Tuesday, July 02, 2024

Suicides in the Life of Sigmund Freud

 

Suicides in the Life of Sigmund Freud

David Lester

 

 

          Freud was one of the first physician-assisted suicide on September 23, 1939, as his suffering from oral cancer intensified (see www.drdavidlester.net: Biographical Studies, BS 1991, page 51). I only just found out that suicides were common among Freud’s colleagues and even a patient. This is revealed in an article that I came across by Hamilton as I begin my review of research on suicide in 2001.

 

Hamilton, J. W.  (2001). Freud and the suicide of Pauline Silberstein. Psychoanalytic Review, 89, 889-909.

 

          Disappointingly, Hamilton gives us little information about her suicide. It occurred on May 14, 1891, when Freud was in the early stages of his career. He was still using hypnosis in his psychotherapy and had not developed psychoanalysis yet.[1] Pauline was 19, and she jumped from the third floor a building where she was being taken.

 

          Pauline was the wife of Freud’s closest friend from adolescence, Eduard Silberstein, and they lived in Romania. Freud’s correspondence with Silberstein has been published (in 1990). Pauline had come to Viena for treatment with Freud, but there are no details known about her problem or the treatment. Her suicide was reported in a Viennese newspaper. According to the newspaper, she was in a building where people go for treatment, and she threw herself over the balustrade at 4:40 pm. Her head was shattered, and she died instantaneously.

 

          We know nothing about how Freud felt about the suicide of his patient who was the wife of his closest friend.

 

          There are several suicides in Freud’s life. Herbert Silberer, a member of Freud’s group, died by suicide in 1923 by hanging after Freud threw him out of the group. A neurologist and friend, Nathan Weiss, died by suicide on September 13, 1883, by handing in a Viennese public bath, one month after his marriage. Victor Tausk died by suicide on July 3, 1919, after Freud told Helen Deutsch to terminate her psychoanalysis of Tausk. Tausk shot himself while also hanging himself a week before his wedding (see www.drdavidlester.net: Biographical Studies, BS 1991, page 68).

 

          It is noteworthy that these two suicides both occurred when Freud disbarred them from his group.



[1] Freud’s book on aphasia was published that year.

Wednesday, May 01, 2024

Why are we failing to prevent suicide?

 

 

WHY ARE WE FAILING TO PREVENT SUICIDE?

 

David Lester

 

 

          There has been a tremendous growth in scholarly articles on suicide over the last 21 years. Looking at publications in English included in PsycInfo, the number has risen from 608 items in 2001 to 2,656 in 2021, 337% increase. How has the suicide rate changed over this period?

 

          According to the National Center for Health Statistics (2023), the suicide rate rose from 10.7 per 100,000 per year in 2001 to 14.1 in 2021, a 32% increase. The correlations between the number of publications on suicide and the suicide rate over this 22-year period is 0.87. The more publications on suicide, the higher the suicide rate. This does not look good. What is happening?

 

          Clearly, lots of academics have obtained tenure and promotion, several grants have been awarded from government and private sources, and many graduate students have produced dissertations on suicide. However, it does appear that we have not learned anything useful about suicide, useful in the sense of helping us prevent suicide.

 

          Of course, it could be argued that, without this growth of “knowledge” about suicide, the suicide rate would have risen even higher. That would be nice to believe, but there is no evidence for this.

 

          Hjelmeland and Knizek (2020) noted that Joiner (2005) proposed a theory of suicide in which three factors explained all suicides: thwarted belongingness, perceived burdensomeness and the acquired capability for self-harm. This became the dominant theory of suicide, aided by the factor that Joiner was the editor of Suicide & Life-Threatening Behavior (SLTB). At their peaks, 45% of the articles in SLTB were on Joiner’s theory, 31% of the articles in the Archives of Suicide Research and 23% in Crisis according to Hjelmeland and Knizek. Not only does Joiner’s theory fail to explain all suicidal behavior, it has rarely been applied to suicides. Almost all of the research testing the theory examines the theory’s relevance for suicidal ideation and attempted suicide. Some of the old stalwarts like Louis Dublin, Ronald Maris and Maurice Farber argued that suicidal ideators and suicide attempters are a different population from suicides, although there may be some overlap. The dominance of Joiner’s theory may, therefore, have impeded progress on understanding and preventing suicide.

