Suicidal behavior is an interesting blank space in Keller & Miller's (K&M's) population genetical account on explaining the existence and persistence of common, harmful, heritable mental disorders. I argue that suicidal behavior is yet another of these disorders. It may well be consistent with all three evolutionary models considered by K&M. (Published Online November 9 2006).

Nearly one million people take their own lives each year world-wide - however, contrary to popular belief, suicide can be prevented. While suicide is commonly thought to be an understandable reaction to severe stress, it is actually an abnormal reaction to regular situations. Something more than unbearable stress is needed to explain suicide, and neuroscience shows what this is, how it is caused and how it can be treated. Professor Kees van Heeringen describes findings from neuroscientific research on suicide, using (...) various approaches from population genetics to brain imaging. Compelling evidence is reviewed that shows how and why genetic characteristics or early traumatic experiences may lead to a specific predisposition that makes people vulnerable to triggering life events. Neuroscientific studies are yielding results that provide insight into how the risk of suicide may develop; ultimately demonstrating how suicide can be prevented. (shrink)

Mood disorder patients have greater suicide risk than members of the general population, but how suicidal behavior relates to brain functions has not been fully elucidated. This study investigated how functional connectivity (FC) values between the right/left amygdala and the whole brain relate to suicidal behavior in patients with mood disorder. The participants in this study were 100 mood disorder patients with suicidal behavior (SB group), 120 mood disorder patients with non-suicidal behavior (...) (NSB group), and 138 age- and gender-matched healthy controls (HC group). Whole-brain FC values among the three groups were compared using an analysis of covariance (ANCOVA). Compared to the NSB and HC groups, increased FC values in the right amygdala-bilateral paracentral lobule/precuneus circuit were observed in the SB group (Bonferroni-corrected,p 0.017). Moreover, there were no significant differences in FC values between mood disorder patients with suicide attempt (SA group) and mood disorder patients with suicidal ideation (SI group), while the FC values between the right amygdala and bilateral paracentral lobule/precuneus in the SA group were higher than the mean in the SI group. These findings suggest that right amygdala-paracentral lobule/precuneus dysfunction has an important role in patients with mood disorder and suicidal behavior. (shrink)

Moral constructions of suicide are deliberately avoided in contemporary suicidology, yet morality persists, little or imperfectly acknowledged, in its practices and in the policies, discourses, and instruments that it underpins. This study used narrative methodologies to examine the normative force of suicidology and its implications for persons who had engaged in an act of nonfatal suicidal behavior. I interviewed a convenience sample of twelve persons from two inner–urban community mental health centers who were receiving crisis and case management (...) services after a recent act of nonfatal suicidal behavior. Interviews focused on events leading up to and after participants’ suicidal behavior; the responses their suicidal behavior generated in others, including family, friends, and the health professionals caring for them; and cultural views of suicide more broadly. Analysis of these interviews revealed that, although participants’ narratives were broadly consistent with a number of recognizable, canonical story formats common to our cultural repertoire of stories of suicide, they also revealed important tensions, divisions, conflicts, and challenges to contemporary suicidological discourse and practice. Despite evidence to suggest that biomedical understandings of suicide provided some therapeutic benefit to participants, they did not address important social and moral dimensions of human life or explore their connection to suicidal behavior—aspects of the suicidal event that were critical to its causation and to its retelling and “resolution.” The results of this study provide important insights into the moral features of suicidal behavior, the moral and ethical implications of suicide research, and the limitations of moral and ethical discourse in suicidology. (shrink)

Data on birth order and parent-offspring relations for 1,601 adolescents participating in the National Longitudinal Study of Adolescent Health were used to test hypotheses about the role of adolescent suicidal behavior in parent-offspring conflict. Among adolescents highly dissatisfied with their mothers, the odds that middleborns would make at least one suicide attempt was 23% that of first- and lastborns (p<.001), but their odds of receiving medical treatment for their attempts was 8.5 times greater than the odds for first- (...) and lastborns (p=.032). The results are tentatively interpreted as supporting the hypothesis that adolescents use suicide attempts to leverage investment from their parents. (shrink)

