Suicide Contagion Research Articles

The Werther effect reconsidered in light of psychological vulnerabilities: Results of a pilot study

Findings from three decades of epidemiological studies suggest that media diffusion of stories about suicide is related to increases in suicidal behaviours in the population exposed to the media reports. However, we still know little about the psychological processes and personal vulnerabilities that prompt some people to engage in suicidal behaviours after exposure to media presentations of suicides. This cross-sectional study explored the possible impact of exposure to film suicide in normal young people. Undergraduates from a university (mean age 23 years) completed a questionnaire on exposure to suicide portrayal in fictional films, in which assessment of negative emotional and cognitive reactions resulting from exposure, as well as emotional reactivity, dissociation, thought suppression, and suicidal tendencies were made. Of the 101 participants, 70% reported being distressed by the portrayal of a suicide in a fictional film. Among those, 33% stated they felt distressed about the portrayal for several days to several weeks. The majority of the affected participants (71%) indicated having been mentally preoccupied for some time by the portrayal and experienced intrusive memories (68%). Emotional reactivity and dissociation tendencies were significant predictors of the negative reactions to the suicide film they viewed. Participants who reported that the idea had crossed their mind to imitate the suicidal protagonist in the film were 3.45 times more likely to be suicidal and tended to present higher dissociation and thought suppression propensities compared to those who did not report these thoughts. The results showing possible influences of suicide portrayal in fictional film on suicide related cognitions were based on a survey methodology. Results suggest that fictional suicide portrayals in the media may have a deleterious impact on viewers, and such impacts do not appear to be limited to people having a clinical profile of mental disorders, as previously assumed by researchers in the field.

The Psychological Effect of Media Report on Suicidal Behavior

The mass media play a substantial role in how they influence the public’s understanding and interpretation of suicidal behavior. The impact is obviously seen on those who intend to commit suicide. According to the theory of social learning, improper repots may lead to more suicides while proper reports can help people to cherish their lives. Hence, it is very important for mass media to pay attention to skills of how to report suicidal behaviors. The media can play a significant role in suicide prevention rather than suicide contagion.

P03-443 - Risk factors for suicidal behavior in adolescents from European countries with different suicidal rates: The possible role of cross-cultural differences

IntroductionAdolescence is a time of developmental shifts that may leave young people especially vulnerable to suicidal behaviour. Suicidal rates in different European countries differ, which may be due to many factors, including cross-cultural differences.AimsWe aimed to explore differences in risk factors for suicidal behaviour (poor subjective health and low life satisfaction, health-related behaviours, including alcohol drinking habits, family and peer factors) between European countries with different suicidal rates.MethodsThe data were collected through questionnaires in the survey ‘Health Behaviour in School-aged Children’, 2005/2006, using nationally representative samples of 15 year old students (N = 11,093) from 7 countries (Lithuania, Finland, Ireland, Slovenia, Norway, Italy, Greece).ResultsPrincipal component analyses were used to characterize how selected risk factors for suicide cluster together into factors. Differences for these factors were compared between 3 groups of countries: countries with low, average and high magnitude of suicidal rates (SDR; suicide death rate per 100 000, 15–29 years). Between group differences on first two factors, loaded by items measuring health-related behaviours, were significant and medium-sized and indicated cultural differences in alcohol use. Youth from Northern European countries - with high SDR, reported greater number of drunkenness occasions, whereas frequency of alcohol intake was greater for youth from Southern European countries - with low SDR.ConclusionsResults indicated a possible association of suicidal behaviour and different drinking cultures, arising from different geographical locations and socio-cultural environments. Therefore research and preventive measures should consider specific socio-cultural context.

Inside the outbreaks: the elite medical detectives of the Epidemic Intelligence Service

