It appears that considerably more research has been devoted to risk factors for elder suicide than to identifying protective factors. In fact, there are very few research reports or even commentaries on the latter. Protective factor research is not exactly a growth industry in suicide research but the dearth of any literature on elders is a concern given their high risk (at least for elder men) and growing numbers in the US and elsewhere.
Tony, these references may be helpful:
Article A Systematic Review of Elderly Suicide Prevention Programs
Article Identification of Suicidal Ideation and Prevention of Suicid...
Article Recent developments: Suicide in older people
They address preventive or protective factors for suicide in the elderly.
Hi Tony, it's good to re-connect again. I haven't studied elderly age group so far. However, one of the IASP ex-president Diego De Leo seems to focus quite a bit on this age group. You can search by his name. One of the initial issue I had when I was doing some prelim. on this is at what cut-off age we categorise them as elderly or old, as some researchers use 55 y.o., while some use 65 y.o. Retirement age differs across countries, and I think retirement age is just one parameters to take into account. I think the key is the life cycle as they advance in their age. They play different role, they may attend more funerals than weddings, they may start thinking about death, and world after this physical world, their psychology and needs may change, etc, etc. Belongingness and a sense of purpose are always a protective factors for all age-group, and also Social Connectivity, and Hope. All these factors are connected in a way. I am trying to do a paper on this at a later stage. This also include Meaning in Life, Purpose in Life, etc.
I will also add that there were issues of mistreatment of elderlies as the younger couples now have less time, economy and world politics seem to change faster and move at higher speed, not many things are stable, it's more stressful to bring up a family in many cities - in the West and in the East (they have their own sets of problems). Besides mistreatment, sometimes, another issue is neglect. The busy working couples are happy as long as they don't give them any extra problems. Elderlies feel less belonged in the family as some of them also try to keep problems to themselves and do not want to add more stress or pressure to their children and grandchildren. One aspect worth highlighting is how the Chinese going to cope with previous one-child policy ..as they are many who have reached adult age and middle-age (since the policy started in 1970s), although they have stopped this I think last 1-2 years. There are about 50 years of children born under this policy previously. The issue here is with the rising cost in many cities in China and demand of work-time, etc., one husband and wife will have four elderlies to take care of (not to mention if they have grandparents). I am not sure of the situation in US. It's not so good in Hong Kong and in Kuala Lumpur.
We have problem defining middle-age as well in some of our research initiatives. Currently, some research focus on teenagers (normally late teens) and early adults - say age 15-25 y.o. University samples normally are about 18-22 y.o. This is also the age group where suicide rate has been increasing world-wide. Younger age recorded I think is about 10 or 8 y.o., but fortunately they are not many.
I will go for the two inter-related protective factors which are social connectedness, belongingness, etc., and hope, meaning in life, purpose in life (religion may provide these to some, but not all). There are many good instruments to measure this. These factors I believe are more generic and affect inter-cultural investigation, and also cross-age group. Of course there are specific more micro-factors that may affect only certain specific group - by occupation, location, strong niche cultural factors, govn. policy, lifestyle, extreme poverty group, etc.
Let me know how your paper is progressing. It's interesting.
Regards,
Bob Lew
Kuala Lumpur, Malaysia
Suicide Researcher
Bob: Always nice to hear from you. Thank you for your response. You "nailed it" as we are prone to say in the US with this comment: "Belongingness and a sense of purpose are always a protective factors for all age-group, and also Social Connectivity, and Hope." These are exactly the qualities of life that elder abuse weakens and which I hypothesize foster strong suicide risk and behavior in frail, abused and neglected elders. I have posted a serviceable review article of sorts on this topic on this site. Attached is a piece I wrote for a medical society periodical that briefly outlines my case. My interest in this problem was sparked some years ago when I was struck by how much cases involving every form of elder abuse seethed with risk factors for elder suicide. However, when I turned to the literature I found that there was not much work specific to this area. Interestingly, much of what there is involves Chinese, Chinese-American, or Korean samples. I'm doing a presentation at our state suicide prevention conference in a few weeks and have a good chance for a small grant to fund some "awareness raising" among aged protective services, long term care, home care, and others who might encounter abused elders with signs of possible suicidality. Elder abuse is under-reported in the US, suicide risk screenings are not done on cases that do come to light, there is little longitudinal data on the eventual cause of death in abused elders, there are few autopsies of nursing home patients, and the entire aging field pays far more attention to ADLs than to risk factors among old-old male elders in their 80s who have the highest suicide rate in this country. On top of all this, abused elder men are "invisible" and maybe many more elderly women die by suicides lost sight of by narrow reporting, remediation, and research focusing only on their abuse and their abusers. As you can see, I'm motivated. I'll follow up on your suggestions. Best always! Tony
Hi Tony,
If a sense of purpose or meaning is important in all age groups I can add our paper. Perhaps you read it already. Best regards Béatrice
Beatrice: I was not familiar with your paper and appreciate you sharing it. Tony
Hassan: Thank you for these citations and for following my work. Tony
Hi. I hope you are doing well. I have published several papers about protective factors against suicide. I put the title of papers below. Hope to be useful for your research.