Lethal and nonlethal suicidal behaviors are major global public health problems. Much suicidal behavior occurs after the suicide victim committed a murder or other serious transgression. The present study tested a novel evolutionary model termed the Costly Apology Model against the ethnographic record. The bargaining model sees nonlethal suicidal behavior as an evolved costly signal of need in the wake of adversity. Relying on this same theoretical framework, the CAM posits that nonlethal suicidal (...) class='Hi'>behavior can sometimes serve as an honest signal of apology in the wake of committing a severe transgression, thereby repairing valuable social relationships. To test this hypothesis, the CAM was operationalized into a set of variables, and two independent coders coded 473 text records on suicidal behavior from 53 cultures from the probability sample of the Human Relations Area Files. The results indicated that in ethnographic accounts of suicidal behavior, transgressions, punishment, and shame were relatively common, supporting the CAM, but explicit motives to apologize and evidence of forgiveness were rare, contrary to the CAM. The theoretical variables of the CAM nevertheless formed a cluster distinct from the BRM, and a subset of cases of suicidal behavior were largely related to transgressions and other CAM variables rather than BRM or other variables. Support for the CAM varied widely across cultures, but there was evidence for it in every major geographical region. Exploratory analyses suggested that the CAM is potentially more likely to occur in response to severe conflicts concerning transgressions committed against nonkin. Furthermore, in text records that involved transgressions, male suicidal behavior was most frequently associated with murder, whereas female suicidal behavior was most frequently associated with sexual transgressions. In conclusion, the results provided mixed support for the hypothesis that some instances of suicidal behavior function to send a costly signal of apology to those harmed by a transgression. (shrink)

Human suicide presents a fundamental problem for the scientific analysis of behavior. This problem has been neither appreciated nor confronted by research and theory. Almost all other behavior exhibited by humans and nonhumans can be viewed as supporting the behaving organism's biological fitness and advancing the welfare of its genes. Yet suicide acts against these ends, and does so more directly and unequivocally than any other form of maladaptive behavior. Four heuristic models are presented here to account (...) for suicide in an evolutionary and sociobiological framework. The first model attributes suicide to the extraordinary development of learning and cultural evolution in the human species. Learning may make human behavior so independent of biological constraints that it can occasionally assume a form entirely contrary to the principles of biological evolution. The second model attributes suicide to a breakdown of adaptive mechanisms in extremely stressful novel environments. The third model involves kin and group selection, arguing that in limited circumstances suicide may occur because of beneficial effects it has on other, surviving individuals who share the suicidal individual's genes. The last model suggests that suicide should be tolerated by evolution when it has no effect on the gene pool. This model holds particular promise in accounting for aspects of suicide not attributable to culture. The evidence indicates that suicide is most common in individuals who are unlikely to reproduce and unable to engage in productive activity; such individuals are least capable of promoting their genes. A complete explanation of suicide may derive only from an analysis of its biological significance. (shrink)

Suicidality, a significant problem in New Zealand for the past decade or so, has invited a substantial body of research into causes and prevention. However, given the effort, the prevention results do not appear to be sufficiently convincing when coroners’ views are considered. This paper focuses on two mainstream therapeutic approaches towards persons with borderline personality disorder, in which suicidal behaviour is a prominent feature demanding understanding and active attention. It is argued that dialectical behaviour therapy and psychoanalytically informed (...) therapies are lacking on two accounts. Firstly, the philosophical and methodological underpinnings of both approaches perpetuate what Heidegger refers to as the compound misunderstanding of ourselves as human beings. Secondly, what this translates into is a practice which forgets the human order and misunderstands the experience of the singular human present in despair. As an alternative approach towards dealing with suicide in practice, the author presents concepts central to Heidegger’s phenomenology of human existence and discusses how these may inform and enhance the treatment of suicidal patients. Indo-Pacific Journal of Phenomenology , Volume 7, Edition 2 September 2007. (shrink)

The goal of this article is to shed light on Deep Brain Stimulation (DBS) postoperative suicidality risk factors within Treatment Resistant Depression (TRD) patients, in particular by focusing on the ethical concern of enrolling patient with history of self-estrangement, suicide attempts and impulsive–aggressive inclinations. In order to illustrate these ethical issues we report and review a clinical case associated with postoperative feelings of self-estrangement, self-harm behaviours and suicide attempt leading to the removal of DBS devices. Could prospectively identifying and excluding (...) patients with suicidality risk factors from DBS experimental trials—such as history of self-estrangement, suicide attempts and impulsive–aggressive inclinations—lead to minimizing the risk of suicidality harm? (shrink)

In this article, I argue that depression and suicide are natural kinds insofar as they are classes of abnormal behavior underwritten by sets of stable biological mechanisms. In particular, depression and suicide are neurobiological kinds characterized by disturbances in serotonin functioning that affect various brain areas (i.e., the amygdala, anterior cingulate, prefrontal cortex, and hippocampus). The significance of this argument is that the natural (biological) basis of depression and suicide allows for reliable projectable inferences (i.e., predictions) to be made (...) about individual members of a kind. In the context of assisted suicide, inferences about the decision-making capacity of depressed individuals seeking physician-assisted suicide are of special interest. I examine evidence that depression can hamper the decision-making capacity of individuals seeking assisted suicide and discuss some implications. (shrink)