 

          Lester, et al. (1975, 1979) proposed a methodology in which we might learn about suicides from studies of attempted suicides, specifically by dividing samples of attempted suicides into groups by the lethality of their attempt (or the seriousness of their suicidal intent) and then extrapolating to suicides, the most lethal of them all. This proposal has been ignored.

 

          In other fields, progress is made. There is a great deal of research on medical diseases and, typically, this research leads to better treatments and longer survival rates, sometimes even cures. Apparently, that is not happening in suicidology.

 

References

 

Lester, D., Beck, A. T. & Trexler, L. (1975). Extrapolation from attempted suicides to completed suicides. Journal of Abnormal Psychology, 84, 563-566.

Lester, D., Beck, A. T. & Mitchell, B. (1979). Extrapolation from attempted suicides to completed suicides: a test. Journal of Abnormal Psychology, 88, 78-80.

 

Monday, December 18, 2023

Does Artificial Intelligence Become More Intelligent Over Time?

 


 

DOES ARTIFICIAL INTELLIGENCE BECOME MORE INTELLIGENT OVER TIME?


In 2023, I asked ChatGPT a number of questions about suicide in order to test how knowledgeable it was about suicide. One question I asked concerned the motives for Jocasta’s suicide (Lester, 2023).


David Lester

 

In the play Oedipus Rex, written by Sophocles, why did Jocasta die by suicide?

 

ChatGPT

 

In the play "Oedipus Rex" written by Sophocles, Jocasta, the wife of Oedipus and mother of his children, kills herself out of shock and despair upon realizing that Oedipus is her son and that she had unknowingly married and had children with her own son. The revelation is so devastating to her that she chooses to end her life rather than continue living with the knowledge and shame of her actions.


          I noted that it is clear from the play that Jocasta knew that she had married her son. Jocasta was prepared to live a life married to her son as long as this information was kept secret. Once the fact was likely to be known, she died by suicide, primarily out of shame.

          Has ChatGPT improved over the next six months? I asked it once more why Jocasta died by suicide.

 

David Lester

 

Why did Jocasta die by suicide?

 

ChatGPT

 

In Greek mythology, Jocasta is a character best known for her role in the tragic story of Oedipus. The details of Jocasta's death vary in different versions of the myth, and it's important to note that the story itself is a work of fiction.

 

The most well-known version of the story is found in Sophocles' play "Oedipus Rex." In this version, Oedipus discovers that he has unwittingly fulfilled a prophecy that foretold he would kill his father and marry his mother. When Oedipus realizes the truth, he blinds himself, and Jocasta, horrified by the revelation and the tragic fate of her family, hangs herself.

 

The reasons for Jocasta's suicide are complex and involve a combination of shame, guilt, and horror at the fulfillment of the prophecy. The Oedipus myth explores themes of fate, free will, and the consequences of trying to avoid destiny, making it a powerful and enduring tragedy in Greek literature.

 

          This is impressive. Perhaps it read my article in Suicide Studies? ChatGPT now brings shame and guilt into the motivating forces for Jocasta’s suicide.


Reference

 

Lester, D. (2023). What does artificial intelligence know about suicide? Suicide Studies, 4(3), 25-28.

Thursday, March 02, 2023

What have we learned about suicide? A harsh critique of theory and research

 


WHAT HAVE WE LEARNED ABOUT SUICIDE? A HARSH CRITIQUE OF THEORY AND RESEARCH

 

David Lester

Stockton University

 

 

 

          The purpose of this essay is to review the field of what is known as suicidology in order to explore what we have learned about why people die by suicide. This review is going to be harsh, not in terms of criticizing what researchers and theorists have written, but rather by omitting citations to those who have become well-known in the field, past and present.

 

          I reviewed the research and theory on suicidal behavior from 1897 to 1997 in four books which I titled Why People Kill Themselves. Those books did not, however, critique the papers cited. The aim was to provide for those in the field a convenient reference to what had been published in those years. I did choose the outstanding contributors in the 3rd and 4th editions of the book, but many of those chosen there are not cited here. They did publish a large number of articles on one issue in the field, thereby stimulating others, but their contributions do not necessarily assist our understanding of suicidal behavior.

