«Suicidology» № 1 – 2023
Kozlov V.A., Golenkov A.V., Deomidov E.S. Pathomorphosis of suicidal behavior on the example of choosing methods of suicide. Suicidology. 2023; 14 (1): 3-13. (In Russ / Engl) doi.org/10.32878/suiciderus.23-14-01(50)-3-13
In foreign publications, there has appeared information about an increase in the number of suicides caused by a jump from a height. The aim of the study is to compare the frequency of committing suicides by jumping from a height and self-hanging, as the most common methods of suicide, based on the study of mass media information on cases of suicide. Material and methods. For the period from 2001 to 2021 there have been analyzed the time series of suicides due to hanging – 220 episodes (165 committed by men, 55 committed by women) and 123 episodes of jumping from a height (69 committed by men, 54 committed by women). 16.1% of the remaining cases account for such methods as: suicide with a firearm – 21 cases, railway suicide – 13, infliction of wounds with a stabbing object – 8, poisoning – 8, self-immolation – 6, opening of the veins – 4, drowning – 2, single and undescribed in the media methods – 4. Results. The mean age of men who committed suicide by hanging was 37.6±16.4, the mean age of women – 32.7±14.6. The mean age of men who committed suicide by jumping from a height was 33.7±16.6 (c2, p=0.0997, in relation to the group of men who committed suicide by hanging), women – 33.0±19.6 (c2, p=0.9279, relative to the group of women who committed suicide by hanging). In the Kolmogorov–Smirnov test, no differences in time series were found. A 13-fold increase in the number of hangings occurred in the middle of the observed period, there were four times more men than women. A fourfold increase compared to the average over the observation period, the increase in the number of high jumps occurred from 2019 to 2021, 2.4 times more men than women. The time series of suicide rates for men and women by the method of jumping from a height in the Kolmogorov-Smirnov test differ (p< 0.05). It was concluded that: 1) the classification of suicidal behavior by choosing the method of committing suicide reveals the pathomorphism of this phenomenon, which is realized over long (at least 20 years) time intervals, this is an indirect evidence of the biological multifactorial nature of this phenomenon; 2) monitoring of suicide attempts and completed suicides allows building a strategy for the timely correction of suicidal behavior and prevention of its completion by suicide.
Keywords: suicide, pathomorphosis, hanging, jumping from a height, polynomial trend
Chistopolskaya K.A., Kolachev N.I., Enikolopov S.N., Drovosekov S.E., Zhang J. Adaptation of the Psychological Strain Scales and an empirical testing of the Strain Theory of Suicide by J. Zhang in a Russian sample. Suicidology. 2023; 14 (1): 14-37. doi.org/10.32878/suiciderus.23-14-01(50)-14-37 (In Russ / Engl)
The article presents an operationalization of the Strain Theory of Suicide, which continues the tradition of the social studies in suicidology. Objective: To adapt Psychological Strain Scales (PSS) in a Russian sample, and to test empirically the Strain Theory of Suicide. Participants: the normative sample consisted of 268 students aged 17-18 (М=19.0, SD=1.1), 169 females (63%), 99 men (37%), 1 participant did not state their gender; the clinical sample comprised 146 patients of the Crisis Unit, aged 16-48 (M=23.1, SD=5.9), 105 females (72%), 41 males (28%). Instruments: The following instruments were used: Reasons for Living Inventory, Self-Compassion Scale, Future Self Scale, Multidimensional Scale of Perceived Social Support, Experience in Close Relationships – Revised, Zimbardo Time Perspective Inventory, Slaney’s Almost Perfect Scale, Beck Hopelessness Scale, Psychache Scale. Results: The final version of the PSS (29 items) showed satisfactory fit of the model to empirical data χ2(371)=1252.220, CFI=0.920, TLI=0.912, RMSEA=0.076, SRMR=0.074. Analysis of criterion-oriented validity showed high level of differences in three scales out of four when comparing the normative and clinical samples (Cohen’s d=1.3-1.6). The part of the Strain Theory of Suicide, which speaks of the mediating role of hopelessness and psychache between various types of strains and suicidal behavior, was also confirmed. Conclusions: The Russian adaptation of the Psychological Strain Scales went well, the scales can be used in research and clinical practice, and three scales out of four (Value, Aspiration and Coping Strains) can also be implemented in screenings.