Philosophical discussions of the morality of suicide have tended to focus on its justifiability from an agent’s point of view rather than on the justifiability of attempts by others to intervene so as to prevent it. This paper addresses questions of suicide intervention within a broadly Kantian perspective. In such a perspective, a chief task is to determine the motives underlying most suicidal behaviour. Kant wrongly characterizes this motive as one of self-love or the pursuit of happiness. Psychiatric and (...) scientific evidence suggests that suicide is instead motivated by a nihilistic disenchantment with the possibility of happiness which, at its apex, results in the loss of the individual’s conception of her practical identity. Because of this, methods of intervention that appeal to agents’ happiness, while morally benign, will prove ineffective in forestalling suicide. At the same time, more aggressive methods violate the Kantian concern for autonomy. This apparent dilemma can be resolved by seeing suicide intervention as an action undertaken in non-ideal circumstances, where otherwise unjustified manipulation, coercion, or paternalism are morally permitted. (shrink)

Ethnic minority status and female gender convey a risk for suicidal behavior, yet research of suicidality of ethnic minority female immigrants is scarce. The authors of this article conducted qualitative interviews with 15 young women in the Netherlands, who either had attempted suicide or contemplated suicide, and analyzed these in a narrative psychology tradition. Suicidality was associated with despair and frustration over the violation of the women’s personal autonomy and self-integrity regarding strategic life choices. Autonomy restrictions and violations (...) followed two patterns, which are interconnected with four criteria regarding the capacity for autonomy. Findings are discussed with referral to Durkheim and feminist theories of autonomy. (shrink)

In Europe the elderly population is projected to increase from 18.5% (93.9 million) in 2014 to 28.7% (149.1 million) by 2080. In the USA it is estimated that by the year 2030 more than 20% of the population will be aged 65 years or over. This specific population is at high risk of unrecognised or untreated psychiatric illnesses and suicide. It is well known that completed suicide rate increases with age in both men and women. Although elderly people attempt suicide (...) less often than other age groups, they show a higher completion rate. Generally the methods chosen by elderly are more lethal, the intent is more serious, they are more determined and they show fewer warning sign than the younger population. A recent systematic review and meta-analysis of psychosocial intervention following self-harm in adults found that cognitive behavioural therapy was the most effective in these patients. Unfortunately there have been few reported trials of other potentially effective interventions. Because the scientific literature on psychosocial suicide prevention interventions in the elderly is still scant we decided to conduct a mini-review in order to take stock of the situation. Studies were identified through electronic searches of the Cochrane library, MEDLINE, Scopus and Web of Science databases. PRISMA guidelines were followed and only 7 articles met the inclusion criteria. No firm conclusions can be drawn about this topic because there is still little data and studies used inconsistent outcome measures and designs. Nonetheless, the existing data suggests that psychosocial interventions are promising. (shrink)

Defends Kantian paternalism: Interference with an individual’s liberty for her own sake is justified absent her actual consent only to the extent that such interference stands a reasonable chance of preventing her from exercising her liberty irrationally in light of the rationally chosen ends that constitute her conception of the good. More specifically, interference with an individual’s liberty is permissible only if, by interfering, we stand a reasonable chance of preventing that agent from performing actions she chose due to distorted (...) reasoning and which would result in that agent’s rationally chosen ends not being as fully realized as they would have been had she so acted. -/- Applied to suicide intervention Kantian paternalism implies that such intervention is justified to the extent that it prevents a person from ending her life when, due to distorted reasoning, she engages in suicidal behavior that is at odds with her rationally chosen ends. (shrink)

This paper offers a philosophical analysis of the connection between mental disorder and suicide risk. In contemporary psychiatry, it is commonly suggested that this connection is a causal connection that has been established through empirical discovery. Herein, I examine the extent to which this claim can be sustained. I argue that the connection between mental disorder and increased suicide risk is not wholly causal but is partly conceptual. This in part relates to the way suicidality is built into the definitions (...) of some psychiatric diagnoses. It also relates to the broader normative assumption that suicidal behavior is by definition mentally disordered behavior. The above has significant epistemological implications, which I explore. I propose that the claim that suicide is connected with mental disorder cannot be justified solely by appealing to empirical evidence but also warrants a justification on conceptual and normative grounds. (shrink)

