Motives For Suicide Research Articles

Suicide motives: comparison of assignment of motives by coroners and psychologists.

The accuracy of information contained in coroners' records of suicide obviously affects the validity of data reported in ex post facto suicide studies. The reliability of coroner-assigned suicide motives has been questioned by Shneidman and Farberow (1961) on the basis that coroners' investigators lack sophistication in behavioral research methodology. Andress (1976) suggested that coroners tend to over-assign the motive of Depression/Despondency because they view suicide as a symptom of depression. The present study compared coroner- and psychologist-assigned motives in 166 suicides committed in Riverside County, California between January, 1973 and June, 1974. A Spearman's rank-order correlation of .81 between motives assigned by coroners and psychologists was obtained. Depression was assigned by coroners significantly more often than by the psychologists. The psychologists assigned marital difficulties and sexual problems significantly more often than did coroners. Because of a high percentage of interobserver agreement, it is suggested that more confidence in coroner-assigned motives may be warranted.

Students and suicide: An interpersonal tragedy

Suicide is not peculiar to any age group, sex, background or geographic area. Anyone is a potential victim. Still, warning signs of the impending action are disregarded. Although educators come into daily contact with scores of students, their perceptiveness in distinguishing alarming suicidal tendencies and their ability to react appropriately is noticeably inadequate. Discussion of suicide is virtually ignored in schools. A paucity of available information is just one indicator. Since so few people actually witness a suicide, the need to become more knowledgeable about the topic seems senseless. Informed educators realize, though, that the influences prompting suicide are far greater than previously imagined. The contention, for example, that a person who threatens suicide is least likely to commit it, is fallacious. Current statistics demonstrate that the suicide rate is rapidly increasing. Once every minute someone attempts suicide and sixty or seventy times a day these attempts succeed. It is reported that in the United States some 25,000 persons yearly take their lives.' Among young people between fifteen and nineteen years of age, suicide is the third leading cause of death. The Yale University School of Medicine has estimated that self-destruction accounts for eight to twelve percent of deaths among college students.' The figures are growing steadily. Frequency of suicide increases with age. Self-inflicted death is rare among children below fifteen. The curve enlarges sharply from 3.6 per 100,000 in the 15-19 group, to 27.9 per 100,000 in the 75-84 age bracket.3 Ranking fourth as the cause of death among adolescents, it has become second among college students, surpassed only by accidents.4 Motives for suicide are complex and often hidden. Serious illnes, loss of a close loved one, family problems, depression and an inability to adapt, are just a few causes. The real reasons are very often destroyed with the individual. Surprised family and friends react in a similar manner: I would have never expected it from him. Nevertheless, it is rare that a likely suicide gives no clues ot his forthcoming death. When a student is severely depressed, feeling that life is full of despair with no relief in sight, the though of suicide is a welcome alternative. As trite as a student's difficulties appear to onlookers, their personal perspective dictates events. An individual's external appearance may bear little resemblence to what is actually internalized. Threats and attempts, however, are desperate cries for help. Instead of being an impulsive action, suicide ends a series of personal defeats. Suicides are not necessarily the result of a truly desperate situation. Countless suicides actually occur in seemingly less critical circum-

Suicide—The Other Side

A prevalent feature of many investigations of suicide is a degree of recoil from true empathic closeness to a suicidal person. The motives for this lie within the investigator's own dynamics--they are anxiety over one's own suicide proneness, together with guilt, shame, contempt, and the avoidance of medicolegal involvement. These motives are not altogether unrelated to the suicidal motives themselves, and they hamper the capacity of objective, neutral assessment. With a recognition of these resistances, the seldomly mentioned realistic determinant of suicide becomes discernible, the act sometimes being a clever, courageous choice of death, and not, as usually diagnosed, a pathologically generated escape from life. All suicidal motives should be evaluated according to several concomitant ratings simultaneously, while emphasizing the realistic rating. A neutral, unbiased approach to suicide should reduce the dangerous false glory sometimes attributed to the act, thus contributing to the discrimination of sickness, therapy, and health.

Suicides committed by minors

The bodies of 76 minors, below 18 years of age, who died as a consequence of committing suicide during the years 1960 to 1974 were examined in the Institute of Forensic Medicine in Cracow. The youngest victim was a boy 8 1 2 years of age. The majority of cases (63) referred to minors aged 16–18. The deaths were due to: hanging (41 cases), poisoning (17 cases), leaping from a height (7 cases), and others (11 cases including one case of self shooting). Among the motives for suicide the first place is taken by personal troubles, mostly school failures, then bad health and family conflicts. Prior suicidal attempts were noted in 13 cases and in 10 others oral declarations of suicide were made. Motives for suicide essentially differ from those found in earlier studies from the years 1881–1939, where ill luck in love and undesired pregnancy were treated as one of the important factors leading to suicide.

