The Role of the Narrative in Educative Suicide Awareness Materials: A Randomized Controlled Trial.

There has been a debate about the suitability of different narratives in educative suicide prevention materials. Whereas some suicide prevention experts recommend raising awareness of suicide by highlighting its prevalence, others argue that this approach may normalize suicide and advocate focusing on help resources instead. Unfortunately, empirical evidence regarding this question is lacking. This randomized controlled trial aimed to test the impact of educative news articles that conveyed different narratives of suicide prevention. One article focused on the prevalence of suicide, one article highlighted professional help resources, and one article emphasized on how everyone can help to prevent suicide. We randomized n = 334 participants to read either one of these three articles or an article unrelated to suicide. Data on suicidal ideation, stigmatizing attitudes toward suicidal individuals, attitudes toward suicide prevention, and help-seeking intentions were collected with questionnaires, and implicit measures were used to assess participants' mental accessibility of concepts related to suicide and suicide prevention. Participants exposed to the article highlighting the high prevalence of suicide tended to show a higher accessibility of potentially detrimental cognitive concepts related to suicide. In contrast, the accessibility of the concept of "helping" and that "suicide is preventable" was higher in participants' memory when exposed to materials focusing on help. It seems that the impact of educative suicide awareness materials on readers' access to suicide- and suicide-prevention-related concepts in memory varied depending on the narrative featured in the article.

Effects of the mental health promotion seminar 'Coping with stress' in the undergraduate medical curriculum of the Medical University of Vienna.

BACKGROUND: High prevalence rates of distress and burnout in medical students are well-documented in mental health literature. Different types of interventions have been developed in the past in order to reduce stress in medical undergraduate students and promote better coping skills. There is, however, a paucity of studies that have tested the effectiveness of these interventions. This study aimed to examine the effect of different versions of the seminar 'Coping with stress', which was implemented in the first year of the undergraduate curriculum of the Medical University of Vienna in the summer semester of 2018, on students' mental health. METHODS: Invitations to participate in the study were sent via email to six cohorts of students from the Medical University of Vienna. Two cohorts participated in the onsite version of the seminar 'Coping with stress', whereas two cohorts participated in the online version of the seminar, and two cohorts received no intervention (control group). Data on burnout risk, life satisfaction, stress, and knowledge about available help resources were collected via online questionnaires from n = 137 students before and after the curriculum module that contained the seminar. RESULTS: Medical students who participated in the onsite seminar reported a reduction of some aspects of burnout, a decrease in stress, and an increase in knowledge about available help resources. No such effect was seen in the control group. Participants of the online seminar experienced a similar increase in knowledge about available help resources, but no changes in other outcomes. CONCLUSIONS: The findings support the notion that the onsite seminar of 'Coping with stress' had a positive impact on medical students' mental health and is a useful addition to the medical curriculum by promoting mental health literacy. TRIAL REGISTRATION: This research has been registered in the German Clinical Trial Registry with the registration number DRKS00018981 and the registration date 14/11/2019.

Associations of suicide-related media reporting characteristics with help-seeking and suicide in Oregon and Washington.

OBJECTIVE: Specific content characteristics of suicide media reporting might differentially impact suicides in the population, but studies have not considered the overarching theme of the respective media stories and other relevant outcomes besides suicide, such as help-seeking behaviours. METHODS: We obtained 5652 media reports related to suicide from 6 print, 44 broadcast and 251 online sources in Oregon and Washington states, published between April 2019 and March 2020. We conducted a content analysis of stories regarding their overarching focus and specific content characteristics based on media recommendations for suicide reporting. We applied logistic regression analyses to assess how focus and content characteristics were associated with subsequent calls to the US National Suicide Prevention Lifeline (Lifeline) and suicides in these two states in the week after publication compared to a control time period. RESULTS: Compared to a focus on suicide death, a focus on suicidal ideation, suicide prevention, healing stories, community suicide crises/suicide clusters and homicide suicide was associated with more calls. As compared to a focus on suicide death, stories on suicide prevention and stories on community suicide crises/suicide clusters were also associated with no increase in suicides. Regarding specific content characteristics, there were associations that were largely consistent with previous work in the area, for example, an association of celebrity suicide reporting with increases in suicide. CONCLUSION: The overall focus of a media story may influence help-seeking and suicides, and several story characteristics appear to be related to both outcomes. More research is needed to investigate possible causal effects and pathways.