Peña-Guzmán (2017) argues that empirical evidence and evolutionary theory compel us to treat the phenomenon of suicide as continuous in the animal kingdom. He defends a “continuist” account in which suicide is a multiply-realizable phenomenon characterized by self-injurious and self-annihilative behaviors. This view is problematic for several reasons. First, it appears to mischaracterize the Darwinian view that mind is continuous in nature. Second, by focusing only on surface-level features of behavior, it groups causally and etiologically disparate phenomena under a (...) single conceptual umbrella, thereby reducing the account’s explanatory power. Third, it obscures existing analyses of suicide in biomedical ethics and animal welfare literatures. A more promising naturalistic approach might seek a theoretical understanding of the social/ecological circumstances that drive humans and perhaps other animals to self-destruction. (shrink)

The documented efficacy and long-term benefit of antidepressants in patients with recurrent forms of severe anxiety or depressive disorders support their use in those individuals with these disorders, who experience suicidal thoughts or behavior. In general, it is assumed that antidepressants are beneficial for all symptoms of depression, including suicidality. However, some evidence suggests that Selective Serotonin Reuptake Inhibitors [SSRIs] may cause worsening of suicidal ideas in vulnerable patients. Systematic reviews and pooled analysis of experimental, observational, and (...) epidemiological studies have investigated the use of SSRIs and their association with suicidality. Taking account of the methodological limitations of these studies, the current evidence fails to provide a clear relationship between their use and risk of suicidality in adults. However, in children and adolescents, there appears to be a bit of increased risk of suicidal ideations and attempts, but not of completed suicides. This risk can be anticipated and managed clinically. Clinicians are, therefore, advised to maintain a close follow-up during the initial treatment periods and remain vigilant of this risk. This advisory, however, should not deter clinicians from the use of effective dosages of antidepressants for a sufficient period of time, in every age group of patients, when clinically needed, and if found suitable otherwise. (shrink)

There is a growing trend among some physicians, psychiatrists, bioethicists, and other mental health professionals not to treat physician-assisted suicide (PAS) as suicide. The grounds for doing so are that PAS fundamentally differs from other suicides. Perhaps most notably, in 2017 the American Association of Suicidology argued that PAS is distinct from the behavior that their organization seeks to prevent. This paper compares and contrasts suicide and PAS in order to see how much overlap there is. Contrary to the (...) emerging view that emphasizes their differences, I argue that there is significant overlap such that we ought not to separate PAS into its own category, making it diverge from how we think about and address suicide more generally. I start by examining several prominent theories of suicide and argue that PAS fits squarely within them. I then examine several apparent differences between PAS and other kinds of suicide and argue that these differences are merely apparent or they do not justify treating PAS as a fundamentally different kind of thing from suicide. (shrink)

Many people believe that only humans have the cognitive and behavioral capacities needed for suicidal behavior, such as reflexive subjectivity, free will, intentionality, or awareness of death. Three counterarguments — based on (i) negative emotions and psychopathologies among nonhuman animals, (ii) the nature of self-destructive behavior, and (iii) the problem of model fidelity in suicide research — suggest that self-destructive and self-injurious behaviors among human and nonhuman animals vary along a continuum.

Suicide has been condemned in our culture in one way or another since Augustine offered theological arguments against it in the sixth century. More recently, theological condemnation has given way to the view that suicidal behavior must always be symptomatic of emotional disturbance and mental illness. However, suicide has not always been viewed so negatively. In other times and cultures, it has been held that circumstances might befall a person in which suicide would be a perfectly rational course (...) of action, in the same sense that any other course of action could be rational: that it could be sensible, i.e., defensible by good reasons, or that it could be in keeping with the agent's fundamental interests. Indiscriminate use of modern life-sustaining technologies has renewed interest in the possibility of rational suicide. Today proponents of rational suicide tend to equate the rationality of suicide with the competence of the decision to commit suicide. (shrink)

