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November 17, 1989, Vol 262, No. 19 >
ARTICLE | November 17, 1989

An Epidemiologic Study of Risk Factors in Two Teenage Suicide Clusters FREE

Lucy E. Davidson, MD; Mark L. Rosenberg, MD; James A. Mercy, PhD; Jack Franklin, PhD; Jane T. Simmons, PhD
[+] Author Affiliations

Reprint requests to Division of Injury Epidemiology and Control, Centers for Disease Control, 1600 Clifton Rd, F36, Atlanta, GA 30333 (Dr Mercy).


JAMA. 1989;262(19):2687-2692. doi:10.1001/jama.1989.03430190071034
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References

Two clusters of teenage suicides occurred in Texas between February 1983 and October 1984. The eight suicides from the first cluster and the six from the second were investigated together in a case-control study using a closedresponse questionnaire administered to parents. Three control teenagers were matched with each case subject on the basis of school district, grade, race, and sex. Questions concerned the direct and indirect exposures of subjects to previous suicides as well as their life circumstances and behaviors. Case subjects were not more likely than control subjects to have had direct exposure to suicide as measured by their acquaintance with a person who committed suicide. Similarly, indirect exposure to suicide through the media was not associated significantly with suicide. Case subjects were more likely to have attempted or threatened suicide previously, to have damaged themselves physically, and to have known someone closely who died violently. Case subjects were more likely to have broken up with their girlfriends or boyfriends recently. They also had moved more often than control subjects, attended more schools, and lived with more parent figures. Identification of high-risk youths through knowledge of relevant risk factors can help to direct preventive services to those young people most susceptible to suicide.

(JAMA. 1989;262:2687-2692)

