Index
Acetaminophen, 285-286
Adherence to treatment, 253-254, 316, 429
adolescents, 354
medications, 43, 234-235, 253-254, 255, 337-338, 350, 353
Administration on Aging, 15, 438
Adolescents and youth, 2, 15, 19, 40-41, 42, 70, 87-89, 131, 200, 211, 425, 438, 452
see also School factors
adherence to treatment, 354
alcohol and substance abuse, 40-41, 49, 88-89, 276
assessment instruments, 230
barriers to treatment, 20, 333, 336, 343, 354-355, 362, 475
childhood trauma, 167, 173-174, 177, 179-180, 199
clustering of suicides, 395
cost of suicide to society, 56
crisis centers and hotlines, 290
drug overdoses, 286
firearm use in suicide, 41, 167, 280, 283-284
genetic factors, 131-132
imitation and contagion, 131-132, 278, 395
military personnel, 305
Native Americans, 308-309
number of suicides, xi, 1, 17, 40, 46, 57-58 , 425
physicians of, 354-355
pregnancy prevention, 275
preventive efforts, 20, 333, 336, 343, 354-355 , 362, 475
psychological autopsies, 378
racial/ethnic factors, 45, 46, 47-48, 49, 256
religious influences, 256
rural areas, 36
serotonin, 127
sexual orientation, 54-55
surveillance, 386
violence and aggressive behavior, 95, 100
Adoption, children, 2, 132, 133, 140-141
Adrenal gland, see Hypothalamic-pituitary-adrenal axis;
Noradrenergic system
African-Americans, 44-47, 57, 256, 397-398, 452
childhood trauma, 162
employment factors, 205-206
firearm use in suicide, 280
Age factors, xi, 7, 10, 38, 396-400, 452-453
see also Adolescents and youth;
Children;
Elderly persons
alcohol abuse, 84
anti-psychotic medications, 236
anxiety disorders, 75
assessment of patients, 231, 232
bipolar disorder, 234
cost of suicide to society, 56, 57
hotlines, 290
inpatient care, 250
Native Americans, 308
racial/ethnic factors, 44-45, 47-48
serotonin, 126-127
sexual orientation, 54-55
Agency for Health Care Policy and Research, 302
Agency for Health Care Research and Quality (AHRQ), 14, 436
Aggression, see Child abuse;
Impulsivity;
Sexual abuse;
Violence and aggressive behavior
AIDS, see HIV/AIDS
Air Force, see U.S. Air Force
Alaskan Natives, 47-49, 199, 310, 355-356
Alcohol abuse, 2, 3, 5, 69, 70, 81-85, 86, 96, 99-100, 394
see also Substance abuse
barriers to treatment, 342
bipolar disorder, 74
childhood trauma, 165, 167, 168, 179
diagnosis, 71
firearm use in suicide, 40, 81, 83, 282
genetic factors, 131, 136, 137-138
historical perspectives, 21, 22
international perspectives, 81, 83, 85, 211
National Institute on Alcohol Abuse and Alcoholism (NIAAA), 1, 12, 20, 433
Native Americans, 81, 82, 83, 308, 309-310
race/ethnicity, 81, 82, 83, 84, 308, 309-310
religious influences, 202, 203
school-based prevention programs, 276
surveillance, 380
Ambulatory care, see Inpatient care
American Academy of Pediatrics, 14, 183, 436
American Association of Suicidology, 14, 278, 290
American College of Family Physicians, 14, 436
American College of Physicians, 14, 436
American Foundation for the Prevention of Suicide, 14, 278, 438
American Indians, see Native Americans
American Medical Association, 5, 339-340
American Psychiatric Association, 14, 71, 438
American Psychological Association, 14
American Society of Internal Medicine, 14, 436
Amitriptyline, 287
Annenberg Public Policy Center, 278
Anticonvulsants, 233, 235-236, 287
Antidepressant medications, 2, 235, 237-242 , 299, 340, 341, 347, 349, 353, 403
clinical trials, 238-240, 241-242, 257
serotonin reuptake inhibitors (SSRIs), 238-239, 240, 241, 342
tricyclic antidepressants, 239, 240, 287
Anti-psychotic medications, 4, 236-237, 350
Anxiety disorders, 75-76, 84, 86, 95, 400-401 , 462
see also Panic disorder;
Post-traumatic stress disorder
antidepressant medications and, 240, 242
assessment of patients, 231
Beck Anxiety Scale, 231
childhood trauma, 176, 178, 183
inpatient care, 250
medications, 240, 242, 258, 299
panic disorder, 76
psychotherapy, 247
religious influences, 203
see also specific countries
insecticides as means of suicide, 280
Association of Poison Control Centers, 287
Attitudes and beliefs, 6, 70, 89-90, 204, 230, 316, 349-350, 351, 352-353
see also Depression;
Guilt and shame;
Religious influences;
Self-efficacy and self-esteem;
Social and cultural factors;
Stigma;
Temperament
clergy, 257
correctional institution staff, 358, 359
discrimination,
gender-based, 209-210
racial/ethnic, 209-210, 214, 215, 332-334 , 355, 358-359
gatekeeper training, 299
school-based prevention programs, 294-295
Australia, 36, 39, 50, 81, 134, 164, 196, 207, 208, 256, 278, 285, 312
Austria, 35, 196, 278, 279-280, 288, 296
Autopsies, see Brain and brain repositories;
Coroners and medical examiners;
Psychological autopsies;
Tissue samples
Beck Anxiety Scale, 231
Beck Depression Inventory, 231, 400
Beck Hopelessness Scale, 231
Befrienders International Centers, 289, 290
Benzodiazepines, 242
widows and widowers, 3, 23, 198, 204, 352
Big Horn Center for Public Policy, 303
Biological factors, x, 2, 119-155, 213-215, 424, 426, 429, 431-432
see also Brain and brain repositories;
Genetic factors;
Neurochemistry;
Pharmaceuticals
biological markers, 230
childhood trauma, 158, 170-172, 184
physiological stress system, 26, 75, 77, 89, 92, 94, 119, 120-122, 130, 131, 140
psychological autopsies and, 378
violence, 119, 120, 122, 125, 126, 128, 131, 136, 138, 140, 235-236, 241
see also Depression
adolescents and youth, 87
electroconvulsive therapy, 242-243
inpatient care, 251
lithium treatment, 4, 233-235, 253, 348
mood stabilizers, 233-236, 253, 346, 348, 350
serotonin, 125
Black persons, see African-Americans
Borderline personality disorder, 79-81
Brain and brain repositories, 10, 119, 120, 123-124, 127-130, 139-149, 425-426 , 428, 429
see also Hypothalamic-pituitary-adrenal axis;
Neurochemistry;
Serotonin
antidepressants, negative effects, 240
cerebrospinal fluid, 123, 124-126
childhood trauma, 158, 171-173, 181-182
noradrenergic system, 122, 128-129, 140
psychological autopsies and, 378
Britain, see United Kingdom
Canada, 35, 47, 48, 57, 207, 278, 284, 309-310 , 344
Carbamazepine, 235
Case-control studies, 142, 309, 356, 402
Case management, 254
Center for Studies of Suicide Prevention, see Suicide Research Unit
Center for the Study and Prevention of Suicide , 306
Centers for Disease Control and Prevention (CDC), 1, 9, 12, 14, 19-20, 307, 308
Internet site, 57
media coverage of suicides, 278
research centers, 406, 410, 411
surveillance, 12-13, 303, 382, 384, 385- 386, 387, 433-434
Cerebrospinal fluid, 123, 124-126
Child abuse, 4, 80, 158-159, 162-164, 174-178 , 182, 297, 432
prevention programs, 176-177, 181, 182-183 , 184, 303-304
sexual, 132-133, 141, 158, 161-170 (passim), 173, 174, 175, 176, 177, 179-181, 183
