Risk for Suicide and the Role of Family

Abstract

Limited research exists that examines the contribution of family factors to the development and treatment of suicide. Although suicidal behavior occurs within an individual, the context in which it occurs can add necessary insights for understanding and preventing suicide. In this article, the existing literature on the family’s psychosocial role in the development of suicidal behavior is reviewed. Additionally, a review of the limited research on the family’s role in treatment following a suicidal action is provided. Finally, several directions for future research and clinical work are discussed to enhance our understanding of the family’s role in preventing suicide.

Keywords

death/bereavement family demography family health family processes suicide

Get full access to this article

View all access options for this article.

References

Abbar

Courtet

Bellivier

Leboyer

Boulenger

J. P.

Castelhau

. . . Buresi

(2001). Suicide attempts and the tryptophan hydroxylase gene. Molecular Psychiatry, 6, 268-273.

Agerbo

(2007). High income, employment, postgraduate education, and marriage: A suicidal cocktail among psychiatric patients. Archives of General Psychiatry, 64, 1377-1384. doi:10.1001/archpsyc.64.12.1377

Agerbo

Nordentoft

Mortensen

P. B.

(2002). Familial, psychiatric, and socioeconomic risk factors for suicide in young people: Nested case-control study. British Medical Journal, 325, 74. doi:10.1136/bmj.325.7355.74

Baller

R. D.

Richardson

K. K.

(2002). Social integration, imitation, and the geographic patterning of suicide. American Sociological Review, 67, 873-888.

Barstad

(2008). Explaining changing suicide rates in Norway 1948-2004: The role of social integration. Social Indicators Research, 87, 47-64. doi:10.1007/s11205-007-9155-x

Bastia

B. K.

Kar

(2009). A psychological autopsy study of suicidal hanging from Cuttack, India: Focus on stressful life situations. Archives of Suicide Research, 13, 100-104. doi:10.1080/13811110802572221

Bateson

Jackson

Haley

Weakland

(1956). Toward a theory of schizophrenia. Behavioral Science, 1, 251-264.

Baumann

A. A.

Kuhlberg

J. A.

Zayas

L. H.

(2010). Familism, mother-daughter mutuality, and suicide attempts of adolescent Latinas. Journal of Family Psychology, 24, 616-624. doi:10.1037-a0020584

Beautrais

A. L.

(2002). A case control study of suicide and attempted suicide in older adults. Suicide and Life-Threatening Behavior, 32, 1-9. doi:10.1521/suli.32.1.1.22184

10.

Bennett

P. J.

McMahon

W. M.

Watbe

Achilles

Bacon

Coon

. . . Gray

(2000). Tryptophan hydroxylase polymorphisms in suicide victims. Psychiatric Genetics, 10, 13-17.

11.

Berkman

L. F.

Glass

(2000). Social integration, social networks, social support, and health. In Berkman

L. F.

Kawachi

(Eds.), Social epidemiology (pp. 137-173). Oxford, England: Oxford University Press.

12.

Binswanger

I. A.

Stern

M. F.

Deyo

R. A.

Heagerty

P. J.

Cheadle

Elmore

J. G.

. . . Koepsell

T. D.

(2007). Release from prison: A high risk of death for former inmates. New England Journal of Medicine, 356, 157-165. doi:10.1056/NEJMsa064115

13.

Boardman

A. P.

Grimbaldeston

A. H.

Handley

Jones

P. W.

Willmont

(1999). The North Staffordshire Suicide Study: A case-control study of suicide in one health district. Psychological Medicine, 29, 27-33. doi:10.1017/S0033291798007430

14.

Brent

D. A.

Baugher

Bridge

Chen

Chiappetta

(1999). Age- and sex-related risk factors for adolescent suicide. Journal of the American Academy of Child & Adolescent Psychiatry, 38, 1497-1505. doi:10.1097/00004583-199912000-00010

15.

