a rich basis for further research and have potentially high relevance to the construction of suicide-awareness messages.

The Press Coverage of Celebrity Suicide and the Development of Suicide Frequencies in Germany

The existence of the so-called "Werther effect" is well confirmed, and there are several recommendations on how the media should (not) report suicide to minimize the risk of copycat behavior. Unfortunately, very little is known about how suicide is actually reported. The article examines the German press coverage of six celebrity suicides with respect to compliance with guidelines on suicide reporting and analyzes changes in suicides in the wake of the reporting. It concludes that German media do not respect the recommendations in a substantial number of their articles. In addition, a significant increase in suicides and similar suicides is found.

Increasing help-seeking and referrals for individuals at risk for suicide by decreasing stigma: the role of mass media

Increasing help-seeking and referrals for at-risk individuals by decreasing stigma has been defined as Aspirational Goal 10 in the National Action Alliance for Suicide Prevention's Research Prioritization Task Force's 2014 prioritized research agenda. This article reviews the research evidence on the impact of mass media awareness campaigns on reducing stigma and increasing help-seeking. The review will focus on both beneficial and iatrogenic effects of suicide preventive interventions using media campaigns to target the broad public. A further focus is on collaboration between public health professionals and news media in order to reduce the risk of copycat behavior and enhance help-seeking behavior. Examples of multilevel approaches that include both mass media interventions and individual-level approaches to reduce stigma and increase referrals are provided as well. Multilevel suicide prevention programs that combine various approaches seem to provide the most promising results, but much more needs to be learned about the best possible composition of these programs. Major research and practice challenges include the identification of optimal ways to reach vulnerable populations who likely do not benefit from current awareness strategies. Caution is needed in all efforts that aim to reduce the stigma of suicidal ideation, mental illness, and mental health treatment in order to avoid iatrogenic effects. The article concludes with specific suggestions for research questions to help move this line of suicide research and practice forward.

Newspaper coverage of suicide and initiation of suicide clusters in teenagers in the USA, 1988-96: a retrospective, population-based, case-control study

BACKGROUND

Public health and clinical efforts to prevent suicide clusters are seriously hampered by the unanswered question of why such outbreaks occur. We aimed to establish whether an environmental factor-newspaper reports of suicide-has a role in the emergence of suicide clusters.

METHODS

In this retrospective, population-based, case-control study, we identified suicide clusters in young people aged 13-20 years in the USA from 1988 to 1996 (preceding the advent of social media) using the time-space Scan statistic. For each cluster community, we selected two matched non-cluster control communities in which suicides of similarly aged youth occurred, from non-contiguous counties within the same state as the cluster. We examined newspapers within each cluster community for stories about suicide published in the days between the first and second suicides in the cluster. In non-cluster communities, we examined a matched length of time after the matched control suicide. We used a content-analysis procedure to code the characteristics of each story and compared newspaper stories about suicide published in case and control communities with mixed-effect regression analyses.

FINDINGS

We identified 53 suicide clusters, of which 48 were included in the media review. For one cluster we could identify only one appropriate control; therefore, 95 matched control communities were included. The mean number of news stories about suicidal individuals published after an index cluster suicide (7·42 [SD 10·02]) was significantly greater than the mean number of suicide stories published after a non-cluster suicide (5·14 [6.00]; p<0·0001). Several story characteristics, including front-page placement, headlines containing the word suicide or a description of the method used, and detailed descriptions of the suicidal individual and act, appeared more often in stories published after the index cluster suicides than after non-cluster suicides.

INTERPRETATION

Our identification of an association between newspaper reports about suicide (including specific story characteristics) and the initiation of teenage suicide clusters should provide an empirical basis to support efforts by mental health professionals, community officials, and the media to work together to identify and prevent the onset of suicide clusters.

FUNDING

US National Institute of Mental Health and American Foundation for Suicide Prevention.

How people bereaved by suicide perceive newspaper reporting: qualitative study

BACKGROUND

People bereaved by suicide are often reported to be distressed by media reporting. Current media guidelines for reporting suicide focus especially on prevention of copycat behaviour.

AIMS

To explore bereaved individuals' experiences of media reporting after suicide and to examine their priorities in relation to media guidelines.