Keywords: suicide, strain theory of suicide, psychological strain scales, hopelessness, psychache
Rozanov V.A., Semenova N.V., Samerkhanova К.М., Vuks D.О. Suicide prevention programs (systematic review of russian-language scientific sources). Suicidology. 2023; 14 (1): 38-64. (In Russ / Engl) doi.org/10.32878/suiciderus.23-14-01(50)-38-64
The aim of this review is to systematize studies on specific interventions (programs, strategies) for the prevention or correction of suicidal behavior published in Russian-language scientific sources. Methodology. A search was made for Russian-language publications on the topic of suicide prevention in the scientific electronic libraries eLibrary and CyberLeninka using various combinations of the following keywords: program / strategy / method + prophylaxis/prevention/impediment/ determent + suicide/suicidal behavior. Results. 457 sources were identified and processed, of which 17 papers were included in the analysis, describing 15 studies in which there was a detailed description of the contingent, program, criteria and quantitative indicators of effectiveness (before and after the intervention). Among the programs tested, school-based programs for teenagers, using psychocorrective and psychotherapeutic techniques, often combined with educational and outreach approaches aimed at parents and teaching staff, predominate. To assess suicidal tendencies among adolescents, questionnaires of suicidal risk are used, all authors report on the effectiveness of the developed programs, mainly by indirect criteria and without taking into account long-term results. Findings. There is great potential in the development and implementation of suicide prevention strategies, but there is a need to increase the level of research in this area. In particular, it is necessary to use more widely indicators such as the prevalence of suicidal thoughts and attempts, and not just indirect methods for assessing suicidal risk, and be guided by the principles of evidence.
Keywords: suicide prevention programs, Russian-language publications, systematic review
Kasimova L.N., Svyatogor M.V., Sychugov E.M. The role of clinical and social risk factors in the onset and development of suicidal behavior in adolescents and young adults. Suicidology. 2023; 14 (1): 65-83. (In Russ / Engl) doi.org/10.32878/suiciderus.23-14-01(50)-65-83
Among the leading causes of death among young people aged 15-29, interpersonal violence is the third most common cause of death while suicide is the fourth. Aim: to analyze data from foreign studies to assess the relationship and risk factors for aggressive and suicidal behavior in young people to predict the likelihood of developing these types of behavior. Material. Foreign publications of recent years. The literature search was carried out using the Scopus, MEDLINE, PsychINFO, PRISMA, eLIBRARY.RU databases. The search period encompassed 12 years. An article was included if the study examined the relationship between aggressive and suicidal behavior and reported empirical data from a sample of individuals under 25 years of age. The review included 126 publications. Results. This review confirms that aggressive and self-aggressive behavior is widespread among young people. Many epidemiological, clinical, retrospective, prospective, and family studies have found a strong association between aggression and suicide. It has been shown that aggression can increase the risk of suicidal behavior both in adolescents with mental disorders and in healthy ones. The combined presence of suicidal thoughts and self-directed aggression (self-harming ability) may predict the risk of attempting suicide. Self-directed aggression is also a risk factor for completed suicide. Impulsive-aggressive behavior is the mechanism by which the risk of suicide is increased primarily among young suicides. Impulsivity and aggression may be intermediate phenotypes of suicide, predominantly in younger individuals. Anger and hostility have a direct impact on suicidal thoughts, plans and suicide attempts. At the same time, hostility is a more serious risk factor for young people than for adults. Studies focusing on "dual-harm", that is, the combined display of aggression towards others and aggression towards oneself, show that young people who cause double harm are at greater risk of suicide than those who do not. those who harm only themselves, and those who harm only others. Conclusion. Achieving a better understanding of the factors underlying the risk of suicidal and violent behavior is critical to improving prevention strategies to combat these behaviors. The data presented in the review show that it is useful to include aggressive behavior in screening programs to provide a more sensitive approach to identifying adolescents who have suicidal thoughts.