Brent

D. A.

Bridge

Johnson

B. A.

Connolly

(1996). Suicide behavior runs in families. A controlled family study of adolescent suicide victims. Archives of General Psychiatry, 53, 1145-1152. doi:10.1001/archpsyc.1996.01830120085015

16.

Brent

D. A.

Holder

Kolko

Birmaher

Bragher

Roth

. . . Johnson

B. A.

(1997). A clinical psychotherapy trial for adolescent depression comparing cognitive, family, and supportive therapy. Archives of General Psychiatry, 54, 877-885. doi:10.1001/archpsyc.1997.01830210125017

17.

Brent

D. A.

Melhem

(2008). Familial transmission of suicidal behavior. Psychiatric Clinics of North America, 31, 157-177. doi:10.1016/j.psc.2008.02.001

18.

Brent

D. A.

Oquendo

Birmaher

Greenhill

Kolko

Stanley

. . . Mann

J. J.

(2004). Familial transmission of mood disorders: Convergence and divergence with transmission of suicidal behavior. Journal of the American Academy of Child & Adolescent Psychiatry, 43, 1259-1266. doi:10.1097/01.chi.0000135619.38392.78

19.

Brodsky

B. S.

Mann

J. J.

Stanley

Tin

Oquendo

Birmaher

. . . Brent

(2008). Familial transmission of suicidal behavior: Factors mediating the relationship between childhood abuse and offspring suicide attempts. Journal of Clinical Psychiatry, 69, 584-496. doi:10.4088/JCP.v69n0410

20.

Brugha

Bebbington

Tennant

Hurry

(1985). The list of threatening experiences: A subset of 12 life event categories with considerable long-term contextual threat. Psychological Medicine, 15, 189-194. doi:10.1017/S003329170002105X

21.

Cavanagh

J. T.

Carson

A. J.

Sharpe

Lawrie

S. M.

(2003). Psychological autopsy studies of suicide: A systematic review. Psychological Medicine, 33, 395-405.

22.

Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. (2010). 10 leading causes of death, United States: 2010, all races, all sexes. Retrieved from http://webappa.cdc.gov/sasweb/ncipc/leadcaus10_us.html

23.

Cerel

(2006, April). Suicide attempts in parents of minor children. Paper presented at the annual conference of the American Association of Suicidology, Seattle, WA.

24.

Cerel

Currier

G. W.

Conwell

(2006). Consumer and family experiences in the emergency department following a suicide attempt. Journal of Psychiatric Practice, 12, 341-347.

25.

Cerel

Jordan

J. R.

Duberstein

P. R.

(2008). The impact of suicide on the family. Crisis, 29, 38-44.

26.

Cerel

Roberts

T. A.

(2005). Suicidal behavior in the family and adolescent risk behavior. Journal of Adolescent Health, 36, 352e9-352e16.

27.

Çetin

F. Ç

. (2001). Suicide attempts and self-image among Turkish adolescents. Journal of Youth and Adolescence, 30, 641-651.

28.

Cheng

A. T. A.

Chen

T. H. H.

Chen

C.-C.

Jenkins

(2000). Psychosocial and psychiatric risk factors for suicide: Case-control psychological autopsy study. British Journal of Psychiatry, 177, 360-365. doi:10.1192/bjp.177.4.360

29.

Chioqueta

A. P.

Stiles

T. C.

(2007). The relationship between psychological buffers, hopelessness, and suicidal ideation: Identification of protective factors. Crisis, 28, 67-73.

30.

Corcoran

Nagar

(2010). Suicide and marital status in Northern Ireland. Social Psychiatry & Psychiatric Epidemiology, 45, 795-800. doi:10.1007/s00127-009-0120-7

31.

Coryell

Young

E. A.

(2005). Clinical predictors of suicide in primary major depressive disorder. Journal of Clinical Psychiatry, 66, 412-417.

32.

Dageid

Duckert

(2008). Balancing between normality and social death: Black, rural, South African women coping with HIV/AIDS. Qualitative Health Research, 18, 182-doi:10.1177/1049732307312070

33.

