Why People Die by Suicide

Transcription

1 Why People Die by Suicide Thomas Joiner, PhD The Robert O. Lawton Distinguished Professor of Psychology Florida State University Tallahassee, Florida

2 Disclosure The faculty have been informed of their responsibility to disclose to the audience if they will be discussing off-label or investigational use(s) of drugs, products, and/or devices (any use not approved by the US Food and Drug Administration). Applicable CME staff have no relationships to disclose relating to the subject matter of this activity. This activity has been independently reviewed for balance.

3 Case Examples from Robins The Final Months 1. He became very agitated restlessly pacing from room to room. At other times he would sit almost motionless for prolonged periods. His speech diminished greatly He began to lose weight and to say that he was a burden on his family and would never get well. He developed insomnia Robins E. The Final Months: A Study of the Lives of 134 Persons Who Committed Suicide. Oxford University Press: 1981.

4 Case Examples from Robins The Final Months 2. He stopped eating and lost 25 pounds and said that he was a burden to his family Robins E. The Final Months: A Study of the Lives of 134 Persons Who Committed Suicide. Oxford University Press: 1981.

5 Case Examples from Robins The Final Months 3. He experienced insomnia, weight loss (he lost pounds in the last months of his life) outbursts of rage he had often paced the floor, crying and wringing his hands. Robins E. The Final Months: A Study of the Lives of 134 Persons Who Committed Suicide. Oxford University Press: 1981.

6 Sketch of the Theory Those Who Desire Suicide Perceived Burdensomeness Thwarted Belongingness Fearlessness about Death Joiner T. Why People Die By Suicide. Harvard University Press: Serious Attempt or Death by Suicide

7 Van Orden KA, et al. Psychol Rev. 2010;117(2):

8 2010 I look at him and I just think, I m glad that s not me. If I had to be him for five hours, I d hang myself in a shower stall What do they want? What do we have to provide? I d rather hang myself in the shower than go to work thinking that. Doing the same thing every single week because it works that s hell. John E. Richters, PhD. Personal communication.

9 2016 Those are not the shows I go out looking to do, but we have the freedom to look into the camera and say This scene has gone horribly wrong or I am so depressed right now I just want to hang myself in the shower If I m in any way responsible or seen as supportive of [that] I mean, it makes me just want to hang myself in the shower thinking about it. John E. Richters, PhD. Personal communication.

10 Lessons from Virginia Tech Dimoff T. How to Respond to an Active Shooter in the Workplace Accessed August 7, 2018.

11 Rogers M, Hom M, Stanley I, Joiner T. Expanding Lethal Means Counseling to Include Physical and Psychological Distance to Suicide Methods: A Multi-Study Prospective Investigation. Manuscript under editorial review.

12 The Taft Bridge, Connecticut Ave., Washington, DC

13 The suicide barrier (fence) on the Ellington Bridge

14 Bridge Pre: Post: Ellington 3.67 deaths 0.00 deaths Taft 1.69 deaths 2.00 deaths O Carroll PW, et al. Suicide Life Threat Behav. 1994;24(1):89-91.

15 Blood Alcohol Content at the Time of Suicide 92 studies, 167,894 decedents, same pattern of findings. Time frame is key to understanding. Anestis MD, et al. J Abnorm Psychol. 2014;123(4):

16 Blood Alcohol Concentrations in Victims of Sharp Force Injuries in the Stockholm Area Karlsson T, et al. J Forensic Sci. 1988;33(2):

17 Miracle on Ice, February 22, 1980

18 100 Number of Daily Suicides Missing February 22 ( ) Missing Joiner TE, et al. Journal of Social and Clinical Psychology. 2006;25(2):

19 How heavy use of social media is linked to mental illness. May 18, 2018.

20 Empirical Support for the Interpersonal Theory of Suicide using 122 distinct published and unpublished samples, findings revealed support for the interpersonal theory Chu C, et al. Psychol Bull. 2017;143(12):

21 Sketch of the Theory Those Who Desire Suicide Perceived Burdensomeness Thwarted Belongingness Fearlessness about Death Joiner T. Why People Die By Suicide. Harvard University Press: Serious Attempt or Death by Suicide

22 Empirical Support for the Interpersonal Theory of Suicide the interaction between thwarted belongingness and perceived burdensomeness was significantly associated with suicidal ideation Chu C, et al. Psychol Bull. 2017;143(12):

23 Sketch of the Theory Those Who Desire Suicide Perceived Burdensomeness Thwarted Belongingness Fearlessness about Death Joiner T. Why People Die By Suicide. Harvard University Press: Serious Attempt or Death by Suicide

24 Empirical Support for the Interpersonal Theory of Suicide and the interaction between thwarted belongingness, perceived burdensomeness, and capability was significantly related to the number of prior suicide attempts. Chu C, et al. Psychol Bull. 2017;143(12):

25 Empirical Support for the Interpersonal Theory of Suicide However, effect sizes for these interactions were modest. Chu C, et al. Psychol Bull. 2017;143(12):

26 D i s t a l F a c t o r s Those Who Desire Suicide Perceived Burdensomeness Thwarted Belongingness Fearlessness about Death Serious Attempt or Death by Suicide

27 For Those Bereaved by Suicide A loved one s suicide feeling like it was a selfish act may be different than it actually being a selfish act Thwarted belongingness can persist in at-risk people even amid expressions of care But expressions of care can often help Fearlessness about death is usually, but not always apparent to others

28 The Military Suicide Research Consortium (msrc.fsu.edu)

29 Thank you for your attention