Keywords: aggression, suicide, auto-aggressive behavior, self-damaging behavior, impulsivity, hostility, anger
Lyubov E.B. The joys and tortures of Ludwig Boltzmann, or permanence of A chance. Part II: the battle on the road. Suicidology. 2023; 14 (1): 84-100. (In Russ / Engl) doi.org/10.32878/suiciderus.23-14-01(50)-84-100
Part II. The triumph and tragedy of Ludwig Boltzmann, a romantic thinker, luminary of physics and man for all time, is embodied in the cataclysms of science and the world of the late 19th and early 20th centuries. The stages of a long journey in science and life are traced with signs of suicidal behavior maturing over the years against the background of cumulation of chronic mental and somatic ailments, a vicious circle of multiplying psychosocial distress. Mutual devotion to family and purpose (creativity) served as protective (anti-suicidal) factors and brightened up the darkest days. If possible, the testimonies of contemporaries, biographers, excerpts from personal letters and speeches of Professor Boltzmann are given, emphasizing the incarnations of a unique personality: the overthrower of dogmas and traditions, the rebel-demon of the most tender quivering soul and the passion-bearer.
Keywords: Boltzmann, life history, illness, suicide
Kochnova E.N., Merinov A.V. Volodin B.Yu., Novikov V.V. Autoaggressive characteristics of boys and girls that experience different experiences of own body shame. Suicidology. 2023; 14 (1): 101-114. (In Russ / Engl) doi.org/10.32878/suiciderus.23-14-01(50)-101-114
Feeling shame of one's own body is a complex of negatively colored experiences in relation to the external image, which in some cases forms a complex of anti-body attitudes, which with a high degree of probability can be associated with auto-aggressive behavior. The aim of the study was to search for statistically significant differences in the auto-aggressive profile of young people of both sexes who experience and do not experience a distinct sense of shame of their own body. Tasks: to test the hypothesis of a connection between body shame and a tendency to auto-aggressive behavior; to give a detailed suicidological description of girls and boys who are ashamed of their bodies, to assess possible gender-based differences; propose new indicative points for identifying an increased risk of auto-aggressive behavior. Materials and Methods: The study involved 961 subjects: 733 girls and 228 boys, divided into four subgroups. Subjects: girls/boys who had experience of subjectively significant body shame that was relevant at the time of the survey (FBSh and MBSh, respectively), and controls: girls/boys who did not have an experience of body shame that was relevant at the time of the survey (FnBSh and MnBSh, respectively). The number of respondents in the formed subgroups was: FBSh – 383, FnBSh – 350, MBSh – 92, MnBSh – 136 people. The criterion for inclusion in the study groups was the presence of distinct, subjectively significant, feelings of shame of one's own body at the time of the conversation. We used: a questionnaire to identify auto-aggressive patterns and their predictors in the past and present. Mathematical data processing was carried out using the SPSS program. Results and discussion: a history of suicidal attempts was observed in the CTD group more than two times more often than in the control group (5.74% and 1.43%, respectively), thoughts with contemplation of a way to die - three times more often (35.24% and 12.85% respectively). In the MBSh group, differences were found only in relation to the presence of suicidal thoughts in the anamnesis (30.43% and 10.29%). For a number of studied predictors of auto-aggressive behavior, representatives of the FBSh subgroup have a value two or more times higher than those in the control group of FnBSh. Separately, we note the frequency of hopelessness, as one of the most important pro-suicidal predictors (49.34% and 24.86%, respectively). With respect to most indicators, the men's and women's groups are almost the same, thus making the men's group very similar. Conclusions: girls and boys who have feelings of shame about their own bodies represent, from the point of view of suicidology, a very remarkable section of the population that requires close attention. The presence of body shame can and should be used as an indicator and prognostic sign of increased autoaggressive risk. Currently, a fairly large number of specialists in the field of cosmetology and aesthetic medicine work with people who have concerns about their own appearance, including those who are ashamed of their bodies, however, not all of them understand what, behind these "innocent complexes" can hiding a noticeable auto-aggressive potential. This fact makes it necessary to broadcast the " suicidological minimum" in this professional community, and to develop contacts with the psychiatric service.