 

          This review will also focus on why people die by suicide and not people who attempt suicide but survive.

 

The Societal Suicide Rate

 

          The major questions about the societal suicide rate is what determines the variation over time within a region (time-series theories) and what determines the suicide rate from region to region (ecological theories). In fact, the explanations are typically given for both of these variations.

 

          There have scorers of correlational studies on both of these variations, but the results are typically uninteresting theoretically. For example, suicide rates (over time and region) are positively associated with divorce rates and unemployment rates. This is hardly surprising. Have there been any correlates of societal suicide rates that surprise us? No. What is of use for understanding suicide?

 

Insight #1: Henry and Short

 

          One of the theories that has been neglected is that provided by Henry and Short (1954). Henry and Short proposed that, when people in a society are miserable or unhappy, if they have an external cause to blame for their misery, then they will be angry, and homicide rates will increase. If, however, there is no external cause to blame for their misery, then they will blame themselves, become depressed and more likely to kill themselves.

 

          This theory explains, for example, why the oppressed in a society have higher homicide rates while the oppressors have higher suicide rates. In line with this, African Americans in the United States have higher homicide rates while whites have higher suicide rates.

 

          Interestingly, Henry and Short also extended their theory and applied it at the individual level and, in addition, proposed child-rearing techniques of punishment that would lead to individual differences in suicidal-homicidal tendencies. They proposed that love-oriented punishment techniques would lead children to suppress their anger and become depressed and suicidal in the long term, while physical punishment would allow anger to be experienced.

 

Insight #2: Uematsue and the Cohort Effect

 

          Uematsue (1961) in an obscure journal proposed that the number of potential suicides in a cohort is fixed. If that cohort has a high suicide rate at an early age, it will have a low suicide rate later in life, and vice versa. Lester (1984) tested this hypothesis and partially confirmed it. With data available for cohorts only for a maximum of 35 years (rather than lifetime), Lester confirmed Uematsue’s hypotheses for female suicide rates in the United States but not male suicide rates.

 

          This raises the possibility that suicide is, at least in part, genetically determined. Such a hypothesis could, of course, be tested using methodologically sound twin studies, that is, comparing identical with non-identical twin pairs. However, the childhood and subsequent experiences of identical and non-identical twins are not similar.

 

Insight #3: The Natural Suicide Rate

 

Maris (1981) speculated that the suicide rate could never be zero no matter how ideal the social-economic conditions were. Coming from a economic perspective, Yang and Lester (2004) speculated that, just as the unemployment rate can never be zero, perhaps the suicide rate of a society can never be zero. They tested this by devising regression equations for several countries using divorce and unemployment rates to predict the suicide rate over regions of each country. Setting the divorce and unemployment rates to zero still predicted positive and non-zero suicide rates for each country. For a review of recent research on this issue see Yang and Lester (2021).

 

Insight #4: Taylor and Moksony and a Broad Social Variable

 

          Both Taylor (1990) and Moksony (1990) argued that social indicators such as divorce rates do not directly affect the suicide rate. Rather, such social indicators are measures of broader social qualities which affect the suicide rate. Evidence for this comes from a study by Lester (1995) who found that the divorce rate of the states of the United States was associated with the suicide rate of divorced people and also the suicide rates of single, married, and widowed people, indicating that the divorce rate was an indicator of general social malaise.

 

          Lester (1994) correlated many variables over the states and found that one set of variables were highly inter-correlated and the factor score (using a factor analysis) was associated with the suicide rate of the states. The set included the crime rate, the divorce rate, inter-state migration, the percent divorced, And alcohol consumptions positively loaded on the factor and the percent born in state and church attendance loaded negatively on the factor. Again, this suggests the presence of a broader social variable such as social malaise or social disintegration.

 

Insight #5: The Suicide Rate as a Random Walk

 

The random walk was a concept proposed by Pearson (1905) and refers to a mathematical description of a path that consists of a succession of random steps. It describes such diverse phenomena as the path traced by a molecule as it travels in a liquid or a gas and the price of a fluctuating stock or stock index (Malkiel, 1973). If a stochastic process follows a random walk, then any disturbance to the process will persist over time. If the time series suicide rate was a random walk, then the changes from day to day would be random and yet subject to shocks, that is, societal crises. The randomness might explain, in part, why suicide prevention efforts have failed in the last ten years.