Association of 7 million+ tweets featuring suicide-related content with daily calls to the Suicide Prevention Lifeline and with suicides, United States, 2016-2018.

OBJECTIVE: The aim of this study was to assess associations of various content areas of Twitter posts with help-seeking from the US National Suicide Prevention Lifeline (Lifeline) and with suicides. METHODS: We retrieved 7,150,610 suicide-related tweets geolocated to the United States and posted between 1 January 2016 and 31 December 2018. Using a specially devised machine-learning approach, we categorized posts into content about prevention, suicide awareness, personal suicidal ideation without coping, personal coping and recovery, suicide cases and other. We then applied seasonal autoregressive integrated moving average analyses to assess associations of tweet categories with daily calls to the US National Suicide Prevention Lifeline (Lifeline) and suicides on the same day. We hypothesized that coping-related and prevention-related tweets are associated with greater help-seeking and potentially fewer suicides. RESULTS: The percentage of posts per category was 15.4% (standard deviation: 7.6%) for awareness, 13.8% (standard deviation: 9.4%) for prevention, 12.3% (standard deviation: 9.1%) for suicide cases, 2.4% (standard deviation: 2.1%) for suicidal ideation without coping and 0.8% (standard deviation: 1.7%) for coping posts. Tweets about prevention were positively associated with Lifeline calls (B = 1.94, SE = 0.73, p = 0.008) and negatively associated with suicides (B = -0.11, standard error = 0.05, p = 0.038). Total number of tweets were negatively associated with calls (B = -0.01, standard error = 0.0003, p = 0.007) and positively associated with suicide, (B = 6.4 × 10-5, standard error = 2.6 × 10-5, p = 0.015). CONCLUSION: This is the first large-scale study to suggest that daily volume of specific suicide-prevention-related social media content on Twitter corresponds to higher daily levels of help-seeking behaviour and lower daily number of suicide deaths. PREREGISTRATION: As Predicted, #66922, 26 May 2021.

Effects of suicide prevention videos developed by and targeting adolescents: a randomized controlled trial.

Suicide prevention videos featuring young people's personal narratives of hope and recovery are increasingly used in suicide prevention, but research on their effects is scarce. A double-blind randomized controlled trial was conducted to test the effects of a suicide prevention video featuring an adolescent mastering his suicidal ideation by getting help on 14 to 19-year-olds. N = 299 adolescents were randomly allocated to watch the intervention video (n = 148) or a control video unrelated to mental health (n = 151). Questionnaire data were collected before (T1) and immediately after exposure (T2), and 4 weeks later (T3). Data were analyzed with a repeated-measures ANCOVA. The primary outcome was suicidal ideation, assessed with the Reasons for Living Inventory for Adolescents. Secondary outcomes were help-seeking intentions, attitudes towards suicide, stigmatization of suicidality, and mood. There was an immediate beneficial effect of the intervention on suicidal ideation (T2 mean change from baseline within intervention group MChange = - 0.16 [95% CI - 0.20 to - 0.12], mean difference compared to control group MDiff = - 0.09 [95% CI - 0.15 to - 0.03], ηp2 = 0.03), which was not maintained at T3. Participants reported significantly higher help-seeking intentions, which was maintained at 4-week follow-up. They also reported a sustained reduction of favorable attitudes to suicide. Effects on suicidal ideation were mediated by identification with the featured protagonist. Adolescents appear to benefit from suicide prevention narratives featuring personal stories from peers on coping with suicidal ideation and help-seeking.Trial registration DRKS00017405; 24/09/19; retrospectively registered.