Keywords: suicidology, body shame, auto-aggressive behavior
Bokhan N.A., Voevodin I.V., Mandel A.I., Abolonin A.F., Belokrylov I.I. Cognitive coping therapy of alcohol addiction and neurotic disorders in patients with suicidal thoughts. Suicidology. 2023; 14 (1): 115-130. (In Russ / Engl) doi.org/10.32878/suiciderus.23-14-01(50)-115-130
The high prevalence of suicidal phenomena among young patients with addictive and neurotic disorders necessitates the inclusion of suicide prevention components in therapeutic programs. At the same time, among the interventions with proven effectiveness, the leading place is occupied by methods associated with increasing cognitive rationality and adaptability of stress response. The aim of the study: personalization of the method of cognitive coping therapy for suicidal behavior for patients with alcohol addiction and neurotic disorders. Materials and methods: 166 patients (105 with alcohol addiction, 61 with neurotic disorders) of young age (under 35 years of age), with higher and incomplete higher education, were examined. Clinical-psychopathological and psychometric methods were applied. Mathematical data processing was carried out using the SPSS-Statistics V26 program. Results: The presence of suicidal thoughts in history was detected in 33.3% of patients with alcohol addiction and 27.9% of patients with neurotic disorders – in the absence of cases of committing suicide attempts, limiting suicidal behavior to the first two stages of its internal forms, which is typical for a contingent of highly educated youth with these nosologies. Three possible variants of the formation of suicidality (sthenic, hyposthenic and associated with painful loneliness) were identified by the method of factor analysis. Both clinical groups were characterized by the formation of suicidality associated with painful loneliness. An additional option for patients with addiction was the hyposthenic variant (hypothymic symptoms), and for persons with neurotic disorders, the sthenic variant (dysphoric symptoms and aggressiveness). With alcohol addiction among patients with suicidal thoughts, an increased severity of alcoholization was revealed, with neurotic disorders – almost no alcohol consumption. Persons with suicidal thoughts in alcohol addiction were characterized by an increased level of severity of both depression and anxiety, in patients with neurotic disorders, a connection between suicidal thoughts and depression was established, in the absence of a connection between suicidality and anxiety. In the cognitive style of patients with alcohol addiction, suicidal risk was associated with an irrational setting of evaluative dichotomous thinking, in patients with neurotic disorders, with an attitude of obligation towards other people. The coping style associated with suicidal risk in alcohol addiction was characterized by a tendency to unproductive indignation in stressful situations, unwillingness to delegate responsibility and accept support from the environment. In neurotic disorders, suicidal risk was associated with impaired emotional response to stressors (decreased self-control and a tendency to aggressive reactions), as well as an increased willingness to take personal responsibility for the situation (which is generally adaptive for coping "everyday stress", but in this case requires a change of approach to intervention). Conclusion: The identified clinical and psychological characteristics of patients with suicidal risk should be taken into account when implementing suicide prevention as part of psychotherapeutic interventions for alcohol addiction and neurotic disorders.
Keywords: suicidal thoughts, alcohol addiction, neurotic disorders, personalized psychotherapy, prevention
Golenkov A.V. Post-homicidal suicides and mental disorders. Suicidology. 2023; 14 (1): 131-153. (In Russ / Engl) doi.org/10.32878/suiciderus.23-14-01(50)-131-153
Mental disorders (MD) are considered a significant factor in the commission of post-homicidal suicides (PHSUs). The aim of the study is to study the structure of MD among aggressors who committed PHSU in the regions of the Russian Federation (RF) and their socio-demographic and criminological indicators. Materials and methods. We examined 83 cases (61 men and 22 women, aged 18 to 78 years; average – 43.6±13.9 years) of PHSU committed by persons with MD and collected in electronic media in 37 regions of the Russian Federation. Clinical, socio-demographic and criminological indicators of PHSU were taken into account. The comparison group consisted of 312 cases (270 men and 42 women, aged 15 to 86 years; average – 41.9±14.2) of PHSU without MD from 78 regions of the Russian Federation. Mathematical and statistical processing was carried out using descriptive statistics, the distribution of χ2 and t-criterion. Results. PHSU was more often performed by patients with alcohol addiction (27.7%) and various depressive conditions (21.7%). In the first case, these are, as a rule, men, in the second case, women. Children's PHSU clearly prevailed (33.7%); non-family PHSUs accounted for 19.3%, marital PHSUs and special PHSUs (mass, teenage, mercy killing, under a contract) – 18% each, family PHSUs – 10.8%. Men with MD more often committed spousal and out-of-family PHSU, women – children's PHSU. Of the weapons of murder and suicide, firearms (in men), falling (jumping) from a height, poisoning, drowning (in women), and strangulation (in women during murders) were significantly more often used. In men, among the victims, people aged 40 years and older prevailed, in women - children aged 0 to 17 years. Men more often (41%) women were in a state of alcoholic intoxication at the time of the tort. Criminals with MD differed from healthy individuals who committed PHSU by a twofold predominance of women (26.5% vs 13.5%), more often they committed children's PHSU; explosions were used for murders, cold steel, poisoning and self-arson were used for suicides. Conclusion. MD (depressive disorders, MD due to the use of psychoactive substances and psychotic disorders) play a significant role in the commission of PHSU. MD was more common in women, especially affective (depressive) disorders. Criminals with MD who committed PHSU differed from murderers without MD in a larger proportion of women, the predominant focus of aggression on children, murder weapons and suicide methods.