Childhood trauma, xi, 3-4, 21, 22, 52, 80-81, 96-97, 131, 132, 141, 157-191, 199, 432
adolescents, 167, 173-174, 177, 179-180, 199
alcohol abuse, 165, 167, 168, 179
brain effects, 158, 171-173, 181-182
clinical trials, 164, 165, 167, 169, 183
cognitive-behavioral factors, 158, 170, 173, 174-177, 179, 181, 183, 184
community programs and studies, 166, 178, 179, 182, 183
depression, 3, 159, 165, 171-172, 176, 177-178, 183
epidemiology, 157-168 (passim), 178-179 , 184
gender factors, 160, 161, 166, 168, 169, 170, 183
hypothalamic-pituitary-adrenal axis (HPA), 171-172, 173
longitudinal studies, 163, 177-178, 179-180 , 183, 184
memory of, 163
neurochemistry, 158, 171-172, 173, 184
pathway analysis, 157, 164, 179-182
physicians, 183
post-traumatic stress disorder (PTSD), 171-172, 173, 177, 178, 181-182
preventive measures, 176-177, 181, 182-183 , 184, 303-304
prisoners’ children, 159, 161, 165
prospective studies, 165, 166, 177
psychiatric and psychological factors, general, 3, 158, 159, 161, 165, 168, 170, 177-181, 183
psychological autopsies, 165, 167
race/ethnicity, 162
research methodology, 157-158, 162-164, 172-173
clinical trials, 164, 165, 167, 169, 183
epidemiology, 157-168 (passim), 178-179 , 184
pathway analysis, 157, 164, 179-182
prospective studies, 165, 166, 177
resiliency, 174
retrospective studies, 164, 179-180
self-efficacy and self-esteem, 169, 173, 174, 175, 181
sociocultural factors, 170, 173-177, 184
socioeconomic status, 159, 165, 179
substance abuse, 159, 161, 165, 173, 177-179 , 181
Surgeon General’s reports, 157, 176, 182, 295-296
treatment, general, 157, 176-178, 182-183, 184
Children, 87-89
see also Adolescents and youth;
Genetic factors;
School factors
adoption, 2, 132, 133, 140-141
barriers to treatment, 336
educational interventions, 15
historical perspectives, 22
immigrants, 51
isolation from, 250
parental separation from/death of child, ix, 19
personality disorders, 80-81
psychological autopsies, 377
sexual orientation, 54-55
China, ix, 2, 7, 23, 33, 35, 36, 39, 69, 207-213 (passim), 360
Cigarette smoking, see Smoking
City of God, 23
Clinical guidelines, 5, 13-14, 230, 231, 392
barriers to treatment, 336-349 (passim)
emergency care, 345
follow-up care, 255
psychotherapy, 246
Clinical trials, 8, 12, 100, 257, 300-301, 317, 403-404, 423, 424, 429, 432, 433
antidepressant medications, 238-240, 241-242, 257
barriers to treatment, 336
childhood trauma, 164, 165, 167, 169, 183
dexamethasone suppression test, 121
elderly persons, 302
ethical issues, 8, 164, 389-393, 412, 432
firearm use in suicide, 284
follow-up care, 255-256
mood stabilizers, 233, 234, 235, 258
physicians, judgment of risk, 391-392
psychotherapy, 246-250
risk-based allocation, 8, 395, 402-404
serotonin, 127, 238-239, 240, 241-242
Clomipramine, 240
see also Imitation and contagion
Cognitive-behavioral factors, 90, 231, 350, 432, 437
see also Adherence to treatment;
Coping;
Intelligence;
Problem solving;
Self-efficacy and self-esteem
childhood trauma, 158, 170, 173, 174-177 , 179, 181, 183, 184
informed consent, 8, 292, 359, 389-392
locus of control, 93-94, 174, 181;
see also Impulsivity
school-based prevention programs, 294, 295-296
treatments, general, 4, 80, 92, 99, 100, 245-249, 258, 348
Cognitive behavioral therapy (CBT), 92, 245-249
Collaborative Depression Study, 238
Community programs and studies, 4-5
see also Local government;
Outpatient care;
Public education
assessment of patients, 232
barriers to treatment, 335, 336, 345-346
childhood trauma, 166, 178, 179, 182, 183
committee recommendations, 11, 436
developing countries, 360
imitation and contagion, 277
military personnel, 6, 15, 304-307, 436-437 , 438
Native Americans, 308-309
prevention programs, 6, 15, 275, 304-305 , 436-437, 438;
see also “military personnel” supra
surveillance, 379, 381-382, 386, 411
violence, 162, 173, 175-176, 178, 215, 305
Computer applications
see also Databases;
Internet
assessment of risk, 230
Confidentiality, 359, 388-389, 433
Consumer Product Safety Commission, 385
Contagion, see Imitation and contagion
Contracts, no-suicide, see No-suicide contracts
Convulsions, see Anticonvulsants
Coping
see also Problem solving
coping training, 26, 94-95, 100, 274, 317, 437
school-based prevention programs, 294-295, 300-301
Coping and Support Strategy, 300-301
Coroners and medical examiners, 55, 304, 379, 380-381, 384, 411, 432
Correctional facilities, see Prisoners
Counseling, 229, 255, 316, 350, 354
alcohol abuse, 342
crisis centers, 255, 275, 279, 289-290, 297
firearm use in suicide, 284
gatekeeper training 297-298
hotlines, 279, 288, 289-290, 304, 315-316
school-based prevention programs, 297-298 , 299-301, 309
Counselors CARE, 299-301
Crime and criminal behavior
see also Child abuse;
Prisoners;
Sexual abuse;
Substance abuse;
Violence and aggressive behavior
childhood trauma, 165, 174, 176
committee recommendations, 13
parental, 165
psychological autopsies, 377
Crisis response
see also Emergency care
centers, 255, 275, 279, 289-290, 297
hotlines, 279, 288, 289-290, 304, 315-316
primary care referral to, 344-345
school-based prevention programs, 301
Cross-sectional studies, 4, 141, 424
childhood trauma, 164, 167, 179-180
cost of suicide to society, 57
Cultural factors, see Immigrants;
Race/ ethnicity;
Social and cultural factors
Databases, 12, 383-389, 431, 432, 433, 434
see also Registries;
Surveillance cost of suicide to society, 57
military personnel, 305, 306-307
overdose suicides, 287
Death Master Files, 236
Definitional issues, 27-28, 55, 58, 70-71, 375, 376, 379, 380, 411, 424
childhood trauma, 158-159, 163-164
lifetime risk, 394
psychic pain, 97
psychotherapy, 246
sociocultural factors, 193
stigma, 332
Demographic factors, 4, 10, 33-58, 206, 384, 428
see also Adolescents and youth;
Age factors;
Children;
Educational attainment;
Elderly persons;
Epidemiology;
Gender factors;
Geographic factors;
Immigrants and refugees;
Marriage and intimate relations;
Prisoners;
Race/ethnicity;
Rural areas;
Sexual orientation;
Social and cultural factors;
Socioeconomic status;
Urban areas
definitional issues, 27
high-risk occupations, 15, 52-53
military personnel, 6, 15, 304-307, 436-437 , 438
veterans, 1, 12, 14, 20, 230, 336, 433, 438
psychological autopsies, 378
Denmark, 53, 85, 195, 276, 381
Department of Education, 14-15, 438
Department of Health and Human Services
see also Centers for Disease Control and Prevention;
National Institute of Mental Health
Agency for Health Care Policy and Research, 302
Agency for Health Care Research and Quality (AHRQ), 14, 436
Food and Drug Administration, 392
Indian Health Service, 307, 308, 356
National Cancer Institute, 407, 408, 411
National Center for Injury Prevention and Control, 384
