Suicide Contagion Research Articles

Reporting on Suicide Between 1819 and 1944.

Suicide rates increased substantially in many countries during the 19th century. Little is known about news coverage on suicide in this period and its relationship to suicide rates. To test whether there was a covariation between the quantity of reporting and suicide rates and whether the press relied on sensational reporting. A content analysis of Austrian news coverage between 1819 and 1944 was conducted and compared with contemporary findings. There were similar corresponding troughs and peaks in both time series, indicative of covariation. The analysis revealed that variations in the quantity of reporting predicted the following year's suicide rates, a pattern consistent with a long-term Werther effect. Conversely, suicide rates did not predict future values of the quantity of reporting. Furthermore, the press substantially overrepresented "vivid" firearm suicides compared with other more "pallid" methods such as drowning, indicative of sensational reporting. The causal order of the quantity of reporting and suicide rates should be interpreted with caution. The press may have contributed to the establishment of suicide as a mass phenomenon in the 19th century. The contemporary comparison is indicative of temporal stability.

Suicide contagion in response to widely publicized celebrity deaths: The roles of depressed affect, death-thought accessibility, and attitudes.

Suicide contagion often occurs when a suicide death that is widely publicized (typically by the media) results in increases in suicide rates. However, the underlying cognitive and emotional mechanisms behind how and when suicide contagion occurs have been, up to this point, hazily understood. The present study: (a) tested whether individuals with depressed affect respond differently to celebrity suicides widely publicized by the media compared with those who do not have depressed affect, (b) measured 2 potential cognitive mechanisms that may be involved in suicide contagion, death-thought accessibility and attitudes about the acceptability and normality of suicide, and (c) compared responses to widely publicized suicide versus accidental death and natural death. The findings highlight a key moderator--depressive affect--that predicts the likelihood of being susceptible to suicide contagion effects following media coverage of a suicide death, clarify that its boundary conditions include cases of accidental death, and elucidate 2 cognitive mechanisms, death-thought accessibility and attitudes toward suicide acceptability and normality. (PsycINFO Database Record (c) 2016 APA, all rights reserved) Language: en

Preparing for a Sequel: ‘13 Reasons Why’ and Suicide Contagion

Preparing for a Sequel: ‘13 Reasons Why’ and Suicide Contagion

Traditional and new media's influence on suicidal behavior and contagion.

The role of nonfictional and fictional media in suicide contagion has been well established, ostensibly beginning with the publication of Goethe's The Sorrows of Young Werther in 1774. In recent decades, the emergence of several new forms of media (e.g. websites, social media, blogs, smartphone applications) has revolutionized the communication and social interaction paradigms. This article reviews "the Werther effect" (or suicide contagion related to media), special populations who are more influential or susceptible, current media reporting guidelines and their effectiveness, and the latest research on new media and its effect on suicide and suicide contagion. The aim is to update recommendations on how to mitigate the potential negative effects of both traditional and new media on suicidal behavior and suicide contagion.

Toward a Cultural-Structural Theory of Suicide: Examining Excessive Regulation and Its Discontents

Despite its enduring insights, Durkheim’s theory of suicide fails to account for a significant set of cases because of its overreliance on structural forces to the detriment of other possible factors. In this paper, we develop a new theoretical framework for thinking about the role of culture in vulnerability to suicide. We argue that by focusing on the cultural dynamics of excessive regulation, particularly at the meso level, a more robust sociological model for suicide could be offered that supplements structure-heavy Durkheimian theory. In essence, we argue that the relevance of cultural regulation to suicide rests on the (1) degree to which culture is coherent in sociocultural places, (2) existence of directives related to prescribing or proscribing suicide, (3) degree to which these directives translate into internalized meanings affecting social psychological processes, and (4) degree to which the social space is bounded. We then illustrate how our new theory provides useful insights into three cases of suicide largely neglected within sociology: specifically, suicide clusters in high schools, suicide in the military, and suicides of “despair” among middle-aged white men. We conclude with implications for future sociological research on suicide and suicide prevention.

Suicide conversations on Instagram™: contagion or caring?

ABSTRACTBackground: Suicide is a significant public health concern with approximately a million deaths from suicide worldwide each year. There is increasing evidence that media reporting of suicide can lead to imitative suicidal behaviors, and the World Health Organization's (WHO) guidelines for reporting suicides provided a framework of analysis. Given the use and reach of visual social media platforms like Instagram and the paucity of research focusing on the platform, the potential for contagion effects via a social media platform like Instagram should be considered. As such, understanding conversations about suicide on Instagram is of interest to health communicators, public health professionals, and mental health professionals alike.Method: This study examines both the visual and textual components of suicide-themed posts on social media platform Instagram. A random sample of 500 Instagram posts including the hashtags #suicide and/or #suicidal were extracted from a larger sample collected during March-June 2016.Results: Results show that self-harm was present in a majority of Instagram posts, and that posts that mention suicide ideation elicited higher engagement than posts that did not. Public health voices were largely absent from the conversation surrounding suicide on Instagram. Finally, few of the constructive WHO recommendations to prevent media contagion were visible in the study sample. These guidelines should be considered for participation in suicide-related online conversations.Conclusions: Instagram appears to be used frequently for suicide-related communications. Public health and mental health professionals should consider increased involvement on this platform, as well as application of the WHO suicide contagion media guidelines.