Yang (1994) explored whether the suicide rate in the USA from 1933 to 1987 followed a random walk. (The USA started producing mortality statistics for the whole USA only in 1933.) Using econometric techniques of analysis, she found that the time-series suicide rate fits a random walk process overall, for six age groups and for four sex-by-race groups.

 

Insight #6: Suggestion

 

One societal happening that might affect deviations from a random walk is the media coverage of a celebrity suicide. Phillips (1974) and Stack (1987) have documented that celebrity suicides result in an increase in suicides in the society after media coverage of the suicide.

 

Insight #7: Access to Methods for Suicide

 

          There is more to the suicidal act than the outcome. There is also the staging of the act (Lester & Stack, 2015) which involves choosing the method for suicide, the location, whether to write a suicide note, etc. Access to methods for suicide plays a large role. For example, in the UK, when home gas for heating and cooking was coal gas, coal gas was a popular method for suicide. When the UK switched to natural gas, which is less toxic and so more difficult to use for death, the suicide rate declined. In less industrialized and more rural countries, pesticides are used extensively, as is their use for suicide.

 

Discussion

 

          There have been other interesting theories of the suicide rate in societies or in subgroups of the society which have received only partial support (that is, support in some studies and a failure to support the theory in other studies).

 

          For example, the social deviancy theory of suicide argues that suicide rates will be higher in groups in a society which are deviant in age, sexual orientation, ethnicity, etc. For example, Lester (1987) found that the fewer non-whites in a state, the higher their suicide rate.  

 

          Subcultural theories focus on characteristics of the society or part of the society. For example, states with a southern subculture have higher rates of gun ownership and higher rates of suicide using firearms (Lester, 1986-1987).

 

The Individual Suicide

 

Insight #8: Psychiatric Disturbance

 

          It is obvious that an understanding of suicide necessitates taking into account psychiatric disturbance. There are, however, grave problems with psychiatry as a science and, therefore, with psychiatric diagnosis.

 

To introduce you to my major objection, let us assume you have a headache and a fever. You go to your family physician, and he tells you that you have a disease called headache-fever, or HF for short. What would you do? You’d run as fast as you could out of his or her office and look for a good doctor. Medical illnesses are based on causes. What is causing your fever? What is causing your headache? Is it caused by a virus or bacteria? If so, which ones? Lyme’s disease or swine flu? Is it because of a brain tumor and, if so, is it malignant or benign?

 

Psychiatric disorders or mental illnesses are not defined by causes. They are defined by clusters of symptoms. Let us say you are depressed. Maybe it is because you do not have enough serotonin in certain regions of the brain. Maybe you have suppressed and repressed anger felt toward significant others in your life so that you are no longer conscious of the anger (a Freudian, psychoanalytic view). Maybe it is because you have learned from your life’s experiences that you cannot get out of the traps in which you find yourself (learned helplessness). Maybe it is because that are not enough rewards (positive reinforcers) in your life, either because you are in unrewarding relationships and employment or because you lack the skills to obtain rewards from others (a learning theory perspective). Maybe it is simply the melancholia that is part of all of our lives (Wilson, 2008)?

 

Don’t be fooled by new revisions of the Diagnostic and Statistical Manual (DSM). he criteria for this disease, disorders, or illness (call it what you will) still do not involve causes! Part of the motivation for revising the DSM is that psychiatrists cannot agree on which “illness” patients have. Using an older version of the DSM, Beck, et al. (1962) found that four psychiatrists, individually interviewing the same psychiatric patients, agreed only 54% of the time for the specific diagnosis and only 70% for the major category (schizophrenia, affective disorder, anxiety disorder, personality disorder, etcetera). In another study of the older version of the DSM, Sandifer, et al. (1968) had psychiatrists in three cities view tape-recorded interviews of psychiatric patients. In North Carolina, the patients were more often labeled as having neurotic disorders, In Glasgow, Scotland, the same patients were more often labeled as having personality disorders, and in London (England) the patients were more often labeled as having bipolar affective disorder (manic-depressive disorder)!

