Tuesday, May 18, 2021

The end of suicidology continued

 

THE END OF SUICIDOLOGY CONTINUED 

David Lester

          I am well-known for claiming that we have reached the end of suicidology (Lester, 2000, 2019). By this, I mean that I do not think that researchers and theoreticians will advance our understanding of why people die by suicide. There are several aspects to this.

Suicide is Statistically Rare

          First, suicide is statistically rare (Lester, 1994). Rare events are very difficult to predict. However, there are rare events in the physical world (such as hurricanes and lightning strikes) that are rare, but their mechanisms of development are understood.

Too Many Articles Published

          Second, the literature of suicide is becoming so large that a comprehensive view of it is not possible. In my four books entitled Why People Kill Themselves, I reviewed every work on suicide that I could find from 1897 to 1997. I used abstracts from every discipline. I don’t think any one person could do this anymore. I just now downloaded the articles on suicide and self-harm from SafetyLit[1] for May 2, 2021, and there were 106 articles listed. In 52 weeks, that would extrapolate to 5,512 articles in 2021.

Obscure and Low Prestige Journals

          I am not sure that SafetyLit searches all the possible journal domains: anthropology, gender studies, media studies, criminal justice studies, etc. Furthermore, many academic institutions and researchers frown on predatory journals (that is, those that charge a fee[2]), and most of those articles are not included in abstracting services. However, this does not mean that none of them are making a useful contribution to the field.

          For example, my cohort theory of suicide (Lester, 1984) proposed that each cohort of the population born may have only a limited number of potential suicides. If this cohort has a high suicide rate early in life, then it will have a low suicide rate later in life, and vice versa. I found this theory in an article by Uematsue (1961) published in Acta Medica et Biologica which is not a commonly perused journal. (An article by M. Uematsue in 1961 is listed in PubMed, but it is not his article on suicide.)

          If we are seriously interested in studying suicide, then some person or team might profitably search predatory journals for articles on suicide. The most prestigious journals often refuse to publish innovative and short articles on topics. In the good old days, the two journals Psychological Reports and Perceptual & Motor Skills, published by Robert and Carol Ammons, would often publish an article on a new idea, and this idea would appear in the prestigious journal many years later with more substantial research supporting it. The original idea, however, would be in the Ammons’s journals.[3]

Low Levels of Suicidality

          It has often been argued that an understanding of suicidal ideation or of suicide attempts may not advance our knowledge of those who die by suicide. The best that can be said is that the three groups have a limited, quite small overlap in causative factors. Lester, et al. (1979 proposed how this problem might be overcome (by dividing a sample of attempted suicides into groups by the level of their suicide intent and then extrapolating to completed suicides), but their proposal has received very little attention. Recently, I argued that suicidologists should focus on completed suicides (Lester, 2021). 

A Small Test of My Hypothesis

          Of course, those 106 articles in the May 2, 2021, issue of SafetyLit are only a miniscule sample of the literature on suicide that will appear in 2021. However, was anything useful published, useful, that is, for furthering our understanding on completed suicide?

A suicide had a rust stain on his finger from the gun

Suicides who used poisoning differed in age and sex from those using other methods. Omitting suicides by poisoning, 16% of those using other methods tested positive for opioids.

Barriers to transitioning from the ER to outpatient treatment

Pediatricians asking parents about safe gun storage

Patients with major depression, with and without suicidal ideation, differed in their core structural network connectome as noted in the MRIs;

Incarceration of parents and substance misuse contributed to planning suicide in young African Americans

On an addiction recovery program

Zero genetic influence in attempted suicides using genome-wide association

A case of suicide using a table saw

Contact with a suicide prevention worker reduced subsequent risk of attempted suicide in veterans

          I’m getting tired already. For all those articles from 1897 to 1997, I had a3-by-5 card filled out! So, far two of the ten articles are on completed suicide but are of little or no interest. Let me focus on those that remain on the list that seem to be on completed suicide.

A protocol for a study not yet carried out!!!!

