Extrapolation from attempted suicides to completed suicides.

Used D. Lester's (see record 1971-10261-001) methodology for analyzing data from suicide attempters to make extrapolations to completed suicides. A sample of 246 suicide attempters was divided into 3 groups on the basis of their intent to die. When 56 possible correlates of suicidal intent were examined, a number of significant monotonic differences between the groups were found, from which predictions concerning completed suicides were made. Many of the particular findings supported previous observations on suicide, but some deviations from expectations were noted. Results demonstrate that it is possible to make inferences about completed suicides from studies of attempted suicides. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hopelessness, impulsiveness and intent among suicide attempters with major depression, alcohol dependence, or both

The present study examined differences in hopelessness, impulsiveness and suicide intent between suicide attempters with either major depression or alcohol dependence, comorbid major depression and alcohol dependence, and those without these disorders. A sample of 114 patients from consecutive cases of attempted suicide referred to a general hospital in Helsinki was interviewed and diagnosed according to DSM-III-R. Suicide intent was measured by the Beck Suicide Intent Scale (SIS) and hopelessness was assessed by the Beck Hopelessness Scale (HS). Impulsiveness of the suicide attempt was measured by two items of the SIS. Suicide attempters with major depression without comorbid alcohol dependence had higher suicide intent and lower impulsiveness than attempters with non-depressive alcohol dependence. Suicide attempts may differ between subjects with major depression, alcoholism or both disorders in terms of impulsiveness and suicide intent.     

The measurement of pessimism: The Hopelessness Scale.

Administered a scale designed to quantify hopelessness to 294 hospitalized suicide attempters, 23 general medical outpatients, 62 additional hospitalized suicide attempters, and 59 depressed psychiatric patients. The scale had a Kuder-Richardson-20 internal consistency coefficient of .93 and correlated well with the Stuart Future Test (SFT) and the pessimism item of the Beck Depression Inventory (BDI; .60 and .63, respectively). The scale was also sensitive to changes in the patient's state of depression over time, as evidenced by a correlation of .49 with change scores on the SFT and .49 with the change scores on the BDI. Findings also indicate that depressed patients have an unrealistically negative attitude toward the future and that seriousness of suicidal intent is more highly correlated with negative expectancies than with depression. A principal-components factor analysis revealed 3 factors which tapped affective, motivational, and cognitive aspects of hopelessness. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Suicide ideation in a college population: A test of a model.

Examined a model of suicide behavior with 65 undergraduate suicide ideators (as measured by a self-report adaptation of the Scale for Suicide Ideators). The model focuses on the relationship between negative life stress, cognitive rigidity and/or poor problem-solving skills, hopelessness, and suicide ideation and attempting. The model proposes that individuals deficient in the capacity for divergent thinking are cognitively unprepared to cope with the high levels of life stress observed in suicide attempters and, as a result, are likely to become hopeless under such circumstances. This hopelessness resulting from the individual's inability to engage in effective problem-solving places the individual at risk for suicidal behavior. Ss were administered a battery of tests that included the Self-Rating Depression Scale, Life Experiences Survey, and Hopelessness Scale. Results indicate that Ss were under higher levels of negative life stress, were more hopeless, and had higher levels of depression than their nonideating peers. Although no relationship was observed between suicide ideation and cognitive rigidity or between suicide intent and cognitive rigidity, poor problem-solvers under high stress were found to be significantly higher on suicide intent than any other group. Results support a stress/problem-solving model of suicidal behavior in which poor problem-solvers under high life stress are considered to be at risk for depression, hopelessness, and suicidal behavior. (19 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depression and suicidality.