1- Emotional Intelligence Moderates Anhedonia and Suicidal Ideation in Depressed Patients
2- Effect of exercise augmentation of cognitive behavioural therapy for the treatment of suicidal ideation and depression
3- Spirituality moderates hopelessness, depression, and suicidal behavior among Malaysian adolescents
4- Emotional intelligence moderates perceived stress and suicidal ideation among depressed adolescent inpatients
5- Coping Style as a Moderator of Perfectionism and Suicidal Ideation Among Undergraduate Students.
6- Emotional intelligence as a mediator between rumination and suicidal ideation among depressed inpatients: The moderating role of suicidal history
7-
Dear colleague,
Thank you for your question. I do research on suicidality, depression and religiosity/spirituality, but not specific on elderly people. In general these factors are protective. On elderly people I can advice three papers:
- Miller A comparison of suicidal thinking and reasons for living among younger and older adults. Death Studies, 25: 3577365, 2001
- McLaren Age, Gender, and Reasons for Living among
Australian Adults. Suicide and Life-Threatening Behavior 41(6) December 2011
2011 The American Association of Suicidology DOI: 10.1111/j.1943-278X.2011.00061.x
- O'Reilly Religion and the risk of suicide:
longitudinal study of over 1 million people. The British Journal of Psychiatry (2015) 206, 466–470. doi: 10.1192/bjp.bp.113.128694 -> see Table 4 Risk of suicide according to denominational
religiosity may play a role reduce the suicide in elderly by moderating the effect of depression or cognitive impairment, as well as the social support and against the loneliness which important risk factors of suicide in elderly.
For those interested in this topic see:
Older Adult Suicide: Perceptions of Precipitants and Protective Factors
Bryan D. Stice and Silvia Sara Canetto Clinical Gerontologist Bryan D. Stice, PhD Silvia Sara Canetto. 31(4) April 2008: pp. 1–41 Clinical Gerontologist (Posted on this site)
See also Deuter, K., Procter, N., & Evans, D. (2019) Protective factors for older suicide attempters: Finding reasons and experiences to live. Death Studies. (www.tandfonline.com/doi/full/10.1080/07481187.2019.1578303). Study Identified interpersonal relationships, meaningful activities and interests, community engagement, and involvement of mental health services staff.
Hi, Tony:
I'm sure you already have enough bibliography with what has been raised by colleagues, but I attach an article that might be of interest to you because it focuses on older people in Spain, especially how cultural factors modulate the various phases of suicide.
Greetings
David
David:
Thank you for sharing this article. It is very relevant to my efforts to have more suicide prevention attention given to elders. Sadly surprisingly little of what we know from research such as yours has made its way into practice in the US at least.
Best!
Tony
Thank you, Bob. This reference will be especially pertinent to my look at the link between elder abuse and elder suicide, which both prey upon frail elders.
Relationships among dispositional coping strategies, suicidal ideation, and protective factors against suicide in older adults
Meghan A. Marty , Daniel L. Segal & Frederick L. Coolidge Pages 1015-1023 | Received 04 Nov 2009, Accepted 17 Mar 2010, Published online: 09 Nov 2010
- https://doi.org/10.1080/13607863.2010.501068
Psychological Resilience to Suicide Ideation Among Older Adults
Marnin J. Heisel PhD & Gordon L. Flett PhD Pages 51-70 | Published online: 11 Oct 2008
- Download citation
- https://doi.org/10.1080/07317110801947177
- as resilience is a protective factor I can add one of our "resilience paper"
Thomas:
Thanks for your comments and encouragement. A small group of researchers are doing some good work on this in various countries. The data generated by US counties on elder abuse and elder suicide mortality is siloed and only partly useful. Elder death reviews are coming online in some places and hold some promise. "Suspicious deaths" by abused elders are tallied by some states (e.g., PA) but not reported. Avanti coraggio as Pinocchio was once advised.
Regards!
Tony
Yes, see https://wonder.cdc.gov/ucd-icd10.html. Data can be broken down in various ranges (e.g., 5 years, 10 years).
Regards!
Tony
A systematic review of interventions to prevent suicidal behaviors and reduce suicidal ideation in older people
- Chukwudi Okolie (a1) (a2), Michael Dennis (a1), Emily Simon Thomas (a1) and Ann John (a1) (a2)
- DOI: https://doi.org/10.1017/S1041610217001430
- Published online by Cambridge University Press: 02 August 2017
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