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 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),
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.
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.
