The impact of media reporting of suicides on subsequent suicides in Asia: A systematic review.

Introduction: This systematic review is aimed at (1) evaluating the association between media portrayals of suicides and subsequent copycat suicides or attempts among the general public in Asia, (2) understanding the factors associated with copycat suicides and (3) determining the positive impacts of the media reporting of suicides (e.g. increased help-seeking, coping). Method: A systematic review and narrative synthesis of English and Chinese articles from 8 electronic databases (i.e. PsycINFO, MEDLINE, Embase, CINAHL, Web of Science, Ariti, China National Knowledge Infrastructure and OpenGrey) from January 2000 to May 2023 was conducted. Observational studies were included, and the data were analysed through narrative synthesis. The protocol was registered with PROSPERO (CRD42021281535). Results: Among the 32 studies included (n=29 for evidence synthesis) in the review, there is good-quality evidence to show that copycat suicides and suicide attempts increase after media reports of a suicide, regardless of country, celebrity status, study design, type of media, mode of suicide or follow-up period. Females, younger age groups and those sharing similar characteristics as the deceased in publicised suicides (age, gender) were more susceptible to negative impact. Reporting of the mode of death of the deceased increased suicides by the same method among the public. Conclusion: Media portrayals of suicide appear to have a negative impact on copycat suicides at the population level in Asia. Thus, in addition to tighter media control, healthcare systems, professional medical bodies and community outreach services should work collaboratively to promote early help-seeking in those with psychological distress.

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.

Changes in Media Reporting Quality and Suicides Following National Media Engagement on Responsible Reporting of Suicide in Canada: Changements de la Qualité des reportages dans les médias sur les suicides suite à l'engagement des médias nationaux à la déclaration responsable du suicide au Canada.

OBJECTIVE: Responsible media reporting is an accepted strategy for preventing suicide. In 2015, suicide prevention experts launched a media engagement initiative aimed at improving suicide-related reporting in Canada; its impact on media reporting quality and suicide deaths is unknown. METHOD: This pre-post observational study examined changes in reporting characteristics in a random sample of suicide-related articles from major publications in the Greater Toronto Area (GTA) media market. Articles (n = 900) included 450 from the 6-year periods prior to and after the initiative began. We also examined changes in suicide counts in the GTA between these epochs. We used chi-square tests to analyse changes in reporting characteristics and time-series analyses to identify changes in suicide counts. Secondary outcomes focused on guidelines developed by media professionals in Canada and how they may have influenced media reporting quality as well as on the overarching narrative of media articles during the most recent years of available data. RESULTS: Across-the-board improvement was observed in suicide-related reporting with substantial reductions in many elements of putatively harmful content and substantial increases in all aspects of putatively protective content. However, overarching article narratives remained potentially harmful with 55.2% of articles telling the story of someone's death and 20.8% presenting an other negative message. Only 3.6% of articles told a story of survival. After controlling for potential confounders, a nonsignificant numeric decrease in suicide counts was identified after initiative implementation (ω = -5.41, SE = 3.43, t = 1.58, p = 0.12). CONCLUSIONS: We found evidence that a strategy to engage media in Canada changed the content of reporting, but there was only a nonsignificant trend towards fewer suicides. A more fundamental change in media narratives to focus on survival rather than death appears warranted.

Media Exposure of Suicidal Behaviour: An Umbrella Review.