Keywords: post-homicidal suicides, mental disorders, psychoactive substances, Russian Federation
Bimbinov A.A. Criminal liability for virtual "complicity" in the suicide of minors. Suicidology. 2023; 14 (1): 154-168. (In Russ / Engl) doi.org/10.32878/suiciderus.23-14-01(50)-154-168
In 2015–2017, a wave of exposure of the so-called “death groups” swept across the country – various communities on social networks and other Internet resources, where information was disseminated related to young people suicide, including, among other things, calls for the need for such behavior and recommendations for ways of committing suicide. This circumstance prompted the legislator to criminalize "complicity" in a person's suicide. The new norms of the criminal law raise questions even among the professional community, not to mention ordinary citizens. Aim. The work is devoted to the determination of the signs of the composition of crimes, consisting in the organization, incitement and complicity in the suicide of minors using the Internet. Materials and methods. In the course of the work, the norms of the Criminal Code of the Russian Federation on liability for activities aimed at the suicide of others, the theory and practice of their application were studied using private scientific and general scientific methods traditional for criminal law research. Results. The current legislation establishes liability for inciting to commit suicide by persuasion, offers, bribery, deceit or otherwise in the absence of signs of incitement to suicide; for facilitating the commission of suicide by giving advice, directions, providing information, means or instruments for committing suicide, or removing obstacles to its commission or promising to hide the means or instruments for committing suicide and for organizing activities aimed at inciting to commit suicide by disseminating information about the methods of committing suicide or calls for committing suicide. Persuasion and suggestions are verbal forms of mental influence on a person, aimed at making him want to commit suicide. This may include, among other things, one-time statements (messages, comments, etc.) about the necessity, admissibility or possibility of committing suicide. Under such circumstances, the statements of persons who do not attach literal meaning to their words and do not want the onset of socially dangerous consequences can be qualified as a crime. Inducement to commit suicide may be committed in a manner other than those listed in the law. Such a way, for example, can be a playful form of suicide. Advice, instructions and giving information are essentially the same behavior, consisting in giving the person who has decided to inflict death on himself, information about how and where it is possible or better to do so. The difference between assistance and other forms of involvement in suicide lies in the fact that a person who assists the victim in causing his own death manifests his criminal activity after the latter has become determined to commit an act of suicide. Conclusion. It has been established that many features of the offenses under consideration are more than unobvious, some of them contribute to legal arbitrariness and need to be corrected.