REFERENCES

1 +
Annual Summary of Births, Marriages, Divorces and Deaths: United States, 1985 . Washington, DC: National Center for Health Statistics; 1986;. Dept of Health, Education, and Welfare publication (PHS) 86-1120
2 +
Winslow F.  Suicide considered as a mental epidemic . Bull Med-Legal Congress. 1895;:334-351.
3 +
Rovinsky A.  Epidemic suicides . Boston Med Surg J. 1898;;138:238-239.
4 +
 A suicide epidemic in a psychiatric hospital . Dis Nerv System. 1977;;38:327-231.
5 +
Ashton VR, Donnan S.  Suicide by burning as an epidemic phenomenon: an analysis of 82 deaths and inquests in England and Wales in 1978-9 . Psychol Med. 1981;;11:735-739.
6 +
Crawshaw R, Bruce JA, Eraker PL, Greenbaum M, Lindemann JE, Schmidt DE.  An epidemic of suicide among physicians on probation . JAMA . 1980;;243:1915-1917.
7 +
Davis BR, Hardy RJ.  A suicide epidemic model . Soc Biol. 1986;;33:291-300.
8 +
Littmann SK.  Suicide epidemics and newspaper reporting . Suicide Life Threat Behav. 1985;;15:43-50.
9 +
Nalin DR.  Epidemic of suicide by malathion poisoning in Guyana . Trop Geogr Med. 1973;;25:8-14.
10 +
Rubinstein DH.  Epidemic suicide among Micronesian adolescents . Soc Sci Med. 1983;;17:657-665.
11 +
Walton EW.  An epidemic of antifreeze poisoning . Med Sci- Law . 1978;;18:231-237.
12 +
Ward JA, Fox J.  A suicide epidemic on an Indian reserve . Can Psychiatr Assoc J. 1977;; 22:423-426.
13 +
Gould MS, Shaffer D.  The impact of suicide in television movies: evidence of imitation . N Engl J Med. 1986;;315:690-694.
14 +
Last JM. A Dictionary of Epidemiology . New York, NY: Oxford University Press Inc; 1983;.
15 +
Sacks M, Eth S.  Pathological identification as a cause of suicide on an inpatient unit . Hosp Community Psychiatry . 1981;;32:36-40.
16 +
Niemi T.  The time-space distances of suicides committed in the lock-up in Finland in 1963-1967 . Isr Ann Psychiatry Related Disciplines . 1978;; 16:39-45.
17 +
Davidson L, Gould M.  Contagion as a risk factor for youth suicide . In: Report of the Secretary's Task Force on Youth Suicide: Risk Factors for Youth Suicide . Washington, DC: US Dept of Health and Human Services; 1988;;2:88-109. Publication (ADM)89-1622.
18 +
Phillips DP.  The influence of suggestion on suicide: substantive and theoretical implications of the Werther effect . Am Soc Rev. 1974;;39:340-354.
19 +
Phillips DP, Carstensen MS.  Clustering of teenage suicides after television news stories about suicide . N Engl J Med. 1986;;315:685-689.
20 +
Hemenway HB.  To what extent are suicide and other crimes against the person due to suggestion from the press? Bull Am Acad Med. 1911;;12:253-263.
21 +
Phelps EB.  Neurotic books and newspapers as factors in the mortality of suicide and crime . Bull Am Acad Med. 1911;;12:264-306.
22 +
Motto JA.  Newspaper influence on suicide . Arch Gen Psychiatry . 1970;;23:143-148.
23 +
Motto JA.  Suicide and suggestibility: the role of the press . Am J Psychiatry. 1967;;124:252-256.
24 +
Holding TA.  The B.B.C. 'Befrienders' series and its effects . Br J Psychiatry. 1974;;124:470-472.
25 +
Barraclough B, Shepherd D, Jennings C.  Do newspaper reports of coroners' inquests incite people to commit suicide? Br J Psychiatry. 1977;; 131:529-532.
26 +
Blumenthal S, Bergner L.  Suicide and newspapers: a replicated study . Am J Psychiatry. 1973;; 130:468-471.
27 +
Baron JN, Reiss PC.  Reply to Phillips and Bollen . Am Soc Rev. 1985;;50:372-376.
28 +
Stack S.  The effect of Jonestown on the suicide rate . J Soc Psychol. 1983;:119:145-146.
29 +
Phillips DP, Paight DJ.  The impact of televised movies about suicide: a replicative study . N Engl J Med. 1987;;317:809-811.
30 +
Morgenstern H.  Use of ecologic analysis in epidemiologic research . Am J Public Health. 1982;; 72:1336-1344.
31 +
Shafii M, Carrigan S, Whittinghill JR, Derrick A.  Psychological autopsy of completed suicide in children and adolescents . Am J Psychiatry. 1985;;35:330-341.
32 +
Litman RE, Curphey T, Shneidman ES, Farberow NL, Tabachnick MD.  Investigations of equivocal suicide . JAMA. 1963;;184:924-929.
33 +
Diagnostic and Statistical Manual of Mental Disorders . 3rd ed. Washington, DC: American Psychiatric Association; 1980;.
34 +
Thomas DG.  Exact and asymptotic methods for the combination of 2 × 2 tables . Comput Biomed Res. 1975;;8:423-466.
35 +
Schlesselman JJ. Case Control Studies: Design, Conduct, Analysis . New York, NY: Oxford University Press Inc; 1982;.
36 +
Welner A, Welner Z, Fishman R.  Psychiatric adolescent inpatients: 8-10-year follow-up . Arch Gen Psychiatry. 1979;;36:698-700.
37 +
