Loss by suicide. A risk factor for suicidal behavior

1. Data show suicidal behavior often is precipitated by individuals' experience of loss by suicide. This article focuses on three potential links between the two phenomena (i.e., grief experienced by suicide survivors and familial risk factors for suicide; suicide clusters and pacts; consequences of mass media portrayals of suicide). 2. Suicide bereavement has certain typical characteristics that comprise the "suicide survivor syndrome" and may be linked with increased risk of suicidal ideation and behavior. 3. Individuals' suicidal behavior and ideation can lead to suicide clusters (i.e., a group of suicides or attempts occurring close together in time and space) and pacts (i.e., mutual agreements between two people who promise to kill themselves at the same time, often in the same place). 4. Mass media portrayals of suicide may lead to imitative suicides (i.e., the "Werther effect").     

On and Off the Reservation: A Discussion of the Social,Physical, and Mental Health Indicators of Suicide in the Native American Community

This article reviews explanations for the heightened rates of suicide among the US Native American population. Particular attention is afforded to the social, historical, physical, and mental health stressors that may contribute to such high rates. A great deal of scientific research has centered on determining and analyzing the many socio‐demographic indicators of suicide. Studies at the intersection of race/ethnicity and suicide have drawn attention to the fact that certain groups have higher suicide rates than others. At the pinnacle of groups most susceptible to suicide are Native Americans, followed closely by White non‐Hispanics, and then all other racial/ethnic groups ( Sederer 1994 ). As of 2008, Native Americans were more than twice as likely to commit suicide as Blacks, Hispanics, or Asian‐Americans. The analysis begins with an exploration of potential explanations behind the alarming rates of suicide within the Native American community, followed by critiques of the various theories.     

Field Note—Developing Suicide Risk Assessment Training for Hospital Social Workers: An Academic–Community Partnership

This article describes 1 large urban pediatric hospital's partnership with a university to provide suicide assessment and management training within its social work department. Social work administrators conducted a department-wide needs assessment and implemented a 2-session suicide assessment training program and evaluation. Respondents (97.8%) indicated that the training was either helpful or very helpful in 8 suicide assessment skill-based domains. All attendees reported positive changes in perceived competence in 6 of 8 skill-based domains. A brief and time-efficient in-service training can be instrumental in augmenting hospital social worker competence in suicide risk assessment practice. This model of training program development, implementation, and evaluation is feasible, evidence-informed, and may be replicated.     

Socioeconomic System of the Oil Boom and Rural Community Development in Western North Dakota

An oil boom is a complex social and economic phenomenon. The socioeconomic system presented in this article represents a novel effort to explicate boom impacts and changes, within a systems framework, at the community level to enhance community planning and development efforts. Most boomtown studies focus on longitudinal changes of a boom‐bust‐recovery cycle or social‐disruption‐based approaches. This article is an effort to demonstrate that longitudinal changes or social disruptions of a boom manifest through the interactions and interrelationships between social entities and stakeholders acting within the boom conditions and surrounding conditions. The socioeconomic system approach in this article analyzes the boom as a system, which provides a useful lens for many other rural communities currently experiencing unconventional oil and gas development in the United States. The socioeconomic system highlights five main challenges or factors that need to be addressed through community development strategies: develop affordable housing, invest in community infrastructure, expand public services, attract new businesses to the area, and develop better community integration strategies to build trust and unity within the community. This article is qualitative and exploratory in nature. As a result, it explicates the functions, structure, and relationships between system entities to provide a broader understanding of coherence, conflicts, and synergies within a system.     

Personal and Professional Knowledge of and Experience With Suicide and Suicide Prevention Among Stakeholders in Clinical and Community Practice

Community-dwelling veterans at risk for suicide may be in contact with a variety of providers in agency-based settings that offer health and human services. The study aim is to describe the perspective of agency-based clinical and community providers who may come into contact with veterans in need of suicide prevention services and to examine the nature of their personal and professional relationships to individuals at risk for suicide among this sample.