 

There have been three modern critiques of the current psychiatric system. Robert Whitaker’s Anatomy of an epidemic: Magic bullets, psychiatric drugs, and the astonishing rise of mental illness in America, Irving Kirsch’s The Emperor’s new drugs: Exploding the antidepressant myth, and Daniel Carlat’s Unhinged: The trouble with psychiatry. These books were favorably reviewed by Marcia Angell, a former editor of The New England Journal of Medicine, a prestigious scholarly medical journal, in The New York Review of Books (June 23 and July 14, 2012). Loren Mosher, a prominent psychiatrist, resigned from the American Psychiatric Association back in 1998, accusing the association of selling out to the pharmaceutical industry that markets psychiatric medications.[1]

 

          Even allowing for these problems with the psychiatric diagnostic system, I have never come across a methodologically sound study of psychiatric diagnosis of suicides. A sound study must have a control or comparison group, AND the diagnosis must be carried blind as to the presence of suicide or not. In all published studies, the diagnoses have been made by psychiatrists knowing that the person was a suicide. This knowledge accounts for some psychiatrists deciding that ALL suicides are psychiatrically disturbed.

 

Insight #9: Typologies of Suicides

 

          There have been many typologies of suicides proposed, but no one typology seems to be ideal. Van Hoesel (1983) chose typologies proposed by ten scholars and had judges classify 404 suicides from the files of the medical examiners in Baltimore and Maryland into the categories listed in the ten typologies. There were 69 subtypes in these ten typologies. Correlations between the 69 subtypes revealed five clusters of subtypes.

 

Escape (90 suicides)

Confusion (52 suicides)

Aggression (77 suicides)

Alienation (23 suicides

Depression/Low Self-Esteem (112 suicides)

 

          It is almost certain that no single theory of suicide can explain all suicides, and so a meaningful typology of suicides must be devised. Van Hoesel’s appears to be the best currently available. Next, it may be possible to find the causes for suicide that are specific for each type.

 

Insight #10: The Moods of Suicides

 

In his book Turning Points De Leo (2010) presented moving accounts from nine people who attempted to kill themselves, but who survived. Eight of the nine were happy to have survived. These accounts illustrate several features well-known to suicidologists, such as escape from mental and physical pain (Sergio and Maria), anger (Sandro), hopelessness and a feeling of being a burden (Anna), and suicide soon after discharge from a psychiatric hospital (Fabrizio). It is noteworthy that anxiety is noted by some. Alessa, Lucia and Maria all talk of suffocating and not being able to breathe anymore, and two of them (Lucia and Maria) indicate that the anxiety was long-standing and not simply a result of the decision to kill themselves. In fact, Maria tried to die to get away from the anxiety.

 

          Most commonly, depression and, in particular, the cognitive component of depression now labelled as hopelessness are proposed as present in suicides (Beck, et al. 1974). To this we might now add anxiety. Menninger (1938) classified the motives for suicide as to kill, to be killed and to die. The emotions accompanying these motives are anger, guilt and depression. Lester (1997) suggested that shame (as distinct from guilt) also plays a role in some suicides.

 

          This suggests that a typology based on the emotions experienced by suicides could be of value.

 

Insight #11: A Two-Self Theory of Suicide

 

          Lester (2022) proposed a two-self theory of suicide which he formally presented as a series of postulates and corollaries. Lester defined a subself is defined as a coherent system of thoughts, desires and emotions, organized by a system principle. For this theory of suicide, it is assumed that there are two subselves, a suicidal subself and a non-suicidal subself.

 

Postulate 1: Not every individual has both a suicidal subself and a nonsuicidal subself.

Postulate 2: At any point in time, one subself is in control of the mind. It may be said to have executive power.

Corollary 2a: When one subself has executive power, the other subself is said to be suspended.

Corollary 2b: A subself may appear in many situations, or only on rare special occasions. One subself may be domineering while the others is submissive.

Corollary 2c: A subself may have executive power for anywhere from seconds to hours or even longer periods of time.

Corollary 2d: Selfhood is whichever subself has executive power at the time.

Corollary 2e: The existence of two subselves accounts for the inconsistency in the behavior of individuals.

Postulate 3: Individuals can seek to create new subselves for the future.

Postulate 4: The individual can try to integrate the subselves.

Postulate 5: The suicidal subself may be a regressive subself developed early in life, formed by the introjection of the desires and thoughts of powerful others (in particular, parental figures) and imitation of their personality and behavioral styles.

