Suicidal gesture

Suicide is the intentional taking of one's own life. Psychologists have devoted much effort to its study, attempting to identify those at greatest risk for suicide and to intervene effectively to prevent suicide.

Sociologist Fmile Durkheim introduced what has become a well-known classification of suicide types. Altruistic suicides, according to Durkheim, are those that occur in response to societal demands (for example, the soldier who sacrifices himself to save his comrades). Egoistic suicides occur when the individual is isolated from society and so does not experience sufficient societal demands to live. The third type is the anomic suicide. Anomie is a sense of disorientation or alienation which occurs following a major change in one's societal relationships (such as the loss of ajob or the death of a close friend); the anomic suicide occurs following such sudden and dramatic changes.

Research supports Durkheim's ideas that suicide is associated with social isolation and recent loss. Many other variables, both demographic and psychological, have also been found to be related to suicide. Numerous studies have shown that the following demographic variables are related to suicide: sex, age, marital status, employment status, urban versus rural dwelling, and race. Paradoxically, more females than males attempt suicide, but more males than females commit suicide. The ratio in both cases is about three to one. The difference between the sex ratios for attempted and completed suicide is generally explained by the fact that males tend to employ more lethal and less reversible methods than do females (firearms and hanging, for example, are more lethal and less reversible than ingestion of drugs).

Age is also related to suicide. In general, risk for suicide increases with increasing age; however, even though suicide risk is higher in older people, much attention has been devoted to suicide among children and adoles cents. This attention is attributable to two factors. First, since 1960 there has been an increase in the suicide rate among people under twenty-five years of age. Second, suicide has become one of the leading causes of death among people under twenty-one, whereas suicide is surpassed by many illnesses as a cause of death among older adults. Other demographic variables are related to suicide. Suicide risk is higher for divorced than married people. The unemployed have a higher suicide rate than those who are employed. Urban dwellers have a higher suicide rate than rural dwellers. Caucasians have a higher suicide rate than African Americans.

In addition to these demographic variables, several psychological or behavioral variables are related to suicide. Perhaps the single best predictor of suicide is threatening to commit suicide. Most suicide victims have made some type of suicide threat (although, in some cases, the threat may be veiled or indirect, such as putting one's affairs in order or giving away one's belongings). For this reason, psychologists consider seriously any threat of suicide. A related index of suicide risk is the detailedness or clarity of the threat. Individuals who describe a suicide method in detail are at greater risk than those who express an intent to die but who describe the act only vaguely. Similarly, the lethality and availability of the proposed method provide additional measures of risk. Suicide risk is higher if the individual proposes using a more lethal method and if the individual has access to the proposed method.

Another useful indicator of suicide risk is previous suicide attempts. People who have made prior attempts are at higher risk for suicide than people who have not. The lethality of the method used in the prior attempt is a related indicator. An individual who survives a more lethal method (a gunshot to the head) is considered at higher risk than one who survives a less lethal attempt (swallowing a bottle of aspirin).

Suicide risk is associated with particular behavioral or psychological variables: depression, isolation, stress, pain or illness, recent loss, and drug or alcohol abuse. These factors may help explain why certain of the demographic variables are related to suicide. For example, people who are unemployed may experience higher levels of stress, depression, and isolation than people who are employed. Similarly, divorced people may experience more stress and isolation than married people. The elderly may experience more isolation, depression, and pain or illness than younger people.

Although the demographic and psychological variables summarized above have been found to be related to suicide, the prediction of suicide remains extremely difficult. Suicide is a statistically rare event; according to basic laws of probability, it is very difficult to predict such rare occurrences. What happens in actual attempts to predict suicide is that, in order to identify the "true positives" (individuals who actually attempt suicide), one must accept a very large number of "false positives" (individuals who are labeled suicidal but who, in fact, will not attempt suicide).

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