by Michael D. Anestis, Ph.D.
Earlier today, when I learned about the death by suicide of former NFL linebacker Junior Seau, I decided it would be worthwhile to write a quick post on interesting new findings related to suicidal behavior. None of the findings below are directly related to this story, but in the spirit of raising awareness, I thought there might be some value in quickly summarizing a couple of cool effects that I came across in the current issue of Suicide and Life-Threatening Behavior. We've discussed similar findings in the past, but replication is remarkably important in science and, as such, I chose to bring these studies up on PBB.
Interesting finding #1:
I've discussed this issue at length in the past (link, link), but its importance cannot be overstated. There is an understandable and widely held belief that talking to people about suicide might increase their risk for thinking about or even engaging in suicidal behavior. A growing number of studies have not only debunked this myth, but have acutally shown that the opposite is true: that asking about suicide appears to decrease levels of suicidal ideation, particularly in high risk samples.
In a study in the current issue of SLTB, Chrarles Mathias and colleagues (2012) recruited 170 adolescents (age 12-17; 50% male; 57% Hispanic) who had experienced psychiatric inpatient care. Participants were assessed for suicidal ideation at baseline and then again every six months for up to two years. Suicidal ideation was assessed using a self-report questionnaire. Of the 170 participants, 159 completed the second assessment, 126 completed the third, 77 completed the fourth, and 54 completed all five. Three of the lost participants were missing due to attrition (e.g., did no return for an appointment). The remainder were missing due to the fact that their initial assessment occurred late enough in the project that the project had ended before they could have completed all time points. In other words, the missing data should not be seen as a sign that individuals were becoming increasingly severe and dropping out of the study due to that increased severity.
What did they find? First off, a greater number of assessments was associated with lower suicidal ideation in the final assessment, even after accounting for initial levels of suicidal ideation. In other words, not only did asking about suicidal ideation once no cause an increase in thoughts of suicide, but asking repeatedly was actually associated with continuingly decreasing levels of ideation. In total, 51% of the participants reported a decrease in ideation during the study, 29% reported no change, and 21% experienced an increase from their first to final assessment. Furthermore, amongst those who reported decreases in ideation, substantially more reported large decreases than moderate or small decreases. On the flip side of that coin, amonst those who reported increases, more reported small increases than moderate or large increases (the difference between small and large was not statistically significant, however).
Using more comprehensive model testing procedures, the authors found that individuals who reported low levels of ideation at the onset of the study tended not to experience meaningful increases in ideation in response to repeated assessments. Indviduals with moderate levels of ideation typically reported a decline in ideation between the first and second assessments, but no significant change beyond that point. Perhaps most importantly, individuals who initially reported high levels of ideation typically reported sharp declines in ideation during the first year, followed by a less steep decline in year 2.
There were several other interesting findings in this study, but the take home message is clear and entirely consistent with prior work on this topic: assessing for suicide risk is not only safe, but beneficial, particularly with high risk individuals. In other words, there is substantial potential value and no discernable risk with the institution of wide spread suicide risk assessment protocols.
Interesting finding #2:
In our past discussions of the interpersonal-psychological theory of suicidal behavior (IPTS), we have discussed the importance of thwarted belongingness as a driving force behind suicidal desire. Put simply, when individuals feel as though they lack meaningful connections to others, the likelihood that they will desire death by suicide increases substantially. In many cases, efforts to decrease thwarted belongingness focus on close individuals bonds and understandably so. That being said, such relationships are not the only path towards increasing an individuals sense of belonging. A couple of years ago, I discussed work examining the relationship between professional sporting events and suicidal behavior (link) and a study in the current issue of SLTB replicated the effects noted in that earlier PBB article.
Specifically, Gaelle Encrenaz and colleagues (2012) examined the association between the 1998 World Cup and monthly deaths by suicide in France. Controlling for the effects of variables like seasonality (e.g., deaths by suicide peak in the spring), the authors found that, between June 11th and July 11th of 1998, there was a decrease of 95 deaths by suicide - a 10.3% decrease from the norm. Furthermore, they found a decrease of 19.9% on days following games (victories, in this case) by the French team.
Do these findings mean that the occurance and associated outcomes of sporting events are amongst the most important variables to consider in suicide resarch? Of course not. What they indicate, however, is that events that cause us to feel connected to a group make us feel very differently about ourselves and, perhaps most importantly, about our death.
Dr. Mike Anestis is an incoming assistant professor in the Department of Psychology at the University of Southern Mississippi.
Articles cited in this post:
Encrenaz, G., Contrand, B., Leffondre, K., Queinec, R., Aouba, A., Jougla, E., Miras, A., & Lagarde, E. (2012). Impact of the 1998 Football World Cup on suicide rates in France: Results from the National Death Registry. Suicide and Life-Threatening Behavior, 42, 129-135.
Mathias, C.W., Furr, R.M., Sheftall, A.H., Hill-Kapturczak, N., Crum, P., & Dougherty, D.M. (2012). What's the harm in asking about suicidal ideation? Suicide and Life-Threatening Behavior, 42, 1-11.