The use of suicidal motives in the psychotherapy of attempted suicides.

Patients' reasons for their suicide attempts were categorized and related to levels of hopelessness and depression. The findings are discussed in the light of the psychotherapy of suicidal individuals.

Capital punishment as suicide and as murder.

Capital punishment may actually contribute to the incidence of murder because it can be sought as a result of suicidal motivations, and because it sets a malignant example of the use of killing as a legitimate coping device. Two case studies are offered as illustration.

A study on suicide.

From approximately 15,000 consecutive medicolegal autopsies, a series of 764 completed ‘suicides’ has been collected and studied. When analysed, this series revealed three principal types of self-destruction and the important difference between ‘attempted’ and ‘completed’ suicide. Motivation for suicide, medical treatment, family relationship, and alcohol have also been discussed. Still further, while the Registrar-General's figures reveal a considerable reduction in the rate of suicide at a time when it has been escalating—these ‘missed suicides’ are fully explored.

Comment on Faber's analysis of Jocasta's suicide in "Oedipus Rex".

Faber (1970) has analyzed the suicidal behavior in Sophocles' plays and noted that it illustrates the psychodynamics of suicide as proposed by Freud. An individual is angry at someone but unable to express the anger, and so turns it inward onto himself. For example, Oedipus, prior to enucleating himself, seems intent on killing Jocasta. When he finds her dead, his frustrated anger is turned inward onto himself. Faber interprets Jocasta's suicide in the same way. Jocasta is in desperate passion and cries aloud to her first husband. Faber sees Jocasta as reproaching Laius for his role in the tragedy and for abandoning her. Jocastn's suicide is motivated in part by the frustrated anger toward her dead husband. The thesis of this note is that the motivation for Jocasta's suicide may be open to an alternative interpretation. As Faber himself has noted, not all of Sophocles' suicides fit the pattern (Antigone, for example). It will be argued here that Jocasta may not fit the pattern either. The Greek original is by no means clear. 6py i j Xpwpiy (Storr, 1912) means to indulge one's emotion, and this emotion may be any violent emotion. Though commonly anger, it could just as well be anguish. Kahei means to call by name and carries no connotation of emotion. Jocasta calls out to Laius, therefore, not necessarily in anger bur possibly in anguish and helplessness. Laius was her first love, husband, and the one to whom she turned for support in her youth. In this time of distress, she turns to him again. Laius cannot join her to give her support, but she can join him through death. Her reunion fantasy (Greenberg, 1964) becomes a reunion. Suicide is particularly common after loss (MacMahon B: Pugh, 1965), a fact noted by Freud. Jocasta has lost two husbands, the first through murder and the second when he proved to be her son. This second loss may re-activate the trauma of the first and may be sufficient to propel1 her toward that relatively rare event-the taking of one's own life.

Psychotropic Drugs In Addiction

To the Editor.— I feel moved to take exception to Dr. Blackwell's article, Psychotropic Drugs in Use Today, when he states the lack of abuse of diazepam (225:1637, 1973). Anyone like myself, who runs a drug treatment program, especially with methadone maintenance, knows of addictive abuse of these products. I would judge at least 30% of my patients have abused diazepam and a number of them had to be gradually withdrawn from dosage of 40 to 80 mg daily. They suffered severe withdrawal symptoms. Because of the central nervous system depressant action, diazepam also potentiates the depressant effect of methadone and makes for a very unmanageable patient. I have seen this same depressant effect on patients other than addicts. We have all seen suicides in people robbed of their own defense mechanisms, after having their anxiety removed by diazepam. Consequently, unprotected against their depression, they succeed in their suicidal motives.

Epidemiological differences between white and nonwhite suicide attempters.

Using the Monroe County (N.Y.) Psychiatric Case Register, a stable data source, the authors attempted to determine differences between white and nonwhite suicide attempters, to identify the factors that are associated with self-destructive behavior in both groups, and to determine the subsequent mortality rate among suicide attempters. They found a number of differences between whites and nonwhites and conclude that the motivation for suicide, the techniques used to treat attempts, and the degree of risk of further psychiatric difficulty may be different for the two groups.