Suicide mortality in the United States following the suicides of Kate Spade and Anthony Bourdain.

OBJECTIVE: The suicides of Kate Spade and Anthony Bourdain, two major American icons, in a span of days in June 2018 represent a unique and tragic natural experiment to characterize associations with actual suicides in the aftermath of celebrity suicides. The aim of this study was to identify changes in suicide counts after their deaths. METHODS: Suicide data were obtained from the United States' Centers for Disease Control and Prevention's public-use mortality file. A time-series analysis was performed, examining monthly suicide data by age group (⩽19, 20-44, 45-64 and ⩾65 years), for both men and women, for all suicide methods and for hanging versus non-hanging methods, from January 1999 to December 2018. Seasonal autoregressive integrated moving-average models were fitted to the pre-June 2018 period, estimating suicides in subsequent months and identifying deviations from expected values. The volume of Twitter posts about Kate Spade and Anthony Bourdain was used as a proxy of societal attention. RESULTS: Tweets about the celebrities were mainly concentrated in June 2018 and faded quickly in July. Total suicides exceeded the 95% confidence interval for June and approximated the upper limit of the 95% confidence interval in July. Over this 2-month span, there were 418 (95% confidence interval = [184, 652]) more suicides than expected, including 275 (95% confidence interval = [79, 471]) excess suicides in men and 182 (95% confidence interval = [93, 271]) in women. These equate to 4.8%, 4.1% and 9.1% increases above expected counts. There were 392 (95% confidence interval = [271, 514]) excess suicides by hanging, a 14.5% increase, with no significant increase in all other methods combined. CONCLUSION AND RELEVANCE: These findings demonstrate that mortality following celebrity suicides can occur at a similar magnitude to that observed for other public health emergencies. They underscore the urgency for interventions to mitigate imitation effects after celebrity suicide reporting.

The Impact of Educative News Articles about Suicide Prevention: A Randomized Controlled Trial.

Media stories featuring stories of personal experiences of coping with suicidal ideation have been shown to decrease suicide risk, but it is unclear whether more impersonal awareness materials have similar effects. This study aimed to test the impact of impersonal educative news articles featuring interviews with suicide prevention experts. Because the impact of news articles may be determined by the articles' pull quotes and headlines, we also aimed to compare the impact of two versions of the same suicide prevention news article. One version featured headlines and pull quotes highlighting the message that suicide is preventable, whereas the other version focused on the message that suicide is prevalent. In a web-based randomized controlled trial, n = 425 participants either read a news article featuring a prevention expert with one of the above versions of the same text or an article unrelated to suicide. Data on suicidal ideation, stigmatizing attitudes toward suicidal individuals, policy attitudes toward suicide prevention, help-seeking intentions, and assumptions on the prevalence of suicide-related behavior were measured with questionnaires. The assumed prevalence of suicide in the population was greater in both intervention groups than in the control group, but the articles did not have an impact on other outcomes, and there were no differences for variations in headlines and pull quotes. Impersonal suicide prevention articles appear safe to use and do not have an impact on suicide risk factors in general population samples.

Effects of suicide awareness materials on individuals with recent suicidal ideation or attempt: online randomised controlled trial.