This study reports on qualitative data from a sample of Veterans’ Affairs (VA) and community providers serving veterans and military families in one Midwestern state (N = 70). Providers completed a survey assessing exposure to suicide, including contact with and relationship to someone suicidal, and organizational characteristics of the providers’ employing agencies. Semi-structured interview questions probed for the nature of how they would react with suicidal individuals. Most providers (94%) had some prior contact with someone who was suicidal, and nearly three quarters (77%) knew someone who had died by suicide. Providers reported powerful emotional responses of sadness and remorse to suicidal experiences. While these providers interact with veterans and military families as part of their jobs, they may have their own history of being exposed to suicide, both professionally and personally.     

Confronting Cruelty

Abstract

The present article reports on a study of the attitudes and behaviour of young people towards help-seeking during times of emotional distress and, in particular, when contemplating suicide. Twent- one young people aged between 16 and 24 years, as well as six parents and 14 youth service providers who lived in ‘Subcity’, a metropolitan community, were interviewed about their understandings of youth suicide and effective interventions. Nearly all the young people, service providers and parents identified a range of barriers that impede or prevent young people from asking for help when they need it most, including issues related to trust and confidentiality, parental support and fear, stigma and perceived loss of esteem. Implications for social work practice include an emphasis on developing parenting skills and community development related to education about suicide and the provision of appropriate support services.     

Well London: Results of a Community Engagement Approach to Improving Health Among Adolescents from Areas of Deprivation in London

This article reports findings among adolescents of the impact of Well London, a program of wellbeing interventions delivered across 20 deprived neighbourhoods of London using a community engagement model. Twelve hundred and fifty-four adolescents were surveyed from matched intervention and control areas. There was no significant intervention effect on the main outcome measures: unhealthy eating, physical activity, and mental health. Factors influencing the results may include the possibility that the communities defined by the cluster randomized controlled trial (CRCT) were not an accurate reflection of the adolescent’s natural community, and interactions within the school environment in particular could have led to a dilution of effect.     

Reddit and the Social Studies: Exploring the r/Democratic Curriculum

In this article the author seeks to present social studies educators with practical means for using Reddit—an emerging social media website—as a tool for providing students with a democratic education grounded in citizenship and multicultural education. The author focuses on ways in which Reddit offers students the opportunity to learn from experts, explore social studies content that may not be present within a traditional textbook, and voice their opinion in an online community that values equality and democracy among its members.     

Dying in jail: The phenomenon of adolescent suicide in correctional facilities

Adolescent suicide is increasing in the United States and the incidence of suicide gestures and attempts in juvenile correctional facilities is high. The attitudes of correctional staff toward adolescents and toward suicidal behavior may contribute to the increase. Suicide is often the outcome of a progression of problems that have isolated the adolescent from meaningful social relationships. Correctional staff must be aware of the phenomenon of adolescent suicide and be given training to deal with it effectively within the institution. Institutional staff have commonly seen suicide gestures or attempts as acting out behavior rather than a symptom of low self-esteem or inability to cope with institutional placement. This discussion examines the phenomenon of adolescent suicide and the impact the juvenile justice system has on its occurrence. It will also include an examination of interdisciplinary interventive strategies which can be used in an institutional setting.     

A qualitative analysis of suicide risk factors,preferred means,and means restriction feasibility within a homeless shelter environment

Suicide completion rates among homeless individuals are approximately nine times higher than the general population. The purpose of this study was to capture the state of social support among homeless individuals, understand how homeless community members support peers in crisis, examine the awareness of suicidal ideation, identify common methods for suicide, and generate strategies for means restriction within a shelter. Twenty individuals residing at an emergency shelter were interviewed. Participants were of diverse cultural identities overrepresented in the sample relative to the general population. Interviews revealed that 40% of participants lacked social support. However, the majority indicated that if they encountered someone at risk for suicide, they would provide support and encouragement to the at-risk individual. Almost half of participants reported knowing of an individual in the shelter who had previously attempted suicide and/or was currently or previously feeling suicidal. Overdose was identified as a primary method for suicide; however, the majority of participants were unable to generate strategies for means restriction. The present study offers a glimpse into the experience of homeless individuals and provides valuable information regarding risk factors for suicide within this highly marginalized and underserved population.     