Best practices for psychological autopsies

Two premature studies on COVID and suicide (good studies will not be possible for a year or two)

Comment with no data on pesticides and suicide

The death rate in those who ingest pesticides

A comment on someone else’s article on the trends in poisoning suicides in Canada – could it be due to misclassification?

Suicide rates by veterans by area (zip code) affected by variables such as latitude, hours of sunshine, rates of firearm ownership, etc.

A case of suicide after taking Dextromethorphan

News coverage of suicide in Brazil

News coverage of suicide in India

Youth suicide on the rise in Malawi

Review of suicide during epidemics of infectious diseases: little robust evidence

Celebrity suicides result in a rise in suicides in the next few days in South Korea

How to reduce suicide in veterans transitioning out of the military

An attempt to predict the impact of California’s Mental Health Services Act on suicides. No impact was predicted (This was not a direct study of its impact)

Only white American are less likely to die by suicide after a mental health visit

Patients with primary malignant bone tumors have a higher risk of suicide

Editorial: opioid addicts have a high rate of suicide

Reason for medical students in India to die by suicide (such as academic stress)

In Massachusetts, Workers in occupations with higher injury and illnesses rates and more job insecurity had higher rates of deaths of despair

A comment of an article reporting three suicides using sodium nitrite

An increased suicide mortality rate was associated with weight loss in the year before a suicide

          I did not expect any startling discoveries or new ideas, and there were not any.

          Perhaps it would be better to study a suicidology journal. Suicide & Life-Threatening Behavior is edited by Thomas Joiner, and 32%-45% of the articles in that journal in recent years have been on Joiner’s Interpersonal Theory of Suicide (Hjelmeland & Knizek, 2020) which raises ethical issues. Let us look at one issue of the Archives of Suicide Research (2021, issue 1), a journal which has less bias.

LGBTQ youth have higher rates of suicidal ideation and behavior: a review

Problems in adult attachment are associated with suicidal ideation: a review

Experience of racial discrimination in Africa-American men is associated with suicidal ideation

Race/ethnic groups who die by suicide differ in substance abuse, physical health and relationship problems

Greater social support is associated with less suicidal ideation in prisoners

Suicidal ideation predicts later attempted suicide in veterans

Emotion dysregulation predicts suicidal ideation in veterans

Lack of optimism, as well as perceived burdensomeness, predicted suicidal ideation in inpatient adolescents

An education program for clinicians increased their knowledge about self-harm in the elderly

          Only one study is on suicide (and that studied distal variables by the method used for suicide), and all of the variables studied have been known for a long time to be associated with suicidal ideation and attempts.

Discussion

           I realize that I chose a very small sample of articles on suicide. A complete perusal of the thousands of articles in abstract services on suicide for 2021 might reveal a new theory or hypothesis about those who die by suicide, but I’m not optimistic.

          Grants will be awarded, publications appear, academics will be tenured and promoted as a result, both predatory and non-predatory journals will make money, etc., but we won’t be any closer to understanding suicide. Yes, I am  a pessimist, but also I wish I had been able to keep scouring the literature after 1997 to see if there was a jewel out there waiting to be discovered, read and brought to the attention of us all.

References

Hjelmeland, H., & Knizek, B. L. (2020). The emperor’s new clothes! Death Studies, 44, 168-178

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

Lester, D. (1994). Reflections on the statistical rarity of suicide. Crisis, 15, 187-188.

Lester, D. (2000). The end of suicidology. Crisis, 21, 158-159.

Lester, D. (2019).  The end of suicidology. Hauppauge, NY: Nova.

Lester, D. (2021). Suicidologists should stop studying non-lethal suicidal behavior. Suicide Studies, 2(1), 24-25.

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

Uematsue, M. (1961). A statistical approach to the host factor of suicide in adolescence. Acta Medica et Biologica, 8, 279-286.

 



[1] www.safetylit.org/archive.htm

[2] Some prestigious charge submission and publication fees too.

[3] It used to be a joke that you get one point for every article published, except for articles published in the Ammons’s journal for which you get a point deducted.

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