AIM: To analyse recommended interventions for the safe and responsible dissemination of suicidal behaviour in the media for preventive purposes. BACKGROUND: Suicide is a serious public health problem that leads to more than 700,000 deaths per year, which translates into one death every forty seconds. The media play a significant role in shaping public perceptions and reflecting societal issues. Because of its active role in the construction of reality, the way in which the media report and expose suicidal behaviour has the capacity to influence the population in either a preventive or harmful way. DESIGN: An umbrella review was carried out and a report was written according to the Preferred Reporting Items for Overviews of Reviews. METHODS: We systematically searched for reviews published from inception to February 2023 in MEDLINE (PubMed), CINAHL and PsycInfo (via EBSCOhost), Web of Science, Embase, Cochrane Library of Systematic Reviews, Scopus, and Google Scholar. A narrative synthesis of the results was conducted. RESULTS: Six systematic reviews with a moderate to high quality level were selected. Among the recommended interventions were the inclusion of positive messages of hope, resilience, or of overcoming the event, narratives with information on available resources or the promotion of support-seeking attitudes as an effective prevention mechanism, as well as the avoidance of repetitive reporting of the same suicide. The appropriate and responsible dissemination of information on suicidal behaviour in the media with complete and up-to-date information on available centres, organisations, institutions, and resources has proven to be effective, especially in vulnerable populations. CONCLUSION: Educating and training the media in an appropriate approach to disseminating suicidal behaviour helps to reduce the number of suicidal behaviours. Knowing what information is advisable to include in the news item as well as what information to avoid is a strong point. Guidelines to promote responsible media reporting are a key component of suicide prevention strategies. This study was prospectively registered in the International Prospective Register of Systematic Reviews (PROSPERO) on 23 April 2022 with the registration number CRD42022320393.

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.

Werther or Papageno? Examining the effects of news reports of celebrity suicide versus non-celebrity peer suicide on intentions to seek help among vulnerable young adults.

INTRODUCTION: A large body of literature has examined the Werther effect following news reports of suicide, yet much less attention has been paid to the protective Papageno effect. This research explored the causal relationships between news reports of real celebrity suicides (e.g., pop-rock star Chester Bennington) and real non-celebrity "peer" suicides (e.g., college student Madison Holleran) and intentions to seek help. METHODS: Two survey experiments confirmed successful experimental manipulation (N = 280) and tested behavioral theory, clinical indicators, and intentions to seek help (N = 641) in samples of college students (18-25). RESULTS: Participants were motivated to seek help if they believed it could lead to positive outcomes, yet this was less likely among participants with depression. Exposure to news reports of non-celebrity suicides had a small positive effect on help-seeking intentions. Among participants with depression, news reports of celebrity suicides had a small positive effect on intentions. CONCLUSIONS: This research could not establish Werther effects for either of the news reports. Exposure to news reports of non-celebrity suicides had a small positive effect on intentions overall, but young adults with higher levels of depression were slightly more motivated to seek help after viewing news reports of celebrity suicides.

Prevention of the Werther effect: compliance of the Italian newspapers to the 'reporting on suicide' recommendations.

OBJECTIVES: Suicide media coverage could lead to imitation, the so-called 'Werther effect'. The World Health Organization (WHO) published specific recommendations for reporting suicide news. This study aimed to quantify the compliance of Italian newspapers with the WHO suicide reporting guidelines. STUDY DESIGN: This was a quantitative content analysis study. METHODS: All articles published by the three main Italian newspapers from June 2019 to May 2020 describing suicides or attempted suicides were included. The articles were analyzed using a checklist based on the WHO recommendations, which included 18 'negative' items (e.g. 'presence of the word 'suicide' in the title') and nine 'positive' items (e.g. 'the article reports the contacts of a suicide prevention hotline'). Each negative item was scored -1, and each positive item was scored +1. Multivariate linear regressions were performed to identify factors associated with lower adherence to WHO recommendations and higher social media engagement with the articles. RESULTS: A total of 3483 articles were screened, and 110 articles were included in the final analysis. The suicidal was male in 73.6% of cases. The median checklist score was -6 (interquartile range 3). Five percent of the articles had at least one positive item. The word 'suicide' was found in 90% of the titles. Female suicides were associated with a higher checklist score (coefficient 0.81, P = 0.039). No correlation was found between the checklist score and the social media engagement of the articles. CONCLUSIONS: Italian newspapers do not adhere completely to the WHO recommendations on reporting suicide, leading to a potential imitation effect. Public health professionals should make decision-makers and journalists aware of the importance of these recommendations.

