Examining the Associations Between Substance Misuse and Suicide Bereavement.

Focusing on the understudied question of substance misuse among suicide bereaved adults we investigated patterns of binge drinking and non-prescribed drug use among a recently bereaved sample (n = 1,132). Comparing our respondents to the non-bereaved, those in the 2022 National Survey of Drug Use and Health (n = 71,369), we did not find heightened problematical substance misuses among our respondents. With t-tests and multiple regression analyses we examined whether binge drinkers and non-prescribed drug users had heightened levels of grief difficulties, PTSD, self-blaming and depression compared to others not bingeing or using non-prescribed drugs. Results showed binge drinkers had more of all these grieving problems when important confounding variables were also considered. Analysis of the demographic correlates of bingeing showed them dimly aware of their own additional grieving and substance misusing problems. Since 75% indicated being under the care of counseling professionals, this represents an important opportunity for psycho-educational helping.

Suicide and Life Insurance.

Much has been written about the history of suicide and, notably, about societies that condemned both the act and the actor, resulting in a perpetuation of suicide being stigmatized in many cultures. One aspect of this perceived stigmatization involves exclusionary clauses in life insurance policies that reject paying benefits to survivor-beneficiaries of the decedent if the decedent has died by suicide within a prescribed time frame. From the perspective of the individual, life insurance is designed to protect the estate of a decedent from a significant financial burden. From the insurer's perspective, there are essentially 2 reasons for having a suicide exclusion clause: limiting risk and preventing or discouraging fraud. This column examines these rationales in light of the estimated few suicides that do occur during exclusionary clause time frames. Observations are made about the effect of these clauses on those impacted by the loss of a loved one who died by suicide within the exclusionary time frame. An examination of the perspectives of both the life insurance industry and the impacted survivors of suicide decedents raises questions about what are reasonable and appropriate exclusionary clause time frames that protect both the insurer and survivor-beneficiaries. The forensic expert consulting on such cases should be cognizant of these competing perspectives and engage in therapeutic assessment whenever possible, identifying opportunities to promote thoughtful suicide postvention.

A Comparison of Physician-Assisted/Death-With-Dignity-Act Death and Suicide Patterns in Older Adult Women and Men.

OBJECTIVE: To examine Oregon's Death-with-Dignity-Act (DWDA) death and suicide patterns among women age 65 and older, relative to patterns among same-age men, as a way to assess DWDA's impact on older adult women, a group considered vulnerable. DESIGN: Oregon's 1998-2018 DWDA- and suicide-mortality rates and confidence intervals were calculated. RESULTS: Between 1998 and 2018 women age 65 and older represented 46% of DWDA deaths and 16.3% of suicides in their age group. Among women age 65 and older DWDA and suicide mortality increased whereas among same-age men DWDA deaths increased and suicides declined. DWDA deaths were the most common form (52.7%) of self-initiated death for older adult women, and firearm suicides (65.7%) for older adult men. CONCLUSION: Legalization has a substantial impact on older adult women's engagement in self-initiated death. In Switzerland and in Oregon, where assisted suicide/medical-aid-in-dying (MAID) is legal and where assisted-suicide/MAID and suicide comparative-studies have been conducted, older adult women avoid self-initiated death except when physician-approved. Older adult women's substantial representation among assisted-suicide/MAID decedents, relative to suicide, may be a clue of their empowerment to determine the time of their death, when hastened-death assistance is permitted; or of their vulnerability to seeking a medicalized self-initiated death, when in need of care.

Suicide Bereavement and Differences in Religiosity.

Background: The trauma from experiencing a loved one's suicide is often seen as an instigator of change in a person's religious life. Aims: We sought to examine whether suicide-bereaved adults were any differently disposed to religious participation and observances compared with the nonbereaved and whether religiously involved bereaved had any better mental health compared with religiously disaffiliated bereaved. Method: The 2016 General Social Survey (GSS) presented 11 new questions identifying suicide bereavement status. We examined how the bereaved (n = 516) compared with the nonbereaved (n = 916) in terms of their religious beliefs and participation. We also investigated whether suicide bereaved religiously committed adherents, who prayed at least weekly (n = 372), showed any better mental health compared with bereaved who were religiously disaffiliated (n = 102). Results: Initially, results showed the bereaved more inclined to pray and to believe in an afterlife compared with the nonbereaved. However, after sex differences were controlled for, most of the remaining differences between these contrasted groups faded. Limitations: Caution is advised regarding generalizations from these data to all subgroups of suicide bereaved due to the modest number of respondents in many subpopulations. The GSS does not include potentially important grief-related indices, and importantly, most of the current sample were friends of the deceased and not first-degree relatives. Conclusion: We discuss the implications of these findings and the need for further research on the interconnections between religiosity and suicide bereavement.

Suicide exposures and bereavement among American adults: Evidence from the 2016 General Social Survey.

BACKGROUND: We investigated lifetime suicide exposures and bereavement among a representative sample of American adults from the 2016 General Social Survey. METHODS: Questions on lifetime suicide exposures, bereavement and mental health status were administered to 1432 respondents. Suicide exposed and bereaved respondents were compared to non-exposed respondents on three different measures of mental health functioning with cross tabulations and means comparison tests. RESULTS: 51% of respondents had exposures to one suicide or more during their lifetimes, and 35% were deemed bereaved by suicide, having experienced moderate to severe emotional distress from their losses. Findings suggested more exposures and bereavements were associated with greater numbers of bad mental health days and more expectations of "having nervous breakdowns" but with no clear associations with CES-D scores. CONCLUSIONS: These findings suggest suicide exposures and bereavement are far more pervasive than commonly thought, with more than half of the population exposed and a third bereaved. Health professionals need to more actively assess for suicide exposures and bereavements, and be vigilant for significant impacts of suicide even when the suicide decedent is not a first degree family relative, helping to reduce the mental health distress presently associated with these experiences.

The continuum of "survivorship": definitional issues in the aftermath of suicide.

In light of prevailing confusion over the meaning of the term "suicide survivor," we propose a more exact terminology for designating different levels of impact on those left behind by suicide, ranging on a continuum from those exposed to suicide through those who are affected by it and finally to those who are bereaved by suicide in the short- or long-term, as a function of their loss of a close emotional attachment through this tragic form of loss. We briefly note the possible utility of this terminological specificity in promoting more clearly targeted research and intervention efforts, and call for closer investigation of various categories of "survivorship" in future studies.

The temporal distribution of black suicides.

Suicides by both white and black groups in 1998-2002 peaked on Mondays but the peak was less pronounced for black suicides than for white suicides.

The variation of the mean age of suicides in the United States.

In the United States from 1968-1996, the mean age of suicides was positively associated with measures of domestic social integration. It is suggested that the mean age of suicides could be an interesting dependent variable in suicidological research.

Suicide among the elderly: levels and trends.

Despite the publicity attending increased rates of suicide for the young, U.S. suicide rates continue to be highest in old age. Suicide thus represents a major mental health problem for a still-neglected age group. National levels and trends of suicide among the aged are presented by sex and race for 1933-1978. Explanations of these trends are considered, and information is provided on recognition and prevention of geriatric suicide.