Social Modeling in the Transmission of Suicidality
Abstract
Abstract. Evidence from twin, adoption, and family studies suggests that there is strong aggregation of suicidal behaviors in some families. By comparison, the role of social modeling through peers has yet to be convincingly established. This paper uses data from four large studies (the WHO/EURO Multicentre Study on Suicidal Behaviour, the WHO/SUPRE-MISS, the CASE study, and the Queensland Suicide Register) to compare the effects of exposure to fatal and nonfatal suicidal behavior in family members and nonfamilial associates on the subsequent suicidal behavior of male and female respondents of different ages. Across all studies, we found that prior suicidal behaviors among respondents' social groups were more important predictors of suicidal behavior in the respondents themselves than previous research had indicated. Community-based suicide attempters in the WHO SUPRE-MISS had higher rates of exposure to prior suicide in nonfamilial associates than in family members. In an adolescent population, exposure to prior fatal suicidal behavior did not predict deliberate self-harm when exposure to nonfatal suicidal behavior (both familial and social) were controlled for, but exposure to nonfatal suicidal behaviors in family and friends was predictive of deliberate self-harm and suicide ideation, even after controlling for exposure to fatal suicidal behavior. The potential impact of “containment” of information regarding suicidal behaviors as a prevention initiative is discussed, in light of information behavior principles of social marketing.
References
(1998). The approval of suicide: A social-psychological model. Suicide and Life-Threatening Behavior, 28, 205–225
(2004). A social marketing approach to changing mental health practices directed at youth and adolescents. Health Marketing Quarterly, 21, 51–75
(2004). Psychiatric diagnoses in 3275 suicides: A meta-analysis. BioMed Central Psychiatry, 4, 37–47
(2004). Genetics of suicide: An overview. Harvard Review of Psychiatry, 12, 1–13
(1977). Social learning theory. Englewood Cliffs: Prentice Hall
(2004). The social marketing approach: A way to increase reporting and treatment of sexual assault. Child Abuse and Neglect, 28, 253–265
(1996). Suicidal behavior runs in families. A controlled family study of adolescent suicide victims. Archives of General Psychiatry, 53, 1145–1152
(2005). Family genetic studies, suicide, and suicidal behavior. American Journal of Medical Genetics Part C: Seminars in Medical Genetics, 133C, 13–24
(2004). Familial transmission of mood disorders: Convergence and divergence with transmission of suicidal behavior. Journal of the American Academy of Child and Adolescent Psychiatry, 43, 1259–1266
(2000). Psychosocial and psychiatric risk factors for suicide: Case-control psychological autopsy study. British Journal of Psychiatry, 177, 360–365
(2004). Familial suicide behavior: Association with probands suicide attempt characteristics and 5-HTTLPR polymorphism. Acta Psychiatrica Scandinavica, 110, 459–464
(2006). Definitions of suicidal behavior. Lessons learned from the WHO/EURO Multicenter study on suicidal behavior. Crisis, 27, 4–15
(2005). Lifetime risk of suicidality in an Australian community: Prevalence, suicidal process, and help-seeking behavior. Journal of Affective Disorders, 86, 215–224
(2004a). Suicide in Queensland 1999-2001: Mortality rates and related data. Brisbane: Australian Institute for Suicide Research and Prevention
(2004b). Who are the kids who self-harm? An Australian self-report school survey. Medical Journal of Australia, 181, 140–144
(2004). Familial transmission of suicidal ideation and suicide attempts: Evidence from a general population sample. Psychiatric Research, 126, 159–165
(1990). Suicide clusters and media exposure. In S.J. Blumenthal & D.J. Kupfer (Eds.), Suicide over the life cycle (pp. 517-532). Washington, DC: American Psychiatric Press
(1994). Clustering of attempted suicide: New Zealand national data. International Journal of Epidemiology, 23, 1185–1189
(2002). Implications of suicide contagion for the selection of adolescent standardized patients. Academic Medicine, 77, 100–102
(1994). A cluster of suicides at a London psychiatric unit. Suicide and Life Threatening Behavior, 24, 256–266
(2003). Contagion of suicidal symptoms as a function of assortative relating and shared relationship stress in college roommates. Journal of Adolescence, 26, 495–504
(2001). Twin studies of psychiatric illness: An update. Archives of General Psychiatry, 58, 1005–1015
