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SUICIDE.
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Reasons for, incidence, risk factors (stress, socioeconomics, age, health, depression), cultural attitudes, religion, impact on survivors.... More...
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Paper Abstract:
Reasons for, incidence, risk factors (stress, socioeconomics, age, health, depression), cultural attitudes, religion, impact on survivors.

Paper Introduction:
Suicidal behavior is an indication that something is fundamentally wrong with the individual or with the situation in which the individual is found. Based on surveys of relatives of suicides, it has been determined that most people who commit suicide have long-lasting emotional problems such as depression, anxiety, unhappy relationships, alcohol or drug problems, unemployment, feelings of loneliness and guilt, problems with relatives, and so on. Many had received help in some form. The indications are that most contributory factors are generally long-lasting. Case histories show that the early life of those who commit suicide often involves broken homes, separation and divorce, incest, rape and sexual abuse, loss of one or both parents, domestic violence, alcohol abuse by parents, and similar adverse life events. In later periods of life, suicidal people

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"Suicide and Attempted Suicide." World Health (March- April 1994), 18-2 .Kushner, H.I. Osgoodfurther indicates that environment has a major effect on human behavior andthat suicide rates are highest for the elderly in urban areas, particularlyin lower class, inner-city neighborhoods. Fowler, and D.Young, "Suicide," American Journal of Psychiatry (April 1991),524-527.Pahl, 64.Erica B. Elderly widowers represent the most "at-risk" group. Women tend to take anoverdose of drugs or a poison, which reduces their chances of beingsuccessful.[ii] There is an age component to suicide in that suicide attemptsincrease with age. Fowler, and D. The reason why thismight be so is not known as yet, but those reasons could be genetic,developmental, environmental, or some combination of all three.[iv] Historically, suicide has most often been condoned for the elderly,especially for those who are physically ill or suffering intense pain.This was certainly the case in Roman times, and such commentators as Senecaand Pliny the Elder extolled the virtues of suicide for the elderly.Osgood notes some of the demographic factors that may be discerned forsuicide among the elderly. Self-destruction in the Promised Land. "The Mind in Its Despair." U.S. All subjects averaged just under two stressors. Based on surveys of relatives of suicides, it has been determinedthat most people who commit suicide have long-lasting emotional problemssuch as depression, anxiety, unhappy relationships, alcohol or drugproblems, unemployment, feelings of loneliness and guilt, problems withrelatives, and so on. Religion has been studied as a factor in elderly suicide rates, andof the three major religious groups in the United States, Jews have thelowest suicide rates, followed by Catholics, and then Protestants with thehighest rate of all. While thereare a number of indicators available to psychiatrists and psychologiststoday, they are only indicators and not demonstrable evidence that anindividual will attempt suicide. Two other factors that have been related to elderlysuicide are moving and fear of institutionalization and dependency. The onlysignificant difference between sexes was that economic problems weresignificantly more likely to be the suicide-precipitating stressor amongmales (28 percent) than females (13 percent). The elderly do not attemptsuicide as often as younger people, but they are more often successful whenthey do. Many had received help in some form. One problem is that while there aremany people who could be considered at high risk for suicide, only a few ofthem actually attempt it. The death of a spouse, whether by suicide or bynatural causes, results in grief, depression, tension, anxiety, confusion,and a severe sense of loss. It is thus impossible to predict which personswill and which persons will not attempt suicide and equally impossible tohospitalize all who could be identified as potential suicides. Forsome suicides, they may show an outward strength that belies their innerturmoil and that thus fools friends, family, and coworkers.[ix] The loss of a spouse has been shown to be a particular stressor forthe elderly. This makes prediction and preventionproblematic and only adds to the grief and guilt of survivors who may feelthey should have done something, even though no one can tell them when totake action or what action to take. Rich, G.M. Physical health plays a role as illness is believed tobe an important contributing factor in up to half of all suicides, andcertain diseases--including cancer and brain disorders such as dementia,stroke, and multiple sclerosis--bring on secondary depression thatincreases suicide attempts. TheChurch also teaches that suicide is a mortal sin punishable in theafterlife. Goode, "The Mind in Its Despair," U.S. New Brunswick, New Jersey: Rutgers, 1989.Miller, M. Miller, Suicide after Sixty (New York: Springer, 1979), 5 6.H.I. This means that men are more successful whenthey do try, and this is related to the means they choose, such asfirearms, hanging, or jumping from high places. I is difficult to compile statistics on the religionof suicides and to define who belongs precisely in what category. Recent studies of attempted suicide show that this actionis more common among young women, people with low educational levels, thosewho are unemployed, those who are disabled, and people who are divorced andseparated: The picture that emerges is of powerless groups or those with little chance to improve themselves, facing troubles in finding a place in society, and having many emotional and relationship problems as well. The elderly account for 25 percent of all suicides, though theyconstitute just 1 percent of the total population. Information aboutthose who had committed suicide was gathered from family members, friends,and employers. Suicidal behavior is an indication that something is fundamentallywrong with the individual or with the situation in which the individual isfound. Hospital, psychotherapy, school, and police records werealso evaluated. News & World Report (August 9, 1993), 58-59.Kerkhof, A.J.F.M. New York: Springer, 1979.Pahl, Jorg J. Suicide after Sixty. There is a strong temptation to ignorethese signs and to hope that tomorrow will bring a better outlook. Endnotes BibliographyFarberow, N.L., D. Warstradt, R.A. The rate of the conflict-separation-rejection stressor decreased from 56 percent among those 19 years oryounger to 17 percent among those who were over 8 years old. Work helps protect against suicide, but someoccupations are high-risk for suicides, including attorneys, female (butnot male) physicians, musicians, dentists, law enforcement officers, andinsurance agents. The frequencyof stressors by age decade was then considered, and conclusions were drawn. Among the factors that may influence suicidesare chronic intractable pain, disfigurement (especially among women), andloss of mobility. Kushner, Self-destruction in the Promised Land (NewBrunswick, New Jersey: Rutgers, 1989), 8.C.L. Gallagher-Thompson, M. The negative effect of socialisolation has been cited as a key variable in elderly suicides, and livingalone is a factor. Young. "Changes in Grief and Mental Health of Bereaved Spouses of Older Suicides." Journals of Gerontology (November 1992), 357-366.Goode, Erica B. Forinstance, statistical surveys show that Caucasians in the U.S. In later periods of life,suicidal people may experience sexual abuse, forced marriage, problems within-laws and dowry, wife battering, war, torture, and concentration camps.Suicide victims seem to report these experiences more often than normalcontrol groups. Medical illnesswas the major stressor among individuals who were 8 or older. Still,there also seem to be certain attitudes fostered by each religion whichmight have an effect on suicide rates. For men, suicides increase after age 45, with thegreatest number taking place after age 55. News & WorldReport (August 9, 1993), 58-59.N.L. Suicide is a form of desertion, and indeed it is desertion in itsworst form. "The Rippling Effects of Suicide," USA Today (September 1996), 62-64.Rich, C.L., G.M. Gilewski, and L. have highersuicide rates than Blacks (with the exception of Black males aged 2 to 25years).[vii] Suicide affects family members and other loved ones of the person whocommits the act, and the resulting psychological scars are deep and long-lasting. The highest suicide rates are in the loosely federatedProtestants, a denomination with numerous factions and divisions.[v] One of the key problems for those studying suicide is how suicidebecomes the answer for one person in a given group and not for others: That is, why, when faced with a similar set of circumstances-- whether cultural, psychological, or biological--does one person commit suicide while another does not? They may make "jokes" about theirintentions, claiming that the world would be a better place without them orstating that they want to die. Researchers know the problems and yetmust interview friends, family, and co-workers in the weeks following asuicide in order to reconstruct a detailed profile of the victims and theirpersonalities. Mostpatients would be actively suicidal for only about 24 to 48 hours at most.In addition to the social factors that have been identified as riskfactors, chemical messengers in the brain have been studied for what theymight say about suicide. It hasbeen found that moving affects suicides more deeply than non-suicides andthat elderly men are most affected by moving. The spouses of suicides are thus more prone to become suicidesthemselves.[x] Suicide is a difficult problem to predict or control. Even when they may perceive problems, the issue iswhen to take action and how to tell a suicidal frame of mind from a lessdamaging form of depression or malaise. In all age groups, suicide rates aresignificantly higher for males than for females, and the disparity is evengreater for the elderly than for any other age group.. Most of the feelings decrease over time.However, the coping process for survivors of suicide victims seems to be amore difficult one as compared to survivors of those who died by naturalcauses. Alcoholism itself is a risk factor, and up to 15 percent ofalcoholics commit suicide.