Danigelis

Pope

(1979). Durkheim’s theory of suicide as applied to the family: An empirical test. Social Forces, 57, 1081-1106.

34.

Denney

J. T.

(2010). Family and household formations and suicide in the United States. Journal of Marriage and Family, 72, 202-213. doi:10.1111/j.1741-3737.2009.00692.x

35.

Denney

J. T.

Rogers

R. G.

Krueger

P. M.

Wadsworth

(2009). Adult suicide mortality in the United States: Marital status, family size, socioeconomic status, and differences by sex. Social Science Quarterly, 90, 1167-1185. doi:10.1111/j.1540-6237.2009.00652.x

36.

Diamond

Siqueland

Diamond

G. M.

(2003). Attachment-based family therapy for depressed adolescents: Programmatic treatment development. Clinical Child and Family Psychology Review, 6, 107-127. doi:10.1023/A:1023782510786

37.

Diamond

Wintersteen

M. B.

Brown

G. K.

Diamond

G. M.

Gallop

Shelef

Levy

(2010). Attachment-based family therapy for adolescents with suicidal ideation: A randomized controlled trial. Journal of the American Academy of Child & Adolescent Psychiatry, 49, 122-131.

38.

Duberstein

P. R.

Conwell

Conner

K. R.

Eberly

Caine

E. D.

(2004). Suicide at 50 years of age and older: Perceived physical illness, family discord and financial strain. Psychological Medicine, 34, 137-146. doi:10.1017/S0033291703008584

39.

Durkheim

E. S.

(1951). Suicide: A study in sociology ( Spaulding

J. A.

Simpson

Trans.). Glencoe, IL: Free Press. (Original work published 1897)

40.

Eng

P. M.

Rimm

E. B.

Fitzmaurice

Kawachi

(2002). Social ties and change in social ties in relation to subsequent total and cause-specific mortality and coronary heart disease incidence in men. American Journal of Epidemiology, 155, 700-709. doi:10.1093/aje/155.8.700

41.

Fergusson

D. M.

Lynskey

M. T.

(1995). Suicide attempts and suicidal ideation in a birth cohort of 16-year-old New Zealanders. Journal of American Academy of Child & Adolescent Psychiatry, 34, 1308-1317.

42.

Filiberti

Ripamonti

Totis

Ventafridda

De Conno

Contiero

Tamburini

(2001). Characteristics of terminal cancer patients who committed suicide during a home palliative care program. Journal of Pain and Symptom Management, 22, 544-553.

43.

Gibbs

J. P.

(2000). Status integration and suicide: Occupational, marital, or both? Social Forces, 78, 949-968.

44.

Gould

M. S.

(2001). Suicide and the media. In Hendin

Mann

J. J.

(Eds.), Annals of the New York Academy of Sciences: Vol. 932. The clinical science of suicide prevention (pp. 200-224). New York: New York Academy of Sciences.

45.

Gould

M. S.

Fisher

Parides

Floy

Shaffer

(1996). Psychosocial risk factors of child and adolescent completed suicide. Archives of General Psychiatry, 53, 1155-1162. doi:10.1001/archpsyc.1996.01830120095016

46.

Gould

M. S.

Greenberg

Velting

D. M.

Shaffer

(2003). Youth suicide risk and preventive interventions: A review of the past 10 years. Journal of the American Academy of Child & Adolescent Psychiatry, 42, 386-405. doi:10.1097/01.CHI.0000046821.95464.CF

47.

Gururaj

Isaac

M. K.

Subbakrishna

D. K.

Ranjani

(2004). Risk factors for completed suicides: A case-control study from Bangalore, India. Injury Control and Safety Promotion, 11, 183-191.

48.

Hawton

Fagg

Simkin

(1996). Deliberate self-poisoning and self-injury in children and adolescents under 16 years of age in Oxford, 1976-1993. British Journal of Psychiatry, 169, 202-208. doi:10.1192/bjp.169.2.202

49.