(1995). Suicide contagion among adolescents during acute psychiatric hospitalization. Psychiatric Services, 46, 915–918
(2003). Divorce and suicide risk (Letter). Journal of Epidemiology and Community Health, 57, 993–
(1969). Attempted suicide in social networks. British Journal of Preventive and Social Medicine, 23, 116–123
(1970). Attempted suicide as language: An empirical study. British Journal of Psychiatry, 116, 465–473
(2001). Confidential death to prevent suicidal contagion: An accepted, but never implemented, 19th century idea. Suicide and Life Threatening Behavior, 31, 460–466
(2005). Maternal suicidality and risk of suicidality in offspring: Findings from a community survey. American Journal of Psychiatry, 162, 1665–1671
(2004). Using social marketing to increase recruitment of pregnant smokers to smoking cessation services: A success story. Public Health, 118, 239–243
(1997). Social and familial risk factors in suicidal behavior. Psychiatric Clinics of North America, 20, 519–550
(2000). The social relations of suicides. In R.W. Maris, A.L. Berman, & M.M. Silverman (Eds.), Comprehensive textbook of suicidology (pp. 240-265). New York: Guilford
(2005). Clustering of suicides among people with mental illness. British Journal of Psychiatry, 187, 476–480
(2004). The epidemiology of mood disorders. Current Psychiatry Reports, 6, 411–421
(1994, April). Werther effects in a black college sample. Paper presented at the 27th Annual Congress of the American Association of Suicidology, New York
(1986). Clustering of teenage suicides after television news stories about suicide. New England Journal of Medicine, 315, 685–
(2001). Adolescent suicide and suicide contagion in three secondary schools. International Journal of Emergency Mental Health, 3, 163–168
(2006). Critical issues in psychological autopsy studies. Suicide and Life-Threatening Behavior, 36, 491–510
(2002). Suicide risk in relation to family history of completed suicide and psychiatric disorders: A nested case-control study based on longitudinal registers. The Lancet, 360, 1126–1130
(2005). Marketing mental health to men: Theoretical and practical considerations. Journal of Clinical Psychology, (epub ahead of print). www3.interscience.wiley.com/cgi-bin/fulltext/109931579/PDFSTART
(2001). Suicidal behavior in twins: A replication. Journal of Affective Disorders, 66, 71–74
Eds. (2004). Suicidal behavior in Europe: Results from the WHO/EURO Multicenter Study on Suicidal Behavior. Göttingen: Hogrefe & Huber
(2004). Imitation of suicidal behavior. In D. De Leo, U. Bille-Brahe, A. Kerkhof, & A. Schmidtke (Eds.). Suicidal behavior: Theories and research findings (pp. 209-218). Göttingen: Hogrefe & Huber
(1998). Media effects on imitation of suicidal behavior. In D. De Leo, A. Schmidtke, & R.F.W. Diekstra (Eds.), Suicide prevention: A holistic approach (pp. 121-137). Dordrecht: Kluwer/Academic Press
(1979). A family study of suicide. In M. Schou & E. Stromgren (Eds.), Origin, prevention, and treatment of affective disorders (pp. 277-287). London: Academic Press
(1987). Celebrities and suicide. American Sociological Review, 52, 401–402
(1996). The effect of the media on suicide: Evidence from Japan, 1955-1985. Suicide and Life-Threatening Behavior, 26, 132–142
(2000). Media impacts on suicide: A quantitative review of 293 findings. Social Science Quarterly, 81, 957–971
(2002). Media coverage as a risk factor in suicide. Injury Prevention, 8, 30–32
(2005). Suicide in the media: A quantitative review of studies based on nonfictional stories. Suicide and Life-Threatening Behavior, 35, 121–133
(1994). Suicide contagion among psychiatric inpatients. Nordic Journal of Psychiatry, 47, 191–194
(1994). Suicide clustering in a psychiatric hospital with a history of a suicide epidemic: A quantitative study. American Journal of Psychiatry, 151, 1087–1088
(1998). Contagion of deliberate self-harm among adolescent inpatients. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 211–217
(1979). An integrative theory of intergroup conflict. In W.G. Austin & S. Worchel (Eds.), The social psychology of intergroup relations (pp. 33-47). Monterey, CA: Brooks/Cole
(1997). Suicide contagion. In R.W. Maris, S. Canetto, & M.M. Silverman (Eds.), Review of suicidology (pp. 96-137). New York: Guilford
(1986). Psychiatric disorders in the biological and adoptive families of adopted individuals with affective disorders. Archives of General Psychiatry, 43, 923–929
(2007). Behind impulsive suicide attempts: Indications from a community survey. Journal of Affective Disorders, doi:10.1016/j.jad.2007.02.015