Postulate 6: The suicidal subself may be formed as a result of early experiences.

Postulate 7: The possibility of attributing negatively valued aspects (thoughts, desires, emotions, or behaviors) of oneself to the suicidal subself may enable the individual to maintain high self-esteem since the negative aspects of the suicidal subself do not color the nonsuicidal subself.

Postulate 8: The two subselves may become enmeshed, and the psychotherapist must help the client create sufficiently impermeable boundaries so that the nonsuicidal subself can withstand pressure from the suicidal subself to take over executive power and resist intrusions from the suicidal subself into the nonsuicidal subself when the nonsuicidal subself has executive power.

Postulate 9: It is possible to create new subselves such as mediators and recording secretaries.

 

Discussion

 

          Many theories of individual suicide are not theories that are applicable to all suicides, but merely provide one type of suicide and, therefore, should be included in typologies of suicide. For example, Joiner (2005) proposed that suicides have perceived burdensomeness, thwarted belonging, and the acquired capacity to inflict self-harm. However, Lester and Gunn (2022) found that this theory applied to only 3% of a sample of suicides that they studied. Perceived burdensomeness alone was found in only 15% of the sample.

 

          Another example comes from Transactional Analysis which proposes that suicidal individuals were exposed to desires of their parents that they not exist (Stewart & Joines, 1987). Perhaps the infant is handled with disgust or perhaps the mother wishes that the baby had never been born, a wish that may be expressed directly or consciously transmitted to the baby.

 

          A learning (or social learning) theory of suicide proposes that the individual learned suicide from others. A famous example is that both Ernest Hemingway and his brother Leicester Hemingway died by suicide, following in the footsteps of their father’s choice to die by suicide.

 

Methodology

 

Insight #12: The Method of Substitute Subjects and Suicidal Intent

 

          The method of substitute subjects is the study of attempted suicides in order to learn about suicides. Suicides are deceased and cannot interviewed (of course), while attempted suicides can be interviewed and given psychological inventories. Also, of course, attempted suicides are of interest in their own right.

 

          But, as Lester, et al. (1975) noted, to learn about suicides from a study of attempted suicides, the attempters must be classified in terms of suicidal intent (or the lethality of their attempt). For example, a sample of attempted suicides can be divided into three groups, minimal suicidal intent, moderate suicidal intent and high suicidal intent. Then, if some variable increases (or decreases) in a linear fashion over these three groups, then extrapolation can be made to those who died by suicide. (Correlational studies using a suicidal intent score can also be used.)

 

Insight #13: Comparison Subjects

 

          This Insight is different because no research study has ever appeared on this idea. Palmer (1960) conducted a study of murderers by comparing them with their same sex siblings. Palmer also interviewed the parents of the men – murderer and brother. The use of same sex siblings, controlling for birth order of course, is that the subjects are matched on many variables, such as family dynamics (especially between the parents) and social and economic factors. Palmer was interested primarily in the physical and psychological frustrations that the men had experienced in the childhoods and adolescence, and he found that the murderers had experienced significantly more frustrations and had developed much less effective coping mechanisms. A study of suicides and their same-sex siblings would be extremely valuable!

 

Discussion

 

          As mentioned in the beginning of this review of what we know about suicide, the harshness is not in the comments about those cited, but in the omission of scholars whom others may think have contributed greatly to suicidology. What is apparent, however, is how little we know about why people die by suicide.

 

          For example, given an adequate typology of suicides, have we a theory of causation of any type? One might argue that we can list some risk factors. But risk factors and not necessarily causes. For example, a risk factor for coming down with influenza is mingling socially with others during a flue epidemic without taking precautions such as wearing a mask or having a flu shot. But those are not the causes of influenza – a virus is the cause.

 

 

References

 

Angell, M. (2012a). The epidemic of mental illness: Why? www.nybooks.com/articles/archives/2011/jun/23/epidemic-mental-illness-why/?pagination=false

Angell, M. (2012b). The illusions of psychiatry. www.nybooks.com/articles/
archives/2011/jul/14/illusions-of-psychiatry/?pagination=false

Beck, A. T., Ward, C H., Mendelson, M., Mock, J. E., & Erbaugh, J. K. (1962). Reliability of psychiatric diagnoses. American Journal of Psychiatry, 119, 351-357.

