Suicide and reputation damage

Perceived reputation moderates the link between honor concerns and depressive symptoms

Prior research has shown that U.S. cultures of honor have higher rates of depression and suicide. While links between honor endorsement and suicide have been established in the literature, a direct test of the primary mechanism underlying this association (reputation damage leading to depression) has not yet been tested. The current study sought to address whether shifts in perceived reputation might be associated with higher levels of depression for honor endorsing individuals. An online sample of 305 participants were tracked across two time points, assessing perceived individual reputation and perceived family reputation, as well as depressive symptoms. Analyses revealed that higher levels of honor concern at Time 1 were linked with higher levels of depressive symptoms at Time 2, but only for those with low perceived reputation - these relationships held while controlling for the stability in reputation and depression across time points, as well as controlling for participants' gender. Findings provide the first empirical evidence that reputation damage may contribute to detriments in mental health in honor endorsers.

Size Estimation of Under-Reported Suicides and Suicide Attempts Using Network Scale up Method

Objective:

To estimate (under reporting) UR of SDS (Suicide deaths) and SAS (suicide attempts) in Kermanshah Province which is among provinces with high suicide rate in Iran.

Methods:

For estimating the size of UR suicide death registers, all cases of SAS and suicide deaths were retrieved from forensic medicine and health centers. Then, using network scale up method, a sample of 500 cases, aged 18 to 65 years, were randomly selected from the general population on the basis of age - sex proportion. To find the 95% confidence interval, bootstrap technique was used.

Results:

 The average coverage of SDS was 58.4%, the lowest and highest coverage rate of SDS were attributed to self-immolation (34.2%) and hanging (81.2%), respectively. The coverage rate of SAS for self-immolation and deliberate self-poisoning were 82.4% and 77.2%, respectively. Size estimation of SAS by NSU method revealed that deliberate self-poisoning with medication (61.7%), poisoning with toxins and chemicals (20.6%), and self-immolation (7.7%) were the most frequent methods of SAS.

Conclusion:

Given the low coverage of suicide registers, all causes of death, especially deaths classified as accident or deaths with undetermined category, are required to be accurately registered. Investigations of causes of death, correction of wrong codes, as well as interviews with survivors to give them assurance can reduce the rate of suicide denial and result in increased accuracy of death register coverage.

Suicide: What the General Public and the Individual Should Know

Background

The predominant, current western view is that all suicide is the result of mental disorder. This view is much too narrow and does not admit extensive information regarding the social, economic, and forensic factors (among many others) which may contribute to completed suicide. A consequence of this narrow view is that prevention strategies mainly focus on the detection and treatment of mental disorder. A preferred approach is to place greater emphasis on public health approaches to suicide prevention.

Objective

To develop and suggest a body of information which may be useful in a public health approach to suicide.

Conclusion

It is suggested that the following be available to the general public: i) suicide is a fact of life which should be minimised, ii) suicide has many different triggers, iii) most people who take their lives are able to make decisions, and iv) increased public discussion and understanding of suicide is desirable. Five pieces of information that may be useful to those contemplating suicide include: i) don’t murder the part of you that wants to live, ii) suicide actions may leave you alive but disabled, iii) suicide hurts other people, iv) suicidal impulses do pass if you hold on, and v) suicide is a waste.

Cultural Differences in Shame and Guilt as Understandable Reasons for Suicide

According to the World Health Organization, a major barrier to suicide prevention work is the social stigma surrounding suicide. Since clinical research has long shown that shame and guilt are often involved in suicide and suicide ideation, the present two studies explore the extent to which individuals associate shame and guilt with suicide ideation and behavior according to their cultural background. Using a scenario approach, 1,147 Americans in two separate studies read about a traumatic situation in which the target person experienced intense shame or intense guilt. A mini meta-analysis of these studies showed that all participants were more likely to link the experience of shame to suicidality than guilt. Additionally, participants from U.S. dignity states were more likely to report suicide ideation when the target experienced guilt as opposed to shame. Our findings support the notion that the centrality of the emotions of shame and guilt varies relative to the social context, which has implications on how others perceive suicide.