Kovacs M, Puig-Antich J.  Major psychiatric disorders as risk factors in youth suicide . In: Report of the Secretary's Task Force on Youth Suicide: Risk Factors for Youth Suicide . Washington, DC: US Dept of Health and Human Services; 1988;;2:143-159. Publication (ADM)89-1622.
38 +
Schuckit MA, Schuckit JJ.  Substance use and abuse: a risk factor in youth suicide . In: Report of the Secretary's Task Force on Youth Suicide: Risk Factors for Youth Suicide . Washington, DC: US Dept of Health and Human Services; 1988;;2:172-183. Publication (ADM)89-1622.
39 +
Farberow NL.  Preparatory and prior suicidal behavior as risk factors . In: Report of the Secretary's Task Force on Youth Suicide: Risk Factors for Youth Suicide . Washington, DC: US Dept of Health and Human Services; 1988;;2.
40 +
Hagnell 0, Rorsman B.  Suicide in the Lundby study: a controlled prospective investigation of stressful life events . Neuropsychobiology . 1980;; 6:319-332.
41 +
Rich CL, Young D, Fowler RC.  San Diego suicide study: young vs old subjects . Arch Gen Psychiatry . 1986;;43:577-582.
42 +
Paykel ES.  Stress and life events . In: Report of the Secretary's Task Force on Youth Suicide: Risk Factors for Youth Suicide . Washington, DC: US Dept of Health and Human Services: 1988;;2:110-130. Publication (ADM)89-1622.
43 +
Pfeffer CR.  The family system of suicidal children . Am J Psychother. 1981;;35:330-341.
44 +
Pfeffer CR.  Family characteristics and support systems as risk factors for youth suicide . In: Report of the Secretary's Task Force on Youth Suicide: Risk Factors for Youth Suicide . Washington, DC: US Dept of Health and Human Services; 1988;;2:71-87. Publication (ADM)89-1622.
45 +
Youth Suicide in the United States, 1970-1980 . Atlanta, Ga: Centers for Disease Control; 1986;.
46 +
Light RJ, Pillemer DB. Summing Up: The Science of Reviewing Research . Cambridge, Mass: Harvard University Press; 1984;.
47 +
McLaughlin JK, Blot WJ, Mehl ES, Mandel JS.  Problems in the use of dead controls in case-control studies . Am J Epidemiol. 1985;;121:131-139.
48 +
Yufit R.  Developing a suicide screening instrument for adolescents and young adults . In: Report of the Secretary's Task Force on Youth Suicide: Strategies for the Prevention of Youth Suicide . Washington, DC: US Dept of Health and Human Services; 1989;;4:129-144. Publication (ADM)89-1624.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Annual Summary of Births, Marriages, Divorces and Deaths: United States, 1985 . Washington, DC: National Center for Health Statistics; 1986;. Dept of Health, Education, and Welfare publication (PHS) 86-1120
2 +
Winslow F.  Suicide considered as a mental epidemic . Bull Med-Legal Congress. 1895;:334-351.
3 +
Rovinsky A.  Epidemic suicides . Boston Med Surg J. 1898;;138:238-239.
4 +
 A suicide epidemic in a psychiatric hospital . Dis Nerv System. 1977;;38:327-231.
5 +
Ashton VR, Donnan S.  Suicide by burning as an epidemic phenomenon: an analysis of 82 deaths and inquests in England and Wales in 1978-9 . Psychol Med. 1981;;11:735-739.
6 +
Crawshaw R, Bruce JA, Eraker PL, Greenbaum M, Lindemann JE, Schmidt DE.  An epidemic of suicide among physicians on probation . JAMA . 1980;;243:1915-1917.
7 +
Davis BR, Hardy RJ.  A suicide epidemic model . Soc Biol. 1986;;33:291-300.
8 +
Littmann SK.  Suicide epidemics and newspaper reporting . Suicide Life Threat Behav. 1985;;15:43-50.
9 +
Nalin DR.  Epidemic of suicide by malathion poisoning in Guyana . Trop Geogr Med. 1973;;25:8-14.
10 +
Rubinstein DH.  Epidemic suicide among Micronesian adolescents . Soc Sci Med. 1983;;17:657-665.
11 +
Walton EW.  An epidemic of antifreeze poisoning . Med Sci- Law . 1978;;18:231-237.
12 +
Ward JA, Fox J.  A suicide epidemic on an Indian reserve . Can Psychiatr Assoc J. 1977;; 22:423-426.
13 +
Gould MS, Shaffer D.  The impact of suicide in television movies: evidence of imitation . N Engl J Med. 1986;;315:690-694.
14 +
Last JM. A Dictionary of Epidemiology . New York, NY: Oxford University Press Inc; 1983;.
15 +
Sacks M, Eth S.  Pathological identification as a cause of suicide on an inpatient unit . Hosp Community Psychiatry . 1981;;32:36-40.
16 +
Niemi T.  The time-space distances of suicides committed in the lock-up in Finland in 1963-1967 . Isr Ann Psychiatry Related Disciplines . 1978;; 16:39-45.
17 +
Davidson L, Gould M.  Contagion as a risk factor for youth suicide . In: Report of the Secretary's Task Force on Youth Suicide: Risk Factors for Youth Suicide . Washington, DC: US Dept of Health and Human Services; 1988;;2:88-109. Publication (ADM)89-1622.
18 +
Phillips DP.  The influence of suggestion on suicide: substantive and theoretical implications of the Werther effect . Am Soc Rev. 1974;;39:340-354.