National Institute on Aging, 12, 407, 408, 433
National Institute on Alcohol Abuse and Alcoholism (NIAAA), 1, 12, 20, 433
National Institute on Drug Abuse (NIDA), 1, 12, 433
National Institutes of Health (NIH), 431
Social Security Administration, 236
Department of Veterans Affairs (DVA), 1, 12, 14, 20, 230, 336, 433, 438
Depression, ix, 5, 17-19, 72-73, 84, 86, 89, 90, 91-92, 95-96, 98, 231, 310, 400-401 , 462
see also Antidepressant medications;
Bipolar disorder;
Depression;
Guilt and humiliation;
Psychic pain;
Self-efficacy and self-esteem
adolescents and youth, 49, 87, 284, 300
anxiety disorders and, 76
barriers to treatment, 4-5, 73, 252-253, 335, 337, 339-342, 343, 349, 351-353
Beck Depression Inventory, 231, 400
bereavement, 4, 19, 22, 42, 352
widows and widowers, 3, 23, 198, 204, 352
childhood trauma, 3, 159, 165, 171-172, 176, 177-178, 183
committee recommendations, 11, 13, 435
dexamethasone suppression test, 121
diagnosis, 72, 99, 231, 339-341, 355
elderly persons, 42, 43, 44, 301-302, 339-340 , 351-353, 438
electroconvulsive therapy, 242-244
family history of, 3, 86, 159, 165, 287
gatekeeper training, 298-299
gender factors, 39-40
historical perspectives, 21-22
informed consent, 390
lithium treatment, 235
locus of control, 93-94
personality disorders and, 80
phenobarbital, epileptic patients, 287
racial/ethnic factors, 49
religious influences, 203
time factors, 72, 125, 240, 241, 248, 401
Desipramine, 287
Developing countries, 360-361, 431
see also specific countries
Dexamethasone suppression test, 121
Diagnosis and screening, 5, 70-71, 99, 200, 230-233, 257-258, 297, 434-436, 438
see also Clinical guidelines;
Coroners and medical examiners;
Surveillance
alcohol abuse, 81
barriers to, 331, 332, 339-356 (passim), 360, 361
bipolar disorder, 74
childhood trauma, 184
definitional issues, 27
depression, 72, 99, 231, 339-341, 355
developing countries, 360
elderly persons, 302, 339-340, 352, 353, 438
emergency care, 345
follow-up care, 230, 232, 250, 255
gatekeepers, 297-299, 336, 437, 438
historical perspectives, 273
Native Americans, 308
no-suicide contracts, 292
prisoners, 358
psychological autopsies, 378
schizophrenia, 77
school-based prevention programs, 299-301
serotonin, 123-124
sociocultural factors, 231, 232
standards, 170, 230, 231, 232;
see also Clinical guidelines
substance abuse, 71, 99, 335, 339, 342, 349
Diagnostic and Statistical Manual (DSM), 71-76 (passim), 79
Dialectical behavioral therapy, 80, 248, 249-250
Discrimination, 209-210, 214, 215, 332-334, 355, 358-359
Divalproex, 235
Divorce, ix, 3, 85, 165, 167, 196, 197, 198-199
Domestic gas poisoning, 288
Dopamine, 77, 122, 126, 127, 171, 172
Drug abuse, see Alcohol abuse;
Substance abuse
Drug Abuse and Early Warning Network, 287
Drug treatment, see Pharmaceuticals
DSM, see Diagnostic and Statistical Manual
E-codes, see External cause-of-injury codes
Ecological-transactional approaches, 99
Economic factors, ix-x, 3, 69, 193, 196, 205-209 , 212, 214, 215
see also Employment;
Funding;
Health insurance;
Socioeconomic status
barriers to treatment, 5, 334-340, 350, 351;
see also Health insurance
cost of suicides, x, 55-57, 58, 423
historical perspectives, 21, 22
life insurance, 380
managed care, 336-339, 340, 341, 432
phenobarbital, 287
prisons, 357
research centers, 406
Education, see Professional education;
Public education;
School factors
Educational attainment, 50
schizophrenia, 78-79
Elderly persons, 15, 41-44, 57, 256, 301-302, 317, 438, 452
adherence to treatment, 43, 353
barriers to treatment, 331-332, 333, 351-353 , 362
cost of suicide to society, 56
depression, 42, 43, 44, 301-302, 339-340, 351-353, 438
firearms, 353
imitation and contagion, 278
inpatient care, 250
international perspectives, 41, 311
number of suicides, 1, 17, 39, 41, 44-45, 48, 425
personality characteristics, 95
pharmacotherapy, 302
racial/ethnic factors, 44-45, 48, 57
surveillance, 386
Electroconvulsive therapy, 242-244, 251
adolescents and youth, 345, 354
assessment of patients, 230, 255
barriers to treatment, 335, 345, 354
cost of, 56
crisis centers, 255, 275, 279, 289-290, 297
follow-up care, 255-256
hotlines, 279, 288, 289-290, 304, 315-316
number of attempted suicides, 17, 285-286
overdoses, 285-286
surveillance, 385, 386-387, 424, 426
Emergency Department Data Systems, 387
Employment, 3
bipolar disorder, 74
health insurance, employer-based, 337
high-risk occupations, 15, 52-53, 197, 205-206, 317
military personnel, 6, 15, 304-307, 436-437 , 438
psychological autopsies, co-workers, 378
race ethnicity, 205-206
sick leave for depression, 299
unemployed persons, 3, 40, 51, 52, 85, 196, 205, 207, 208, 215, 354
England, see United Kingdom
Epidemiologic Catchment Area Study, 47, 169, 384
Epidemiology, 3, 4, 47, 258, 311, 313-316, 384-385, 424
see also Surveillance
alcohol abuse, 85
antidepressant medications, 237-238
anti-psychotic medications, 236-237
centers for research, 10-12, 406-411, 425-431
childhood trauma, 157-168 (passim), 178-179, 184
committee recommendations, 10, 425-426 , 430
firearms, 280
follow-up care, 253
military personnel, 306-307
Native Americans, 308
occupational factors, 53
religious influences, 203
school-based prevention programs, 294-295
Epilepsy, anticonvulsants, 233, 235-236, 287
see also Legal issues
childhood trauma, 164
clinical trails, 8, 164, 389-393, 412, 432
committee recommendations, 12, 428
confidentiality, 359, 388-389, 433
informed consent, 8, 292, 359, 389-392
prisoners, 359
Ethnicity, see Race/ethnicity
Ethnographic research, 10, 11-12, 426, 428, 431
see also specific countries
alcohol abuse, 85
employment factors, 205
historical perspectives, 21-22, 210-211
Euthanasia/assisted suicide, 21, 44
External cause-of-injury codes (E-codes), 387
Faith-based interventions, see Religious influences
Falls, see Jumping
Family factors, 2, 3, 130-135, 141-142, 165, 174, 176-177, 182-183, 197-199, 200, 209, 212, 215, 316, 362
see also Child abuse;
Childhood trauma;
Children;
Divorce;
Genetic factors;
Parenthood
adoption, 2, 132, 133, 140-141
bipolar disorder, 74
brother’s suicide, 19
depression, history of, 3, 86, 159, 165, 287
domestic, 141, 159, 166, 173, 175, 178, 198-199, 297
elderly persons, 44
emergency care, 345
follow-up care, 255-256
military personnel, 305
prisoners, 358
problem solving, 247
psychological autopsies, 377, 378
racial/ethnic factors, 49
stigma of suicide, 334
substance abuse, 86
suicide note of woman, 18
Family History-Research Diagnostic Criteria, 378
Fatality Analysis Reporting System (FARS), 383
Federal government, 1, 12-15, 19-20, 278, 340, 381, 428, 438
see also Centers for Disease Control and Prevention;
Funding;
Surgeon General;
terms beginning “Department...” and “National...”