Suicide and Dangerous Sports: Parachuting

To the Editor.— Suicide can often be carried out in a manner that facilitates disguise of the suicidal intent. The possibility of suicidal intent in some motor vehicle accidents has been noted, 1 and some interesting data have recently been published by Poynter concerning fatalities in parachute jumpers. 2 In 1969, 37 parachute jumpers were killed during or as a result of their jumps. Of these fatalities, many are due to malfunctioning equipment, errors in judgment, and inexperience. In other cases the possibility of suicidal motivation is clearer. Poynter thought that one death was clearly suicidal. Two other deaths occurred in men who had a history of drinking and who may have been intoxicated at the time of the jump. Of the 37 deaths, ten (including the three mentioned above) involved failure of the parachutist to pull either ripcord in order to activate the chutes. Given an estimate of 16,000

Do Blacks Hate Themselves?

The social science literature on Negro psychology contains a rather striking paradox. On the one hand, social scientists, the author of this book included, have assumed that racial prejudice and discrimination by whites have resulted in self-hatred among Negroes. On the other hand, there is little empirical evidence, comparing blacks with whites, indicating that blacks do hate themselves more than whites. One set of comparative evidence, suicide rates, suggests that currently held assumptions concerning Negro self-hatred are incorrect. The black suicide rate is lower than the white suicide rate. Herbert Hendin begins this study of black suicide by noting one exception to the nationat statistics. Among black males between the ages of 20 and 35 in New York City the suicide rate is twice that among white males of the same age. Further, he notes that there has been an increase in the black suicide rate between 1950 and 1960. At least some of this increase can be accounted for by the official redefinition of suicides. Since 1958 victims of falls from buildings have been classified as suicidal. "Between 50 and 60 per cent of the black suicides in New York each year are by jumping." There is, as Hendin notes, the problem that some of these were either pushed or fell by acident. It remains that the rate is higher among this age group, and it is this fact which Hendin hopes to understand and to explain. The major theoretical point underlying this volume is that suicide does not have the same meaning nor the same antecedents in different societies or subcultures. Suicide, Hendin argues, is a culturally defined psychological phenomenon. Thus, suicide cannot be understood or explained by using broad cross-cultural factors such as social integration, group solidarity and the like. His book is an attempt to document the unique meaning and cause of suicide among blacks in America. In order to describe the indigenous black meaning of suicide, Hendin interviewed 25 Negroes who attempted suicide. "Usually 7 or 8 visits were sufficient, although in one, 15 visits were necessary." There is some question as to the adequacy of this "sample" of patients. Most obviously the people interviewed had only attempted suicide--none were successful. While attempting and completing suicide are related phenomena, there is some question as to whether or not they are causally identical. Beyond this, as we have already noted, between 50 and 60 per cent of the black suicides in New York are the result of iumping from buildings. Of the patients included in the study only four of the 25 jumped. Three of these four were females. Thus, even if one is willing to equate victims from building falls with suicides, and therefore grant the higher rate among black males in New York City, it is clear that this group of patients is not typical of New York black suicide victims. The conclusion of the study contains no surprise, especially to one who noticed in the preface that Hendin had studied under Abram Kardiner (Coauthor with Lionel Ovesey of The Mark of Oppression). Hendin, closely following his mentor, writes: The American Negro's life history, character, and motivation for suicide are inseparably linked to the experience of being black in our culture.

7. Europe

Based on case histories of patients suffering from endogenous depression and from schizophrenia admitted to an Austrian mental hospital during the last hundred years, LENZ identifies and contrasts basic universal features in these two psychoses with clinical manifestations influenced by Zeitgeist, culture and religion. He supports his view regarding milieu determined variability of some symptoms in these two mental disorders by observations made and differences noted in other cultures. A similar study confined to depressive states, and as far as these are concerned, arriving at similar conclusions has been carried out by LAUTER and SCHÖN at a German University Clinic. HELGASON compared his findings regarding the frequency of mental disorders in Iceland with those previously obtained by Fremming on the island of Bornholm. HENDIN contrasts differences in the frequency of and motivations for suicide in Denmark, Sweden and Norway. BASTIDE and RAVEAU studied problems of acculturation in three categories of French speaking Africans residing in France: long-term students, students who had come for a short period, and married workers. Pentecostal sects, according to KIEV, flourish among West Indian immigrants in Britain. He studied the important role played by these sects in religious healing both of physical and emotional disorders. In a second article, jointly with FRANCIS, he reports three psychiatric cases in members of the Subud sect.