Long-Term Changes in the Quality of Media Reporting of Suicide Following a Celebrity Suicide in India.

Online portals of selected English and local language newspapers and television channels were searched to identify suicide news reports published one year after the celebrity suicide (ACS). These reports (n = 1952) were compared with the corresponding period of the previous year, immediately following the celebrity suicide (ICS) (n = 2486), and a three-month period before the celebrity suicide (BCS) (n = 1381) to assess longitudinal changes in quality of media reporting. There was a decline in reporting of several potentially harmful characteristics over time such as mentioning the deceased's age and gender (p < .001 for both), and location of suicide (p < .001). The quality of media reporting of suicide was significantly better at one year compared to the period immediately following celebrity suicide. This change was mainly driven by an improvement in the reporting quality of English news reports while local language reports continued to remain poorly adherent to reporting guidelines.

The Werther effect following the suicides of three korean celebrities (2017-2018): an ecological time-series study.

BACKGROUND: The suicide rate in Korea was the highest among the member countries of the Organization for Economic Cooperation and Development(OECD) for 2013-2016 and 2018-2020. In korea, suicide was the leading cause of death among individuals aged 10-39, and the second leading cause of death for aged 40-59. Thus, this study aimed to examine the Werther effect of the suicides of three Korean idol singers (Jonghyun: December 18, 2017, Sulli: October 14, 2019, and Hara Gu: November 24, 2019). METHODS: The study conducted Poisson regression and used the cause-of-death statistics microdata from 2016 to 2020 provided by Statistics Korea. The case periods ranged from the day of the suicide of each celebrity to 10 weeks after. The control periods were all weeks from 2016 to 2020, excluding the case periods. RESULTS: The suicide rates in Korea significantly increased by 1.21, 1.30, and 1.28 times after the deaths of Jonghyun, Sulli, and Hara Gu, respectively. The Werther effect was more evident in women than men. Suicide rate among individuals aged 10-29 years was greater than those for other age groups. CONCLUSIONS: This study confirmed that the rate of copycat suicides increased after three celebrity singers in Korea died by suicide. Nevertheless, the rate of suicide after the suicide of the three celebrity singers was lower than those in previous studies in Korea.

Towards the Influence of Media on Suicidality: A Systematic Review of Netflix's 'Thirteen Reasons Why'.

Online streaming series 'Thirteen Reasons Why' (13RW), released in March 2017, was criticized for its sensationalist portrayal of the main character's suicide, leading some people to voice fears of a global contagion of self-harm behaviors. The current investigation provides a systematic review of original studies analyzing the role of 13RW as an influencing factor for suicide. Articles were identified through a systematic search of Medline, Web of Science, Scopus, PsycInfo, and a manual search of reference lists from inception until the 16 January 2023. Twenty-seven published articles were identified from an initial search of 496 studies. The positive effects of watching 13RW included a reduction in suicide stigma and a greater likelihood to discuss mental health concerns and seek for help. However, several studies reported negative outcomes, including significant increases in the rate of deaths by suicide in adolescents, the number of admissions for suicidal reasons, and the prevalence and severity of suicidal ideation and self-harm behaviors in vulnerable viewers. Still, due to methodological limitations, no causal relationship could be established. Preventive measures are required to alert of the risk and should be particularly addressed to susceptible subjects. Psychoeducational programs should be focused on this kind of phenomena in vulnerable populations.

Shifting attitudes toward suicide over time: A latent profile analysis using the Korea National Suicide Survey.