Correlated suicidality ratings for 90 patients in a voluntary psychiatric hospital ward with 5 possible indices of depression: self-ratings of depression, MMPI Depression scale scores, depressive diagnosis, and alcohol and drug use. Included in the group were 7 Ss who were suicides subsequent to hospitalization. Both depression and suicidality emerged in the factor structure as multidimensional and independent factors. Overt depressive measures were related in specific and complex ways to suicidality, while the possible covert depressive measures of alcohol and drug use did not correlate or correlated negatively with suicidality. High-suicidality Ss had significantly longer hospitalizations, suggesting dependency and/or control problems. Suicidal Ss tended to be characterized by self-reports of physical disequilibrium and control problems rather than by feelings of despondency and hopelessness. (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Problem-solving deficits in suicidal patients: Trait vulnerability or state phenomenon?

A diathesis-stress model had been proposed (D. E. Schotte and G. H. Clum; see PA, Vols 69:1287 and 74:15906), in which deficits in interpersonal problem-solving skills are said to predispose individuals under chronic stress to depression, hopelessness, and suicide ideation. The present study examined the stability of interpersonal problem-solving skills in a short-term, longitudinal study of hospitalized suicide ideators (N?=?36). The Ss displayed marked changes in depressive symptoms, state anxiety, hopelessness, and suicide intent over time, and these improvements were associated with improvements in interpersonal problem-solving skills. It is concluded that interpersonal problem-solving deficits may be a concomitant, rather than a cause, of depression, hopelessness, and suicide intent. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Big Ten Student Suicide Study: a 10-year study of suicides on midwestern university campuses

The Big Ten Student Suicide Study was undertaken from 1980-1990 to determine the suicide rates on Big Ten University campuses. The study design attempted to address many of the statistical and epidemiological flaws identified in previous studies of campus student suicides. The 10-year study collected demographic and correlational data on 261 suicides of registered students at 12 midwestern campuses. The largest number of suicides for both males and females were in the 20-24-year-old age group (46%), and amongst graduate students (32%). The overall student suicide rate of 7.5/100,000 is one half of the computed national suicide rate (15.0/100,000) for a matched sample by age, gender, and race. Despite the overall lower suicide rate, the analyses revealed that students 25 and over have a significantly higher risk than younger students. Although women have rates roughly half those of men throughout their undergraduate years, graduate women have rates not significantly different from their male counterparts (graduate women 9.1/100,000 and graduate men 11.6/100,000).     

Hopelessness and social desirability as moderator variables in predicting suicidal behavior.

Hopelessness has been identified as the major variable linking depression to suicidal intent. M. M. Linehan and S. L. Nielsen (see record 1982-01443-001) found that the Hopelessness Scale was strongly contaminated with social desirability. Results from 54 attempted-suicide patients (mean age 26.9 yrs) show that hopelessness was a key variable in predicting suicidal behavior and ideation. Social desirability had no influence on hopelessness, and it is concluded that the Hopelessness Scale is appropriate for use in suicide assessment. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hopelessness, depression, and suicidal intent among psychiatrically disturbed inpatient children.

The Hoplessness Scale for Children was developed and administered to 66 8–13 yr old children along with the Children's Depression Inventory, Bellevue Index of Depression, Depression Symptom Checklist, and the Self-Esteem Inventory. As predicted, Ss who scored high on the Hopelessness Scale showed significantly more severe depression and lower self-esteem than those who scored low on the scale. Ss who evinced suicidal attempt or ideation, independently assessed at intake diagnosis, showed greater hopelessness than Ss with no such intent. Suicidal intent was more consistently correlated with hopelessness than with depression, a finding parallel to results obtained with adults. Overall, findings suggest that negative expectations toward oneself and the future can be assessed in children and are related both to depression and suicidal intent. (26 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Development of a geriatric scale of hopelessness: Implications for counseling and intervention with the depressed elderly.