BACKGROUND: Awareness materials featuring ways of coping with suicidal ideation can reduce suicidal ideation, the so-called Papageno effect. All of the previous experimental studies on this subject have been conducted with individuals not at risk of suicide. AIMS: To assess effects of suicide awareness materials in a sample of individuals with recent suicidal ideation. Trial registration: German Clinical Trial Registry ID number DRKS00013613. METHOD: Adults (n = 266) with recent self-reported suicidal ideation or attempt were randomised to read an educative article featuring a lay individual with personal experience of suicidality (n = 86), a similar article featuring a mental health expert (n = 90), or an unrelated article (n = 90) in a double-blind online randomised controlled trial. Questionnaire data were collected before (T1) and immediately after exposure (T2) as well as 1 week later (study end-point, T3) and analysed with linear mixed models. The primary outcome was suicide risk as assessed using the Survival and Coping Beliefs subscale of the Reasons for Living Inventory (RFLI); secondary outcomes were suicide-prevention knowledge and mood. RESULTS: There was an immediate beneficial effect on suicide risk in the intervention group exposed to the message delivered by the individual with personal experience (group 1) as compared with the control group that was maintained until the study end-point (study end-point: RFLI score mean difference from baseline within group 1 MD = -0.36 (95% CI -0.66 to -0.06), mean difference compared with control group MD = -0.71 (95% CI -1.27 to -0.14); d = -0.18). The effect was particularly pronounced for individuals with recent suicide attempt (RFLI score at T3, compared with control group: MD = -1.55 (95% CI -2.52 to -0.57); d = -0.23). Participants in this group also showed increased prevention-related knowledge compared with the control group. CONCLUSIONS: Individuals with a recent suicide attempt appear to benefit from a printed narrative of positive coping with suicidal ideation. The intervention materials do not increase short-term suicide risk.

Perceptions of LGBQ+ youth and experts of suicide prevention video messages targeting LGBQ+ youth: qualitative study.

BACKGROUND: Young lesbian, gay, bisexual, transgender, queer as well as other sexual/gender minorities (LGBTQ+) persons have higher rates of suicidal ideation and behavior compared to their non-LGBTQ+ peers, particularly during their coming out. The "It Gets Better" project is a multi-national media campaign that aims to reduce suicide among LGBTQ+ adolescents by providing personal narratives of hope delivered by mainly adult LGBTQ+ persons. There is only little knowledge so far on how young LGBTQ+ people as well as experts in suicide prevention and counseling perceive these videos, and how to potentially improve the videos based on their perceptions. METHODS: A total of n = 19 LGBQ+ adolescents and young adults and n = 9 experts participated in focus groups to discuss perceptions of a selection of "It Gets Better" videos. Eight focus groups were conducted to assess perceptions on the process of watching the videos, possible effects on young LGBQ+ viewers in general, and suicidal LGBQ+ youth in particular, as well as factors that were relevant to their perceptions. RESULTS: Messages were found to be helpful in terms of promoting hope. LGBQ+ youth identified several key strategies to increase identification with messages, which they considered crucial for their effectiveness. Criticism emerged from a perceived lack of diversity in terms of portrayed sexual identities, and some shallowness in the portrayal of suicidal ideation and how things can get better. The experts' perceptions of the videos were largely consistent with LGBQ+ youth, highlighting a positive potential of videos to support coming out and identity building processes. CONCLUSIONS: Young people and experts view the videos as helpful and relevant, but identified several strategies to better tailor them to the needs of LGBTQ+ adolescents, including suicidal peers. The insights gained are useful to the increasing number of suicide prevention projects using personal narratives of coping delivered via media to help prevent suicide.

[Language development in children with migration background and parental reading to children]. / Sprachentwicklung bei Kindern mit Migrationshintergrund und elterliches Vorlesen.

Introduction: The majority of children with a migration background suffer from language deficits in one or both languages. The aim of our study was to describe the patterns of language acquisition in children with Turkish background in Austria and to find factors which influence these Patterns. Method: Fifty-two children at the age of 5 to 6 years and their parents were assessed. Inclusion criteria for parents were Turkish migration background and use of Turkish at home. Inclusion criteria for children: no hearing impairment, no blindness, no chronic disease, average cognitive development, born in Austria, and attending a kindergarten. Language competence was measured with Havas 5. Parents were administered a questionnaire about socio-demographics and their child centered literacy orientation (CCLO). Results: There was a significant difference between language patterns in Turkish and German. Moreover, language competence was higher in both Turkish and German, the more parents tended to read to their children in Turkish. Discussion: Children acquired a grammatically correct but simple Turkish, while their competence in German was reduced. Reading to the children seems to stimulate language development not only of their natural language, but also of German. Conclusion: Early literacy in migrant languages should be integrated in training programs.