Agency for Health Care Policy and Research, 302
Agency for Health Care Research and Quality (AHRQ), 14, 436
historical perspectives, 1, 19-20, 273
Indian Health Service, 307, 308, 356
Field dependence, 181
Finland, 35, 50, 73, 80, 85, 196, 205, 239, 279, 304, 310-311, 312, 313
Firearms, 6, 15, 33, 36, 280-285, 316, 437
adolescents and youth, 41, 167, 280, 283-284
alcohol abuse and, 40, 81, 83, 282
committee workshop agendas, 475
elderly persons, 353
gun control legislation, 283, 284-285, 316
racial/ethnic factors, 45, 48-49, 280
Russian roulette, 380
Follow-up care, 4-5, 251, 252-256, 259
see also Outpatient care
adolescents and youth, 255-256, 345
assessment of patients, 230, 232, 250, 255
barriers to, 345
bipolar disorder, 74
contact letters, 254, 255, 259, 348
primary care and, 253, 335-336
schizophrenia, 78
telephone contacts, 254
time factors, 174(n.11), 231, 255, 259, 394, 425
Food and Drug Administration, 392
Ford Foundation, 407
Foreign countries, see International perspectives
Funding, x, 9, 10, 11-12, 13, 14, 311, 317, 423, 424, 435, 436, 438
research centers, 406, 408-409, 410, 411, 427, 428, 431
school-based prevention programs, 304
state reporting programs, 13
surveillance, 12-13, 384, 433-434
uninsured persons, 362
Gas poisoning, see Auto exhaust;
Domestic gas poisoning
Gatekeepers, 297-299, 336, 437, 438
see also Health insurance;
Managed care;
Primary care
Gay persons, see Sexual orientation
Gender factors, ix, 7, 9, 33, 38, 39-40, 130, 136, 138, 197, 198, 208, 210-211, 396-400, 452-453
see also Marriage and intimate relations;
Sexual orientation
alcohol and substance abuse, 40, 84
assessment of patients, 231
barriers to treatment, 333, 351, 354
discrimination, 209-210
childhood trauma, 160, 161, 166, 168, 169, 170, 183
cost of suicide to society, 56
crisis centers and hotlines, 290
depression, 39-40
discrimination, 209-210
drug overdoses, 286
elderly persons, 17, 41-42, 43, 46, 351
firearm use in suicide, 280, 283, 285
follow-up care, 255-256
international perspectives, 39, 57, 195, 196, 208, 211, 212
maternal depression, 3, 86, 159, 165
mood disorders, 71, 72, 74, 136
notes by female suicide victims, 18-19
occupational factors, 53
pregnancy prevention, adolescents, 275
racial/ethnic factors, 44-45, 46, 50, 170, 206, 215, 280, 290, 305, 355, 398-399 , 452
religious influences, 202
rural areas, young males, 36
serotonin, 138
Genetic factors, 2, 89, 96, 127, 130-142, 214, 256, 406
adolescents and youth, 131-132
committee recommendations, 10, 11, 13, 426-427, 430, 431
gender-related, 131, 136, 137-138
impulsivity, 130, 131, 132-133, 136, 138, 141-142, 430
psychological autopsies, 378-379
twin studies, 2, 132, 133-134, 140-142
violence and aggressive behavior, 2, 11, 130, 131, 136, 138, 141-142, 430
Geographic factors, 33, 34, 38-39, 196, 393, 395-400, 443, 451-459
see also International perspectives;
Regions of the U.S.;
Rural areas;
Social and cultural factors;
Urban areas
Government role, see Federal government;
Local government;
State government
Grief, see Bereavement
Guilt and humiliation
see also Stigma
cultural influences, 23, 24, 69
historical perspectives, 21, 22, 24
notes of suicide victims, 18, 19
Guns, see Firearms
Hamilton Rating Scale for Depression, 231, 232, 244
prisoners, 51
Health insurance, 14, 334, 362, 434
depressive patients, 73
managed care, 336-339, 340, 341, 432
Medicaid, 353
Native Americans, 356
Healthy People 2001, 20
Hispanics, 50-51, 199, 256, 304
Historical perspectives, , xi 21-25, 196, 376
childhood trauma, 161, 169, 182
corticosteriods, 120-121
depression, 21-22
federal government role, 1, 19-20, 273
firearm use in suicide, 282
guilt and humiliation, 21, 22, 24
imitation and contagion, 276
Native Americans, 307
preventive efforts, 1, 19-20, 302, 310-311
prisoners, 356-357
psychotherapy, 245
racial/ethnic factors, 45, 46, 47, 48
religious influences, 201-202
sociocultural factors, general, 21-25, 194- 195, 199, 201-202, 210-211, 214
surveillance, 385
theory, 25-28, 194, 198, 264, 273
unemployment, 207
costs of care, 357
registries, 13
surveillance, general, 13, 388, 432, 433, 434
Homosexuality, see Sexual orientation
Hopelessness, see Bipolar disorder;
Depression;
Personal suffering;
Psychic pain
Hospital Discharge Data Systems, 387
Hospitalization, see Emergency care;
Inpatient care
Hotlines, 279, 288, 289-290, 304, 315-316
Humiliation, see Guilt and humiliation
Hypothalamic-pituitary-adrenal axis (HPA), 2, 11, 92-93, 120-122, 140, 181-182
childhood trauma, 171-172, 173
Immigrants and refugees, 49-51, 58, 206, 209, 256, 304
religious influences, 202
Imipramine, 287
Imitation and contagion, 41, 131-132, 276- 278, 316, 385, 395-400, 475
adolescents and youth, 131-132, 278, 395
Impulsivity, 2, 13, 41, 42, 80, 95, 96, 99, 142, 212, 435
see also Bipolar disorder;
Child abuse;
Violence and aggressive behavior
coping style, 94
genetic factors, 130, 131, 132-133, 136, 138, 141-142, 430
insecticides as means of suicide, 280
lithium treatment, 235
India, 212-213
Indian Americans, see Native Americans
Indian Health Service, 307, 308, 356
Inpatient care, 230, 250-253, 345-346, 386, 394-395
see also Emergency care;
Follow-up care
alcohol abuse, 84
anxiety, 250
barriers to treatment, 4-5, 73, 252-253, 335, 337, 338, 340, 345
bipolar disorder, 74
committee recommendations, 11, 430
discharged patients, 4-5, 73, 252-253, 335, 345;
see also Follow-up care
time factors, 4, 74, 84, 255, 259, 345-346 , 425, 430, 434
gatekeeper training, 299
involuntary hospitalization, 250
schizophrenia, 78
time factors, 43, 345-346, 373
discharged patients, 4, 74, 84, 255, 259, 345-346, 425, 430, 434
length of stay, 11, 249, 259, 337, 338, 400, 401, 430, 462-464
Insecticides, see Pesticides
Insurance, see Health insurance;
Life insurance
Intelligence
schizophrenia, 78-79
Interdisciplinary approaches, 20, 25-27, 273, 375, 423, 434
centers for research, 10-12, 406-411, 425-431
childhood trauma, 184
school-based prevention programs, 274
International Classification of Diseases, 387
International perspectives, ix, 3, 21-22, 69, 196, 210-213, 215-216, 275, 302-303 , 310-312, 423, 424, 425
see also Immigrants and refugees;
specific countries and world regions
alcohol abuse, 81, 83, 85, 211
bipolar disorder, 73-74
childhood trauma, 164
crisis centers, 289
developing countries, 360-361, 431;
see also specific countries
employment factors, 205
gender factors, 39, 57, 195, 196, 208, 211, 212
means of committing suicide, 282-286 (passim), 288, 289
media reporting of suicides, 278-280
number of suicides, 17, 33, 35-36, 39, 41, 57, 58, 425
occupational factors, 53
professional education, 12
research centers, 410, 425-426, 428, 431
school-based prevention programs, 296, 437
serotonin reuptake inhibitors (SSRIs), 239
socioeconomic status, 207-208, 212-213
surveillance, 360-361, 381, 387, 411, 431, 434
United Nations, 90, 302, 303, 305, 310, 312
World Bank, 428
World Health Organization, 35, 211, 212, 275, 278, 296, 302, 303, 305, 310, 312, 387, 428
Internet
cost of suicide to society, 57
crisis services, 290
media coverage of suicides, 278
Interpersonal relations, see Marriage and intimate relations