Keywords: suicide, teenager, mobile applications, social networks, instant messengers, online communities, self-destructive behavior, Internet, corpus delicti
Abdulvaliev A.F., Belousov A.V., Sidorenko D.V., Sidorova N.V., Tolstoluzhinskayа E.M., Khabarova E.A. Protection of the victims rights in the course of proceedings on cases of incitement to suicide. Suicidology. 2023; 14 (1): 169-185. (In Russ / Engl) doi.org/10.32878/suiciderus.23-14-01(50)-169-185
Based on the historical and legal stages of the formation of institutions for social security of life and health of a person and a citizen, the article examines the specifics of law enforcement in criminal cases of incitement to suicide. The aim of the study is to highlight the algorithm for applying the provisions of the criminal procedural law when using legal methods and means in the investigation and consideration of crimes of this category. Materials and methods: an analysis of codified legal acts containing the norms of criminal and criminal procedural law, as well as the specifics of law enforcement was carried out. In particular, 50 verdicts, 4 rulings of the court of cassation of general jurisdiction, 3 cassation rulings, a ruling of the European Court of Human Rights and statistical information on the state of crime in the Russian Federation in criminal cases initiated under articles 110, 110.1 and 110.2 of the Criminal Code of the Russian Federation in the period from 2015 were analyzed. years to 2022. For the same purposes, the theoretical works of scientists in the field of criminal justice and forensic methods of investigating criminal cases of criminal suicide are summarized. Special methods of research were system-structural, historical, comparative legal, statistical and sociological. The results of a study of law enforcement practice showed that suicidal acts among adult women are 74%, and among adult men – 4%. The analysis of the data made it possible to describe the forensic characteristics of a typical victim of criminal suicide. In the course of the work, an algorithm was developed for applying the provisions of the criminal procedural legislation in the investigation and consideration of crimes of this category, which includes an indication of the specifics of initiating a criminal case without a statement from the victim; involvement of a legal representative or the implementation of a procedural replacement of the victim; legal support of the rights of the victim; compensation for non-pecuniary damage in criminal proceedings. Conclusions. The analysis of the empirical study made it possible to identify initial situations that require procedural regulation and form methods and means that provide the victim with legal protection in the investigation of crimes of criminal suicide.
Keywords: victim rights, victim, crime, incitement to suicide, inducement to commit suicide, criminal justice, criminal suicide, forensic science
Zotov P.B., Skryabin E.G., Ponomareva M.N., Reichert L.I., Akselrov M.A., Mateikovich E.A., Shevlyukova T.P., Izmailova A.A. Suicidal eye injuries. Suicidology. 2023; 14 (1): 186-203. doi.org/10.32878/suiciderus.23-14-01(50)-186-203 (In Russ / Engl)
A review of the scientific literature on cases of eye injuries due to suicidal motives is presented. It is noted that these are quite rare observations in clinical practice, and summarizing the collected material, only some specific characteristics of this contingent can be distinguished. More often these are middle-aged men suffering from a mental illness, having experience of intentional self-harm, including suicidal motives, problems with law, often abusing drugs or alcohol. The choice of the object of impact (the organ of vision) may be due to the limited availability of means for self-harm, severe mental pathology and/or the desire to quickly achieve the effect with the help of improvised piercing and cutting objects. Less commonly, eye damage is made as the result of the use of firearms and intentional head wounds. High trauma, morbidity, risk of loss of vision and death indicate the predominance of these individuals true motives to die and the rarity of attempts designed for other (non-lethal) purposes. In conclusion, the authors assume that the noted features of the contingent that inflict eye injuries for suicidal reasons make it difficult to effectively prevent such tragedies. This indicates the importance of a deeper study of the topic, the need to train medical personnel and draw their attention to possible factors and risk groups, to involve specialists in other areas of activity in preventive work (employees of the Federal Penitentiary Service, social services, etc.).
Keywords: suicide, eye, organ of vision, suicidal eye injuries, organ of vision, cases of suicidal eye injuries
«Suicidology» № 2 – 2023
Bozhchenko A.P. Suicide risk factors established during the forensic medical examination of a corpse. Suicidology. 2023; 14 (2): 3-21. (In Russ / Engl) doi.org/10.32878/suiciderus.23-14-02(51)-3-21