Beneficial and harmful effects of educative suicide prevention websites: randomised controlled trial exploring Papageno v. Werther effects.

BackgroundSuicide prevention organisations frequently use websites to educate the public, but evaluations of these websites are lacking.AimsTo examine the effects of educative websites and the moderating effect of participant vulnerability.MethodA total of 161 adults were randomised to either view an educative website on suicide prevention or an unrelated website in a single-blinded randomised controlled trial (trial registration with the American Economic Association's registry: RCT-ID: 000924). The primary outcome was suicidal ideation; secondary outcomes were mood, suicide-prevention-related knowledge and attitudes towards suicide/seeking professional help. Data were collected using questionnaires before (T1), immediately after exposure (T2), and 1 week after exposure (T3) and analysed using linear mixed models.ResultsNo significant intervention effect was identified for the entire intervention group with regard to suicidal ideation, but a significant and sustained increase in suicide-prevention-related knowledge (T3vT1P < 0.001, d = 1.12, 95% CI 0.96 to 1.28) and a non-sustained worsening of mood (P < 0.001, T2vT1, d = -0.59, -0.75 to -0.43) were observed. Participants with increased vulnerability experienced a partially sustained reduction of suicidal ideation (T3vT1, P <0.001, d = -0.34, -0.50 to -0.19).ConclusionsEducative professional suicide prevention websites appeared to increase suicide-prevention-related knowledge, and among vulnerable individuals website exposure may be associated with a reduction of suicidal ideation.

Measuring attitudes towards suicide: Preliminary evaluation of an attitude towards suicide scale.

OBJECTIVES: Our study aimed to validate a previously published scale assessing attitudes towards suicide. Factor structure, convergent and discriminant validity, and predictive validity were investigated. METHOD: Adult German participants (N=503; mean age=24.74years; age range=18-67years) anonymously completed a set of questionnaires. An exploratory factor analysis was conducted, and incongruous items were deleted. Subsequently, scale properties of the reduced scale and its construct validity were analyzed. A confirmatory factor analysis was then conducted in an independent sample (N=266; mean age=28.77years; age range=18-88years) to further confirm the factor structure of the questionnaire. RESULTS: Parallel analysis indicated a three-factor solution, which was also supported by confirmatory factor analysis: right to commit suicide, interpersonal gesture and resilience. The subscales demonstrated acceptable construct and discriminant validity. Cronbach's α for the subscales ranged from 0.67 to 0.83, explaining 49.70% of the total variance. CONCLUSIONS: Positive attitudes towards suicide proved to be predictive of suicide risk status, providing preliminary evidence for the utility of the scale. Future studies aiming to reproduce the factor structure in a more heterogeneous sample are warranted.

Effects of Suicide Awareness Material on Implicit Suicide Cognition: A Laboratory Experiment.

In spite of the increasing adoption of suicide awareness campaigns to prevent suicide, little is known about the effective construction of awareness messages used and on their impact on suicidal cognition. We hypothesized that media reporting on an individual overcoming a suicidal crisis increases the automatic association between "life" and self. University students (N = 112) were randomly allocated to one of three groups in a laboratory experiment. Participants allocated to treatment group 1 or group 2 read awareness material about a person coping with suicidal ideation by getting professional help. The only difference between the two groups was the amount of social similarity (low vs. high) between the protagonist and the participants. The control group read an article unrelated to suicide. Awareness material increased implicit cognition in terms of a strengthening of self-life associations. This effect was restricted to participants scoring low on wishful identification with the suicidal protagonist. This finding suggests that only individuals who do not wishfully identify with a protagonist going through difficult life circumstances benefit from the awareness material in terms of suicidal cognition. These findings provide a rich basis for further research and have potentially high relevance to the construction of suicide-awareness messages.

Blurred world view: A study on the relationship between television viewing and the perception of the justice system.

