The impact of media reporting of the suicide of a singer on suicide rates in Taiwan.

PURPOSE: To examine if widespread media reporting of the suicide of a young female singer by charcoal burning increased suicide rates, and to examine whether the suicide induced a high risk of imitation suicide by this method among the young female group. METHODS: Poisson time series autoregression model was applied to examine the relative risk of overall and subgroup (age, gender and method) suicides during the 2-week period after the initiation of media reporting of the celebrity suicide. RESULTS: We found a significant increase (adjusted relative risk = 1.17, p = 0.04) in suicide deaths following media reporting of the celebrity suicide. The increase in suicides was particularly significant among female and young age groups. A marked increase in suicide by charcoal burning among females (adjusted relative risk = 1.44, p < 0.0001) was further observed. CONCLUSIONS: Detailed description of a specific suicide method following celebrity suicides may induce extensive modeling effect, attracting wider age/sex groups to model the method. Our finding provides further support for restraining media reporting of celebrity suicide in suicide prevention.

Predicting suicide attempts among treatment-seeking male alcoholics: an exploratory study.

Documented risk factors for suicide among alcohol-dependent patients are sensitive but insufficiently specific to effectively identify individuals who are prone to future suicide attempt. As a first step to assess factors not previously considered, this pilot study involved a group of male alcohol-dependent patients (N = 175) coming to detoxification to examine the potential utility of adverse childhood experiences (ACE) along with other documented events to discriminate individuals with a history of attempted suicide from their detoxifying peers. Family health history questionnaires were used to evaluate their ACEs. Receiver operating characteristic (ROC) analysis was applied to examine the predictive power of ACEs, alone or in combination with documented risk factors, to lifetime history of attempted suicide. Among our participants, 48 (27.4%) had a history of a suicide attempt and 156 (89.1%) reported at least one out of the nine categories of ACEs. Modeling by ROC analysis, we found that a cutoff of four or more ACEs plus a history of personal violence achieved the best predictive power to a history of any suicide attempt, producing a sensitivity of 0.7, specificity of 0.81, and area under curve of 0.75. A prospective study to replicate and extend our findings is necessary.

Association between childhood adversities and suicide attempts among alcoholic inpatients in Taiwan.

OBJECTIVE: Alcohol dependence is frequently associated with suicide attempts. A history of adverse childhood experiences (ACEs) increases the risk of emotional and behavioral problems in adulthood. Child abuse is reported to increase suicide risk among alcohol-dependent patients. However, other types of ACEs, including ACEs related to family dysfunction that may have exceptional impact among the Chinese, are rarely explored. METHOD: The contribution of a broad spectrum of ACEs to lifetime risk of suicide attempts among alcoholic inpatients in Taiwan was examined. Family Health History Questionnaires were used to assess ACEs among 194 male alcohol-dependent inpatients admitted for alcohol detoxification. Logistic regression analysis was applied to examine the prediction of ACEs for lifetime risk of suicide attempts. RESULTS: The rate of attempted suicide in this cohort was 27.4%. The prevalence of ACEs was high, with around 90% of participants reporting at least one type of ACE. In the regression analysis, after adjusting for lifetime depression, illicit drug use, and severity of alcohol dependence, having had a battered mother (odds ratio [OR] = 3.99, 95% CI [1.40, 11.34]) and having parents who were separated/divorced (OR = 7.35, 95% CI [1.56, 34.72]) were associated with the risk of suicide attempts, but having experienced physical and sexual abuse were not. A 1-unit increase in childhood adversity raised the likelihood of a suicide attempt by 61% (OR = 1.61, 95% CI [1.16, 2.25]). CONCLUSIONS: There is a direct and graded relationship between childhood adversities and lifetime risk of suicide attempts among male alcoholic patients. In Chinese societies, adversities related to parental separation, divorce, and interparental violence may have a specific effect in aggravating suicide risk.

Media representation of gender patterns of suicide in Taiwan.

BACKGROUND: Extensive media reporting of suicide events has been indicated as a contributing factor to the upsurge in suicide rates in Taiwan in the past decade. AIMS: The study compares gender differences in sociodemographic profiles and method of suicide selectively reported in the newspapers and all suicide cases registered in official death records. It also identifies gender differences in media reports of suicides. METHODS: Articles reporting suicide news from four major newspapers in Taiwan (China Times, United Daily, Liberty Times, and Apple Daily) in 2009 were retrieved and analyzed. Gender differences in sociodemographic profiles of suicides reported in the newspapers and official records of all suicide deaths were compared. Any gender differences in newspaper depictions of contributing factors of suicide and situations surrounding the suicidal acts were compared. RESULTS: Newspapers in Taiwan tended to overreport unusual methods of suicide among men and extended suicide among women. The reasons for suicide in men were more frequently portrayed as work-related or after legal problems, whereas in women suicide was more frequently framed as due to mental illness or relationship problems. The news media tended to underreport mental illness as a reason for suicide in men. LIMITATION: The analysis was based solely on news reporting in the four major newspapers during the year 2009. CONCLUSIONS: Media representation of suicide generally follow societal-gendered assumptions of acceptable/unacceptable behaviors. Media professionals should be more careful and responsible in reporting suicide news and avoid any gender bias in their framing of suicide stories. Sensitive rather than sensational reporting should be promoted in order not to reinforce the myths of suicides in the community.

Economic fluctuations and suicide: a comparison of Taiwan and Hong Kong.

This study examines the impact of unemployment on suicide rates in Taiwan and Hong Kong during the period of rising unemployment (1997-2003) and its subsequent decline (2003-2007), with 2003 as the turning point. During these initial years of high unemployment, suicide rates increased markedly in Hong Kong and Taiwan; however, as employment conditions improved, suicide rates fell in Hong Kong but continued to increase in Taiwan. ARMAX time-series models with appropriate time lags were used to assess the impact of unemployment on suicide rates for both periods. It was found that for Taiwan, the unemployment rate was positively related with the suicide rate for both males and females during the period of high unemployment, whereas a negative relationship was observed as the rate of unemployment decreased. On the other hand, the reduction in suicide rates since 2003 was not statistically significantly related to the improvement of employment conditions for Hong Kong; whereas the suicide rate in Taiwan still remained at a high level due to the increasing number of charcoal burning suicide deaths despite improvements in employment conditions. In conclusion, lower unemployment was not necessarily associated with lower suicide rates. Exogenous factors other than economic ones have been suggested to be important for understanding differences in suicide patterns in Hong Kong and Taiwan. The impact of employment conditions on suicide across different countries deserves further investigation.