RESUMEN Al definir “suicidio”, la Real Academia Española toma una opción filosófica que se aleja de algunos propósitos y puntos de vista de la salubridad pública, y acentúa su carácter de actividad íntima que realiza un sujeto capaz de acción. Los límites del concepto no son claros; hay un continuo entre el suicidio y encontrar la muerte por causa natural, accidental o conducta de riesgo. Pero el suicidio solo puede ser fruto de un acto soberano, de modo que quien esté (...) privado de voluntad no es un suicida. Esto permite discutir los planteamientos de B. Spinoza e I. Kant, así como algunas posturas de sanidad pública que no ven ese carácter soberano del suicidio. ABSTRACT In its definition of “suicide”, the dictionary of the Spanish Royal Academy opts for a philosophical position that distances itself from some public health objectives and points of view, in order to emphasize the nature of suicide as an intimate act carried out by a subject capable of action. The boundaries of the concept are unclear: there is a continuum between suicide and death due to natural or accidental causes or reckless behavior. But suicide can only be the result of a sovereign act, and, therefore, someone who lacks will cannot be a suicide. This makes it possible to discuss the proposals of B. Spinoza and I. Kant, as well as some of the public health approaches that disregard the sovereign nature of suicide. (shrink)

BackgroundSuicide research aims to contribute to a better understanding of suicidal behaviour and its prevention. However, there are many ethical challenges in this research field, for example, regarding consent and potential risks to participants. While studies to-date have focused on the perspective of the researchers, this study aimed to investigate the views and experiences of members of Human Research Ethics Committees (HRECs) in dealing with suicide-related study applications.MethodsThis qualitative study entailed a thematic analysis using an inductive approach. We conducted (...) semi-structured interviews with a purposive sample (N = 15) of HREC Chairs or their delegates from Australian research-intensive universities. The interview guide included questions regarding the ethical concerns and challenges in suicide-related research raised by HREC members, how they dealt with those challenges and what advice they could give to researchers.ResultsThe analysis identified four main themes: (1) HREC members’ experiences of reviewing suicide-related study applications, (2) HREC members’ perceptions of suicide, suicide research, and study participants, (3) Complexity in HREC members’ decision-making processes, and (4) HREC members’ relationships with researchers.ConclusionsReliance on ethical guidelines and dialogue with researchers are crucial in the assessment of suicide-related study applications. Both researchers and HREC members may benefit from guidance and resources on how to conduct ethically sound suicide-related studies. Developing working relationships will be likely to help HRECs to facilitate high quality, ethical suicide-related research and researchers to conduct such research. (shrink)

Media guidelines on safe suicide-related reporting are within the suicide prevention armamentarium. However, implementation issues beleaguer real-world practice. This study evaluated the perspectives of the Malaysian media community, persons with lived experience of suicidal behavior, and mental health professionals on suicide-related reporting in terms of the impact, strategies, challenges, and the implementation of guidelines on safe reporting. Three focus group discussions of purposively sampled Malaysian media practitioners, PLE, and MHP were audio-recorded, transcribed, coded and thematically analyzed. Inclusion criteria (...) were: English fluency, no clinical depression or suicidal ideation, no recent previous suicide attempts or suicide bereavement. Three major themes emerged: Unsafe Reporting; Impact; and Safe Reporting. Most described current reporting as unsafe by being potentially triggering to media users and may contribute to contagion effect. Positive impacts identified included raised awareness toward suicide and its prevention. Unsafe reporting was attributed to inadequate awareness, knowledge, and guidance, lack of empathy and accountability, job-related factors, popularity-seeking, lack of monitoring and governance, and information source with unsafe content. Majority agreed on how suicide stories should be framed to produce a safe report. The media community diverged on how detailed a suicide story should be. Safe reporting challenges included difficulties in balancing beneficial versus harmful details, social media ubiquity and its citizen reporters. Participants suggested these safe reporting strategies: stakeholder engagement, educational approaches, improving governance and surveillance, and guidelines revision. Most acknowledged the relevance of guidelines but were unaware of the existence of local guidelines. Implementation challenges included the dilemma in balancing media industry needs vis-à-vis safe reporting requirements, stakeholder engagement difficulties and social media regulation. There is poor awareness regarding safe suicide-related reporting across all groups. PLE and MHP were negatively impacted by current unsafe messaging which aggravated trauma and grief reactions. Postvention support gaps for mental health professionals were highlighted. Safe reporting promotion strategies should include stakeholder engagement to increase awareness on minimizing Werther and maximizing Papageno effects. Strategic re-examination and dissemination of local media guidelines to address new media issues, and effective surveillance mechanisms, are crucial in sustainable improvement of safe reporting practices. (shrink)