Previous studies suggest that distorted representations of reality on television can lead to distorted perceptions of reality among viewers. In this study, 322 individuals in Austria reported their weekly television consumption and whether they believe that there is active practice of capital punishment in Austria, which has been abolished since 1968. The more television participants watched, the more likely they mistakenly believed that there is, or recently was, capital punishment in Austria, even when controlling for participants' age and education. It seems that television has the potential to influence viewers' perception and knowledge of core aspects of society.

Determining the effects of films with suicidal content: a laboratory experiment.

BACKGROUND: Media stories on suicide can increase suicidal ideation, but little is known about variations in media effects with regard to audience vulnerability and story contents. AIMS: We investigated the impact of three drama films with suicidal content that varied with regard to the final outcome (suicide completion, mastery of crisis and death by natural causes) and tested the moderating effect of baseline suicidality of the participants on the effects. METHOD: Within a laboratory setting, we randomly assigned 95 adults to three film groups. We used questionnaires to analyse the effects of the films on mood, depression, life satisfaction, self-worth, assumed benevolence of the world and suicidality, as well as identification with the protagonist. We stratified the sample into participants with suicidal tendencies above and below the sample median. RESULTS: The film that ended with the protagonist's suicide led to a deterioration of mood particularly in individuals with baseline suicidality below the median, who also experienced an increase in self-worth. Participants with stronger suicidal tendencies experienced a rise in suicidality that depended on their level of identification with the protagonist. The film featuring the main character positively coping with his crisis increased life satisfaction particularly among participants with higher suicidal tendencies. CONCLUSIONS: The effects of suicide-related media material seem to vary with individual vulnerability and with type of media portrayal. Individuals with lower vulnerability experience more emotional reactions when exposed to a film culminating in suicide, but individuals with higher vulnerability experience a rise in suicidal tendencies particularly if they identify with the protagonist who died by suicide. In contrast, portrayals of individual mastery of crisis may have beneficial effects in more vulnerable individuals.

Associations of Suicide Referents With Different Moral Connotation With Actual Suicides.

Background: Different words used for suicide (so-called suicide referents) have different moral connotations, and neutral referents are recommended in media reporting guidelines. Aims: To assess how different referents in media reports are related to actual suicides. Method: Austrian news articles for each month between 2000 and 2021 (n = 276 months) were obtained from the Austrian Press Agency. Time series were modeled for media items referring to suicide as a crime [Selbstmord], an act of freedom [Freitod], or neutral connotation [Suizid]. Temporal associations with suicides in the month before, during, and after the reporting were examined. Results: Terminology referring to suicide as an act of free will [Freitod] was weakly associated with increases in total, male, and female suicides and with suicides in up to 64-year-olds in the same month. No other statistically significant associations were found. Limitations: No detailed content analysis of media reports was done. Conclusion: During times of prevalent use of referents suggesting suicide to be an act of freedom, there are small-sized increases in suicides. The simultaneous occurrence of this referent and suicides might reflect effects of a societal framing present in both the media and the community rather than a sheer media effect.

Suicide-Related Media Reporting With a Focus on Sexual and Gender Minority Identities.

Background: Little is known about the quality of media reports on suicide and prevention targeting persons with sexual or gender minority identities (LGBTQ+). Aims: To assess the quality of suicide-related media reporting of LGBTQ+ people and its consistency with media guidelines. Method: We conducted a content analysis of 5,652 media items in two US states (Washington and Oregon) published within 1 year. Results: There were only few differences in the reporting about suicide in LGBTQ+ as compared to non-LGBTQ+ reports. LGBTQ+ media items more often portrayed suicide as monocausal [Oregon: OR = 1.75, 95% CI (1.03-2.98), p = .038; Washington: OR = 3.00, 95% CI (1.81-4.97), p < .001] and linked them to adverse life experiences [OR = 2.16, 95% CI (1.38-3.38), p < .001; OR = 2.09, 95% CI (1.30-3.38), p = .002] than non-LGBTQ+ items. They also more often featured mental health experts [OR = 1.79, 95% CI (1.04-3.10), p = .034; OR = 2.12, 95% CI (1.23-3.67), p = .006] and contacts to support services [OR = 2.22, 95% CI (1.41-3.48), p < .001; OR = 2.70, 95% CI (1.64-4.45), p < .001]. Limitations: Aspects possibly influencing the portrayal of LGBTQ+ suicide and prevention beyond the characteristics listed were not investigated. Conclusion: Suicide-related media reporting related to LGBTQ+ issues features potentially beneficial aspects but tends to overlook multifactorial causes of suicide. Diverse factors contributing to LGBTQ+ suicide and prevention warrant greater attention.