The book describes the history of the EIS in 3 segments, including the ‘‘Grand Adventures of Dr. Langmuir’s Boys,’’ covering the inception of the program through 1970; the ‘‘Golden Age of Epidemiology,’’ dealing with changes in the organization and presenting short histories of some of the outbreaks that EIS officers evaluated through 1982; and ‘‘Complex Challenges,’’ covering more recent events in the program’s history from 1983 to the present. Short chapters in each section focus primarily on the facts of various epidemics, the geopolitical climates that influenced the investigations, and the reporting of the investigations. The quotes included from the field officers give the stories a fictional and dramatic character and draw readers into the accounts of the outbreaks. Although I read most of the book in 2 sessions, this text could be read in segments without critical loss of flow. Each of the short chapters stands alone and provides interesting factual reading and substantial entertainment for fans of field epidemiology. Chapter 21, ‘‘Into the Twenty-first Century’’ briefly summarizes many of the public health challenges that society faces today, and that EIS officers are engaged in worldwide—in addition to comments on the political backgrounds that influence the prevention of some of these contemporary diseases. The book is a valuable addition to the ever-lengthier literature on epidemics. Most chapters offer multiple brief, but fascinating accounts of epidemiologic investigations. The vignettes are not closely tied to one another, except perhaps for the temporal associations related to the book’s organization into 3 time periods. Consequently, within any chapter, the author might give attention to an enteric pathogenassociated outbreak, followed by a chronic disease example or a behavioral health example (such as a cluster of suicides) and also supply information on the unfolding history of the EIS program at that particular time. The examples provided were all informative to read, and, from my first- (or at least second-) hand knowledge of many of the outbreaks, few errors in fact appear in the accounts of the various epidemics covered. The author deserves congratulations on the extensive sleuthing that he undertook in writing this book: he conducted hundreds of interviews with EIS officers and outbreak-related personnel, and he researched numerous textbooks, articles, archives, and government documents that are difficult to access. He lists these useful sources at the book’s end and provides a full bibliography online. He surprisingly includes his e-mail address so interested readers can contact him, presumably to correct errors or provide other feedback.

Increasing railway suicide acts after media coverage of a fatal railway accident? An ecological study of 747 suicidal acts

BackgroundWhile coverage of a celebrity suicide in the mass media may trigger copycat suicides, evidence for the effect of media reports of non-prominent suicides is moderate. Diversification of current media...

Le meurtrier de masse

Multicide and other mass killing are sufficiently dramatic to excite great interest from clinicians, criminologists and behavioural scientists. A review of avaible literature on the topic is presented and analysed, in order to define mass murder and to learn about sociodemography and psychopathology of mass killers. Mass homicide is typically defined as the intentional killing of multiple individuals, injuring five or more persons, of whom three or more are killed, during the course of one criminal event. The functional difference between mass and serial homicide is quite obvious, particularly in setting, time, victim status and modus operandi. Classification of these acts requires a number of parameters. Mass murderers usually involve disgruntled employees, annihilation of families, and recently school shootings. Although they are rarely psychotic, mass murderers have serious deficiencies in long-term emotional relationships. They have no obvious personality type but tended to be egocentric, rigid and obsessional. They are few individuals with signifiant histories of criminal offending or violence. For example, school shooting perpetrators are more than twice as likely as their victims to have been bullied by their peers. They are described as loners and poorly integrated into school activities. The formulation of a plan for a massacre might be fostered through identification with a role model offered through films, television, Internet, or other media. Suicides, homicide-suicides, murder-suicides and suicide pacts tend to co-occur in the context of mass murders. The biological, psychological, and social determinants of auto- and heteroagressivity remain to be similar. Furthermore suicide-related reporting, especially of nonfictional individual suicides, triggers additional suicides: So-called imitative effects. Similarly copycat crimes were reported to follow violent episodes that receive wide coverage in the media. Suicides and mass-murders are likely to be imitated. But media discourse supports preventive efforts when it educates the public about the treatment of mental ill and suicidality. The prevention of copycat suicides and mass murders rests on the adoption of precise guidelines for the reporting of these episodes.

Geospatial mapping of suicide clusters in Cantebury New Zealand

BackgroundDespite strong public and professional interest in suicide clusters, the scientific literature on this subject has been dominated by anecdotal reports. Precise definitions of suicide clusters are lacking.AimTo apply geospatial...

Suicide contagion in France: an epidemiologic study

BackgroundWerther effect is a type of suicide contagion by which the media coverage following the suicide of a famous person entails a significant increase in the number of suicides. Our...

Role of media reports in completed and prevented suicide: Werther v. Papageno effects

Media reporting of suicide has repeatedly been shown to trigger suicidal behaviour. Few studies have investigated the associations between specific media content and suicide rates. Even less is known about the possible preventive effects of suicide-related media content. To test the hypotheses that certain media content is associated with an increase in suicide, suggesting a so-called Werther effect, and that other content is associated with a decrease in suicide, conceptualised as a Papageno effect. Further, to identify classes of media articles with similar reporting profiles and to test for associations between these classes and suicide. Content analysis and latent class analysis (LCA) of 497 suicide-related print media reports published in Austria between 1 January and 30 June 2005. Ecological study to identify associations between media item content and short-term changes in suicide rates. Repetitive reporting of the same suicide and the reporting of suicide myths were positively associated with suicide rates. Coverage of individual suicidal ideation not accompanied by suicidal behaviour was negatively associated with suicide rates. The LCA yielded four classes of media reports, of which the mastery of crisis class (articles on individuals who adopted coping strategies other than suicidal behaviour in adverse circumstances) was negatively associated with suicide, whereas the expert opinion class and the epidemiological facts class were positively associated with suicide. The impact of suicide reporting may not be restricted to harmful effects; rather, coverage of positive coping in adverse circumstances, as covered in media items about suicidal ideation, may have protective effects.