Evaluated hopelessness, depression, and self-esteem in 138 65–80 yr old subclinically depressed people drawn from community settings. In Phase 1, a factor analysis was performed on the contents of interviews with 60 Ss. Analysis yielded 4 distinct factors of geriatric hopelessness. In Phase 2, a geriatric hopelessness scale (included as a table) was developed on the basis of hopelessness themes suggested by factor analysis and was administered to 78 Ss. Results of this validity study show that Ss who scored high on the geriatric hopelessness scale had significantly higher depression and lower self-esteem scores than Ss who scored low on the scale. It is suggested that the same correlational patterns that exist in youth and adults between hopelessness and depression continue into old age. It is further suggested that identification of clients' latent themes of hopelessness would help counselors obtain more focused insight into clients' pessimism and negative outlooks and would provide the particular kind of encouragement and reinforcement needed. (43 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depression and suicide on Gotland. An intensive study of all suicides before and after a depression-training programme for general practitioners

In 1983 and 1984, the Swedish Committee for the Prevention and Treatment of Depression (PTD) organised a postgraduate training programme on the diagnosis and treatment to all the general practitioners on Gotland, Sweden. In the following years, the frequency of suicide and inpatient care for depression decreased significantly, as well as the frequency of sick leave for depression. The results of the Gotland study have provided evidence for the view that early recognition and adequate treatment of depression is one essential method of suicide prevention (Rutz et al., 1989; Rutz et al., 1992). A detailed retrospective clinical analysis, of all 115 consecutive suicide victims on Gotland between 1981 and 1992 presented in this study, showed that male gender and violent methods were overrepresented. 50 suicides had a DSM-III-R axis I diagnosis and half of them (n = 25) had primary major depression. Bipolar II disorder was relatively overrepresented in this sample. After the PTD programme, the proportion of depressive suicides was significantly lower than before. This finding strongly suggests that the significant decrease in the suicide rate after the PTD programme is a direct result of the robust decrease in depressive suicides of the area served by trained GPs. The practical importance of this finding is briefly discussed.     

Mind-body skills groups for posttraumatic stress disorder and depression symptoms in Palestinian children and adolescents in Gaza.

A mind-body skills group program was evaluated to determine its effects on symptoms of posttraumatic stress disorder (PTSD) and depression, and on hopelessness in children and adolescents in Gaza. The 10-session mind-body skills groups included meditation, guided imagery, breathing techniques, autogenic training, biofeedback, genograms, and self-expression through words, drawings, and movement. Data were analyzed from 129 children and adolescents meeting criteria for PTSD. Significant improvements in PTSD and depression symptoms and a significant decrease in a sense of hopelessness were observed immediately following participation in the program. At 7-month follow-up, the improvements in the total PTSD and depression scores were largely maintained and the decreased sense of hopelessness was fully maintained despite ongoing violent conflict and economic hardship. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Suicide in head and neck cancer patients

PURPOSE: It has been well documented that patients with a diagnosis of cancer are at an increased risk of committing suicide. However, there is a paucity of literature on the risk of suicide in the head and neck cancer patient. The purpose of this investigation was to determine the incidence of suicide and expressed suicidal intent in a series of such cancer patients. PATIENTS AND METHODS: A retrospective chart review of 241 patients who were diagnosed with head and neck cancer at the University of Maryland Oral and Maxillofacial Surgery Oncology Division was done. RESULTS: Three patients were identified who committed suicide, 1.2% of the series. Two patients expressed suicidal intent, and four patients refused all treatment and counseling, preferring to die of their disease. CONCLUSIONS: Head and neck cancer patients have many of the same risk factors for suicide as patients with other forms of cancer. To reduce this risk, it is essential that the surgeon maintain good rapport with the patient, because this serves as a foundation for all other aspects of their therapy. In addition, these patients need to be fully evaluated for depression, hopelessness, pain, and other factors important in raising the possibility of suicide, and appropriate, aggressive management must be provided.     

Alcohol, drugs and narcotics in suicides in the Aarhus police district

For a period of one year all suicides in Aarhus police district were investigated with a view to identifying the presence of alcohol or drugs in the body of the deceased. Fifty-one suicides occurred, 46 of which were examined. One third of the suicides were due to poisoning and one fourth to hanging. Alcohol was detected in 20% and drugs or narcotics were found in approximately 60%. The most frequent findings were benzodiazepines, analgetics, antidepressants and carbon monoxide. Approximately 40% of the deceased had received psychiatric treatment.     