Interval estimation, 401-402, 464-467
Israel, 198
Japan, 23, 204, 207, 210, 278, 288
Latinos, see Hispanic persons
see also Crime and criminal behavior;
Ethical issues;
Prisoners
confidentiality, 359, 388-389, 433
informed consent, 8, 292, 359, 389-392
litigation, 357
malpractice claims, 346-347
military personnel, 306-307
no-suicide contracts, 292
Legislation
means of suicide, reducing access to, 280
preventive efforts, 273
prisoners, 357
proscriptions against suicide, 23, 25, 212, 215
surveillance, 382, 383, 384, 386, 387
Lesbians, see Sexual orientation
Life insurance, 380
LINK, 304-307
Lithium, 4, 233-236, 254, 258, 348
LivingWorks Suicide Intervention Workshop , 297-298
Local government, 438
see also Community programs and studies
childhood trauma, 162
surveillance, 379, 381-382, 386, 411
see also Coroners and medical examiners
Locus of control, 93-94, 174, 181
see also Impulsivity
Longitudinal studies, 6, 10, 72, 91, 99, 206, 210-211, 259, 317, 412, 424, 431-432
centers for research, 406, 426, 428, 429, 430
childhood trauma, 163, 177-178, 179-180 , 183, 184
cost of suicide to society, 56-57
firearm use in suicide, 280
marital status, 198
neurochemistry, 140
parenthood, 199
personality characteristics, 95
religious influences, 203
school-based prevention programs, 294-295
sexual orientation, 54-55
unemployment, 207
youth, 87-88
Low-base rate events, 27, 232, 290, 313, 344, 375, 376-377, 423, 424, 425-426, 431
Managed care, 336-339, 340, 341, 432
Manic-depression, see Bipolar disorder
Marriage and intimate relations, 165, 167, 175, 197-199, 208, 212-213
alcohol abuse, 83-84
dowry deaths, 212
divorce, ix, 3, 85, 165, 167, 196, 197, 198-199
immigrants, 50-51
religious influences, 202
widows and widowers, 3, 23, 198, 204, 352
Mass media, 6, 15, 276-280, 289, 294, 304, 310, 316, 437
Means of completing suicide, reducing access to, 21, 52, 206, 274, 280- 289, 313, 316, 347, 437
see also Firearms
alcohol abuse and, 83
acetaminophen, 285-286
domestic gas poisoning, 288
overdoses, 15, 241, 285-287, 340
pesticides, 280
psychological autopsies, 377
railway suicides, 289
suffocation, 33
Measure of Adolescent Potential for Suicide, 299-300
Media, see Mass media Medicaid, 353
Medical examiners, see Coroners and medical examiners
Medications, see Pharmaceuticals
Men, see Gender factors
Methodology, see Research methodology
Mianserin, 287
Million Clinical Multiaxial Inventory, 400
Minorities, see Race/ethnicity
Mixed-effects regression models, 400-401, 448-450, 451-454, 458-464
Moclobemide, 240
Mood disorders, 70, 71-75, 80, 84, 86, 92, 339, 394
see also Bipolar disorder;
Depression;
Impulsivity
anxiety disorders and, 75, 247
childhood trauma, 174
coping style, 94
gender factors, 71, 72, 74, 136
psychotherapy, 247
school-based prevention programs, 301
Mood stabilizers, 233-236, 346, 350
anticonvulsants, 235-236
clinical trials, 233, 234, 235, 258
Motor vehicle deaths, 48, 276, 383, 432
surveillance, 380
National Bioethics Advisory Commission, 389
National Cancer Institute, 407, 408, 411
National Center for Injury Prevention and Control, 384
National Child Abuse and Neglect Data System, 160
National Comorbidity Survey, 47, 71
childhood trauma, 178, 179-180
National Death Index, 231, 236
National Electronic Disease Surveillance System, 387
National Electronic Injury Surveillance System (NEISS), 385
National Health Interview Survey, 72
National Highway Traffic Safety Administration, 383
National Institute of Drug Abuse, 20
National Institute of Mental Health (NIMH), 1, 9, 20, 238, 376, 435, 436, 438
Center for Studies of Suicide Prevention (Suicide Research Unit), 19, 27
committee recommendations, 10, 12-15 (passim), 427-431, 433
elderly persons, 302
media coverage of suicides, 278
Native Americans, 307
racial/ethnic factors, 47
research centers, 406, 410, 411
National Institute on Aging, 12, 407, 408, 433
National Institute on Alcohol Abuse and Alcoholism (NIAAA), 1, 12, 20, 433
National Institute on Drug Abuse (NIDA), 1, 12, 433
National Institutes of Health (NIH), 431
National Prescription Audit, 287
National Strategy for Suicide Prevention, 20, 90, 278, 338, 340, 342, 346
National Violent Death Reporting System, 13, 383-384, 432-434
Native Americans, 1, 17, 45, 47-49, 57, 307-310 , 313, 317, 355-356
alcohol abuse, 81, 82, 83, 308, 309-310
Netherlands, 198
Neurochemistry, 2, 92-93, 119-142
see also Alcohol abuse;
Brain and brain repositories;
Pharmaceuticals;
Serotonin;
Substance abuse;
Tissue samples
anxiety disorders and, 77, 92-93
cerebrospinal fluid, 123, 124-126
childhood trauma, 158, 171-172, 173, 184
committee recommendations, 13, 426, 429
dopamine, 77, 122, 126, 127, 171, 172
hypothalamic-pituitary-adrenal axis (HPA), 2, 11, 92-93, 120-122, 140, 181-182
childhood trauma, 171-172, 173
memory, 91
pathway analysis, 77, 119, 121, 122, 130, 142
psychological autopsies, 378
violence and aggressive behavior, 119, 120, 122, 125, 126, 128, 131, 136, 138, 140, 235-236, 241;
see also Genetic factors
Noradrenergic system, 122, 128-129, 140
Nortriptyline, 287
No-suicide contracts, 291-292
Notes by suicide victims, 18-19, 28, 32, 132, 380
Nursing homes, 43
Oregon State Adolescent Suicide Attempt Data System (ASADS), 386, 388
childhood trauma, 162, 164, 177
clinical trials, 8
committee recommendations, 11
coping training, 94-95
elderly persons, 302
lithium treatment, 235
managed care, 337
personality disorders, 79
school-based prevention programs, 294-296
surveillance, 386
Outpatient care, 249, 250, 251, 252-253, 395
see also Emergency care;
Follow-up care
assessment of patients, 230, 232
bipolar disorder, 74
childhood trauma, 169
crisis centers, 255, 275, 279, 289-290, 297
depression, 73
schizophrenia, 78
Overdose suicides, 15, 241, 285-287, 340
Pain, see Physical pain;
Psychic pain;
Terminal illness
Panic disorder, 76
Paracetamol, see Acetaminophen
Parenthood, 3, 159, 160, 168, 175-176, 199
see also Child abuse;
Childhood trauma;
Children;
Family factors
adoption, 2, 132, 133, 140-141
death of, 167
firearm use in suicide, 284
maternal depression, 3, 86, 159, 165
preventive measures, 275
suicide of parent, 165
Pathway analysis, 89, 90, 97, 100, 119, 141
childhood trauma, 157, 164, 179-182
genetic, 141
neurological, 77, 119, 121, 122, 130, 142
school-based prevention programs, 276
Peer influences, 275, 304, 305
see also Imitation and contagion psychological autopsies, 378
Personal suffering, ix, xi, 2, 17-19
psychological autopsies, 377
Personality disorders, 79-81, 95-97
borderline personality disorder, 79-81
childhood trauma, 177
psychological autopsies, 377, 378
serotonin, 123-124
Pesticides, 280
Pharmaceuticals, 5, 11, 80, 128, 229, 230, 233-242, 248(n.7), 250, 258, 259, 425, 437
see also Antidepressant medications;
Mood stabilizers;
Substance abuse
Acetaminophen, 285-286
adherence to treatment, 43, 234-235, 253-254, 255, 337-338, 350, 353
Amitriptyline, 287
anticonvulsant medications, 233, 235-236 , 287
anti-psychotic medications, 4, 236-237, 350
anxiolytics, 240, 242, 258, 299
benzodiazepines, 242
bipolar disorder, 74
Carbamazepine, 235
Clomipramine, 240
Desipramine, 287
dexamethasone suppression test, 121