Death, Attractiveness, Moral Conduct, and Attitudes to Public Figures

In this study, 2,894 participants rated attitudes toward their favorite public figure on the Celebrity Attitude Scale. It was noted whether each figure was alive or dead, and a panel of four independent judges assessed each in terms of their moral conduct and physical attractiveness. Dead figures appealed less and were subject to lower "intense personal" celebrity worship, and death was unrelated to "borderline pathological" and "deleterious imitation" celebrity worship. Physical attractiveness was positively related to overall celebrity worship and "intense personal" celebrity worship, but negatively related to "borderline pathological" and "deleterious imitation" celebrity worship. Moral conduct was associated negatively with "deleterious imitation" celebrity worship. Results are discussed briefly in terms of their implications for research on physical attractiveness and "copycat suicide".

Dyads of Father and Son Suicide Separated by Time and Circumstances

We encountered 2 dyadic suicides among fathers and sons. In the first dyad, the father was a 64-year-old man with complications of heart surgery. He committed suicide with a shotgun. The decedent's son was a 38-year-old man. Five years after his father's death, the son had an argument with his wife. That morning, he drove to the house where his father had lived and inflicted a handgun wound to his head. In the second dyad, the son was a 22-year-old man whose girlfriend left him. He inflicted a shotgun injury to the head. His blood alcohol level was 294 mg/dL. The father of this decedent was a 43-year-old man who 1 year later was despondent after a fight with his girlfriend. He was found dead at home with a single handgun wound to the chest. His blood alcohol level was 173 mg/dL. All 4 suicides appear to have been premeditated and all 4 men used guns. Suicide in a family tends to cause depression and complicate bereavement in survivors more than other types of death. Copycat suicide is well-documented in high-profile cases. The effect of father-son relationships is likely closer and more influential than celebrity suicides.

The Evolution of Epidemic Suicide on Guam: Context and Contagion

Thirty years of suicide rates for Guam were analyzed by age, sex, period, and cohort. Youth suicide increased rapidly in the 1990s; certain cohorts have higher rates. Four explanatory factors are discussed, including ecological factors and migration from the Federated States of Micronesia. Direct and indirect suicide contagion followed the death by suicide of a respected politician, strongly influencing period and cohort patterns. Suicide pacts inflated suicide among young people. These factors acted in combination to produce epidemic levels of suicide in the 1990s.

P03-310 - Imitation suicide: the werther effect

Suicide is the primary emergency for the mental health professional and it is also a major public health problem. Altough it is impossible to predict, there are numerous clues that can help to reduce the risk of suicide. Goethes's novel Die Lieden des Jungen Werther, first published in 1774, in which the protagonist of the story decides to commit suicide by shooting himself, was followed by a wave of imitation suicides across Europe. Later, in 1974, Phillips coined the term “Werther Effect” to describe a situation where the observer copies the suicidal behaviour he has seen modelled in the media. However this was not the first demonstration of the contagious effect of suicide. There are descriptions of several similar suicides among young men in ancient Greece, and it is said that Shakespeare's novel, Romeo and Juliet, inspired a countless number of young couples to commit suicide. It is known that reading about, seeing or hearing about suicidal behaviours seems to induce imitative behaviour, and this is more notorious among adolescents. There are several reports of increased suicidal behaviour after exposure to suicide-related material on the media. The individual characteristics of adolescents who are susceptible to imitation are currently unknown, but it is accepted that the amount and duration of exposure to the information are important factors in the imitative learning. The authors intend to do a psychopathological and sociological approach to the theme.

