Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-76fb5796d-22dnz Total loading time: 0 Render date: 2024-04-26T14:50:13.236Z Has data issue: false hasContentIssue false

4 - Understanding Why: Drivers of Suicide Risk

from Section 1 - Suicide Prevention Overview

Published online by Cambridge University Press:  15 May 2021

Christine Yu Moutier ,
Anthony R. Pisani  and
Stephen M. Stahl
Christine Yu Moutier
Affiliation:
The American Foundation for Suicide Prevention
Anthony R. Pisani
Affiliation:
University of Rochester Medical Center, New York
Stephen M. Stahl
Affiliation:
University of California, San Diego
Get access

Summary

As is the case for all complex health outcomes, there are many risk factors known to increase risk of suicide. In Chapter 6, we will address the clinical assessment of suicide risk, which incorporates risk and protective factors. In the current chapter, we will show how risk factors – health and environmental – weave together and escalate risk at particular moments in a person’s life. This chapter will explore how the interaction of biological, psychological, and social/environmental risk factors can increase risk of suicide, differentiating between more enduring and more dynamic factors. We will show how these various factors intersect with life stressors to increase suicide risk. Research related to the global burden of suicide indicates that while cultural factors and available lethal means play a huge role in the suicide risk of a population, many risk and protective factors are shared cross nationally, likely simply being human risk factors for suicide.