METHOD

In-depth interviews with 40 people bereaved by suicide, with qualitative analysis. Review of four guidelines.

RESULTS

There is a difference of emphasis between guidance for the press that aims to prevent copycat suicides (especially avoidance of details such as method used) and the perspectives of bereaved people (who prioritise sympathetic and accurate reporting, sometimes including details of the death and images of the person who died). We found that bereaved relatives were sometimes keen to talk to the press. Those who were upset by the press focused on careless reporting, misquoting and speculation that gave an inaccurate impression of the death.

CONCLUSIONS

The Leveson Inquiry has drawn attention to the damage that can be caused by irresponsible journalism. Guidelines written to prevent 'copycat' suicides are important, but so are the needs of bereaved relatives. Because accuracy matters greatly to the bereaved, families should be able to work with an intermediary such as a police press officer to prepare a statement for the press to minimise the risk of misrepresentation.

Personal suicidality in reception and identification with suicidal film characters

The authors investigated the impact of suicidality on identity work during film exposure. Adults with low suicidality (n = 150) watched either It's My Party or The Fire Within, censored versions of these films not depicting the suicide, or the control film that concluded with a non-suicidal death. Baseline suicidality was measured with questionnaires before the movie. Identity work and identification with the protagonist were measured after the movie. Suicidality was directly associated with identity work during film dramas depicting suicide methods. The reception of suicide-related media content seems to partially depend on personal suicidality. Potential implications for suicide prevention are discussed.

Suicide coverage in U.S. newspapers following the publication of the media guidelines

A nationally representative sample of 968 local and national newspapers was examined to determine whether the 2001 U.S. media guidelines were followed in articles published in 2002-2003, and featuring individual cases of suicidal behavior (N = 157). We found that, during this period of time, U.S. newspaper suicide coverage did not consistently reflect the influence of the media guidelines. On the positive side, only 19% of stories included inappropriate imagery. On the negative side, suicide stories often detailed suicide method (56% of stories) and location (58%), and rarely provided information about warning signs and risk factors (1%), the roles of depression (4%) and alcohol (2%), and prevention resources (6%). Our findings, together with previous evidence, suggest the need for sustained dialogue with the media about suicide reporting.

Copycat effects after media reports on suicide: a population-based ecologic study

This study aimed to investigate whether the risk of increased suicide occurrence after reports on suicide is associated with the social characteristics of the reported suicides and whether this varies with similarity between the reported suicides and suicides in the population. We collected reports on all 179 individual suicides named in the 13 largest Austrian nationwide newspapers from 1996 to 2006. Information on social status and sociodemographic characteristics of the reported suicides, on certainty of labelling the death as a suicide, and on the suicide methods applied were extracted from the articles. We conducted logistic regression analyses, with the increase of post-report suicides within 28 days after the reports as dependent variable. In model 1, the increase of suicides that matched the reported individual suicide with regard to age group, sex and suicide method was used as outcome variable. In model 2, the increase of suicides that were different from the reported suicide with regard to these characteristics was the outcome. In model 3, the post-report increase of total suicides was the dependent variable. Celebrity status of the reported suicide, age of the reported suicide between 30 and 64 years, and definitive labelling as a suicide were associated with an increased risk of a post-report increase of similar suicides; criminality (i.e. the individual was reported as suspected or convicted of crime) of the reported suicide was associated with a lower risk of a post-report increase. In dissimilar suicides, none of the variables was associated with a post-report increase of suicides. Celebrity status of the reported suicide was the only predictor of a post-report increase of total suicides. The findings support the hypothesis that social variables of reported suicides impact the risk of post-report copycat behaviour. Evidence of copycat effects seemed to be strongest in suicides that were similar to the respective model with regard to age group, sex, and suicide method.

Depression moderated the effect of exposure to suicide news on suicidality among college students in Taiwan

The present study was designed to examine whether age, gender, and depression level may moderate the effect of exposure to suicide news on the suicidality of college students in Taiwan. A representative sample of 3,222 college students were recruited from Southern Taiwan with a total of 2,602 useable surveys returned. Results showed that only depression level reached a significant moderating effect and further examination showed that the exposure to suicide news significantly predicted suicidality solely in the severely depressed group.