Midlife suicide:A systematic review and meta-analysis of socioeconomic, psychiatric and physical health risk factors

Suicide is an increasing contributing cause of mortality in middle-aged adults; however, knowledge to guide prevention is limited. This first systematic review and meta-analysis of studies on midlife suicide has provided an overview of published research on this issue and synthesized the evidence on socioeconomic and physical and mental health factors associated with this mortality. Using PRISMA guidelines MEDLINE, Embase, PsycINFO, Scopus and Web of Science were searched for English-language publications that involved persons aged 35 to 65, used individual-level data, and reported prevalence of exposure(s) or relative risks. The search identified 62 studies on midlife suicides and associated factors (28 for SES, 22 for psychiatric disorder and 23 for physical illness). All studies were from high income countries, and most (80.6%) used data from population registries. Meta-analyses showed that the pooled prevalence of exposure in suicide decedents was 57.8% for psychiatric disorder, 56.3% for low income, 43.2% for unemployment, and 27.3% for physical illness. The associated pooled risk ratio was 11.68 (95% confidence intervals: 5.82–23.47) for psychiatric illness of any type, 12.59 (8.29–19.12) for mood disorders, 3.91 (2.72–5.59) for unemployment, 3.18 (2.72–3.72) for being separated or divorced, 2.64 (2.26–3.10) for cancer, 2.50 (0.96–6.38) for central nervous system illness, and 2.26 (1.16–4.41) for low income. In conclusion, midlife suicide is strongly associated with socioeconomic difficulties and physical and psychiatric illnesses that are common in this age population. Future investigations should consider the interactions between risk factors, the intersectionality of sex and ethnicity, and include data from low- and middle-income countries

A Systematic Review of Social Factors and Suicidal Behavior in Older Adulthood

Suicide in later life is a global public health problem. The aim of this review was to conduct a systematic analysis of studies with comparison groups that examined the associations between social factors and suicidal behavior (including ideation, non-fatal suicidal behavior, or deaths) among individuals aged 65 and older. Our search identified only 16 articles (across 14 independent samples) that met inclusion criteria. The limited number of studies points to the need for further research. Included studies were conducted in Canada (n = 2), Germany (n = 1), Hong Kong (n = 1), Japan (n = 1), Singapore (n = 1), Sweden (n = 2), Taiwan (n = 1), the U.K. (n = 2), and the U.S. (n = 3). The majority of the social factors examined in this review can be conceptualized as indices of positive social connectedness—the degree of positive involvement with family, friends, and social groups. Findings indicated that at least in industrialized countries, limited social connectedness is associated with suicidal ideation, non-fatal suicidal behavior, and suicide in later life. Primary prevention programs designed to enhance social connections as well as a sense of community could potentially decrease suicide risk, especially among men

Phyllis Bronstein (1939-2012)

This article memorializes Phyllis Bronstein (1939-2012). Bronstein was a feminist scholar, social and clinical psychologist, and activist for social justice. At the University of Vermont, she engaged almost 100 undergraduates in her research teams, mentored the research and professional development of 43 graduate students, and trained over 90 clinical psychology students in the feminist family therapy program she developed. Bronstein published over 45 chapters and journal articles, and three edited books. One stream of her scholarship focused on sociocultural factors in parenting, child and adolescent development, with studies conducted in the United States and Mexico. Bronstein is perhaps best known for two volumes on the integration of multicultural and gender issues into the psychology curriculum, coedited with Kathryn Quina and published by the American Psychological Association. Bronstein\u27s third stream of scholarship addressed sexist, racist, and ageist practices in academic and clinical professions

The Role of Gender and Suicide Precipitant in Attitudes Toward Nonfatal Suicidal Behavior

This study examined factors affecting young adults\u27 attitudes about nonfatal suicidal behavior. It evaluated how respondent sex, respondent gender identity, the precipitant of the suicidal act (i.e., a relationship loss, an achievement failure, or a physical illness), and gender of the suicidal person influence reactions to a suicidal decision. In this study of nonfatal suicidal behavior, like in studies of suicide, attitudes were least negative when the suicidal act was in response to a physical illness. Men were more liked, to agree with and accept the suicidal decision than women. Androgynous persons, on the other hand, tended to view the decision to kill oneself as foolish, independent of precipitant They also reported less agreement, acceptance, and sympathy for such decision The implications of these findings for the prevention of suicidal behaviors are considered. Because gender seems to play a role in the acceptability of suicidal behavior prevention programs ought to explicitly examine gender issues in attitudes toward suicidal behavior

Cultural scripts of gender and suicide: an analysis on Italian newspapers_2021 International Society of Critical Health Psychology (ISCHP) Conference

Suicide beliefs and attitudes vary by culture and, often, also by the gender of the suicidal person, as related to dominant femininity/masculinity ideologies. Suicide attitudes, as components of the suicide script, describe and prescribe the conditions when suicide is potentially permissible, for whom, and via what method. Studies (mostly from Anglophone countries) show that suicide scripts act as models and impact suicide prevalence. This study explored cultural scripts of gender and suicide in a new setting, Italy, through an analysis of newspapers suicide stories. Suicide stories in 2009-2019 newspapers were identified. Analyses focused on the who (e.g., the sex of the suicide decedent), how (i.e., the method), and why (e.g., the presumed suicide-cause). A total of 748 male and 175 female suicide stories were identified. Men’s suicide stories focused on work or community roles. When men’s suicide was associated with physical illness, it was narrated as a dignified decision. Relationship motives typically involved jealousy or a break-up. Suicide-emulation concerns appeared only in men’s stories. Women’s suicide stories focused on their presumed psychological fragility and inadequacy. When relationship motives were mentioned, they typically involved lovesickness. This study documented differences in how men’s and women’s suicide are narrated in Italian newspapers. The more-positive (e.g., suicide as an agentic, powerful, and dignified response to external adversities) connotation of male suicide stories, relative to female suicide stories (e.g., suicide as a symptom of psychological weakness and inadequacy) may offer a key for understanding men’s higher suicide mortality

Suicidal Self-Burning in Women and Men Around the World: A Cultural and Gender Analysis of Patterns and Explanations

Self-burning is a violent suicide method with high morbidity and mortality. In some regions it is most common among women and in other regions among men. This pattern is consistent with a foundational idea in suicide-scripts theory (Canetto, 1997) – specifically, that the typical suicidal individual and suicide method vary by culture. Women’s predominance, in some regions, among the suicidal self-burning challenges many myths about gender and suicide, including the idea that women always avoid disfiguring, painful, and highly lethal methods. A common script in terms of the motivation and meanings of suicidal self-burning is that it is a way to protest against social injustices and persecution. In the case of women, the social injustices and persecution are institutionally enabled but typically perpetrated by close family. The social injustice context and the protest message of women’s suicidal self-burning are well-articulated in the literature but are often lost when the situation is summarized as a family problem or a mental health issue. The social injustices and persecution associated with men’s suicidal self-burning typically involve distant institutions, such as the government. The social injustice and protest framework remains central to the dominant narrative of men’s suicidal self-burning. Questions about personal (e.g., mental health) difficulties potentially contributing to men’s suicidal self-burning are not asked. To correct these gender biases in the suicidal self-burning literature, we recommend privileging attention to social factors in theory, research, and the prevention of women’s suicidal self-burning; and to psychological and close relationship factors in theory, research, and the prevention of men’s self-burning