Estimation of the rate and number of underreported deliberate self-poisoning attempts in western Iran in 2015

OBJECTIVES

Rates of attempted deliberate self-poisoning (DSP) are subject to undercounting, underreporting, and denial of the suicide attempt. In this study, we estimated the rate of underreported DSP, which is the most common method of attempted suicide in Iran.

METHODS

We estimated the rate and number of unaccounted individuals who attempted DSP in western Iran in 2015 using a truncated count model. In this method, the number of people who attempted DSP but were not referred to any health care centers, n₀, was calculated through integrating hospital and forensic data. The crude and age-adjusted rates of attempted DSP were estimated directly using the average population size of the city of Kermanshah and the World Health Organization (WHO) world standard population with and without accounting for underreporting. The Monte Carlo method was used to determine the confidence level.

RESULTS

The recorded number of people who attempted DSP was estimated by different methods to be in the range of 46.6 to 53.2% of the actual number of individuals who attempted DSP. The rate of underreported cases was higher among women than men and decreased as age increased. The rate of underreported cases decreased as the potency and intensity of toxic factors increased. The highest underreporting rates of 69.9, 51.2, and 21.5% were observed when oil and detergents (International Classification of Diseases, 10th revision [ICD-10] code: X66), medications (ICD-10 code: X60-X64), and agricultural toxins (ICD-10 codes: X68, X69) were used for poisoning, respectively. Crude rates, with and without accounting for underreporting, were estimated by the mixture method as 167.5 per 100,000 persons and 331.7 per 100,000 persons, respectively, which decreased to 129.8 per 100,000 persons and 253.1 per 100,000 persons after adjusting for age on the basis of the WHO world standard population.

CONCLUSIONS

Nearly half of individuals who attempted DSP were not referred to a hospital for treatment or denied the suicide attempt for political or sociocultural reasons. Individuals with no access to counseling services are at a higher risk for repeated suicide attempts and fatal suicides.

Suicide is preventable, sometimes

OBJECTIVE

The objective was to examine the assumption that suicide is inevitably preventable.

CONCLUSIONS

Suicide may not always be avoidable. This does not mean that every effort should not be made to prevent it or vigorously treat illnesses that are often contributory. The assumption, however, may give rise to undue optimism, and unjustified blame when suicides do occur.

The suicide of Adam Czerniakow

OBJECTIVE

The aim of this article is to describe the circumstances surrounding the suicide of Adam Czerniakow during the Holocaust.

METHOD

Examination of Czerniakow's (translated) diary and other Holocaust literature.

RESULTS

Head of the "Judenrat" (Jewish Council) in the Warsaw ghetto, Czerniakow had the impossible task of obeying oppressive German orders, while trying to serve and protect his people. Following instruction to have ready for deportation from the ghetto several thousand Jews each day, Czerniakow took his life. Although Czerniakow may not have known the precise destination of those deported (they were sent to death camps), he is believed to have held grave fears for their fate.

CONCLUSIONS

Suicide in the context of avoiding having to perform an unacceptable task is not commonly recorded, but may have applied in Czerniakow's case and was not infrequent among Judenrat members.

Suicide in Old Norse and Finnish folk stories

OBJECTIVE

The aim of this study was to examine the folk stories of Norway, Iceland and Finland with a view to discovering accounts of suicide as an escape option from intolerable predicaments, and to compare any such accounts with material from Southern Europe.

METHOD

The Poetic Edda (Norway/Iceland) and The Kalevala (Finland) were examined for accounts of suicide, and evidence regarding the influence of these texts and individual accounts was collected.

RESULTS

The Poetic Edda provided one account and The Kalevala three accounts of suicide performed as a means of escaping intolerable situations. Both the Poetic Edda and The Kalevala are in public awareness and have influenced the politics and culture of their respective regions. The individual suicides have been depicted in literature, music and the visual arts, from the distant past to the present time.

CONCLUSION

Suicide as a means of escape from intolerable predicaments has been public knowledge in these regions for a millennium. This is consistent with findings from Southern Europe and substantiates that intolerable predicaments may lead to suicide.

The suicidal desire of Tolstoy

AIM

To explore whether a healthy, successful individual may experience suicidal desires.

METHOD

Examination of "A Confession" by Leo Tolstoy.

RESULTS

Confirmation that a physically and mentally healthy, well resourced individual may experience suicidal desires.