Firearm suicides during confrontations with police

We reviewed the case records of suicides in Marion County, Indiana (Indianapolis) and in surrounding counties from 1984 through 1992. Out of 1203 suicides, there were 14 in which armed, on-duty police officers were confronting, pursuing, or apprehending the subject of the death investigation. All subjects were male, and the peak age range was 30 to 34 years. The head, especially the right temple, was the usual site of the fatal wound. More than half of the incidents started as domestic disputes with a wife or girlfriend. Many of the others occurred when police officers pursued or arrested a suspect wanted for a previous felony. Ethanol was involved in less than half of the cases, and drugs were not a factor. In at least four cases, the presence of police was a factor that precipitated the suicide. The histories of the 14 cases demonstrate the potential for controversy and the challenges for forensic scientists investigating suicides during police confrontations.     

Perceived problem-solving ability as a predictor of depression, hopelessness, and suicide ideation in a college population.

A longitudinal design with a mild, naturalistic stressor (poor grade on a midterm exam) tested whether perceived problem-solving ability predicted adjustment in a sample of 303 college students. Participants completed assessments before (Time 1) and after (Time 2) the stressor. Individuals who appraised their problem-solving ability as lower at Time 1 were found to be more vulnerable to the stress of a low grade and experienced higher levels of depression and hopelessness, though not of suicide ideation, at Time 2. These results were obtained independent of pretest scores on these adjustment measures. The results support the model of Perceived Problem-Solving?×?Stress as a predictor of adjustment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Illness attributions and hopelessness depression: The role of hopelessness expectancy.

According to hopelessness theory, hopelessness expectancy is the proximal, sufficient cause of hopelessness depression. Consequently, hopelessness expectancy is viewed as mediating the influence of all other factors on hopelessness depression. Using a longitudinal research design, hopelessness expectancy was examined as a mediator of the relation between illness attributions and hopelessness depression in a sample of 57 adults with rheumatoid arthritis. Although hopelessness expectancy was a strong predictor of hopelessness depression, it moderated rather than mediated the relation between attributions and depression. Finding support for a moderating rather than a mediating model is inconsistent with theory but is consistent with the findings of J. H. Riskind et al (1987). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluating the hopelessness model of depression: Diathesis-stress and symptom components.

The hopelessness model of depression posits that latent attributional diatheses combine with stressors to produce a specific subtype of depression characterized by a specific set of symptoms. Associations between attributional diathesis, stress, and symptoms were examined to test the prediction that hopelessness depressions are characterized by a specific symptom profile. 57 depressed outpatients were categorized into subgroups on the basis of whether or not they met the criteria of L. Y. Abramson et al (1988) for hopelessness depression, defined as a match in content domain between attributional diathesis and negative stressor. Support for hopelessness depression was mixed. The hopelessness subtype differed from other major depressions with respect to symptom profile. However, the differences in symptomatology were not wholly consistent with the predictions of the hopelessness model. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Decline in self-reported dysphoria after treatment entry in inner-city cocaine addicts.

This study examined self-reported dysphoria in 82 consecutive admissions to intensive outpatient treatment for cocaine abuse on whom data for the Beck scales for depression, anxiety, and hopelessness were available for intake and 4 subsequent weeks with no more than 1 missing data point. Mean scores on the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI) decreased significantly between intake and Week 1, with no further significant changes from Weeks 1–4. Similar drops in the rate of clinically significant BDI and BAI scores also were observed. Scores on the Beck Hopelessness Scale (BHS) showed no significant changes. By Week 4, rates of clinically significant depression, anxiety, and hopelessness were similar (17%, 13%, and 16%, respectively) . These findings suggest that assessing depression and anxiety using the BDI and BAI in this population should be postponed for at least 1 week after intake and that intake levels of self-reported mood may be inappropriate baseline measures for evaluating treatment effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)