Introduction: South Korea has a high suicide rate, and changes in sociodemographic factors can further increase the rate. This study aims to (1) classify participants using the Attitudes toward Suicide Scale (ATTS) through latent profile analysis (LPA), (2) identify and compare the associations between sociodemographic factors with the ATTS in two survey years (2013, 2018), and (3) determine the moderating effect of survey year. Methods: Six sub-factors of the ATTS were used for LPA with a total of 2,973 participants. Sociodemographic characteristics were compared between groups, and multinomial logistic regression was conducted for each survey year. A moderation analysis was conducted with the survey year as moderator. Results: LPA identified three groups of attitudes toward suicide: incomprehensible (10.3%), mixed (52.8%), and permissive (36.9%). The proportion of permissive attitudes increased from 2013 (32.3%) to 2018 (41.7%). Participants reporting suicidal behavior were more likely to be in the mixed and permissive groups than the incomprehensible group in both years. People reporting no religious beliefs were associated with the permissive group in the two survey years. The influence of education and income levels on groups differed by survey year. Discussion: There were significant changes between 2013 and 2018 in attitudes toward suicide in the Korean population.

Suicide among soldiers and social contagion effects: An interrupted time-series analysis.

BACKGROUND: Suicide has become an increasingly concerning problem among soldiers in recent years. Previous research has hypothesized that media-related social contagion effects, termed "Werther effects," may contribute to military suicide numbers. Unfortunately, there is limited empirical knowledge on such social contagion effects in soldiers. We contribute to the literature by investigating this phenomenon in the context of a specific historical suicide case, allowing us to provide a longitudinal assessment: Crown Prince Rudolf, heir to the Imperial throne of the Austro-Hungarian Empire, who died by suicide in January 1889. His death was a well-known news story that shook the monarchy to its foundations. Notably, soldiers of the late nineteenth century were an especially vulnerable portion of the population, proven by the fact that the Austro-Hungarian military had one of the highest suicide rates at the time compared to other European countries. METHODS AND RESULTS: An interrupted time-series analysis, relying on annual military suicide rates between 1873 and 1910, indicated a significant increase in the suicide rate the year of Rudolf's death, a pattern consistent with a social contagion effect. In fact, time series analysis estimated that there were about 30 excess suicides per 100,000 population within the year of Rudolf's death. Additionally, we identified a substantial change in the trend after Rudolf's death, pointing to a long-term decrease in military suicide rates. The latter was not observed in the general population but appeared to be unique to soldiers. DISCUSSION: Although we are very careful when interpreting causal effects with our historical data, we discuss the latter finding by questioning whether a change in military culture, that is, the establishment of better conditions for soldiers in the aftermath of Rudolf's suicide, contributed to decreasing suicide numbers. Although tentative, these findings are also highly relevant for the study of military suicide today.

Suicide of a Tenor Amidst the Stage Setting of the Werther Opera's Death Scene.

Background: Reporting on suicide can elicit an increase in suicides, a phenomenon termed the "Werther effect." The name can be traced back to an alleged spike in suicides after the publication of Goethe's novel The Sorrows of Young Werther in 1774, in which the protagonist Werther dies by suicide. Aims: Acknowledging the importance and primacy of systematic ecological and individual-level studies, we provide a historical single-case report of the suicide of a "late arrival of the Werther epidemic," as the death was headlined in a news report in 1927. Method: Archival research on tenor Paul Vidal's suicide was conducted. Results: Vidal reconstructed the scene of the final act of the opera Werther in his apartment and died by a gunshot, as did Werther. Limitations: Causal interpretations must be made with caution. Conclusion: Striking similarities between Werther's and Vidal's deaths support the idea of strong identification with the fictional narrative and suggest causal effects. Considering the repeated high level of immersiveness and the intense emotions of opera performances, it is likely that performing the role of Werther increases identification processes, contributing to detrimental effects. The lack of knowledge regarding the role of fictional suicide stories on artists' suicides is discussed.

Is the narrative the message? The relationship between suicide-related narratives in media reports and subsequent suicides.