Divalproex, 235
education of practitioners, 99
electroconvulsive therapy and, 243-244
hospitalization, 250-251
hospitalization discharge follow-up care, 4-5, 251, 253
Imipramine, 287
lithium, 4, 233-236, 254, 258, 348
managed care, 337-338
medication resistant patients, 243, 254
Mianserin, 287
overdose suicides, 15, 241, 285-287, 340
serotonin reuptake inhibitors (SSRIs), 238-239, 240, 241-242, 342
special mental health care providers, 99, 347, 349
time factors, 234, 235, 240, 241, 242, 244, 248, 254, 350
vaproic acid, 235
Physical pain, 21
elderly persons, 44
Physician assistants, 344-345
adolescents, 354-355
alcohol abuse, 99
barriers to treatment and intervention, 331, 335-346 (passim), 348, 358, 359, 360, 435
childhood trauma, 183
clinical trials, judgment of risk, 391-392
education of, 99, 297, 298-299, 317, 344-345 , 436
elderly persons, 43, 339, 352, 353
managed care, 336-337, 340, 341
Physiological stress system, 26, 75, 77, 89, 92, 94, 119, 120-122, 130, 131, 140
Pituitary gland, see Hypothalamic-pituitary-adrenal axis
domestic gas, 288
pesticides, 280
Poisson regression, 7, 396-400, 445-459, 465- 467
Political factors, x-xi, 3, 196, 209-210
committee recommendations, 11, 431
surveillance, 379
terrorists, 195
Population Council, 407
Population laboratories, see Research methodology
Population studies, see Epidemiology
Populations at risk, see Demographic factors
Post-traumatic stress disorder (PTSD), 43, 51, 70, 71, 75, 76-77, 89
childhood trauma, 171-172, 173, 177, 178, 181-182
psychotherapy, 246
Pregnancy prevention, 275
Preventive measures, xi, 2-4, 6-7, 89-90, 273-317, 428
see also Clinical trials;
Coping;
Crisis response;
Diagnosis and screening;
Means of committing suicide, reducing access to;
Pharmaceuticals;
Specialty mental health care;
Treatment
barriers to, 331-373
centers for, xi
childhood trauma, 176-177, 181, 182-183 , 184, 303-304
committee recommendations, 10-11, 15, 21, 423, 424, 436-438
federal role, historical perspectives, 19- 20
historical perspectives, 1, 19-20, 302, 310-311
military personnel, 6, 15, 275, 304-305, 436-437, 438
veterans, 1, 12, 14, 20, 230, 336, 433, 438
research methodology, 6-7, 80, 89-90, 273-275, 290, 295, 304, 313-316
school-based, 181, 273, 274, 275-276, 293-297, 299-301, 304, 306, 317, 436, 437, 438
gatekeeper training, 297-298
Native Americans, 308-309
state government, 276, 279, 303-304, 312, 313, 436, 438
Universal, Selective, and Indicated model, 274-275
Primary care
adolescents, 354-355
alcohol abuse, 99
assessment of patients, 230
barriers to treatment and intervention, 331, 335-337, 339-345, 348, 352, 353, 434-435
childhood trauma, 182-183
clinical trials, judgment of risk, 391-392
education of practitioners, 99, 297, 298-299 , 317, 344-345, 436
elderly persons, 43, 339, 352, 353
managed care, 336-337, 340, 341
time factors, pre-suicide contacts with, 43-44, 301, 331-332, 341, 342-343, 344, 346, 353, 434
Prison Litigation Reform Act, 357
Prisoners, 51-52
assessment of patients, 230
barriers to care, 356-360
Privacy, see Confidentiality
Problem solving, 70, 89-90, 91, 95, 99, 194
see also Coping
family-based, 247
school-based prevention programs, 275, 301
treatments, 4, 245, 246-247, 249
Professional education, 99, 273, 316, 344-345 , 436
see also Clinical guidelines
autopsies, 55
committee recommendations, 12, 13, 14, 36, 431, 437
coroners and medical examiners, 380-381
developing countries, 360
gatekeeper training, 297-299, 344-345, 437, 438
physicians, 99, 297, 298-299, 317, 344-345 , 436
research centers, 12, 406, 431
school-based prevention programs, 296, 297
supportive therapists, 297
Professional organizations
American Academy of Pediatrics, 14, 183, 436
American Association of Suicidology, 14, 278, 290
American College of Family Physicians, 14, 436
American College of Physicians, 14, 436
American Foundation for the Prevention of Suicide, 14, 278, 438
American Medical Association, 5, 339-340
American Psychiatric Association, 14, 71, 438
American Psychological Association, 14
American Society of Internal Medicine, 14, 436
committee recommendations, 14, 436, 438
Prospective studies, 6, 11, 141, 412, 430, 432
childhood trauma, 165, 166, 177
Psychiatric and psychological factors, 2, 4, 11, 68-118, 119, 199, 200, 212, 230-233 , 426, 429, 437
see Alcohol abuse;
Anxiety disorders;
Diagnosis and screening;
Guilt and humiliation;
Mood disorders;
Pharmaceuticals;
Psychological autopsies;
Specialty mental health care;
Substance abuse
adherence to treatment, 253-254, 255
adolescents and youth, 40-41
barriers to treatment, 331-362 (passim)
childhood trauma, 3, 158, 159, 161, 165, 168, 170, 177-181, 183
electroconvulsive therapy, 242-244, 251
employment factors, 205
genetic factors, 130
interventions, 229-270
prisoners, 51-52
psychotherapy, 2, 4, 11, 52, 80, 94, 203-204 , 229, 244-250, 258, 259, 437
clinical trials, 246-250
cognitive behavioral therapy, 92, 245-249
coping training, 26, 94-95, 100, 274, 294-295, 300-301, 317, 437
dialectical behavioral therapy, 80, 248, 249-250
elderly persons, 302
no-suicide contracts, 291
resiliency training, 2, 17, 100, 275, 302, 424
school-based prevention programs, 294-295, 300-301
see also Cognitive-behavioral factors
racial/ethnic factors, 46-47, 49, 356
religious influences, 203-204
statistical analysis, 69, 71-100 (passim), 393-395, 400-401
theory, general, 25-26
Psychic pain, 17-19, 68, 87, 91-92, 93, 97-99, 100, 214-215, 350
see also Depression;
Guilt and humiliation;
Personal suffering
assessment of patients, 231, 232
Beck Hopelessness Scale, 231
elderly persons, 302
follow-up care, 253
medication for, 236
Native Americans, 309
primary care, 339
prisoners, 357
psychological autopsies, 378
Psychological autopsies, 230-231, 343, 349, 377-379
anxiety disorders, 75
elderly persons, 43
international perspectives, 212
military personnel, 306
see also Schizophrenia
anti-psychotic medications, 4, 236-237, 350
electroconvulsive therapy, 242-243
Public education, 15, 274, 310, 316
see also School factors
mass media, 6, 15, 276-280, 289, 294, 304, 310, 316, 437
Public opinion, see Attitudes and beliefs;
Mass media;
Stigma
Race/ethnicity, 1, 7, 10, 11, 38, 44-51, 57, 58, 138, 200, 214, 256, 396-400, 424, 425, 452-453
see also Immigrants and refugees;
specific racial/ethnic groups
adolescents and youth, 45, 46, 47-48, 49, 256
alcohol abuse, 81, 82, 83, 84, 308, 309-310
barriers to treatment, 332-334, 336, 346, 355-356
centers for research, 406, 428
childhood trauma, 162
cost of suicide to society, 56-57
crisis centers and hotlines, 290
discrimination, 209-210, 214, 215, 332-334 , 355, 358-359
elderly persons, 44-45, 48, 57
employment factors, 205-206
firearm use in suicide, 45, 48-49, 280
gender factors, 44-45, 46, 50, 170, 206, 280, 290, 305, 315, 355, 398-399, 452
genetic factors, 130
historical perspectives, 45, 46, 47, 48
psychiatric and psychological factors, general, 46-47, 49, 356
religious influences, 46, 50-51, 202
Railway suicides, 289
Reasons for Living Inventory, 231
Refugees, see Immigrants and refugees
Regions of the U.S., 36, 37, 39, 48, 81, 428
childhood trauma, 169