Profiles of behavioral problems in children who witness domestic violence

Unlike previous investigations of shelter-based samples, our study examined whether profiles of adjustment problems occurred in a community-program-based sample of 175 school-aged children exposed to domestic violence. Cluster analysis revealed three stable profiles/clusters. The largest cluster (69%) consisted of children below clinical thresholds for any internalizing or externalizing problem. Children in the next largest cluster (18%) were characterized as having externalizing problems with or without internalizing problems. The smallest cluster (13%) consisted of children with internalizing problems only. Comparison across demographic and violence characteristics revealed that the profiles differed by child gender, mother's education, child's lifetime exposure to violence, and aspects of the event precipitating contact with the community program. Clinical and future research implications of study findings are discussed.     

Random-effects models for analyzing clustered data from a nutrition education intervention

When evaluating the effects of public health intervention, larger units, or clusters, of individuals are often the unit of randomization and implementation. Ignoring dependency in the data due to clustering can misrepresent intervention effects. Random-effects models (REMs) may be a useful way to analyze such data. The present study compares results of analyses of data from a nutrition intervention program using four different methods: (a) usual multiple regression analysis using individual subject data, (b) usual multiple regression analysis using the classroom cluster as the unit of analysis, (c) two-level REM model with subjects clustered within classrooms, and (d) two-level REM model with subjects clustered within sites.     

Mapping Prefrontal Cortex Functions in Human Infancy

It has long been thought that the prefrontal cortex, as the seat of most higher brain functions, is functionally silent during most of infancy. This review highlights recent work concerned with the precise mapping (localization) of brain activation in human infants, providing evidence that prefrontal cortex exhibits functional activation much earlier than previously thought. A systematic evaluation of the activation patterns in these neuroimaging studies mainly based on functional near‐infrared spectroscopy reveals that prefrontal cortex function can be broadly divided into two distinct anatomical clusters with different functional properties. One cluster of activations falls within the region of the medial prefrontal cortex and is mainly involved in affective processes; another cluster is located in lateral aspects of the prefrontal cortex and shows sensitivity to cognitive processes such as memory and attention. This distinction is in line with adult data and evolutionary models and may represent a developmentally continuous organization principle of prefrontal cortex function. All in all, this review is aimed at providing a synthesis of new findings that are emerging from the use of neuroimaging techniques with infants as well as at encouraging further theory‐driven research to understand the developmental origins of prefrontal cortex function.     

Sleep disturbances and suicide—New battles for veterans of U.S. wars in Afghanistan and Iraq: A retrospective review

In this article, we systematically reviewed 116 veterans’ medical records to explore the mitigating factors in sleep disturbance, polytrauma clinical triad (PCT), and suicide. We discovered that a particular nonaction (i.e., no standardized completion of sleep-disturbance screenings) had strong implications for resulting suicides among veterans with reported sleep disturbances, PCT, and suicidal ideations. This study provides strong propositions for the further study of this veteran cohort—Operations Enduring Freedom (OEF), Iraqi Freedom (OIF), and New Dawn (OND)—with regard to the impact of sleep disturbance on PCT and its relationship with suicide symptoms, ideation, and completion. The purpose of this study was to examine the outcomes of sleep disturbances on complex relationships among the three primary diagnoses—posttraumatic stress disorder (PTSD), traumatic brain injury (TBI), and chronic pain—that establish the PCT cluster. We identified that those diagnosed with sleep disturbances had increased suicidal ideations and rates of completed suicides. We analyzed these factors in veterans returning from the current wars in Afghanistan and Iraq. We hypothesized that (a) clinicians were not completing sleep-disturbance screenings as a standard practice for the OEF/OIF/OND veterans diagnosed with PCT who reported sleep disturbance concerns within the U.S. Department of Veterans Affairs; (b) if no sleep-disturbance screening instruments were used by clinicians, veterans would be at a greater risk of suicide completion.     

