Predicting suicide attempts via a computer test

From Medical News Today:

Two powerful new tests developed by psychologists at Harvard University show great promise in predicting patients’ risk of attempting suicide. Both new tests are easily administered within minutes on a computer, giving quick insight into how patients are thinking about suicide, as well as their propensity to attempt suicide in the near future.

In one study, 124 patients in a psychiatric emergency department were administered a modified Stroop test measuring speed in articulating the color of words on a computer screen. Suicidal individuals were found to pay more attention to suicide-related words than to neutral words.

“Suicide Stroop scores predicted six-month follow-up suicide attempts above and beyond well-known risk factors such as a history of suicide attempts, patients’ reported likelihood of attempt, and clinicians’ predictions regarding patients’ likelihood of attempt,” says co-author Christine B. Cha, a doctoral student in psychology at Harvard.

A second study adapted the Implicit Association Test developed by Harvard psychologist Mahzarin R. Banaji, using reaction times to semantic stimuli to measure 157 subjects’ automatic mental associations — in this case, the strength of associations between words related to “self” and words related to either “life” or “death/suicide.” Participants were shown pairs of words on a screen, with response speed revealing unconscious associations between the terms. For instance, a rapid response to stimuli associating self with death/suicide suggests a strong unconscious association between the two.

The researchers found that those participants with strong associations between self and death/suicide were six times more likely to attempt suicide within the next six months than those holding stronger associations between self and life.

Suicide and its circumstances

originally appeared in The Psychiatric Times:

Circumstances Associated with Suicide

The Centers for Disease Control and Prevention (CDC) estimated the suicide rate in the United States at 11.6 per 100,000 in 2007 (18.4 and 5.0 per 100,000 in male and female populations, respectively). Mental health problems were the most common known circumstance associated with suicide deaths. Firearm was the most common method used (50.7 percent overall). The full surveillance report on violent deaths, dated May 14, is posted at <www.cdc.gov/mmwr/pdf/ss/ss5904.pdf>.

Mental Health Month: Facts of the Day

Stats on Suicide/NIMH:

Suicide is a major, preventable public health problem. In 2006, it was the eleventh leading cause of death in the U.S., accounting for 33,300 deaths.¹ The overall rate was 10.9 suicide deaths per 100,000 people.¹ An estimated 12 to 25 attempted suicides occur per every suicide death.¹

Suicidal behavior is complex. Some risk factors vary with age, gender, or ethnic group and may occur in combination or change over time.

What are the risk factors for suicide?

Research shows that risk factors for suicide include:

• depression and other mental disorders, or a substance-abuse disorder (often in combination with other mental disorders). More than 90 percent of people who die by suicide have these risk factors.²
• prior suicide attempt
• family history of mental disorder or substance abuse
• family history of suicide
• family violence, including physical or sexual abuse
• firearms in the home,³ the method used in more than half of suicides
• incarceration
• exposure to the suicidal behavior of others, such as family members, peers, or media figures.²

However, suicide and suicidal behavior are not normal responses to stress; many people have these risk factors, but are not suicidal. Research also shows that the risk for suicide is associated with changes in brain chemicals called neurotransmitters, including serotonin. Decreased levels of serotonin have been found in people with depression, impulsive disorders, and a history of suicide attempts, and in the brains of suicide victims. ⁴

Are women or men at higher risk?

• Suicide was the seventh leading cause of death for males and the sixteenth leading cause of death for females in 2006.¹
• Almost four times as many males as females die by suicide.¹
• Firearms, suffocation, and poison are by far the most common methods of suicide, overall. However, men and women differ in the method used, as shown below.¹

Suicide by:	Males (%)	Females (%)
Firearms	56	31
Suffocation	23	19
Poisoning	13	40

If you are in a crisis and need help right away:

Call this toll-free number, available 24 hours a day, every day: 1-800-273-TALK (8255). You will reach the National Suicide Prevention Lifeline, a service available to anyone. You may call for yourself or for someone you care about. All calls are confidential.

“how would you kill yourself?”

A friend invited me to a  Thanksgiving “Orphans” dinner this past Thursday. It was really wonderful. We ate, drank and played some games. Even though it was a joyous occasion, I can never seem to escape being reminded of some random topic in my life that don’t need reminding. We played a game called “If,” where we are supposed to complete “If” statements, such as “If you were to become an animal, you’d be….” Some statements were more strange than others, with one being “If you had to kill someone, your method would be…” Upon hearing this sentence, someone shouts, “Let’s make it a little darker.  How would you kill yourself?”

People actually started pondering and responding to this question, even talking about where one would need to shoot oneself in order to die instantly (this person was a doctor). Another pointed out how men tend to complete more suicides and that more women tend to choose taking pills as the preferred method. Someone then adds, “that’s because women don’t really mean it.”

I don’t know if it was inappropriate for someone to bring this topic up, but it was hard for me to sit there while people so casually talked about suicide. The thing is, it’s not that hard for me to think about the methods without someone having to bring it up. By discussing this topic, it only gives me more ideas. I don’t know if this is always the case, but once you’ve gone through something like this, you can never act as if you’ve never thought of it; thinking about suicide and death is always going to be a part of me, or at least very close to me.