OBJECTIVES: When journalists report on the details of a suicide, the way that they contextualize the meaning of the event (i.e. the 'narrative') can have significant consequences for readers. The 'Werther' and 'Papageno' narrative effects refer to increases and decreases in suicides across populations following media reports on suicidal acts or mastery of crises, respectively. The goal of this study was to investigate the impact of these different narrative constructs on subsequent suicides. METHODS: This study examined the change in suicide counts over time in Toronto, Canada. It used latent difference score analysis, examining suicide-related print media reports in the Toronto media market (2011-2014). Articles (N = 6367) were coded as having a potentially harmful narrative if they described suicide in a celebrity or described a suicide death in a non-celebrity and included the suicide method. Articles were coded as having potentially protective narratives if they included at least one element of protective content (e.g. alternatives to suicide) without including any information about suicidal behaviour (i.e. suicide attempts or death). RESULTS: Latent difference score longitudinal multigroup analyses identified a dose-response relationship in which the trajectory of suicides following harmful 'Werther' narrative reports increased over time, while protective 'Papageno' narrative reports declined. The latent difference score model demonstrated significant goodness of fit and parameter estimates, with each group demonstrating different trajectories of change in reported suicides over time: (χ2[6], N = 6367) = 13.16; χ2/df = 2.19; Akaike information criterion = 97.16, comparative fit index = 0.96, root mean square error of approximation = 0.03. CONCLUSION: Our findings support the notion that the 'narrative' matters when reporting on suicide. Specifically, 'Werther' narratives of suicides in celebrities and suicides in non-celebrities where the methods were described were associated with more subsequent suicides while 'Papageno' narratives of survival and crisis mastery without depictions of suicidal behaviours were associated with fewer subsequent suicides. These results may inform efforts to prevent imitation suicides.

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.

Quality of newspaper reporting of suicide in Odisha, India, against the World Health Organization guidelines.

Background: Imbalanced media reporting of suicide may increase suicide risk among vulnerable individuals. Aim: This study aims to assess the quality of suicide reporting in print newspapers of Odisha, a high suicide burden state in Eastern India. Materials and Methods: We analyzed all eligible media reports of suicide in selected English and local language printed newspapers of Odisha between October 1, 2019, and September 30, 2020. Quality assessment was carried out against international as well as local reporting guidelines. Results: A total of 248 news reports were analyzed. Majority of the articles reported identifying details (such as name [74.2%], age [60.9%], and gender [98.4%] of deceased) as well as a detailed description about the suicide event (suicide method [87.5%] and location [84.3%]). More than half (54.8%) of the reports attributed suicide to a single cause. Conclusion: Suicide reports in print newspapers of Odisha are poorly adherent to local and international suicide reporting guidelines.

The Tool for Evaluating Media Portrayals of Suicide (TEMPOS): Development and Application of a Novel Rating Scale to Reduce Suicide Contagion.

Research suggests that media adherence to suicide reporting recommendations in the aftermath of a highly publicized suicide event can help reduce the risk of imitative behavior, yet there exists no standardized tool for assessing adherence to these standards. The Tool for Evaluating Media Portrayals of Suicide (TEMPOS) allows media professionals, researchers, and suicide prevention experts to assess adherence to the recommendations with a user-friendly, standardized rating scale. An interdisciplinary team of raters constructed operational definitions for three levels of adherence to each of the reporting recommendations and piloted the scale on a sample of articles to assess reliability and clarify scale definitions. TEMPOS was then used to evaluate 220 news articles published during a high-risk period following the suicide deaths of two public figures. Post-hoc analyses of the results demonstrated how data produced by TEMPOS can be used to inform research and public health efforts, and inter-rater reliability analyses revealed substantial agreement across raters and criteria. A novel, wide-reaching, and practical approach to suicide prevention, TEMPOS allows researchers, suicide prevention professionals, and media professionals to study how adherence varies across contexts and can be used to guide future efforts to decrease the risk of media-induced suicide contagion.

Emergency department visits for self-harm in adolescents after release of the Netflix series '13 Reasons Why'.