Heikkinen

M. E.

Isometsa

E. T.

Marttunen

M. J.

Aro

H. M.

Lonnqvist

J. K.

(1995). Social factors in suicide. British Journal of Psychiatry, 167, 747-753.

50.

Hollis

(1996). Depression, family environment, and adolescent suicidal behavior. Journal of the American Academy of Child & Adolescent Psychiatry, 35, 622-630.

51.

Hooley

J. M.

(2007). Expressed emotion and relapse in psychopathology. Annual Review of Clinical Psychology, 3, 349-372.

52.

Hughes

M. E.

Waite

(2002). Health in household context: Living arrangements and health in late middle age. Journal of Health and Social Behavior, 43, 1-21. doi:10.2307/3090242

53.

Johnson

B. A.

Brent

D. A.

Bridge

Connolly

(1998). The familial aggregation of adolescent suicide attempts. Acta Psychiatrica Scandinavica, 97, 18-24. doi:10.1111/j.1600-0447.1998.tb09957.x

54.

Joiner

(2005). Why people die by suicide. Cambridge, MA: First Harvard University Press.

55.

Kariminia

Butler

T. G.

Corben

S. P.

Levy

M. H.

Grant

Kaldor

J. M.

Law

M. G.

(2007). Extreme cause-specific mortality in a cohort of adult prisoners—1988 to 2002: A data-linkage study. International Journal of Epidemiology, 36, 310-316.

56.

Kim

C. D.

Seguin

Therrien

Riopel

Chawky

Lesage

A. D.

Turecki

(2005). Familial aggregation of suicidal behavior: A family study of male suicide completers from the general population. American Journal of Psychiatry, 162, 1017-1019. doi:10.1176/appi.ajp.162.5.1017

57.

Kposowa

A. J.

(2000). Marital status and suicide in the National Longitudinal Mortality Study. Journal of Epidemiology & Community Health, 54, 254-261.

58.

Lobo Prabhu

S. L.

Molinari

Bowers

Lomax

(2010). Role of the family in suicide prevention: An attachment and family systems perspective. Bulletin of the Menninger Clinic, 74, 301-327. doi:10.1521/bumc.2010.74.4.301

59.

Miller

Azrael

Hepburn

Hemenway

Lippman

S. J.

(2006). The association between changes in household firearm ownership and rates of suicide in the United States, 1981-2002. Injury Prevention, 12, 178-182. doi:10.1136/ip.2005.010850

60.

Montgomery

Fewer

(1988). Family systems and beyond. New York NY: Human Sciences Press.

61.

Moscicki

E. K.

(2001). Epidemiology of completed and attempted suicide: Toward a framework for prevention. Clinical Neuroscience Research, 1, 310-323.

62.

Pompili

Lester

Grispini

Innamorati

Calandro

Iliceto

. . . Girardi

(2009). Completed suicide in schizophrenia: Evidence from a case-control study. Psychiatry Research, 167, 251-257.

63.

Qin

Agerbo

Mortensen

P. B.

(2002). Suicide risk in relation to family history of completed suicide and psychiatric disorders: A nested cast-control study based on longitudinal registers. Lancet, 360, 1126-1130. doi:10.1016/S0140-6736(02)11197-4

64.

Qin

Mortensen

P. B.

(2003). The impact of parental status on the risk of completed suicide. Archives of General Psychiatry, 60, 797-802. doi:10.1001/archpsyc.60.8.797

65.

Reynolds

C. F.

III Frank

Perel

J. M.

Imber

S. D.

Cornes

Miller

M. D.

. . . Kupfer

D. J.

(1999). Nortriptyline and interpersonal psychotherapy as maintenance therapies for recurrent major depression: A randomized controlled trial in patients older than 59 years. Journal of the American Medical Association, 281, 39-45.

66.