A Review of the Werther Effect and Depictions of Suicide: 13 Reasons Why

The purpose of this review is to evaluate what influence Netflix’s show 13 Reasons Why will have on the public in accordance with the Werther effect. The Werther effect occurs when a publicized suicide is correlated with an increase in suicides (Philips, 1974). This effect is also referred to as suicide contagion and suicide suggestion. Research about the Werther effect can be generalized to gauge the possibility and severity of a contagion effect after the release of 13 Reasons Why. Additionally, censorship and trigger warnings were analyzed as possible mitigating factors when viewing graphic suicide-related content. The limited effects of censorship and the lack of research surrounding trigger warnings have serious implications when it comes to moderating the effects of suicide contagion. Furthermore, Ayers et al. (2017) found that Google searches for “How to kill yourself” significantly increased after the release of 13 Reasons Why. Thus, it is vital that research is done about suicide rates following the release of the show. The results indicate that television shows depicting suicide are associated with an increase in suicide and that warning labels increased desire to view violent content (Bushman, 2006; Schmidtke & Hafner,1988). This review is meant to contribute to the literature on suicide contagion and gauge the impact 13 Reasons Why will have on the public.

Representing violence in cinema industries

The representation and the consumption of violence in films trace their roots down to the bio¬social and cultural-anthropological nature of the human being. This notwithstanding, the mass character of the habitual consumption of violent screen spectacle is a result of commercially predicated symbolic violence. With the example of television, presented is the escalation of screen violence in the post-Soviet period of national history. In light of the possibility for the Werther effect, materials of a sociological study (the city of Kirov, 2016) are used in considering the consumption of screen violence by urban moviegoers of the Russian heartland, the convergence of gender differences related to it, and the psychological and institutional- economical logic of the symbolic violence perpetrated by the film industry at the point of consumption. Ma¬terials of a survey among high-school students of three Russian cities are adduced for verifying the hypothesis of the existence of a risk group among screen violence consumers. It stands to reason that to propagate physical violence in real life does not constitute a purpose of film industry. However, habitual consumption of violence in films, coupled with some spectators' predisposition toward aggressive behavior (the risk group), is capable of eliciting such a dysfunction. Based on the materials of an experimental-statistical comparison be¬tween the risk group and a control group, it is shown that, for instance, the screen spectacle of gore brings forth a sensation of delight among, respectively, 84 and 21% of young movie-goers; about the punishment of a film character intent on succeeding in life by the means of violence, lamentation is experienced by 72 and 6%; to an occasional impulse to hit someone succumb 54 and 3%. These and other empirically garnered facts attest to the capacity of violence in films for impacting manifestations of physical violence in real life.

Suicide clusters among young Kenyan men.

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.

Mapping suicide mortality in Ohio: A spatial epidemiological analysis of suicide clusters and area level correlates

Previous studies have investigated spatial patterning and associations of area characteristics with suicide rates in Western and Asian countries, but few have been conducted in the United States. This ecological study aims to identify high-risk clusters of suicide in Ohio and assess area level correlates of these clusters. We estimated spatially smoothed standardized mortality ratios (SMR) using Bayesian conditional autoregressive models (CAR) for the period 2004 to 2013. Spatial and spatio-temporal scan statistics were used to detect high-risk clusters of suicide at the census tract level (N=2952). Logistic regression models were used to examine the association between area level correlates and suicide clusters. Nine statistically significant (p<0.05) high-risk spatial clusters and two space-time clusters were identified. We also identified several significant spatial clusters by method of suicide. The risk of suicide was up to 2.1 times higher in high-risk clusters than in areas outside of the clusters (relative risks ranged from 1.22 to 2.14 (p<0.01)). In the multivariate model, factors strongly associated with area suicide rates were socio-economic deprivation and lower provider densities. Efforts to reduce poverty and improve access to health and mental health medical services on the community level represent potentially important suicide prevention strategies.