Type
Chapter
Information
Suicide Prevention
Stahl's Handbooks
 , pp. 43 - 72
Publisher: Cambridge University Press
Print publication year: 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bertolote, J. M., & Fleischmann, A. (2002) Suicide and psychiatric diagnosis: a worldwide perspective. World Psychiatry: Official Journal of the World Psychiatric Association (WPA), 1(3): 181–85.Google ScholarPubMed
Shneidman, E. S. (1993) Suicide as Psychache: A Clinical Approach to Self-Destructive Behavior. Northfield, NJ: Jason Aronson.Google Scholar
Durkheim, E. (1951) Suicide: A Study in Sociology. New York, NY: Free Press. (Original work published 1897).Google Scholar
Abramson, L. M., Alloy, L. B., Hogan, M. E., et al. (2000) The hopelessness theory of suicidality. In Joiner, T. & Rudd, M. D. (Eds.), Suicide Science: Expanding the Boundaries Norwell, MA: Kluwer Academic Publishers, 17–32.Google Scholar
Beck, A. T. (1967) Depression: Clinical, Experimental, and Theoretical Aspects. New York, NY: Harper & Row.Google Scholar
Klonsky, E. D., & May, A. M. (2015) The three-step theory (3ST): A new theory of suicide rooted in the “ideation-to-action” framework. International Journal of Cognitive Therapy, 8(2): 114–29.Google Scholar
O’Connor, R. C. (2011) Towards an integrated motivational-volitional model of suicidal behaviour. International handbook of suicide prevention: Research, Policy and Practice, 1: 181–98.Google Scholar
Hawton, K., Hall, S., Simkin, S., et al. (2003) Deliberate self-harm in adolescents: a study of characteristics and trends in Oxford, 1990–2000. J Child Psychol Psychiatry, 44(8): 1191–98.CrossRefGoogle ScholarPubMed
Cavanaugh, J. T., Carson, A. J., Sharpe, M., & Lawrie, S. M. (2003) Psychological autopsy studies of suicide: a systematic review. Psychol Med, 33(3): 395–405.Google Scholar
Nordentoft, M., Mortensen, P. B., & Pedersen, C. B. (2011) Absolute risk of suicide after first hospital contact in mental disorder. Arch Gen Psychiatry, 68(10): 1058–64. doi: 10.1001/archgenpsychiatry.2011.113CrossRefGoogle ScholarPubMed
Harris, E. C., & Barraclough, B. (1997) Suicide as an outcome for mental disorders. A meta-analysis. Br J Psychiatry, 170: 205–28.CrossRefGoogle ScholarPubMed
Kessler, R. C., Mickelson, K. D., & Williams, D. R. (1999) The prevalence, distribution, and mental health correlates of perceived discrimination in the United States. J Health Soc Behav, 40(3): 208–30.CrossRefGoogle ScholarPubMed
Nock, M. K., Borges, G., Bromet, E. J., et al. (2008) Cross-national prevalence and risk factors for suicidal ideation, plans and attempts. Br J Psychiatry, (2): 98–105. doi: 10.1192/bjp.bp.107.040113Google Scholar
Perlis, R. H., Huang, J., Purcell, S., et al. (2010) Genome-wide association study of suicide attempts in mood disorder patients. Am J Psychiatry, 167(12): 1499–507.Google Scholar
McGowan, P. O., Sasaki, A., D’Alessio, A. C., et al. (2009) Epigenetic regulation of the glucocorticoid receptor in human brain associates with childhood abuse. Nature Neuroscience, 12(3): 342–48.Google Scholar
Turecki, G., Ernst, C., Jollant, F., Labonté, B., & Mechawar, N. (2012) The neurodevelopmental origins of suicidal behavior. Trends Neurosci, 35 (1):14–23. doi: 10.1016/j.tins.2011.11.008. Epub 2011 Dec 15.CrossRefGoogle ScholarPubMed
Felitti, V. J., Anda, R. F., Nordenberg, D., et al. (1998) Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. Am J Prev Med, 14(4): 245–58. doi: 10.1016/S0749-3797(98)00017-8Google Scholar
Olfson, M., Wall, M., Wang, S., Crystal, S., Gerhard, T., & Blanco, C. (2017) Suicide following deliberate self-harm. Am J Psychiatry, 174(8): 765–74. doi: 10.1176/appi.ajp.2017.16111288Google Scholar
Hawton, K., Zahl, D., & Weatherall, R. (2003) Suicide following deliberate self-harm: long-term follow-up of patients who presented to a general hospital. Br J Psychiatry, 182(6): 537–42.Google Scholar
Fedyszyn, I. E., Erlangsen, A., Hjorthøj, C., Madsen, T., & Nordentoft, M. (2016) Repeated suicide attempts and suicide among individuals with a first emergency department contact for attempted suicide: a prospective, nationwide, Danish register-based study. J Clin Psychiatry, 77(6): 832–40. doi: 10.4088/JCP.15m09793Google Scholar
Asarnow, J. R., Porta, G., Spirito, A., et al. (2011). Suicide attempts and nonsuicidal self-injury in the treatment of resistant depression in adolescents: findings from the TORDIA study. Journal of the American Academy of Child and Adolescent Psychiatry, 50(8): 772–81.Google Scholar
Prinstein, M. J., Nock, M. K., Simon, V., Aikins, J. W., Cheah, C. S., & Spirito, A. (2008) Longitudinal trajectories and predictors of adolescent suicidal ideation and attempts following inpatient hospitalization. Journal Consult Clin Psychol, 76(1): 92–103.Google Scholar
Emslie, G. J., Mayes, T., Porta, G., et al. (2010) Treatment of Resistant Depression in Adolescents (TORDIA): week 24 outcomes. Am J Psychiatry, 167(7): 782–91.CrossRefGoogle ScholarPubMed
Brent, D. A., Emslie, G. J., Clarke, G. N., et al. (2009) Predictors of spontaneous and systematically assessed suicidal adverse events in the treatment of SSRI-resistant depression in adolescents (TORDIA) study. Am J Psychiatry, 166(4): 418–26.CrossRefGoogle ScholarPubMed
Williams, G. E., Daros, A. R., Graves, B., et al. (2015) Executive functions and social cognition in highly lethal self-injuring patients with borderline personality disorder. Personality Disorders: Theory, Research, and Treatment, 6(2): 107–16. doi: 10.1037/per0000105CrossRefGoogle ScholarPubMed
Jager-Hyman, S., Cunningham, A., Wenzel, A., Mattei, S., Brown, G. K., & Beck, A. T. (2014) Cognitive distortions and suicide attempts. Cognitive Therapy and Research, 38(4): 369–74. doi.org/10.1007/s10608-014–9613-0Google Scholar
Ryan, C., Russell, S. T., Huebner, D., Diaz, R., & Sanchez, J. (2010) Family acceptance in adolescence and the health of LGBT young adults. External J Child Adolesc Psychiatr Nurs 23(4): 205–13.Google Scholar
Gunnell, D., & Miller, M. (2010). Strategies to prevent suicide. BMJ, 341:157–8.CrossRefGoogle ScholarPubMed
Mann, J.J., Michel, C.A., Auerbach, R.P. (2021) Improving suicide prevention through evidence-based strategies: A systematic review. Am J Psychiatry, doi:10.1176/appi.ajp.2020.20060864Google Scholar
Barber, C. W., & Miller, M. J. (2014) Reducing a suicidal person’s access to lethal means of suicide. Am J Prev Med, 47(3S2): S264–72.CrossRefGoogle ScholarPubMed
Lubin, G., Werbeloff, N., Halperin, D., Shmushkevitch, M., Weiser, M., & Knobler, H. Y. (2010) Decrease in suicide rates after a change of policy reducing access to firearms in adolescents: a naturalistic epidemiological study. Suicide Life Threat Behav, 40: 421–4. doi: 10.1521/suli.2010.40.5.421CrossRefGoogle ScholarPubMed
Johnson, R. M., Barber, C., Azrael, D., Clark, D. E., & Hemenway, D. (2010) Who are the owners of firearms used in adolescent suicides? Suicide Life Threat Behav, 40(6): 609–11.Google Scholar
Baxley, F., & Miller, M. (2006) Parental misperceptions about children and firearms. Arch Pediatr and Adolesc Med, 160(5): 542–47.CrossRefGoogle ScholarPubMed
Bennewith, O., Nowers, M., & Gunnell, D. (2007) Effect of barriers on the Clifton suspension bridge, England, on local patterns of suicide: Implications for prevention. Br J Psychiatry, 190: 266–67.CrossRefGoogle ScholarPubMed
Gunnell, D., Hawton, K., Bennewith, O., et al. (2013) A multicentre program of clinical and public health research in support of the National Suicide Prevention Strategy for England. Southampton (UK): NIHR Journals Library.CrossRefGoogle Scholar
Linehan, M. M., Goodstein, J. L., Nielsen, S. L., & Chiles, J. A. (1983) Reasons for staying alive when you are thinking of killing yourself: the reasons for living inventory. J Consult Clin Psychol, 51: 276–86.Google Scholar
Malone, K. M., Oquendo, M. A., Haas, G. L., Ellis, S. P., Li, S., & Mann, J. J. (2000) Protective factors against suicidal acts in major depression: Reasons for living. Am J Psychiatry, 157(7): 1084–88.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×