In recent years, much has been learned about the strategic and organizational contexts of suicide attacks. However, motivations of the agents who commit them remain difficult to explain. In part this is because standard models of social learning as well as Durkheimian notions of sacrificial behavior are inadequate in the face of the actions of human bombers. In addition, the importance of organizational structures and practices in reinforcing commitment on the part of suicide recruits is an under-explored factor in (...) many analyses. This essay examines the potential applicability of evolutionary models of altruism to the understanding of commitment to suicide on the part of terrorist organizational recruits. Three evolutionary models of sacrificial behavior in nonhuman species and many categories of human behavior are explored cross-organizationally: reciprocity, inclusive fitness theory, and induced altruism. Reciprocal altruism is unlikely to be a major motivator in suicide attacks because the costs exhibited by attackers are too high to be adequately compensated. However, the role of evolved self-deception in perceptions of personal death, and thus of rewards in the afterlife, is potentially illuminating. Inclusive fitness theory can help explain the motivations of attackers because rewards to kin often are offered by organizations to suicide recruits. However, suicide bombers also often act out of revenge for the loss of or injury to relatives, and inclusive fitness theory generally, as well as more specific theoretical models of retaliatory aggression, may not adequately account for the bombers' actions. Predictions from induced altruism theory appear to be well supported because suicide terror organizations tend to be tightly structured around practices intended to maintain and reinforce commitment though the manipulation of kinship-recognition cues. (shrink)

Contemporary approaches to the study of suicide tend to examine suicide as a medical or public health problem rather than a moral problem, avoiding the kinds of judgements that have historically characterised discussions of the phenomenon. But morality entails more than judgement about action or behaviour, and our understanding of suicide can be enhanced by attending to its cultural, social, and linguistic connotations. In this work, I offer a theoretical reconstruction of suicide as a form of moral experience that delineates (...) five distinct, yet interrelated domains of understanding: the temporal, the relational, the existential, the ontological, and the linguistic. Attention to each of these domains, I argue, not only enriches our understanding of the moral realm but also provides a heuristic for examining the moral traditions and practices that constitute contemporary understandings of suicide. (shrink)

This paper seeks to think creatively about the body of research which claims there is a link between heavy metal music and adolescent alienation, self-destructive behaviours, self-harm and suicide. Such research has been criticised, often by people who belong to heavy metal subcultures, as systematically neglecting to explore, in a meaningful manner, the psychosocial benefits for individuals who both listen to contemporary heavy metal music and socialize in associated groups. We argue that notions of survival, strength, community, and rebellion are (...) key themes in contemporary heavy metal music. Through literary-lyrical analysis of a selection of heavy metal tracks, this paper aims to redress the balance of risk and benefit. We argue that listening to this type of music, the accompanying social relationships, sense of solidarity and even the type of dancing can ameliorate tumultuous and difficult emotions. Songs which could be read as negative can induce feelings of relief through the sense that someone else has felt a particular way and recovered enough to transform these emotions into a creative outlet. This genre of music may therefore not increase the risk of untoward outcomes in any simple sense but rather represent a valuable resource for young people in difficulty. (shrink)

Older people are confronted with a myriad of challenges throughout the course of their lives in the present society. One of these is the issue of suicidal behaviour among people of older age. This article understands the nature and examines the cause of mortality due to suicide among older people in later life. The author has applied the document analysis method. The information for the current research has been collected using the news content of various Indian newspapers, magazines, and (...) news portals. The researcher was collated 60 occurrences of old-age suicide from the newspapers of Northern Indian states from March 2022 to June 2022. The study has indicated that there is a substantial rise in old-age suicide due to the vulnerable condition of older people in late life. Moreover, the vulnerable condition of older people has led to various factors instrumental in old-age suicide, such as abuse in the family, chronic diseases, depression, poverty, and social rejection that give rise to feelings of committing suicide among the older people. (shrink)

Although the most common understanding of suicide is intentional self-killing, this conception either rules out someone who lacks mental capacity being classed as a suicide or, if acting intentionally is meant to include this sort of case, then what it means to act intentionally is so weak that intention is not a necessary condition of suicide. This has implications in health care, and has a further bearing on issues such as assisted suicide and health insurance. In this paper, I argue (...) that intention is not a necessary condition of suicide at all. Rather, I develop a novel approach that deploys the structure of a homicide taxonomy to classify and characterise suicides to arrive at a conceptually robust understanding of suicide. According to my analysis of suicide, an agent is the proximate cause of his death. Suicide is ‘self-killing,’ rather than ‘intentional self-killing.’ Adopting this understanding of suicide performs several functions: We acquire an external standard to assess diverging analyses on specific cases by appealing to homologous homicides. Following such a taxonomy differentiates types of suicides. This approach has application in addressing negative connotations about suicide. As a robust view, adding intention is an unnecessary complication. It is more consistent with psychological and sociological assessments of suicide than ‘intentional self-killing.’ It has useful applications in informing public policy. This paper’s focus is on classifying types of suicides, rather than on the moral permissibility or on underlying causes of suicidal ideation and behaviour. (shrink)