Adolescence, prise de toxiques et tentative de suicide par défenestration

Suicide represents, in France, the second cause of death in youth aged 15 to 24. Sixteen per cent of juvenile mortality is attributable to suicide. The annual incidence of suicide attempts in this age group is estimated at about 40 000 cases. Jumping from high represents 6% of deaths from suicide: girls resort to this method twice as often as boys. The severity of somatic consequences and the frequency of sequels following a jumping from a window can hold center stage for a long time, at the risk of trivializing the psychopathology underlying such a violent acting-out. These clinical situations particularly involve a multidisciplinary follow up including an early and active participation of psychiatric consultation-liaison teams. Jumping from a window can occur even apart from established mental disorders, such as psychotic or mood disorders. Our four case-reports draw attention to risk factors represented by: substance abuse (alcohol, cannabis, but also cocaine, ecstasy...), the notion of previous suicide attempts and various drive disorders having a self-harm value or displaying an underlying impulsiveness (eating disorders, scarifications, shoplifting, running away...), the precipitating role of a recent loss of a parent or an important removal from family environment, the potential influence, especially in this age group, of spectacular cases of suicide amplified by the Medias ("Werther effect"). Paradoxically, to belong to a well-off milieu can also contribute to the risk of such acting-out, when parents replace affection and availability by an easy access to various consumer goods and a permissive education, thus opening the way to the encounter with different substances.

The cultural dynamics of copycat suicide.

The observation that suicides sometimes cluster in space and/or time has led to suggestions that these clusters are caused by the social learning of suicide-related behaviours, or “copycat suicides”. Point clusters are clusters of suicides localised in both time and space, and have been attributed to direct social learning from nearby individuals. Mass clusters are clusters of suicides localised in time but not space, and have been attributed to the dissemination of information concerning celebrity suicides via the mass media. Here, agent-based simulations, in combination with scan statistic methods for detecting clusters of rare events, were used to clarify the social learning processes underlying point and mass clusters. It was found that social learning between neighbouring agents did generate point clusters as predicted, although this effect was partially mimicked by homophily (individuals preferentially assorting with similar others). The one-to-many transmission dynamics characterised by the mass media were shown to generate mass clusters, but only where social learning was weak, perhaps due to prestige bias (only copying prestigious celebrities) and similarity bias (only copying similar models) acting to reduce the subset of available models. These findings can help to clarify and formalise existing hypotheses and to guide future empirical work relating to real-life copycat suicides.

Alcohol and Other Contextual Factors of Suicide in Four Aboriginal Communities of Quebec, Canada

Aboriginal populations worldwide face increasing rates of suicide. Despite this recurring observation, little research has emerged from Aboriginal settings. This paper describes the psychosocial and behavioral characteristics of 30 consecutive adult suicides from four First-Nations communities in Quebec, Canada. Psychological autopsies guided by the LEDS with family members of the deceased. Suicide among this group is overrepresented by young single men. Alcohol intoxication at the time of death was reported for 22 cases in association with rapid acting out after the precipitating event for 20. All but two cases had a history of alcohol abuse, and drug use was also present in 23 cases. In 16 cases there had been a previous suicide attempt, 14 of which occurred during the previous year. The main socio-demographic characteristics of the communities were overcrowded living arrangements and no job status (90%). Seven cases were incarcerated or locked up at the time of death. Clustering of suicide was observed within seven nuclear families including 16 suicides. This study shows that Aboriginal suicide is the result of a complex interweaving of individual, familial, and socio-historical variables. The impact of contemporary social stressors on individual well-being must be addressed to prevent suicide in this community.

Assisted suicide on TV--the public 'License to Kill'?