CONCLUSION

To reduce suicide rates, a broader understanding of the factors which contribute to suicidal desires is required.

Suicide by couples from the public record

OBJECTIVE

The aim of this paper was to examine accounts on the public record of suicide by couples, with a view to extending our clinical understanding of such events.

METHOD

A collection of print reports was examined and a web search was conducted. Cases were generally only accepted when the names, ages, locations and method of death of the individuals were provided, along with sufficient detail to convey the rudiments of the social and physical setting. Cases were then arranged into groups and classified using a typology of suicide.

RESULTS

Twelve cases were identified which provide valuable insights into the lives of couples who suicide. We found 11 married female-male couples and one female-female couple. A large group (seven couples) was characterized by severe or terminal illness in one or both partners. A small group (three couples) was characterized by serious legal problems. One couple was grieving the loss of an only child, and one example involved a psychotic individual, folie a deux and consequent social stressors. The terminal illness group, the legal difficulties group and the bereaved couple could be classified as 'Type 3 suicide' according to the first author's suicide classification. The case involving the psychotic individual and consequent social stressors could be classified as a combination of Type 1 and Type 3 suicide.

CONCLUSION

Reports on the public record of suicide by couples provide valuable insights into the lives of participants, and their suicides could be grouped (terminal illness, legal difficulties, other) and classified using a typology.

Two cases of 'Type 3' suicide

OBJECTIVE

The aim of this paper was to examine two cases of suicide (apparently 'Type 3', according to a new classification) by individuals without high public profiles that appeared in the press in February 2010, and to determine shared characteristics.

METHOD

All the available public record evidence was examined. Comprehensive accounts of the events of the lives of the individuals were compiled, and a comparison of characteristics was performed.

RESULTS

Andrew Joseph Stack III and Brodie Rae Constance Panlock differed in country of residence, gender, age, and marital, parenting, educational and employment status. However, neither manifested evidence of a mental disorder and both were in a predicament created by external factors. They met criteria for Type 3 suicide (suicide when there is no mental disorder and the predicament to which the individual is exposed is very clear to the observer).

CONCLUSION

These cases support the concept of Type 3 suicide. Apart from the absence of mental disorder and the presence of an external predicament, there were no other shared characteristics, suggesting that Type 3 suicide is not restricted to a particular group.

An observer's typology of suicide

OBJECTIVE

The aim of this study was to present a typology of suicide which may assist in future thinking about suicide.

CONCLUSION

A typology is described in which suicide is conceptualized as the result of a predicament (an uncomfortable set of circumstances from which there are limited escape options). Two predicaments are proposed, one when mental disorder is present and is the driver of completed suicide, and the other when mental disorder is absent, and environmental factors are the drivers of completed suicide. Each predicament is divided into two boxes according to the view of the observer, one in which the predicament is very clearly, and the other in which the predicament is less clearly the driver of the suicide. Examples are provided.

Two models of suicide

Objective: The aim of this paper is to present two models of separate but related aspects of suicide, developed with a view to improving understanding and management of this behaviour. Conclusions: First, the predicament model of suicide posits that all suicide represents an escape from a predicament and associated distress. Predicaments are composed of either external (environmental) or internal (mental disorders) factors, or both. Suicide occurs when a threshold is exceeded on a suicide risk ladder, and the degree of movement toward the threshold in response to a particular stressor depends on a range of factors. Second, the suicide pathways model integrates medical and sociological concepts, with distress as the central component, and three run-offs: mental disorder, medicalized and a non-mental disorder (egoistic/anomic; reaction) suicide.

Predicament suicide: concept and evidence

OBJECTIVE

The aim of this paper is to introduce the term 'predicament suicide' and add to the evidence that suicide may occur in the absence of Axis I diagnoses.

METHOD

The term 'predicament suicide' was described as suicide which occurs when the individual without mental disorder is in unacceptable circumstances from which they cannot find an acceptable alternative means of escape. Accounts of suicide that satisfied these criteria, and could be illustrated by images, were sought.

RESULTS

Four accounts were identified: Ajax, Brutus, Mayor Freyberg and Commander Donnicke.

CONCLUSIONS

Predicament suicide appears to be a useful designation. This work added evidence indicating that suicide may occur in the absence of an Axis I mental disorder.