surveillance, 379, 380, 382, 385-386
Registries, 9, 12, 13, 55, 237, 285, 361, 378, 406, 411, 426, 431, 433
international perspectives, 7, 212
Regression analysis, 7, 341, 396-401, 403
mixed-effects regression models, 400-401 , 448-450, 451-454, 458-464
Poisson regression, 7, 396-400, 445-459, 465-467
Religious influences, 3, 98, 195, 201-204, 214, 256-257
elderly persons, 43
gender factors, 46
historical perspectives, 23
racial/ethnic factors, 46, 50-51, 202
terrorists, 195
Reporting, 7, 8, 12, 380, 384, 424
see also Definitional issues;
Surveillance
childhood trauma, 162-164
coroners and medical examiners, 55, 304, 379, 380-381, 384, 411, 432
developing countries, 361
Research methodology, , x 4, 8-9, 213, 246, 348-349, 375-412
see also Animal studies;
Clinical trials;
Databases;
Definitional issues;
Epidemiology;
Interdisciplinary approaches;
Pathway analysis;
Psychological autopsies;
Registries;
Reporting;
Statistical analysis;
Surveillance
case-control studies, 142, 309, 356, 402
centers for research, 10-12, 406-411, 425-431
childhood trauma, 157-158, 162-164, 172-173
committee recommendations, 10-15, 99-100 , 139-142, 216-217, 257-259, 425-438
cost of suicide to society, 56-57
crisis centers and hotlines, 290
electroconvulsive therapy, 243
follow-up care, 255
genetic studies, 135-142
historical perspectives, 273-274
imitation and contagion, 277
interval estimation, 401-402, 464-467
mood stabilizer use, 233-234
no-suicide contracts, 291
preventive measures, 6-7, 80, 89-90, 273-275 , 290, 295, 304, 313-316
regression analysis, 7, 341, 396-401, 403
mixed-effects regression models, 400-401, 448-450, 451-454, 458-464
Poisson regression, 7, 396-400, 445-459 , 465-467
risk-based allocation, 8, 395, 402-404
sample size considerations, 10, 56, 138, 248, 394, 397, 404-406, 410, 411, 425, 426, 428, 441-442
low-base rate events, 27, 232, 290, 313, 344, 375, 376-377, 423, 424, 425-426, 431
school-based prevention programs, 295
time factors, 395, 401, 402, 406, 429, 462-464
childhood trauma, 174
training, 2, 17, 100, 275, 302, 424
childhood trauma, 164, 179-180
Risk-based allocation, 8, 395, 402-404
Risk factors, general, xi, 2-4, 9, 12, 21, 26-27, 55, 273, 384-385, 423, 425, 426
see also Diagnosis and screening;
Preventive measures;
Treatment
assessment of, 229-233
barriers to treatment and intervention, 331-373
clinical trails, 8, 258, 391-392, 425
committee recommendations, 10, 13-15, 140-142, 423, 425, 426, 429
definitional issues, 28
informed consent, 8, 292, 359, 389-392
occupations, high-risk, 15, 52-53, 197, 205-206, 317
school-based prevention programs, 276
Robert Woods Johnson Foundation, 407
Rockefeller Foundation, 407
Rural areas, 209, 210, 307-310, 336, 356
firearm use in suicide, 283-284
insecticides as means of suicide, 280
number of suicides, 36, 38, 425
Russian roulette, 380
Samaritans, 290
Sample size considerations, 10, 56, 138, 248, 394, 397, 404-406, 410, 411, 425, 426, 428, 441-442
low-base rate events, 27, 232, 290, 313, 344, 375, 376-377, 423, 424, 425-426 , 431
SAMSHA, see Substance Abuse and Mental Health Services Administration
Scale for Suicide Ideation, 230
Schizophrenia, 68, 71, 77-79, 80, 123-124, 138-140, 394
anti-psychotic medications, 236
electroconvulsive therapy, 242-243
inpatient care, 250
lithium treatment, 235
School factors
assessment of students, 232
barriers to treatment, 335, 354
childhood trauma, 174-175
cognitive-behavioral factors, 294, 295-296
counseling, 297-298, 299-301, 309
international perspectives, 296, 437
prevention programs, 181, 273, 274, 275-276 , 293-297, 299-301, 304, 306, 317, 436, 437, 438
gatekeeper training, 297-298
Native Americans, 308-309
professional education for programs, 296, 297
psychological autopsies, 378
self-efficacy and self-esteem, 275, 293, 299-300, 301, 309, 437
time factors, 293, 295, 298, 299, 301
Screening, see Diagnosis and screening
Seizures, see Anticonvulsants
Self-destructive behavior, general, 181
definitional issues, 71
elderly persons, 43
follow-up care, 253
personality disorders, 79
psychosis and, 68
serotonin, 126
Self-efficacy and self-esteem, 74, 92-93, 99
see also Coping;
Depression;
Stigma
childhood trauma, 169, 173, 174, 175, 181
family factors, 334
Native Americans, 309
psychotherapy, 245
school-based prevention programs, 275, 293, 299-300, 301, 309, 437
Serotonin, 2, 121-122, 123-129, 132, 135, 136, 137-138, 142
anxiety disorders and, 77
clinical trials, 127, 238-239, 240, 241-242
lithium treatment, 235
psychological autopsies, 378
serotonin reuptake inhibitors (SSRIs), 238-239, 240, 241-242, 342
Sex differences, see Gender factors
Sexual abuse, 132-133, 141, 158, 159
adolescents and youth, 161, 179-180
Sexual orientation, 53-55, 176, 378
Shame, see Guilt and humiliation
Smoking, 84
Social and cultural factors, ix-x, 2, 3, 4, 10, 11, 33, 58, 141, 193-227, 256-257, 311, 317, 424, 431, 432, 435
see also Community programs and studies;
Demographic factors;
Family factors;
Immigrants and refugees;
International perspectives;
Race/ethnicity;
Religious influences;
Stigma
alcohol abuse, 83
assessment of patients, 231, 232
centers for research, 406, 425-426, 428
childhood trauma, 170, 173-177, 184
cost of suicide to society, x, 55-57, 58, 423
discrimination, 209-210, 214, 215, 332-334 , 355, 358-359
ethnographic research, 10, 11-12, 426, 428, 431
guilt and humiliation, 23, 24, 69
historical perspectives, 21-25, 194-195, 199, 201-202, 210-211, 214
imitation and contagion, 276-278
isolation, 25, 42, 50, 175, 176, 194-195, 196, 197, 198, 200, 208-209, 250, 253, 274, 309, 350
mass media, 6, 15, 276-280, 289, 294, 304, 310, 316, 437
military personnel, 304-305
peer influences, 275, 304, 305, 378
personality disorders, 79
psychological autopsies, 377
self-efficacy, 93
substance abuse, 86
widows and widowers, 23, 198, 204
Social Security Administration, 236
Socioeconomic status, 3, 53, 196, 205-206, 207-209, 214, 215
see also Educational attainment;
Employment
childhood trauma, 159, 165, 179
committee recommendations, 10, 11, 428, 431
educational attainment, 50
immigrants, 50
international perspectives, 207-208, 212-213
psychological autopsies, 377
religious influences, 202
Soviet Union, ix
see also Russia
Spanish-speaking persons, see Hispanics
Specialty mental health care
barriers to, 335, 336-340 (passim), 342, 345-349, 357-359
clinical guidelines, 5, 346, 348-349
cognitive-behavioral aspects, general, 4, 80, 92, 99, 100, 245-249, 258
coping training, 26, 94-95, 100, 274, 317, 437
school-based prevention programs, 294-295, 300-301
diagnosis, 346-348
malpractice claims, 346-347
prisoners, 358-359
problem solving, 4, 245, 246-247, 249
Standards
see also Clinical practice guidelines;
Definitional issues;
Ethical issues
assessment of patients, 170, 230, 231, 232
clinical trials, 8, 389-391, 432
informed consent, 389
media coverage of suicides, 278-279, 289, 304, 310, 437
no-suicide contracts, 291
surveillance, 387
see also Definitional issues
State government
childhood trauma, 162
drinking, minimum age laws, 276
prevention programs, 276, 279, 303-304, 312, 313, 436, 438
surveillance, 379, 381-384, 386, 433