Recently, psychologists have developed indirect measurement procedures to predict suicidal behavior. A prominent example is the Death/Suicide Implicit Association Test (DS-IAT). In this paper, I argue that there is something special about the DS-IAT which distinguishes it from different IAT measures. I argue that the DS-IAT does not measure weak or strong associations between the implicit self-concept and the abstract concept of death. In contrast, assuming a goal-system approach, I suggest that sorting death-related to self-related words takes effort (...) because death-related words trigger avoidance-impulses, which suicide ideation weakens. The DS-IAT taps into weakened automatic responses from the self-preservation system. Additionally, the suggested cognitive structure, illuminated with the selfish-goal theory, explains predictable suicidal behavior. (shrink)

State statutes, case law, and professional codes of ethics in the mental health professions typically stress either a duty or the permissibility of disclosing confidential information in order to prevent clients from seriously harming themselves. These sources are intended to address cases where clients are deemed to be suffering from cognitive dysfunction for which paternalistic intervention, including involuntary hospitalization, is considered necessary to prevent self-destructive behavior.The counselor’s moral and legal responsibility is less apparent when mentally competent clients desire suicide (...) as release from irremediable suffering due to severe physical illness, and this desire is defensible within these clients’ value systems. This paper will explore moral and legal dimensions of a counselor’s decision not to intervene in such cases. The concept of permitted suicide will be introduced and defined, and guidelines for its application developed. (shrink)

By leveraging the case of Hindu sati, this paper elucidates the ways in which structure and culture condition suicidal behavior by way of social psychological and emotional dynamics. Conventionally, sati falls under Durkheim's discussion of altruistic suicides, or the self-sacrifice of underindividuated or excessively integrated peoples like widows in traditional societies. In light of the fact that Durkheim's interpretation was based on uneven data, nineteenth century Eurocentric beliefs, and a theoretical framework that can no longer resist modification and (...) elaboration, by reconsidering sati it is possible to sketch a new model that strengthens Durkheim's theory by making it more robust and generalizable. The following model is built on five principles. First, integration and regulation are not distinct causal forces, but overlapping contextual conditions. Second, to better explain the variation in suicidality across time and space, we must also pay attention to culture as it provides the underlying meanings of suicide that can increase the odds a person or class of persons become suicidal or are protected against suicidality. Third, structure still matters, but in many cases, the role power and power-differentials play must be considered. Fourth, understanding why and how people choose suicide depends on incorporating identity and status processes. Fifth, because the expression of social emotions like shame are patterned by structural and cultural conditions, to understand how suicidality is socioculturally patterned we must further explore the link between identity/status, social emotions, and structure and culture. (shrink)

Suicide as a form of political protest is a little studied social phenomenon that cannot be dismissed simply as being irrational or patholognomic. We consider protest suicide to be a meaningful social action as purposive political act intended to change oppressive policies or practices. This paper synthesizes theoretical propositions associated with suicide in general, and protest suicide in particular, so as to construct a general explanatory model of protest suicide as a social phenomenon. Then, it analyzes protest suicide as a (...) meaningful social action. People considering protest suicide have to discern the logic of the situation in which such action is to take place. This involves answering two fundamental questions: Is suicide an acceptable course of social action? Is the envisaged protest suicide likely to achieve their hopes, aspirations and goals? How these questions are answered gives rise to a set of protest suicide archetypes. Our analysis generates a more sophisticated understanding of the potential reasons for, and motivations behind, protest suicide as a social phenomenon. (shrink)

Non-suicidal self-harm is common in youth. The behavior may have negative and sometimes dangerous consequences, such as feelings of guilt, scars, nerve damage and accidental death. Is this behavior a mental disorder? This question is attracting serious consideration. I want to say that non-suicidal self-harm in youth is never a mental disorder in its own right. Yet, I do not want to commit to saying what is a mental disorder. So I identify the characteristic features and (...) functions of non-suicidal self-harm in youth and show that these features and functions are also seen in non-disordered behaviors in youth. This, I say, shows that non-suicidal self-harm in youth is non-disordered too. I say that non-suicidal self-harm in youth is a characteristic youth behavior that when seen in youth has an understandable practical function. I offer to the general discussion about mental disorder the strategy I use. (shrink)