"Breaking the Silence" Suicide Prevention Media Campaign in Oregon, April 7-14, 2019.

Background: Between April 7 and 14, 2019, the "Breaking the Silence" media engagement campaign was launched in Oregon. Aims: We aimed to assess the consistency of media content related to the campaign with media guidelines and the quantitative footprint on Twitter (now X) over time. Method: Media items related to the campaign were analyzed regarding focus and consistency with media guidelines for suicide reporting and compared with other suicide-related reports published in the same time frame, as well as with reporting in Washington, the control region. Tweets related to the campaign were retrieved to assess the social media footprint. Results: There were n = 104 media items in the campaign month, mainly in the campaign week. Items typically used a narrative featuring suicide advocacy or policy/prevention programs. As compared to other items with a similar focus, they scored better on several protective characteristics listed in media recommendations. Stories of coping with adversity, however, were scarce. The social media footprint on Twitter was small. Limitations: Inability to make causal claims about campaign impact. Conclusion: Media items from the Breaking the Silence campaign appeared mainly consistent with media guidelines, but some aspects, such as stories of recovery, were under-represented.

Who identifies with suicidal film characters? Determinants of identification with suicidal protagonists of drama films.

BACKGROUND: Identification with a media character is an influential factor for the effects of a media product on the recipient, but still very little is known about this cognitive process. This study investigated to what extent identification of a recipient with the suicidal protagonist of a film drama is influenced by the similarity between them in terms of sex, age, and education as well as by the viewer's empathy and suicidality. SUBJECTS AND METHODS: Sixty adults were assigned randomly to one of two film groups. Both groups watched a drama that concluded with the tragic suicide of the protagonist. Identification, empathy, suicidality, as well as socio-demographic data were measured by questionnaires that were applied before and after the movie screening. RESULTS: Results indicated that identification was not associated with socio-demographic similarity or the viewer's suicidality. However, the greater the subjects' empathy was, the more they identified with the protagonist in one of the two films. CONCLUSIONS: This investigation provides evidence that challenges the common assumption that identification with a film character is automatically generated when viewer and protagonist are similar in terms of sex, age, education or attitude.

The role of monocausal versus multicausal explanations of suicide in suicide reporting: A randomized controlled trial.

BACKGROUND: Media guidelines for reporting on suicide recommend that journalists should avoid monocausal explanations of suicide, but it is unclear if media items with monocausal explanations elicit different effects as compared to multicausal portrayals. METHOD: Using a web-based randomized controlled trial (n = 969), we tested five versions of a news article about the suicide of a teenage girl with varying portrayals of reasons for the suicide: (1) bullying as the sole (external) factor (i.e., monocausal), (2) several external social factors, (3) a combination of internal and external factors, (4) a combination of internal and external factors along with a focus on suicide prevention, or (5) no reason for the suicide (control group). We measured perceptions about the cause of suicide, attitudes toward suicide and suicide prevention, and identification with the suicidal protagonist with questionnaires. RESULTS: Readers of articles that portrayed suicide as being caused by one specific reason or exclusively social factors tended to adopt these misconceptions. Identification with the suicidal protagonist did not vary between interventions groups, but was lower in the control group. CONCLUSION: Highlighting the multifactorial etiology of suicide in news articles may help to avoid the misconception that suicide is a monocausal issue.