It was especially uncomfortable when one commented about how women don’t really mean it when they’re attempting suicide. How in the world would he know that? When I made my attempt, I meant every bit of it.  I think it also saddened me to realize some people’s views on those who make an attempt. Whether they picked a “successful” form is another matter. The fact that someone went through just the actions of carrying out a suicide means that the person was carrying an insurmountable amount of pain that I’m not sure can be expressed accurately to those who’ve never been in such position. It’s an ache, a sadness that overwhelms me even as I think about it now.

I really did have a great time at this Thanksgiving gathering, but the lingering thoughts from that dinner isn’t just about the lovely evening I had with friends. I’ve yet to be able to have this topic of suicide leave my mind, and I don’t know if it’ll go away anytime soon. Again, I don’t necessarily think it was a bad thing to have this subject brought up since it could use some public recognition, but it’s never easy to have to rethink what suicide means in your own life.

National Suicide Prevention Week is Here

This week is the 35th Annual National Suicide Prevention Week.

Some Facts:

• Suicide is the 11th leading cause of death in the United States with one suicide occurring on average every 16 minutes.
• Suicide is the 3rd leading cause of death among 15- to 24-years-olds.
• The elderly make up 12.4% of the population, but comprise 16% of all suicides.
• Approximately 811,000 Americans attempt suicide each year.
• One person completes suicide every 16 minutes.
• It is estimated that five million living Americans have attempted to kill themselves.
• Every year in the United States, more than 17,000 men and women kill themselves with a gun; two-thirds more than the number who use a gun to kill another person.
• In the U.S., 50% more people die by suicide than by homicide each year.
• An estimated 5 million Americans are survivors of the suicide of a friend, family member, or loved one.

Some Resources:

American Association of Suicidology
Phone: 202-237-2280
www.suicidology.org

American Foundation for Suicide Prevention
Phone: 1-888-333-AFSP
Phone: 212-363-3500
www.afsp.org

Centers for Disease Control and Prevention
Phone: 1-800-311-3435
www.cdc.gov

National Institute of Mental Health
Phone: 301-443-4513
www.nimh.nih.gov

Substance Abuse and Mental Health Services Administration
Phone: 1-800-487-4890
www.samhsa.gov

Office of the Surgeon General/ National Strategy for Suicide Prevention
www.mentalhealth.org/suicideprevention

Source: American Association of Suicidology

The Family Inheritance

My interest in Sylvia Plath started when I had to read “Mirror” in middle school. Over the years, I’ve read more about her life, The Bell Jar, and her many poems. In one of my depressed moments, I went by myself to the movie theater at night to catch the movie, “Sylvia.” I hate that I am so intrigued by her, sometimes having reached an unhealthy point, but I am. Today I saw the headline: Nicholas Hughes, Sylvia Plath’s son commits suicide. I never knew much about Nicholas Hughes until I started reading his obituary and other articles, but it was just so sad to read that he came to share the same fate as his mother’s.

Mr. Hughes, a prominent fisheries scientist, and his death did bring back to my mind something I’ve thought about: is suicide hereditary? This question was so deftly addressed by The Guardian’s Ian Sample’s article: Death in the Family. In this article, Sample points out the following:

One of the most stark insights into depression and suicide comes from scientists studying bipolar disorder, formerly known as manic depression. People with the condition experience periods of intense mania, and will often feel themselves compelled to attempt grandiose tasks and projects, but fall into a deep depression once they are completed. The condition is thought to be strongly linked to specific genes.

“If you look at a population of people diagnosed with bipolar disorder, a fifth of them will attempt or succeed in committing suicide,” said David Porteous, professor of human molecular genetics at Edinburgh University. “Also, if you look at families where someone has committed suicide, the chances are that you will find another case in the not-too distant family,” he added.(from The Guardian, 24 March 2009, by Ian Sample)

I personally don’t know of any completed suicides in my family tree. But I do know of some suicide attempts that have happened in the family-tree branches not so high above me, with undiagnosed mental-health illnesses scattered about. Understandably, just because the ‘suicide gene’ might be in my veins, it does not bring much, if any comfort, to parents who had to hear from their daughter about her attempt (the plural can’t be used here because I never told them about the other hospital visits I made since that time. Saying something about one is enough; and the ECT thing makes it more than enough).

I do like looking up facts, stats and studies. And on a minor level, reading about the genetics of mental illnesses do give me some comfort-if one could call it that-about this element of myself. But those numbers reflect something much more grim in real life, and when I become depressed, start believing that I’m going to be Maureen Dowd the next day, or decide that I need to kill myself, it doesn’t matter that there might be some hereditary cause for it. Those numbers won’t save me.

After I came out of the psych hospital the time I was told I had bipolar disorder, one of the first things my psychiatrist said was that I should notify my sister of this diagnosis because this disorder has a very good chance of running in the family – including to any children that she might have.

What a thing to have to inherit from your big sister. A mental illness for the kids!