Statistical analysis, 25, 55, 85-86, 160-162, 375, 393-406, 411, 441-468
see also Databases;
Epidemiology;
Reporting;
Surveillance
alcohol use, 81-86 (passim)
anxiety disorders and, 76-77
ethical issues, 375
interval estimation, 401-402
lifetime risk, 394-395
low-base rate event, 27, 232, 290, 313, 344, 375, 376-377, 423, 424, 425-426 , 431
number of suicides, x, xi, 1, 2, 9, 17, 20, 33, 34-58 , (passim) 375, 423, 424
psychiatric and psychological factors, 69, 71-100 (passim), 393-395, 400-401
regression analysis, 7, 341, 396-401, 403
mixed-effects regression models, 400-401, 448-450, 451-454, 458-464
Poisson regression, 7, 396-400, 445-459, 465-467
risk-based allocation, 8, 395, 402-404
sample size considerations, 10, 56, 138, 248, 394, 397, 404-406, 410, 411
low-base rate event, 27, 232, 290, 313, 344, 375, 376-377, 423, 424, 425-426, 431
Stigma, 5, 53-54, 216, 244, 312, 316, 332-334, 349-350, 351, 352, 361, 434
see also Guilt and humiliation child abuse, denial, 163, 175
developing countries, 360-361
media coverage of suicides, 279
Substance abuse, ix, 2, 3, 5, 39, 69, 70, 85-86, 96, 99-100, 435
see also Alcohol abuse
adolescents and youth, 40-41, 49, 88-89, 276
anxiety disorders, 75
barriers to treatment, 339, 342, 349, 350, 361
bipolar disorder, 74
childhood trauma, 159, 161, 165, 173, 177-179, 181
diagnosis, 71, 99, 335, 339, 342, 349
firearm use in suicide, 280
historical perspectives, 21
lithium treatment, 235
media portrayals of, 278
Native Americans, 308
overdoses, 15, 241, 285-287, 340
religious influences, 202, 203
school-based prevention programs, 275
surveillance, 384
Substance Abuse and Mental Health Services Administration (SAMHSA), 1, 9, 12, 14-15, 20, 411, 433, 438
media coverage of suicides, 278
Suffocation, 33
Suicide, Options, Awareness and Relief (Project SOAR), 298
Suicide Research Unit, 27
Supportive therapy, 6, 245, 247, 248, (n.7) 258, 274-275, 297, 299-301, 437
Surgeon General, 1, 27, 193, 340, 344-345, 353, 436
childhood trauma, 157, 176, 182, 295-296
emergency care, 345
media coverage of suicides, 278
specialty mental health care, 346
substance abuse, 384
Surveillance, 12-13, 303, 379-389, 432-434
see also Databases;
Registries;
Reporting Centers for Disease Control and Prevention, 12-13, 303, 382, 384, 385-386, 387, 433-434
childhood trauma, 160
coroners and medical examiners, 55, 304, 379, 380-381, 384, 411, 432
emergency rooms, 385, 386-387, 424, 426
HIV/AIDS, 13, 388, 432, 433, 434
international perspectives, 360-361, 381, 387, 411, 431, 434
legal issues, general, 380, 385-386
legislation, 382, 383, 384, 386, 387
local government, 379, 381-382, 386, 411
professional education, 380-381, 386
regional factors, U.S., 379, 380, 382, 385-386
religious influences, 380, 381
standards, 387
state government, 379, 381-384, 386, 433
Sweden, 5, 76, 207-208, 239, 296, 343-344
Telephone contacts
follow-up services, 254
hotlines, 279, 288, 289-290, 304, 315-316
Television, 277
see also Attitudes and beliefs;
Depression;
Impulsivity;
Personality disorders
Terminal illness
attitudes toward suicide, 333
euthanasia/assisted suicide, 21, 44
Terminology, see Definitional issues
Terrorists, 195
see also Age factors;
Historical perspectives;
Longitudinal studies;
Prospective studies;
Retrospective studies
African-Americans, mental disorders, 47
depression, 72, 125, 240, 241, 248, 401
discharge from inpatient care, suicide following, 4, 74, 84, 255, 259, 345-346 , 425, 430, 434
elderly, death following attempt, 42
electroconvulsive therapy, 243
euthanasia, consideration of, 44
Fatality Analysis Reporting System, 383
follow-up, 174(n.11), 231, 255, 259, 394, 425
health service contacts prior to suicide, 5, 255, 331, 348, 361, 377, 434
hypothalamic-pituitary-adrenal axis dysregulation, 172
imitation and contagion, 41, 131-132, 276-278, 316, 385, 395-400, 475
inpatient care, 43, 345-346, 373
discharge from inpatient care, suicide following, 4, 72, 74, 255, 259, 345-346, 425, 430, 434
length of stay, 11, 249, 259, 337, 338, 400, 401, 430, 462-464
locus of control, 93-94
media reporting of suicides, 279-280
medication, 234, 235, 240, 241, 242, 244, 248, 254, 350
primary care providers, pre-suicide contacts with, 43-44, 301, 331-332, 341, 342-343, 344, 346, 353, 434
psychological autopsies, 377-378, 383
psychotherapy visits, 349
research methodology, 395, 401, 402, 406, 429, 462-464
school-based prevention programs, 293, 295, 298, 299, 301
serotonin reuptake inhibitors (SSRIs), 240
Time series analysis, 77
Tissue samples, 12, 119, 426-427
see also Brain and brain repositories
Tobacco use, see Smoking
Training, see Professional education;
Public education
Trauma, see Childhood trauma
Treatment, general, 4-6, 79-80, 99, 275
see also Adherence to treatment;
Clinical trials;
Emergency care;
Follow-up care;
Health insurance;
Inpatient care;
Outpatient care;
Pharmaceuticals;
Preventive measures;
Specialty mental health care
barriers to, 331-373
discrimination, 209-210, 214, 215, 332-334
managed care, 336-339
see also Health insurance;
Stigma
childhood trauma, 157, 176-178, 182-183 , 184
cognitive-behavioral factors, 4, 80, 92, 99, 100, 245-249, 258, 348
committee recommendations, 10-11, 141, 423, 424, 428, 429
coping training, 26, 94-95, 100, 274, 317, 437
school-based prevention programs, 294-295, 300-301
cost of, 56;
see also Health insurance
developing countries, 360-361
elderly persons, 302
electroconvulsive therapy, 242-244, 251
fragmentation of services, 5, 332, 335-336 , 350, 355, 361, 434
media coverage of suicides, 279
no-suicide contracts, 291-292
psychological autopsies, 377
religious influences, 203-204, 256-257
supportive therapy, 6, 245, 247, 248(n.7), 258, 274-275, 297, 299-301, 437
Tricyclic antidepressants, 239, 240, 287
Trytophan hydroxylase, 135
Twin studies, 2, 132, 133-134, 140-142
Unemployment, 3, 40, 51, 52, 85, 196, 205, 207, 208, 215, 354
Uniform Crime Reports, 384
United Kingdom, 35, 50, 194-195, 212, 251, 276, 286, 288, 312, 381
United Nations, 90, 302, 303, 305, 310, 312
Universal, Selective, and Indicated model, 274-302, 436-438
Urban areas, 209, 210, 299-300, 336
alcohol abuse, 82
drug overdoses, 286-287
firearm use in suicide, 283-284
jumping as means of suicide, 287-288
number of suicides, 36, 37, 38, 425
racial/ethnic factors, 45, 356
railway suicides, 289
U.S. Air Force, 6, 15, 304-307, 313, 436-437, 438
Vaproic acid, 235
Veterans Administration, see Department of Veterans Affairs
Violence and aggressive behavior, 40, 58, 72, 95, 119, 120, 122, 240, 315, 377, 435
see also Child abuse;
Crime and criminal behavior;
Firearms;
Impulsivity;
Sexual abuse
domestic, other than child abuse, 141, 159, 166, 173, 175, 178, 198-199, 297
genetic factors, 2, 11, 130, 131, 136, 138, 141-142, 430
neurobiological factors, 119, 120, 122, 125, 126, 128, 131, 136, 138, 140, 235-236, 241
political violence, , x 3, 195, 209
prisoners, 357
cultural influences, 23, 198, 204
Women, see Gender factors
World Bank, 428
World Health Organization, 35, 211, 212, 275, 278, 296, 302, 303, 305, 310, 312, 387, 428
World Wide Web, see Internet
Youth, see Adolescents and youth
Youth Risk Behavior Survey (YRBS), 385-386