Domestic criminal law does not require the mandatory initiation of criminal cases on the fact of suicide. However, in the event of death in non-obvious conditions, it is required to check the versions of criminally punishable acts – incitement to suicide or disguise as a suicide of intentional murder. Aim of the study: search and systematization of practically the most significant risk factors for suicide, established on the basis of investigative and forensic medical expert material and important for the differential diagnosis of the type of death. Materials and methods: The article analyzes the materials of pre-investigation checks and forensic medical examinations of 200 adult men and women who died as a result of suicide, as well as annual reports of the Bureau of Forensic Medical Examination of St. Petersburg and the Leningrad Region on the structure of violent death (2020-2022). Mathematical processing was carried out using the SPSS-Statistics program). Results: An assessment was made of the influence of the characteristics of the scene of the incident and the anatomical and morphological features established during the study of the corpse on the likelihood of suicide. New data on the systematization of suicide risk factors according to their role in the occurrence of suicidal behavior and the completion of suicide are presented. It has been established that the background factors that create a predisposition to suicide include the gender of the individual (male – DC = 4.1), heredity (suicidal behavior, mental disorders in blood relatives – DC = 8.6), type of constitution (asthenic), significant deviations of body weight from the average values (cachexia, obesity), various mental disorders, as well as chronic somatic diseases (alcohol-associated, cardiovascular, oncological, infectious with cerebral manifestations), markers of dysmorphogenesis (p <0.05). Factors indicating readiness to commit suicide include age (adolescent for females, young and middle for both sexes, senile for males), traces of previous suicide attempts (pigmented stripes on the neck, linear scars on the inner surface of the forearms – for men – DC =36.7, for women – DC =13.3). The factors that make it possible to commit suicide in a certain space-time continuum include the season (autumn-winter period – for the Russian Federation), day of the week (Monday), place of deprivation of life (not a public place), method of deprivation of life (hanging – DC =99.0, not thermal injury, not transport injury, not drowning, not strangulation), traces of nervous stress (onychophagia – DC =5.6, trichotillomania – DC =6.0). Other well-known factors (spring-summer period, Sunday, drunkenness, types of injury – gunshot, acute, as a result of a fall from a great height) are non-specific, increasing the likelihood of not only suicide, but also other types of death (murder, accident). Conclusion: The identified risk factors for suicide expand existing ideas about its nature and can be used for a more objective investigation of cases of death in conditions of non-obviousness, as well as in the timely recognition and prevention of suicidal behavior.
Keywords: violent death, type of death, suicide, mortality, forensic medical examination, suicidal behavior, suicide attempt, murder, risk factors
Lyubov E.B., Zotov P.B. Suicidal risk assessment: new solutions to "damned questions". Suicidology. 2023; 14 (2): 22-35. (In Russ / Engl) doi.org/10.32878/suiciderus.23-14-02(51)-22-35
The conceptual review notes the methodological problems of suicide prediction, the strengths and weaknesses of structured approaches to determining group and individual risk factors for severe mentally ill patients; the limitations and prospects for development in everyday (domestic) practice of predictive tools are indicated on the example of Oxford Mental Illness and Suicide tool (OxMIS).
Keywords: suicide, risk assessment, schizophrenia, bipolar disorder, OxMIS
Kozlov V.A., Golenkov A.V., Bulygina I.E. Methods and means of medical prevention of suicide. Suicidology. 2023; 14 (2): 36-58. (In Russ / Engl) doi.org/10.32878/suiciderus.23-14-02(51)-36-58
Despite the fact that suicides are potentially preventable, the prevention of suicides, the death rate from which is comparable to that from bacterial epidemics, remains an urgent global problem. The WHO describes suicide as "an act of deliberate killing" that is at the extreme end of a continuum of suicidal behavior. The purpose of the study is to systematize information about the methods and means of drug prevention of suicides. Results. The issues of suicide prevention are considered. The authors came to the conclusion that it is necessary to identify predictors of suicidal behavior and form homogeneous population groups: 1) mentally ill (subgroups – in the DSM-V definitions); 2) relatively healthy people (those who do not experience social and economic disadvantage, clinically pronounced health disorders and who cannot be qualified in the DSM-V definitions) – who have a high risk of committing suicide in the future, as having a constant pattern of predictors of suicidal behavior. Such a classification will make it possible to create a register of persons prone to suicide and to carry out planned population and clinical prevention of suicide in target groups. Methods of restricting access to lethal means and objects, programs to raise awareness about the problem of suicides in schools are considered as means of suicide prevention. The issues of using pharmacological agents with a proven anti-suicidal effect, such as cholecalciferols, ketamine, clozapine, lithium salts, long-acting intravenous antipsychotics, and electroconvulsive therapy, are analyzed in particular detail. Based on rational information about the biological activity of the listed pharmacology agents, it follows that schizophrenic and depressive personality disorders are comorbid with suicidality, but are not pathogenetically associated with suicidality. It is concluded that for active and effective suicide prevention it is necessary: 1) to classify potential suicides into homogeneous groups; 2) to create a controlling structure, including using digital computing tools in order to create a register of persons potentially capable of committing suicide. In particular, such a tool can be artificial intelligence technologies and big data analysis for prompt tracking of trigger requests on the Internet and using mobile communications.