Spatial clustering of fatal, and non-fatal, suicide in new South Wales, Australia: implications for evidence-based prevention

BackgroundRates of suicide appear to be increasing, indicating a critical need for more effective prevention initiatives. To increase the efficacy of future prevention initiatives, we examined the spatial distribution of suicide deaths and suicide attempts in New South Wales (NSW), Australia, to identify where high incidence ‘suicide clusters’ were occurring. Such clusters represent candidate regions where intervention is critically needed, and likely to have the greatest impact, thus providing an evidence-base for the targeted prioritisation of resources.MethodsAnalysis is based on official suicide mortality statistics for NSW, provided by the Australian Bureau of Statistics, and hospital separations for non-fatal intentional self-harm, provided through the NSW Health Admitted Patient Data Collection at a Statistical Area 2 (SA2) geography. Geographical Information System (GIS) techniques were applied to detect suicide clusters occurring between 2005 and 2013 (aggregated), for persons aged over 5 years. The final dataset contained 5466 mortality and 86,017 non-fatal intentional self-harm cases.ResultsIn total, 25 Local Government Areas were identified as primary or secondary likely candidate regions for intervention. Together, these regions contained approximately 200 SA2 level suicide clusters, which represented 46% (n = 39,869) of hospital separations and 43% (n = 2330) of suicide deaths between 2005 and 2013. These clusters primarily converged on the Eastern coastal fringe of NSW.ConclusionsCrude rates of suicide deaths and intentional self-harm differed at the Local Government Areas (LGA) level in NSW. There was a tendency for primary suicide clusters to occur within metropolitan and coastal regions, rather than rural areas. The findings demonstrate the importance of taking geographical variation of suicidal behaviour into account, prior to development and implementation of prevention initiatives, so that such initiatives can target key problem areas where they are likely to have maximal impact.

Beneficial and harmful effects of educative suicide prevention websites: randomised controlled trial exploring Papageno v. Werther effects.

BackgroundSuicide prevention organisations frequently use websites to educate the public, but evaluations of these websites are lacking.AimsTo examine the effects of educative websites and the moderating effect of participant vulnerability.MethodA total of 161 adults were randomised to either view an educative website on suicide prevention or an unrelated website in a single-blinded randomised controlled trial (trial registration with the American Economic Association's registry: RCT-ID: 000924). The primary outcome was suicidal ideation; secondary outcomes were mood, suicide-prevention-related knowledge and attitudes towards suicide/seeking professional help. Data were collected using questionnaires before (T1), immediately after exposure (T2), and 1 week after exposure (T3) and analysed using linear mixed models.ResultsNo significant intervention effect was identified for the entire intervention group with regard to suicidal ideation, but a significant and sustained increase in suicide-prevention-related knowledge (T3vT1P < 0.001, d = 1.12, 95% CI 0.96 to 1.28) and a non-sustained worsening of mood (P < 0.001, T2vT1, d = -0.59, -0.75 to -0.43) were observed. Participants with increased vulnerability experienced a partially sustained reduction of suicidal ideation (T3vT1, P <0.001, d = -0.34, -0.50 to -0.19).ConclusionsEducative professional suicide prevention websites appeared to increase suicide-prevention-related knowledge, and among vulnerable individuals website exposure may be associated with a reduction of suicidal ideation.

Mass Killings in the United States from 2006 to 2013: Social Contagion or Random Clusters?

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 14days. 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.

The Werther Effect: An Interview with Andrew Piper and Mark Algee-Hewitt

Andrew Piper (AP): It began as a collaboration. Mark was at McGill as a postdoctoral student. He had been thinking for some time about quantitative and computational approaches to literary study. T...

Why are suicide rates climbing after years of decline?

There is evidence that the increasing rates of suicide can be linked to the legalization of physician-assisted suicide. Factors such as suicide contagion and the increasing positive media reporting on such suicides are also relevant and have led to different standards of treatment for suicidal people who claim the right to have their suicides medically assisted.

A spatio-temporal analysis of suicide in El Salvador

BackgroundIn 2012, international statistics showed El Salvador’s suicide rate as 40th in the world and the highest in Latin America. Over the last 15 years, national statistics show the suicide death rate declining as opposed to an increasing rate of homicide. Though completed suicide is an important social and health issue, little is known about its prevalence, incidence, etiology and spatio-temporal behavior. The primary objective of this study was to examine completed suicide and homicide using the stream analogy to lethal violence within a spatio-temporal framework.MethodsA Bayesian model was applied to examine the spatio-temporal evolution of the tendency of completed suicide over homicide in El Salvador. Data on numbers of suicides and homicides at the municipal level were obtained from the Instituto de Medicina Legal (IML) and population counts, from the Dirección General de Estadística y Censos (DIGESTYC), for the period of 2002 to 2012. Data on migration were derived from the 2007 Population Census, and inequality data were obtained from a study by Damianović, Valenzuela and Vera.ResultsThe data reveal a stable standardized rate of total lethal violence (completed suicide plus homicide) across municipalities over time; a decline in suicide; and a standardized suicide rate decreasing with income inequality but increasing with social isolation. Municipalities clustered in terms of both total lethal violence and suicide standardized rates.ConclusionsSpatial effects for suicide were stronger among municipalities located in the north-east and center-south sides of the country. New clusters of municipalities with large suicide standardized rates were detected in the north-west, south-west and center-south regions, all of which are part of time-stable clusters of homicide. Prevention efforts to reduce income inequality and mitigate the negative effects of weak relational systems should focus upon municipalities forming time-persistent clusters with a large rate of death by suicide. In municipalities that are part of newly-formed suicide clusters and also are located in areas with a large rate of homicide, interrupting the expansion of spatial concentrations of suicide over time may require the implementation of both public health and public safety interventions.