19 +
Phillips DP, Carstensen MS.  Clustering of teenage suicides after television news stories about suicide . N Engl J Med. 1986;;315:685-689.
20 +
Hemenway HB.  To what extent are suicide and other crimes against the person due to suggestion from the press? Bull Am Acad Med. 1911;;12:253-263.
21 +
Phelps EB.  Neurotic books and newspapers as factors in the mortality of suicide and crime . Bull Am Acad Med. 1911;;12:264-306.
22 +
Motto JA.  Newspaper influence on suicide . Arch Gen Psychiatry . 1970;;23:143-148.
23 +
Motto JA.  Suicide and suggestibility: the role of the press . Am J Psychiatry. 1967;;124:252-256.
24 +
Holding TA.  The B.B.C. 'Befrienders' series and its effects . Br J Psychiatry. 1974;;124:470-472.
25 +
Barraclough B, Shepherd D, Jennings C.  Do newspaper reports of coroners' inquests incite people to commit suicide? Br J Psychiatry. 1977;; 131:529-532.
26 +
Blumenthal S, Bergner L.  Suicide and newspapers: a replicated study . Am J Psychiatry. 1973;; 130:468-471.
27 +
Baron JN, Reiss PC.  Reply to Phillips and Bollen . Am Soc Rev. 1985;;50:372-376.
28 +
Stack S.  The effect of Jonestown on the suicide rate . J Soc Psychol. 1983;:119:145-146.
29 +
Phillips DP, Paight DJ.  The impact of televised movies about suicide: a replicative study . N Engl J Med. 1987;;317:809-811.
30 +
Morgenstern H.  Use of ecologic analysis in epidemiologic research . Am J Public Health. 1982;; 72:1336-1344.
31 +
Shafii M, Carrigan S, Whittinghill JR, Derrick A.  Psychological autopsy of completed suicide in children and adolescents . Am J Psychiatry. 1985;;35:330-341.
32 +
Litman RE, Curphey T, Shneidman ES, Farberow NL, Tabachnick MD.  Investigations of equivocal suicide . JAMA. 1963;;184:924-929.
33 +
Diagnostic and Statistical Manual of Mental Disorders . 3rd ed. Washington, DC: American Psychiatric Association; 1980;.
34 +
Thomas DG.  Exact and asymptotic methods for the combination of 2 × 2 tables . Comput Biomed Res. 1975;;8:423-466.
35 +
Schlesselman JJ. Case Control Studies: Design, Conduct, Analysis . New York, NY: Oxford University Press Inc; 1982;.
36 +
Welner A, Welner Z, Fishman R.  Psychiatric adolescent inpatients: 8-10-year follow-up . Arch Gen Psychiatry. 1979;;36:698-700.
37 +
Kovacs M, Puig-Antich J.  Major psychiatric disorders as risk factors in youth suicide . In: Report of the Secretary's Task Force on Youth Suicide: Risk Factors for Youth Suicide . Washington, DC: US Dept of Health and Human Services; 1988;;2:143-159. Publication (ADM)89-1622.
38 +
Schuckit MA, Schuckit JJ.  Substance use and abuse: a risk factor in youth suicide . In: Report of the Secretary's Task Force on Youth Suicide: Risk Factors for Youth Suicide . Washington, DC: US Dept of Health and Human Services; 1988;;2:172-183. Publication (ADM)89-1622.
39 +
Farberow NL.  Preparatory and prior suicidal behavior as risk factors . In: Report of the Secretary's Task Force on Youth Suicide: Risk Factors for Youth Suicide . Washington, DC: US Dept of Health and Human Services; 1988;;2.
40 +
Hagnell 0, Rorsman B.  Suicide in the Lundby study: a controlled prospective investigation of stressful life events . Neuropsychobiology . 1980;; 6:319-332.
41 +
Rich CL, Young D, Fowler RC.  San Diego suicide study: young vs old subjects . Arch Gen Psychiatry . 1986;;43:577-582.
42 +
Paykel ES.  Stress and life events . In: Report of the Secretary's Task Force on Youth Suicide: Risk Factors for Youth Suicide . Washington, DC: US Dept of Health and Human Services: 1988;;2:110-130. Publication (ADM)89-1622.
43 +
Pfeffer CR.  The family system of suicidal children . Am J Psychother. 1981;;35:330-341.
44 +
Pfeffer CR.  Family characteristics and support systems as risk factors for youth suicide . In: Report of the Secretary's Task Force on Youth Suicide: Risk Factors for Youth Suicide . Washington, DC: US Dept of Health and Human Services; 1988;;2:71-87. Publication (ADM)89-1622.
45 +
Youth Suicide in the United States, 1970-1980 . Atlanta, Ga: Centers for Disease Control; 1986;.
46 +
Light RJ, Pillemer DB. Summing Up: The Science of Reviewing Research . Cambridge, Mass: Harvard University Press; 1984;.
47 +
McLaughlin JK, Blot WJ, Mehl ES, Mandel JS.  Problems in the use of dead controls in case-control studies . Am J Epidemiol. 1985;;121:131-139.
48 +
Yufit R.  Developing a suicide screening instrument for adolescents and young adults . In: Report of the Secretary's Task Force on Youth Suicide: Strategies for the Prevention of Youth Suicide . Washington, DC: US Dept of Health and Human Services; 1989;;4:129-144. Publication (ADM)89-1624.

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