The View from Hell

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Does Suicide Contagion Exist?

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It is commonly accepted – I have been accepting it – that highly publicized media reports of suicides cause a phenomenon known as suicide contagion. That is, highly publicized suicides function as “social proof” that suicide is an acceptable option, and people in the area of publicity commit suicide using the publicized method in greater numbers. These are sometimes called “suicide clusters” and are apparently most common among young people.

The studies that provide the basis for the phenomenon of suicide contagion are, apparently, somewhat questionable. Many suffer from lack of control for important variables; those that are controlled suffer from problems with the control groups or small sample size. Using another method, some ecological studies have indicated that the suicide contagion phenomenon is real; others have contradicted those findings.

So say the authors of a 2001 study in the American Journal of Epidemiology, entitled “Is Suicide Contagious? A Study of the Relation between Exposure to the Suicidal Behavior of Others and Nearly Lethal Suicide Attempts” (Mercy et al., Am Epidemiol Vol. 154, No. 2, 2001). These authors set out to determine the strength of the suicide contagion phenomenon – whether suicidal behavior in parents or relatives, or (separately) friends or acquaintances, or recent media reports of suicide, affected serious suicidal behavior in young people.

The study authors interviewed 153 people, ages 13-34, who were “victims” of nearly lethal suicide attempts and who had been treated at local emergency rooms in the Houston, Texas, area. A control group of 513 subjects was similarly interviewed. The conclusion? Not only did the study fail to demonstrate any sort of “suicide contagion,” but the authors note a statistically significant protective effect when a subject heard a news report of suicide within 30 days prior to the suicide attempt or had a friend or acquaintance make a suicide attempt. That is, the ER suicide-attempt group was actually less likely than the control group to be aware of a recent media report of a suicide, or to have experienced the suicidal behavior of an acquaintance! The suicide attempt of a parent or relative had no statistically significant effect on suicidal behavior, whereas the usual “suicide contagion” sources had a statistically significant protective effect – the opposite of what the suicide contagion model predicts. The authors are, of course, careful to note that more study is needed “to understand the mechanisms underlying these findings,” but it does seem that the contagion hypothesis is worth questioning. The appearance of a contagion effect may be little more than apophenia, as with news reports attributing New York physician Douglas Meyer’s jump-from-heights suicide to a contagion effect from Ruslana Korshunova’s highly publicized suicide. From the study:

In this study, we found no evidence that exposure to the suicidal behavior of others is a risk factor for nearly lethal suicide attempts. Even among groups at relatively higher risk for suicidal behavior (i.e., males, alcoholics, depressed persons, adolescents), we found no indication of an effect. On the contrary, we found that exposure to accounts of suicidal behavior in the media and, to a lesser extent, exposure to the suicidal behavior of friends or acquaintances were associated with a lower risk of nearly lethal suicide attempts; however, this appeared to be evident only when the emotional and temporal distance between the exposed individual and the suicide model was greatest. . . . Greater temporal and emotional distance between an individual and a suicide model may enable a person to more fully appreciate the negative consequences of suicide. [Citations omitted. Emphasis mine.]

Note that this study also appears to call into question the statement of a psychologist, from the story I reported in my earlier post, that suicide contagion disproportionately affects those already severely depressed. This study found no effect, even among depressed people.

Much to their credit, the authors propose a couple of alternative readings of their data:

[W]e examined the effects of media exposure over a 30-day interval, in contrast to most prior studies, where media effects were examined immediately after exposure. It is possible that media exposure has its greatest impact on suicidal behavior immediately after the event and that its effects are diluted or even reversed as time passes. Alternatively, it is possible that suicide attempters may be more socially isolated than other groups and are therefore less likely to be exposed to suicide models in their social networks or in the media. [Citations omitted.]

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Written by Sister Y

July 2, 2008 at 11:52 pm

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