n 10 December, a British satellite television channel telecast the documentary ‘Right to Die’, which shows the assisted suicide of 59-year old US citizen Craig Ewert at the Dignitas clinic in Switzerland. Amyotrophic lateral sclerosis patient Ewert’s last 4 days were covered, finally showing him drinking a lethal dose of barbiturates before turning off his lung ventilator with a mouth-operated switch. Beneath being relevant to the ‘Right to Die’ debate and the question of legalization of doctor-assisted dying, 1 another aspect has to be considered urgently. In terms of suicide prevention, an increase of imitative suicides due to the ‘Werther effect’, i.e. the increase of suicide rates after detailed reports about suicide in the media, cannot be excluded. The Werther effect had been proved for the first time after a twice broadcast (1981, 1982) of the six-episode serial ‘Death of a student’ in Germany. 2 The number of railway suicides had increased over extended periods up to 175%, most clearly observable in groups age and sex congruent. 2 An Austrian research group showed that after an increase of subway suicides in Vienna between 1984 and 1987, a decrease of 75% could be achieved by a working group of the Austrian Association for Suicide Prevention who had developed media guidelines and initiated discussion with the media over suicide coverage, culminating in an agreement to refrain from reporting suicides. 3 Based on such studies, it has to be assumed that even for assisted suicides within the framework of euthanasia a Werther effect could be induced. Especially, the extremely detailed report of a seemingly peaceful suicide in the context of a TV documentation may tempt terminally ill people to choose suicide as both an adequate and acceptable way to solve their problem. Evidence for this comes from a Swiss study: after the media had reported extensively about the assisted double suicide of a prominent couple, a considerable rise of suicides—especially among women older than 65 years—occurred for a period of 2 years after the event. 4 Here, the almost enthusiastic kind of reporting might have led to the Werther effect. The German Association of Suicide Prevention recommend in their media guidelines for reporting on suicides to avoid inadvertently romanticizing or idealizing the suicide or labelling the act as a heroic one (e.g. ‘He didn’t want to be a burden for someone’). Also classifying the suicide as comprehensible, inevitable or even positive may encourage others. As well, the detailed description of the suicide method has to be avoided therefore. But with broadcasting ‘suicide documentations’— in this case the assisted suicide of Craig Ewert—the suicide method is apparent to the highest extend. Furthermore, it has to be considered that >90% of suicides are based on mental disorders. 5 According to the German Alliance against Depression, 40–70% of all suicidents suffer from depressive disorders. Assuredly patients who are terminally ill are a special case and their wish to die cannot be labelled with ‘mental disorder’ just by implication. Current studies, however, demonstrate an association of the wish to die or desire to receive euthanasia and psychiatric illness, especially depression, for the latter group, too. Hopelessness and depression were the most relevant predictors of desire for hastened death in a sample of advanced AIDS patients. 6 Similarly, diagnosis of major depression is associated with desire for euthanasia or physician-assisted suicide in palliative cancer patients. 7 Even for patients with amyotrophic lateral sclerosis, willingness to contemplate assisted suicide goes along with elevated levels of depressive symptoms and hopelessness. 8 These results highlight that also in terminally ill subjects the mental status has to be scrutinized thoroughly, otherwise protection of patients whose choices are influenced by depression might fail. Unfortunately, as results from Oregon show, an adequate screening for depression or psychiatric evaluation cannot be guaranteed and current practice may fail to protect these patients. 9,10

Basında yer alan intihar ya da intihar girişimi konulu haberlerde etik sorunlar

Objective: The textual and image content analysis seeks to prove that the Turkish national media do not report suicids in an accurate manner. Methods: For this research seven Turkish daily newspapers which are from different political perspectives (Radikal, Cumhuriyet, Milliyet, Sabah, Tercüman, Zaman and Yeni fiafak) are analyzed all through the year 2005 and also some samples from the Turkish local press are investigated. Results: In the news about suicide (attempts) in Turkish Press; the photo of the deceased is usually printed and the identity information is generally given and the details about method and/or place of a suicide which are unnecessary and may cause copysuicide and/or make relatives/friends of the deceased feel more pain are written. The language which is used by the journalists also romanticises or glorifies suicide; and in the news about suicide the reader almost never reads the perspective of a specialist. And the articles about suicide (attempts) never make reference to counselling services with contact details. Discussion: Turkish national media do not report suicids according to ethical codes; and this is a very important problem, because one of the many reasons which make people commit suicide may be media reports on suicide cases which is called "Werther effect" that designates imitation (or copycat) suicides.

The Media and Suicide

Suicide is a common and preventable event that is often reported by the media when there are sensationalistic elements or if the suicide involves a celebrity. Media reports of suicide can induce a copycat or "Werther effect". There is increasing evidence that sensationalistic reporting of suicides has a direct effect on increasing suicide rates. Responsible reporting guidelines drawn up in consultation with media professionals have been shown to improve reporting of suicides. Local reporting on suicides tends to be sensationalistic but also has a strong educational slant. The media should educate both the public and the medical professional about their role in suicide prevention.

Coping with Youth Suicide and Overdose

From 2000-2005, Somerville, MA, experienced a number of youth overdoses and suicides. The community response followed CDC recommendations for contagion containment. A community coalition, Somerville Cares About Prevention, became a pivotal convener of community partners and a local research organization, the Institute for Community Health, provided needed expertise in surveillance and analysis. Mayoral leadership provided the impetus for action while community activists connected those at risk with mental health resources. Using a variety of data sources (including death certificates, youth risk surveys, 911 call data, and hospital discharges) overdose and suicide activity were monitored. Rates of suicide and overdose for 10-24-year-olds were higher than in previous years. Using case investigation methods, the majority of suicide victims were found to be linked through common peer groups and substance abuse. Subsequent community action steps included: a community-based trauma response team, improved media relationships, focus groups for suicide survivors, and prevention trainings to community stakeholders. Youth suicide and overdose activity subsided in May of 2005. The community partnerships were critical elements for developing a response to this public health crisis. This collaborative approach to suicide contagion used existing resources and provides important lessons learned for other communities facing similar circumstances.