Book Review

This article is concerned with current understandings of the relevance of urban community studies within sociology. It starts by revisiting some of the major critiques made of community studies in the 1960s and 1970s, and briefly reviews whether network analysis, and in particular a focus on ‘personal communities’, provided a satisfactory alternative approach. The main part of the article argues that despite the criticisms there have been there is still much to be gained from a focus on people's attachments to locality, including the networks to which they are linked. Taking processes of globalization and migration as its major themes, the article explores how research has demonstrated the continuing relevance of ‘locality’ and ‘community’ for understanding the ways that contemporary social and economic transformations shape people's experiences. As well as considering different aspects of social exclusion, the article reviews how recent studies have explored the increasingly complex interplay of locality and identity.     

Characteristics of the Homeless Mentally III in Case Management: Differentiation Using Major Diagnostic Categories

The homeless mentally ill are more disabled than other homeless people and require more services, but important variations exist. This study examined relationships between broad Axis I diagnostic clusters and demographic and service variables for 328 clients receiving case management at a community program for the chronic mentally ill homeless. Demographic characteristics, medical history, educational, psychological, and marital history, and case management variables were examined for psychotic, affective, and miscellaneous other clients. Differences were found in such areas as suicide attempts and current suicide status, psychiatric treatment history, education, overall impairment of functioning, length of time homeless, and time in case management but not in status at termination or number of senlices required. Psychotics had lower adaptive functioning, spent less time in case management, but had as successful outcomes as affective clients. Psychiatric diagnosis provides information that might assist case management for the homeless mentally ill.     

Characteristics of the homeless mentally ill in case management: Differentiation using major diagnostic categories

The homeless mentally ill are more disabled than other homeless people and require more services, but important variations exist. This study examined relationships between broad Axis I diagnostic clusters and demographic and service variables for 328 clients receiving case management at a community program for the chronic mentally ill homeless. Demographic characteristics, medical history, educational, psychological, and marital history, and case management variables were examined for psychotic, affective, and miscellaneous other clients. Differences were found in such areas as suicide attempts and current suicide status, psychiatric treatment history, education, overall impairment of functioning, length of time homeless, and time in case management but not in status at termination or number of services required. Psychotics had lower adaptive functioning, spent less time in case management, but had as successful outcomes as affective clients. Psychiatric diagnosis provides information that might assist case management for the homeless mentally ill.     

Suicide prevention in the dot com era: technological aspects of a university suicide prevention program

Western Michigan University's Suicide Prevention Program utilizes multiple technological components, including an online training course, a Web site, and 2 social networking Web site profiles, as integral aspects of a comprehensive program. This article discusses the development, maintenance, use, and impact of the technological aspects of this program, which complement other program activities in meeting program goals. The Web site and use of social networking Web sites have been very well received by members of the university and wider community. Although initial outcomes of each component are positive, low participation in the online training course has limited the usefulness of pretest-posttest comparisons. It is thought that other campus suicide prevention programs may benefit from using technology as a primary method in their suicide prevention programming efforts.     

Old age rational suicide

In the societal debate surrounding voluntary euthanasia or physician‐assisted suicide, there is a concern that older people will be left exposed to any legislation, subject to either faint suggestion or outright coercion from familial or professional carers. Whilst it is critical to take account of older people's potential vulnerability to any current or proposed assisted suicide legislation, there is a parallel strand of research exploring another relationship which older people can have with this debate: one of activism. Sociological research has shown that older people make up the “rank and file” of those active within the right‐to‐die movement. One of the stated motivations of some older people requesting hastened death has been that, in spite of an absence of life‐threatening disease, they feel “tired of life” or that they have lived a “completed life” and feel ready to die. The notion of suicide for reasons of longevity and being tired of life are becoming increasingly significant given the fact of global ageing. This article brings together empirical and theoretical research on the phenomenon of old age rational suicide in order to develop an underexplored area in both the sociology of death and the sociology of ageing.