Prior attempts to study suicide clusters have been beset by problems of definition. Definitions of suicide clusters, such as 3 or more suicides occurring in a community in some unspecified """"""""short"""""""" period of time, do not take into account the probability that 3 or more suicides may occur by chance within many communities in the U.S., within a specified time period. Moreover, previous selections of clusters have been fraught with the biases that make a particular cluster newsworthy and reportable by concerned citizens. In order to avoid the selection biases inherent in the anecdotal reports of suicide clusters that are haphazardly identified by community officials and/or in the media, the project will employ a rigorous operational definition of a suicide cluster that takes chance co-occurrences into account. A psychological autopsy of 200 teenage suicides will be conducted in order to identify the characteristics associated with cluster suicides in adolescents. Of the 200 suicides, 150 will be selected from 50 operationally defined clusters and the remaining 50 will be singleton suicides which occurred outside of a cluster situation The psychological autopsy findings from the set of cluster suicides will be compared to comparable assessments of the singleton suicides. The study will address the question of why a cluster of suicides occurs in one community following the occurrence of a suicide, while in another community the occurrence of a suicide does not have this same aftermath. Although the incidence of cluster suicide, is not large, they are of particular clinical relevance because entire communities, not only individuals, can be at risk for subsequent disruption by coming """"""""under siege"""""""" or being scapegoated and being held unrealistically accountable. Moreover, cluster suicides are likely to be preventable deaths. Prior research has shown that the occurrence of a suicide within a community increases the risk of a subsequent suicide, particular& for teenagers, and thus, can define a high-risk population, Suicide prevention efforts that focus on high risk populations has been a recommended strategy. However, before prevention strategies can be developed, it is first necessary to identify the individual and environmental factors that trigger suicide clusters. This information will enable us to identify those teenagers at highest risk for suicide, within an already defined high risk population, and intervene so that a cluster of teenage suicides can be prevented.
| Gould, Madelyn S; Midle, Jennifer Bassett; Insel, Beverly et al. (2007) Suicide reporting content analysis: abstract development and reliability. Crisis 28:165-74 |