1. Asia

On comparison of the prewar, wartime, and postwar periods, two Japanese psychiatrists, ASAI and HASUZAWA, independently observed significant chan ges in the content of delusions of their schizophrenic patients. The changing contents reflected social events and changes. According to DE Vos suicide in Japan is closely bound up with cultural attitudes towards the family; it is likely to occur in those who hold the cultural beliefs most strongly. By contrast, delinquency appears to have few specifically Japanese features, and to arise mainly in those who have least internalized their cultural tradition. The rele vance of family interdependency, a typical feature of Japanese social organiza tion, to the frequency of and motivation for suicide is also emphasized in the studies by SAKAMOTO and KASAHARA and in studies of double or family suicides by OHARA. SHIKANO and OKONOGI attribute the readier acceptance of the psychoanalytic approach to the treatment of the mentally ill in the postwar period to a change in Japan's socio-political structure and the concurrent change in cultural values. CERNY reports on the treatment of the mentally ill in the People's Republic of China; apart from methods also used in the West, traditional procedures are employed by shamans and also within the framework of scientific medicine. Nineteen patients suffering from Koro came under YAP'S observation. He describes their characteristics and attributes this syn drome to a localized depersonalization of the penis.

Automobile accidents, suicide and unconscious motivation.

Thirty alcoholic and 30 non-alcoholic Patients were evaluated to determine past serious suicidal preoccupation or previous suicidal attempts. These data were correlated with the total number of automobile accidents for which the patient was responsible. The 33 patients deemed to be suicidal averaged 2.70 accidents per patient whereas the 27 non-suicidal patients averaged 1.30 accidents. In the 30-patient alcoholic group, the 17 suicidal patients were responsible for 63 accidents, whereas the 13 non-suicidal patients were responsible for 24 accidents, yielding mean values of 3.70 and 1.77 accidents per person respectively. These differences were statistically significant. Due to the accepted and real hazards of driving, the automobile constitutes an ideal self-injurious or self-destructive instrument, particularly for persons intent upon camouflaging their suicidal motivation from others–and from themselves. With one exception, all patients believed their traffic accidents were fortuitous. Alcohol intoxica...

An unusual case of suicide: Three through-and-through bullet wounds of the heart

The unusual feature of the case presented is the multiplicity of bullet wounds of the heart, self inflicted, any one of which would appear to be immediately fatal. The motives for suicide were apparently poverty and far-advanced pulmonary tuberculosis. Penetrating wounds of the heart may heal spontaneously and death may occur later from another cause independent of the former heart injury.

Some aspects of suicide

1. That, excluding the insane, all suicides are psychasthenics and introverts and in many of them there is a marked element of hysteria interwoven in their natures. 2. That the predominant underlying factors are a narrowing of the field of consciousness and a fixed idea. 3. That when they commit the act they are probably suffering from a functional insanity, very often of physiological origin, and so difficult to detect, which explains the instances of so-called sane suicides. Finally, is suicide ever justifiable? May not the desire to escape from physical suffering or social or financial ruin be urged as a legitimate motive for suicide? To the orthodox thinker such an admission would strike at the very foundations of the moral law which he believes depends not upon the judgments of creatures, but upon the order intended by the Creator.

Suicide in the Plays of Shakespeare

In an essay on Sophocles and Shakespeare, the late Professor John Churton Collins makes, about the latter's use of the motive of suicide, some striking remarks which have hitherto, I believe, been allowed to pass unchallenged. The attitude of the two dramatists toward the crime is, he says, exactly similar:“By neither of them has any glamor of sentiment been cast over it. In no case is it associated with honor, but in all cases with intemperance or ignominy, or with both. … In the suicide of Ajax, the one instance in which Sophocles has represented suicide as a deliberate act, what impresses us throughout is the utter demoralization of the victim… . Labouring at first in a turbid storm of frenzy, he regains self-mastery only to reduce to the dominion of a perverted will an anarchy of conflicting emotions—rage, shame, remorse, pity, grief—perishing desperately, a laughing stock to his foes, a source of sorrow and reproach to his friends. So perish Shakespeare's Romeo and Juliet, Brutus, Cassius, Titinius, Cleopatra, Antony, Enobarbus, Goneril, Othello, and, it would seem, Lady Macbeth. In none of these cases is self-destruction associated with anything but intemperance or retribution. ' The foul'st best fits my latter part of life,' exclaims Enobarbus; and it is remarkable that the poet should have put into the mouth of Brutus, the noblest of those who fall by their own hands in the tragedies, not merely a condemnation of the act generally, but a condemnation of the one suicide which tradition has universally glorified, and which even Bante appears to have excepted from the catalogue of crimes:I did blame Cato for the deathWhich he did give himself; I know not how,But I do find it cowardly and vile,For fear of what might fall, so to preventThe time of life: arming myself with patienceTo stay the providence of some high powersThat govern us below.Hamlet's remark in his famous soliloquy will occur to every one, but still more striking are the words in which Gloucester expresses his thankfulness that he has been saved from such a crime:You ever-gentle gods, take my breath from me;Let not my worser spirit tempt me againTo die before you please.