CHERISH: Understanding Suicide Clusters tHrough ExploRIng Self Harm behaviours

ABSTRACTObjectivesIn Wales suicide accounts for 20% of deaths among men aged 15-24 years and almost 10% of deaths among women of that age. Up to 2% of suicides in young people are thought to occur in clusters. Yet, our understanding of the social and psychological determinants of suicide clusters is limited, with none of the cross-discipline theories proposed having been tested via in-depth research on an actual cluster. This HCRW funded mixed methods study had qualitative and quantitative data linkage work packages to explore here the factors that trigger a suicide cluster, cause it to continue and then eventually subside.&#x0D; ApproachThe data of 1866 individuals’ who attended the Princes of Wales Hospital emergency department (ED) with self harm between 1st January 2006 and 31st December 2013 was anonymously linked within the Secure Anonymised Information Linkage (SAIL) databank. We had a matching rate of 99.7. We performed both time-trend analysis on this data around the apparant suicide cluster in 2007-08, and a comparison across three defined populations: those attending ED at the time of the cluster; those attending during the same period, one year before; and those attending one year after.&#x0D; ResultsWe are able to present the characteristics of those who attend ED during a cluster with self harm compared to those who attend at other times and their long term outcomes.&#x0D; ConclusionTo inform the development of appropriate policy to respond to suicide clusters at an early stage.

Algeria, from social issue to self-immolation; autopsy of a “fashionable” suicide

IntroductionSelf-immolation has been practised for several centuries in some cultures. Tolerated by Mahayana Buddhism and Hinduism. It is practised for many reasons: Sati (rituals), political protests, devotion and renouncement. In addition, it is also observed in some warrior cultures, like Rajputs.The self-immolation trend began in Tunisia during government protests (“Arab spring” revolution) when a man named Bouazizi set himself on fire and died. Fiery copycat suicides spread throughout other countries. Algeria has also discovered this form of protest and faced a wave of self-immolation considered by some commentators to have reached epidemic proportions.ObjectiveOur goal is to show the kind of support that political and health authorities, with the help of psychiatrists, are trying to set up in order to achieve efficient prevention.MethodsIn a case-control study, 20 consecutive case of deliberate self-inflicted burns admitted to the regional burn centre (Douera Hospital, Algeria) were compared with 20 controls who were selected from the community and matched by sex, age and living area. Diagnostic and statistical manual of mental disorders (DSM IV) Axis I (clinical disorders) and Axis II (personality and mental retardation) diagnoses were assessed via detailed clinical interview.ResultsThere have been 69 cases of self-immolation, with an average age of 26 including 87% of men and from which 13% with a psychiatric history. Unemployment and housing crisis are the most common causes. Here, we will provide specific explanations about our country.ConclusionIt turns out that self-immolation is an extreme form of protest against the social malaise to make things change and does not due in the most cases to mental disease.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

Cluster Suicides Among Unemployed Persons in Australia Over the Period 2001–2013

There has been no research on whether particularly vulnerable people such as the unemployed are prone to being in a suicide cluster (defined as an unusually high number of suicides occurring in a defined geographical area and/or over a relatively brief period of time). We investigated the presence of unemployed suicide clusters in Australia over the period 2001–2013 using a Poisson discrete scan statistic approach. Spatial, temporal and spatial/temporal clusters comprised 13.4, 4.4 and 1.7% of all unemployed suicides respectively. These results suggest the importance of targeting preventative efforts in where large numbers of unemployed persons who have died by suicide resided before death.

“We Don’t Cover Suicide … (Except When We Do Cover Suicide)”

Unlike many other unnatural deaths, suicides are occurrences that journalists often hesitate to cover. “Our policy is not to write about suicides,” many journalists say. Except that often they do. This article, based on interviews with 50 US journalists, examines the rationales that journalists invoke as they decide whether to cover a suicide. This can be a high-risk decision because of the potential for suicide contagion and copycat effects. We conclude that in making a decision to cover a suicide, journalists go through a process of routinizing what, at the outset, they had considered an exceptional situation. This routinization provides a means to rationalize covering a death that they often say they would prefer to ignore.