The evolutionary advantage of psychological phenomena can be gleaned by comparing them with physical traits that have proven adaptive in other organisms. The present article provides a novel evolutionary explanation of suicide in humans by comparing it with aposematism in insects. Aposematic insects are brightly colored, making them conspicuous to predators. However, such insects are equipped with toxins that cause a noxious reaction when eaten. Thus, the death of a few insects conditions predators to avoid other insects of similar coloration. (...) Analogously, human suicides may increase the credibility of future suicide threats and attempts from others, conveying an evolutionary advantage to the phenotypic expression of suicidal behavior in low-fitness contexts. (shrink)

In this essay, we present three case studies which suggest that sometimes we are better off supporting a so–called irrational suicide, and that emotional or psychological distress – even if medically controllable – might justify a suicide. We underscore how complicated these decisions are and how murky a physician's moral role can be. We advocate a more individualized route to end–of–life care, eschewing well–meaning, principled, generalizations in favor of a highly contextualized, patient–centered, approach. We conclude that our Western traditions of (...) promoting reasoned behavior and life themselves may at times be counter–productive. (shrink)

ABSTRACTAnxiety and depression diagnoses are associated with suicidal thoughts and behaviours. However, a categorical understanding of these associations limits insight into identifying dimensional mechanisms of suicide risk. This study investigated anxious and depressive features through a lens of suicide risk, independent of diagnosis. Latent class analysis of 97 depression, anxiety, and suicidality-related items among 616 psychiatric outpatients indicated a 3-class solution, specifically: a higher suicide-risk class uniquely differentiated from both other classes by high reported levels of depression and anxious (...) arousal; a lower suicide-risk class that reported levels of anxiety sensitivity and generalised worry comparable to Class 1, but lower levels of depression and anxious arousal; and a low to non-suicidal class that reported relatively low levels across all depression and anxiety measures. Discriminants of the higher suicide-risk class included borderline personality disorder; report... (shrink)

Background:Suicide remains an important cause of premature deaths and draws much media attention. However, unsafe reporting and portrayal of suicides by the media have been associated with increased risk of suicidal behavior. Current evidence suggests that media capacity-building could potentially prevent suicide. However, there are still knowledge gaps in terms of a lack of data on effective strategies for improving awareness and safe reporting of suicide-related media content. This study aims to investigate the effectiveness of a workshop conducted (...) with members of the media community on the safe reporting of suicide-related content.Methods:An interventional single-arm pre and post pilot study was conducted on a sample of the Malaysian media community recruited through purposive and snowball sampling. The media safe reporting workshop was conducted by a suicide prevention expert with a media industry background. Thirty participants completed a self-reported evaluation questionnaire on their awareness and knowledge of reporting on suicide-related media content; before and after the interventional workshop.Results:There was a significant difference between the total scores before and after the intervention, with a large effect size. Post-intervention scores were significantly improved in 8 items, namely those related to the reporting of: (i) the content of any suicide note; (ii) headlines with methods of suicide; (iii) headlines with the location of suicide; (iv) cases of suspected suicide despite the unconfirmed cause of death; (v) suicide news to cater to readers’ interests; (vi) cause of suicide; (vii) details of the location of suicide; and (viii) the negative impact to media community when reporting suicide stories. In particular, there was an improvement in the majority of items for people from the media community with no lived experience of suicidal behavior.Conclusion:The media safe reporting workshop is a potentially effective intervention for improving awareness and knowledge measures relating to safe reporting on suicide among the media community, with a more pronounced effect in those without lived experience of suicidal behavior. Limitations in the sample size, generalizability, short-term evaluation, and lack of a control group warrant future larger, longer-term controlled, and more representative studies. (shrink)

There is a need to understand more of the risk factors involved in the process from suicide ideation to suicide attempt. Cognitive control processes may be important factors in assessing vulnerability to suicide. A version of the Stroop procedure, Delis–Kaplan Executive Function System Color–Word Interference Test and Behavior Rating Inventory of Executive Function were used in this study to test attention control and cognitive shift, as well as to assess everyday executive function of 98 acute suicidal psychiatric patients. (...) The Columbia Suicide History Form was used to identify a group of suicide ideators and suicide attempters. Results showed that suicide attempters scored lower on attention control than suicide ideators who had no history of attempted suicide. The self-report in the BRIEF-A inventory did not reflect any cognitive differences between suicide ideators and suicide attempters. A logistic regression analysis showed that a poorer attention control score was associated with the suicide attempt group, whereas a poorer cognitive shift score was associated with the suicide ideation group. The results found in this study suggest that suicide attempters may struggle with control of attention or inhibiting competing responses but not with cognitive flexibility. (shrink)