OBJECTIVE: To determine whether the release of the first season of the Netflix series '13 Reasons Why' was associated with changes in emergency department presentations for self-harm. METHODS: Healthcare utilization databases were used to identify emergency department and outpatient presentations according to age and sex for residents of Ontario, Canada. Data from 2007 to 2018 were used in autoregressive integrated moving average models for time series forecasting with a pre-specified hypothesis that rates of emergency department presentations for self-harm would increase in the 3-month period following the release of 13 Reasons Why (1 April 2017 to 30 June 2017). Chi-square and t tests were used to identify demographic and health service use differences between those presenting to emergency department with self-harm during this epoch compared to a control period (1 April 2016 to 30 June 2016). RESULTS: There was a significant estimated excess of 75 self-harm-related emergency department visits (+6.4%) in the 3 months after 13 Reasons Why above what was predicted by the autoregressive integrated moving average model (standard error = 32.4; p = 0.02); adolescents aged 10-19 years had 60 excess visits (standard error = 30.7; p = 0.048), whereas adults demonstrated no significant change. Sex-stratified analyses demonstrated that these findings were largely driven by significant increases in females. There were no differences in demographic or health service use characteristics between those who presented to emergency department with self-harm in April to June 2017 vs April to June 2016. CONCLUSIONS: This study demonstrated a significant increase in self-harm emergency department visits associated with the release of 13 Reasons Why. It adds to previously published mortality, survey and helpline data collectively demonstrating negative mental health outcomes associated with 13 Reasons Why.

Celebrity Suicide of a Pre-World War I Spy.

Background: Alfred Redl, a colonel in the Imperial and Royal General Staff and Deputy Director of Military Intelligence for the Austro-Hungarian Empire, was a leading figure of pre-World War I spying. The "spy of the century," as he has been called, died by suicide in Vienna on May 25, 1913. It was a big news story based on espionage, sex, and betrayal. Aim: We aimed to test whether this celebrity suicide elicited an increase in suicides - a phenomenon consistent with the "Werther effect." Method: Given daily suicide numbers were not available, we conducted archival research. Civil death registers for the city of Vienna were used to identify suicides before and after Redl's suicide. Results: The analysis indicated that more people died by suicide in the immediate aftermath and that the quantity of news reporting on Colonel Redl predicted the number of suicides per day - a pattern that is consistent with the Werther effect. Limitations: Causal interpretations are limited. Conclusion: Given the fact that the "Redl affair" is relevant for many scientific disciplines, we discuss multiple contributions to suicide research, history, media research, and research on intelligence and counter-intelligence.

The Impact of a Widely Publicized Celebrity Suicide on Suicide-Related Internet Search Activity.

OBJECTIVE: Media reporting of celebrities' deaths by suicide are prone to suicide contagion effects. The aim of the current study is to examine whether the widely publicized celebrity suicide of Ari Behn in Norway was associated with changes in search activity of suicide-related terms. METHOD: Search activity data for the terms "suicide," "Ari Behn suicide," "how to suicide," and "suicide prevention" were retrieved from Google Trends. We analyzed data as an interrupted time series and used T-tests to compare means before and after the suicide. Crude linear models examining the association between searches for "suicide" over time and an adjusted model controlling for searches after "Ari Behn suicide" were built. The models were tested with structural change tests. RESULTS: A significant increase in search activity for "suicide" (p = < .001), "Ari Behn suicide" (p = .002), and "how to suicide" (p = .006) was found after the suicide. Searches for "suicide prevention" were not significant (p = .11). The structural change test was significant both for the model that did not control for explicit searches (p = <.001) and for the model controlled for explicit searches (p = <.001). CONCLUSIONS: A recent widely publicized suicide in Norway was associated with increases in Google searches for suicide. No indications of the Papageno effect were found. The media should be cautious when reporting about the suicides of prominent public persons. Compliance with generally accepted media reporting guidelines may need more attention.HIGHLIGHTSWe found a significant increase in search activity for suicide related terms.More attention should be devoted to careful media reporting on celebrity suicides.Media should consider the volume of publicity carefully.