Rogers

R. G.

Hummer

R. A.

Nam

C. B.

(2000). Living and dying in the USA: Behavioral, health, and social differentials of adult mortality. New York, NY: Academic Press.

67.

Roy

Rylander

Forslund

Asberg

Mazzanti

C. M.

Goldman

(2001). Excess tryptophan hydroxylase 17 779C allele in surviving cotwins of monozygotic twin suicide victims. Neuropsychobiology, 43, 233-236.

68.

Rubenowitz

Waern

Wilhelmson

Allebeck

(2001). Life events and psychosocial factors in elderly suicides: A case-control study. Psychological medicine, 31, 1193-1202. doi:10.1017/S0033291701004457

69.

Runeson

Asberg

(2003). Family history of suicide among suicide victims. American Journal of Psychiatry, 160, 1525-1526.

70.

Santos

J. C.

Saraiva

C. B.

De Sousa

(2009). The role of expressed emotion, self-concept, coping, and depression in parasuicidal behavior: A follow-up study. Archives of Suicide Research, 13, 358-367. doi:10.1080/13811110903266590

71.

Schneidman

(1993). Suicide as psychache: A clinical approach to self-destructive behavior. Lanham, MD: Rowman & Littlefield.

72.

Schneidman

E. S.

(1996). The suicidal mind. New York, NY: Oxford University Press.

73.

Stack

(2000a). Suicide: A 15-year review of the sociological literature. Part I: Cultural and economic factors. Suicide & Life-Threatening Behavior, 30, 145-162.

74.

Stack

(2000b). Suicide: A 15-year review of the sociological literature. Part II: Modernization and social integration perspectives. Suicide & Life-Threatening Behavior, 30, 163-176.

75.

Sudak

Maxim

Carpenter

(2008). Suicide and stigma: A review of the literature and personal reflections. Academic Psychiatry, 32, 136-142. doi:10.1176/appi.ap.32.2.136

76.

Sun

F.-K.

Long

Huang

X.-Y.

Huang

H.-M.

(2008). Family care of Taiwanese patients who had attempted suicide: A grounded theory study. Journal of Advanced Nursing, 62, 53-61. doi:10.1111/j.1365-2648.2007.04578.x

77.

Talley

A. E.

Bettencourt

B. A.

(2011). The moderator roles of coping style and identity disclosure in the relationship between perceived sexual stigma and psychological distress. Journal of Applied Social Psychology, 41, 2883-2903.

78.

Tsai

S.-Y. M.

Kuo

C.-J.

Chen

C.-C.

Lee

H.-C.

(2002). Risk factors for completed suicide in bipolar disorder. Journal of Clinical Psychiatry, 63, 469-476.

79.

Umberson

(1992). Gender, marital status, and the social control of health behavior. Social Science & Medicine, 34, 907-917. doi:10.2307/2136854

80.

Van Orden

K. A.

Witte

T. K.

Cukrowicz

K. C.

Braithwaite

Selby

E. A.

Joiner

T. E.

(2010). The interpersonal theory of suicide. Psychological Review, 117, 575-600.

81.

Wagner

B. M.

(1997). Family risk factors for child and adolescent suicidal behavior. Psychological Bulletin, 121, 246-298.

82.

Wagner

B. M.

Silverman

M. A. C.

Martin

C. E.

(2003). Family factors in youth suicidal behaviors. American Behavioral Scientist, 46, 1171-1191.

83.

Waite

L. J.

(2006). Marriage and family. In Poston

D. L.

Micklin

(Eds.), Handbook of population (pp. 87-108). New York, NY: Springer.

84.

Wedig

M. M.

Nock

M. K.

(2007). Parental expressed emotion and adolescent self-injury. Journal of the American Academy of Child & Adolescent Psychiatry, 46, 1171-1178. doi:10.1097/chi.0b013e3180ca9aaf

85.

World Health Organization. (2012). Mental health: Suicide prevention (SUPRE). Retrieved from http://www.who.int/mental_health/prevention/suicide/suicideprevent/en/index.html