Several methods have been used to study the psychology of suicide. Epidemiological research determines the distribution of demographic characteristics among suicide victims. Another method is to study survivors of suicide attempts. This enables psychologists to examine intensively their psychological characteristics. A third method is to analyze suicide notes, which may explain the individual's reasons for suicide. A final method is the psychological autopsy. This involves interviewing the victim's friends and family members and examining the victim's personal materials (such as diaries and letters) in an attempt to identify the psychological cause of the suicide.
Although all these approaches have been widely used, each has its limitations. The epidemiological method focuses on demographic characteristics and so may overlook psychological influences. Studying survivors of suicide attempts has limitations because survivors and victims of suicide attempts may differ significantly. For example, some suicide attempts are regarded as suicidal gestures, or "cries for help," the intent of which is not to die but rather to call attention to oneself to gain sympathy or assistance. Thus, what is learned from survivors may not generalize to successful suicide victims. The study of suicide notes is limited by the fact that most suicide victims do not leave notes. For example, in a study of all suicides in Los Angeles County in a single year, psychologists Edwin Shneidman and Norman Farberow found that only 35 percent of the males and 39 percent of the females left notes. Finally, the psychological autopsy is limited in that the victim's records and acquaintances may not shed light on the victim's thought processes.
In 1988, Harry Hoberman and Barry Garfinkel conducted an epidemio-logical study to identify variables related to suicide in children and adolescents. They examined death records in two counties in Minnesota over an eleven-year period for individuals who died at age nineteen or younger. Hoberman and Garfinkel examined in detail the death records of 225 suicide victims. They noted that 15 percent of their sample had not been identified as suicides by the medical examiner but had instead been listed as accident victims or as having died of undetermined causes. This finding suggests that official estimates of suicide deaths in the United States are actually low.
Consistent with other studies, Hoberman and Garfinkel found that suicide was related to both age and sex. Males accounted for 80 percent of the suicides, females for only 20 percent. Adolescents aged fifteen to nineteen years composed 91 percent of the sample, with children aged fourteen and under 9 percent. In addition, Hoberman and Garfinkel found that a full 50 percent of the sample showed evidence of one or more psychiatric disorders. Most common were depression and alcohol or drug abuse. Finally, Hoberman and Garfinkel found that a substantial number of the suicide victims had been described as "loners," "lonely," or "withdrawn." Thus, several of the indicators of suicide in adults also are related to suicide in children and adolescents.
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