[iii] Biological risk factors have also been identified, and chemicalscalled neurotransmitters in suicidal patients have been noted as onepotential cause. Pahl, "The Rippling Effects of Suicide," USA Today(September 1996), 62-63.Ibid., 63.Ibid., 63-64.M. Any theory that attempts to explain the etiology of suicide ultimately must address this issue.[vi] Rich, Warstradt, Nemiroff, Fowler, and Young studied therelationships between specific life stress-causing events, age effects, andsuicide. "Suicide." American Journal of Psychiatry (April 1991), 524-527.-----------------------A.J.F.M. Nemiroff, R.C. Two out ofthree completed suicides are white males, but women are four times moreprone to attempt suicide. Two-thirds of all suicides givesome indication about their intentions. The strongest predictor of suicide is the presence ofpsychiatric disorders, and among the most common problems faced by suicidesare clinical depression, which may be accompanied by a form of alcohol ordrug abuse. While much studyhas been undertaken to identify the psychological and biological factorsthat may predispose the individual to suicide, suicide prediction andprevention remain inexact sciences. Warstradt, R.A. Nemiroff, R.C. Jews have had a long history ofpersecution that has made life precious, and Jews also have strong familyties which Durkheim called "strong social integration." The CatholicChurch stresses a sense of integration in people's lives and has a tightlyknit structure and an authoritarian body of common beliefs and dogmas. Economicproblems peaked among suicidal individuals in their 5 s, and then fell toalmost no significance among those in their 8 s and 9 s. A study of the impact of the death of an older person on themental health and psychological status of the surviving spouse assessedthis element using five self-report scales and a one item self-rated mentalhealth questionnaire. Higher social statusalso means a higher risk of suicide, but a fall in social status alsoincreases the risk. They also sift through medical records and personaleffects. Gallagher-Thompson, M. Until age 7 , conflict, separation, and rejection were the most frequentlife-stressors, and these were especially high among adolescents and youngadults who had committed suicide. The conclusion has to be that suicidal behavior is the result of both social conditions and individual maladaptation.[i] While there may be certain people more prone to suicide than others,experts believe that anyone can become suicidal when their emotional painseems something they cannot escape and when that pain is unbearable.People respond to such circumstances in different ways, from suicidalideation (meaning suicidal thoughts), a common occurrence affecting 2 percent of Americans in their lifetimes, to actual suicide, something thataffects approximately 12.5 persons per 1 , each year. Indeed, patients who are depressive and suicidal show evenlower levels of the chemical than patients who are merely depressive, andthis is also true of schizophrenics who are suicidal. Theindications are that most contributory factors are generally long-lasting.Case histories show that the early life of those who commit suicide ofteninvolves broken homes, separation and divorce, incest, rape and sexualabuse, loss of one or both parents, domestic violence, alcohol abuse byparents, and similar adverse life events. Kerkhof, "Suicide and Attempted Suicide," World Health(March-April 1994), 19.Jorg J. Of the 2 2 subjects for whom enough information wasavailable, 97 percent had undergone one or more stressors prior to thesuicide. The research shows that suicide is usually the result of a long-simmering inner process rather than the result of something sudden, andthis only makes family members feel all the more guilty given that they mayhave missed the signs. The predictive value ofthese stressors by age factors is not strong enough to diagnose suiciderisk, since there seem to be other, unidentified contributing factors. Neurotransmitters relay signals between brain cells, andone of these chemicals, serotonin, has been shown to be at lower levels indepression. Men commit suicide at rates more than three timesthose of women, and this difference is stable for all ages. Fear of beinginstitutionalized and then becoming dependent was also cited in a study asa major precipitating factor in elderly suicide. It leaves behind unanswered questions, pain, and emotionalscars for all the survivors.[viii] There are feelings of guilt at nothaving been able to read the signs and to ascertain that the individual wastroubled enough to commit suicide. Thompson. Gilewski, and L.Thompson, "Changes in Grief and Mental Health of BereavedSpouses of Older Suicides," Journals of Gerontology (November1992), 357-366.----------------------- 1 Suicide also variesby marital status, with markedly higher rates for nonmarried persons, andwith the elderly who have lost spouses being more vulnerable to committingsuicide. Farberow, D. The first 2 4 consecutive cases came from a study investigating283 completed suicides and were evaluated by the team.

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