• Firearm-related internet searches as a correlate of future firearm suicides: Cross-correlation analyses of monthly Google search volumes and method-specific suicide rates in the United States

      Lee, Joo Young; Pham, Angeline; Wong, Jonathan; Deng, Zhuoheng (Elsevier, 2021-07-01)
      Background: No previous study has investigated correlations between monthly Google search volumes (MGSVs) of suicide-related search terms and suicide-method specific monthly suicide rates (MSRs). This study examined if the trends in MGSVs of suicide-related terms preceded the variations in method-specific MSRs. Methods: MGSVs of 97 candidate suicide-related terms were obtained by averaging 10 timeseries data per term retrieved from Google Trends. Robust time-series analysis methods were applied to MGSVs and firearm-, poisoning-, and asphyxiation-specific MSRs in the United States between 2004 and 2017. Cross-correlation coefficients between MGSVs and methodspecific MSRs were calculated at lags of −3 to −1 (months). In the main analysis, the Benjamini-Hochberg procedure was applied to determine significant correlations while minimizing falsepositive findings. Afterwards, a sensitivity analysis identified the cross-correlations reproducible in two different time spans. Results: Fifty-six search terms with no invalid MGSV data were analyzed. MGSVs of 14 terms correlated with firearm-, poisoning-, or asphyxiation-specific MSRs in one or more lags. In the sensitivity analysis, two terms consistently showed significant positive cross-correlations: gun suicide (with firearm-specific suicides; lag -3) and “laid off” (with poisoning- and asphyxiationspecific suicides; lag -2). Limitations: Age- or gender-specific search volumes, lags outside the 1- to 3-month range, non-English searches, and confounding factors of MGSV and MSR were not explored. Conclusions: MGSVs of one firearm-related term (gun suicide) correlated with future firearmspecific MSRs. MGSVs of one method-neutral term (“laid off”) correlated with future poisoning- and asphyxiation-specific MSRs. These terms may be incorporated in novel nowcasting or predictive models for method-specific suicides. © 2021 The Author(s)
    • Intimate partner violence victimization and perpetration as precursors to suicide

      Kafka, Julie M; Moracco, Kathryn Beth E; Taheri, Caroline; Young, Belinda-Rose; Graham, Laurie M; Macy, Rebecca J; Proescholdbell, Scott (2022-03-25)
      It remains unclear how often and under what circumstances intimate partner violence (IPV) precedes suicide. Available research on IPV and suicide focuses largely on homicide-suicide, which is a rare event (<2% of suicides). We focus instead on single suicides (i.e., suicides unconnected to other violent deaths), which are the most common type of fatal violence in the US. Unfortunately, information about IPV circumstances is often unavailable for suicides. To address this gap, we sought to identify the proportion of single suicides that were preceded by IPV in North Carolina (NC), to describe the prevalence of IPV victimization and perpetration as precursors to suicide, and to explore how IPV-related suicides differ from other suicides. We used data from the NC Violent Death Reporting System (2010–2017, n = 9682 single suicides) and hand-reviewed textual data for a subset of cases (n = 2440) to document IPV circumstances. We had robust inter-rater reliability (Kappa: 0.73) and identified n = 439 IPV-related suicides. Most were males who had perpetrated nonfatal IPV (n = 319, 72.7%) prior to dying by suicide. Our findings suggest that IPV was a precursor for at least 4.5% of single suicides. Next, we conducted logistic regression analyses by sex comparing IPV-related suicides to other suicides. For both men and women, IPV was more common when the person who died by suicide had recently disclosed suicidal intent, was younger, used a firearm, and was involved with the criminal legal system, even after controlling for covariates. We also found sex-specific correlates for IPV circumstances in suicide. Combined with homicide-suicide data (reported elsewhere), IPV is likely associated with 6.1% or more of suicides overall. Results suggest clear missed opportunities to intervene for this unique subpopulation, such as suicide screening and referral in IPV settings (e.g., batterer intervention programs, Family Justice Centers) that is tailored by sex.
    • The relationship between trauma exposure and psychiatric hospitalization for suicide ideation or suicide attempt among patients admitted to a military treatment setting

      Ryan, A.T.; Daruwala, S.E.; Perera, K.U. (MDPI AG, 2020)
      Suicide attempts and psychiatric hospitalization represent the final outcomes of a complex dynamical system of interacting factors that influence a particular individual's likelihood of engaging in suicidal behavior, as well as their ability to seek help prior to acting upon suicidal impulses. This study examined the association between different types of lifetime trauma exposure and the likelihood of psychiatric hospitalization following a suicide attempt (SA) rather than suicidal ideation (SI) alone. Electronic medical records for 1100 U.S. military service members and their dependents admitted to a military psychiatric inpatient setting for SA or SI were reviewed for documented lifetime trauma exposure history. Findings indicated that exposure to at least one childhood trauma of any type, and childhood neglect in particular, increased the likelihood that an individual would be hospitalized for SA rather than SI. Exploratory gender-stratified analyses demonstrated that childhood neglect, childhood sexual abuse, and adulthood traumatic loss may be linked with the likelihood of being hospitalized for SA. These findings demonstrate the importance of developing more detailed and nuanced conception of factors known to be associated with suicide as their effects may depend on details of their timing and nature, as well as their interactions with other systems. Copyright 2020 by the authors.