Beck, A. T., Weissman, A., Lester, D., & Trexler, L. (1974). The measurement of pessimism: the hopelessness scale. Journal of Consulting & Clinical Psychology, 42, 861-865.

Carlat, D. (2010). Unhinged. New York: Free Press.

De Leo, D. (2010). Turning points. Bowen Hills, Australia: Australian Academic Press.

Henry, A. F., & Short, J., F, (1954). Suicide and homicide. Glencoe, IL: Free Press.

Joiner, T. E. (2005). Why people die by suicide. Harvard University Press.

Kirsch, I. (2010). The Emperor’s new drugs. New York: Basic Books.

Lester, D. (1972, 1983, 1992, 2000). Why people kill themselves. Springfield, IL Charles Thomas.

Lester, D. (1984). Suicide risk by birth cohort. Suicide & Life-Threatening Behavior, 14, 132-136.

Lester, D. (12986-1987). Southern subculture, personal violence (suicide and homicide) and firearms. Omega, 17, 183-186.

Lester, D. (1987). Social deviancy and suicide. Journal of Social Psychology, 127, 339-340.

Lester D. (1994). Patterns of suicide and homicide in America. Commack, NY: Nova Science.

Lester, D. (1995). Is divorce an indicator of general or specific malaise? Journal of Divorce & Remarriage, 23, 203-205.

Lester, D. (1997). The role of shame in suicide. Suicide & Life-Threatening Behavior, 27, 352-361.

Lester, D., Beck, A. T. & Trexler, L. (1975). Extrapolation from attempted suicides to completed suicides. Journal of Abnormal Psychology, 84, 563-566.

Lester, D., & Gunn, J. F. (2022).  Is perceived burdensomeness present in the lives of famous suicides? Death Studies, 46, 1801-1806.

Lester, D., & Stack, S. (2015). Suicide as a dramatic performance. New Brunswick, NJ: Transaction.

Malkiel, B. G. (1973) A random walk down Wall Street. New York: Norton.

Maris, R. W. (1981). Pathways to suicide. Baltimore: Johns Hopkins University Press.

Menninger, K. A. (1938). Man against himself. New York: Harcourt, Brace.

Moksony, F. (1990). Ecological analysis of suicide. In D. Lester (Ed.) Current concepts of suicide, pp. 121-138. Philadelphia, PA: Charles Press.

Palmer, S. (1960). A study of murder. New York: Thomas Crowell.

Pearson, K. (1905) The problem of the random walk. Nature. 72, 294.

Phillips, D. P. (1974). The influence of suggestion on suicide. American Sociological Review, 39, 340-354.

Sandifer, M., Horden, A., Timbury, G., & Green, L. (1968). Psychiatric diagnosis. British Journal of Psychiatry, 114, 1-9.

Stack, S. (1987). Celebrities and suicide. American Sociological Review, 52, 401-412.

Stewart, I., & Joines, V. (1987). TA today. Chapel Hill, NC: Lifespace.

Taylor, S. (1990). Suicide, Durkheim, and sociology. In D. Lester (Ed.) Current concepts of suicide, pp. 225-236. Philadelphia, PA: Charles Press.

Uematsue, M. A statistical approach to the host factor of suicide in adolescence. Acta Medica et Biologica, 8, 279-286.

Van Hoesel, F. M. T. (1983). An empirical typology of suicide. Master’s thesis, American University. Ann Arbor, MI: Proquest Dissertations Publishing.

Whitaker, R. (2010). Anatomy of an epidemic. New York: Crown.

Wilson, E. G. (2008). Against happiness: In praise of melancholy. New York: Farrar, Straus & Giroux.

Yang, B. (1994) A random-walk hypothesis for the suicide rate and its implications for Durkheim’s theory of suicide. In D. Lester (Ed.) Emile Durkheim: Le Suicide 100 years later, pp. 319-324. Philadelphia, PA: Charles Press.

Yang, B., & Lester, D. (2004). Natural suicide rates in nations of the world. Crisis, 25, 187-188.

Yang, B., & Lester, D. (2021). Is there a natural suicide rate? An update and review. Suicide Studies, 2(4), 5-12.



[1] www.oikos.org/mosher.htm