Keywords: prevention, suicide, ketamine, lithium salts, clozapine, ebselen, cholecalciferol, long-acting intravenous antipsychotics
Polkova K.V., Merinov A.V., Komarov E.V., Starostenko A.E. Suicidal characteristics of young men with hazardous alcohol consumption. Suicidology. 2023; 14 (2): 59-72. (In Russ / Engl) doi.org/10.32878/suiciderus.23-14-02(51)-59-72
The question of defining auto-aggression associated with alcohol consumption still remains open. Due to the RUS-AUDIT test, which discovers “dangerous alcohol consumption”, it became possible to develop a risk group for developing alcohol addiction and determine special consequences, and therefore assess their place in the continuum of paraalcoholic auto-aggression. In this work, we discover the question if the gender of a person who has a pattern of hazardous alcohol consumption, influences their auto-aggressive characteristics. The aim of this study is to study the suicidological characteristics of people with hazardous alcohol consumption in relation to their gender. Materials and methods. The study involved 435 young women (86 with hazardous alcohol consumption, 349 without it) and 456 young men (56 with hazardous alcohol consumption, 400 without it). The main criterion for acceptance into the corresponding group was the dangerous consumption of alcohol score on the RUS-AUDIT test. Mathematical data processing is carried out using the SPSS program. Results and its discussion. Young men with hazardous drinking are twice as likely as women to have attempted suicide in the last two years, which is almost comparable to adult males already addicted to alcohol. The combination of suicidal thoughts with a suicide attempt in the studied male group was 17.86%, in the female group it was 10.47%. Various cases of risky and life-threatening behavior in the assessment with impulsivity significantly prevail (p<0.05) in men, the manifestations of the group, thus showing a kind of “male” variant of the gender vector of auto-aggressive behavior. Narcological gender characteristics of young people with hazardous alcohol consumption (recognition of alcohol abuse in the last two years ) in the female group of alcoholics is 6 times less than in the group of men, which needs development. Feelings of hopelessness and low mood as the most important risk factors for suicidal behavior were mentioned by 50 percent or more of the people in the study groups. Men with hazardous alcohol consumption demonstrated “closedness”, a tendency to “keep everything in themselves”, which is quite consistent with the lower frequency of thinking about the need to visit a psychiatrist / psychotherapist compared to women in the study group (46.15% vs. 68.05%). Conclusions. With adverse events in the whole suicidological profile in the identified foci, however, there are certain gender characteristics, the identification of fundamental importance for the formation of theoretical ideas and practical work of a suicidologist in narcology. Classical suicidal phenomena on the development of an alcohol trajectory are less typical for young women with dangerous forms of alcohol consumption. However, a number of predictors of auto-aggressive broad behavior of an affective type are often found in the group. Men with hazardous alcohol consumption are characterized by risky- victim models of realization of auto-aggressive impulses and PAS consumption.
Keywords: excessive alcohol consumption, prenosological forms of alcohol abuse, domestic drunkenness, habitual drinking, suicidal behavior, auto-aggressive behavior, suicidology, preventology
Zotov P.B., Lyubov E.B., Skryabin E.G., Akselrov M.A., Kicherova O.A., Mateikovich E.A., Prilenskaya A.A., Моlina Т.R., Butenko D.S. Jumping off a bridge with suicidal intent. Suicidology. 2023; 14 (2): 73-103. (In Russ / Engl) doi.org/10.32878/suiciderus.23-14-02(51)-73-103
Jumping from bridges is a rather rare method of suicide recorded in the population with a high degree of trauma and mortality. An analysis of key characteristics, factors and risk groups indicates a certain specificity of the contingent, which differs from other categories of suicide attempters. In many countries, this is usually a young male with a secondary education, single, suffering from a mental illness with experience in observation and treatment by a psychiatrist, without a permanent job experiencing financial difficulties. Due to the impact of negative psychosocial factors, they are in a state of prolonged stress, depressive, have experience of self-harm and less often suicide attempts. Suicidal behavior is formed over a long period, determined by the trouble motives with a true desire to die, actions are planned. Suicidal ideas, as a rule, are not hidden, most potential victims, on the contrary, voice them to others and are ready to discuss them. For the Russian Federation, given the lack of studies on this issue, this profile is probably not entirely accurate. We can assume higher rates of participation of women with a predominance of emotional disorders in the clinic and greater impulsiveness of suicidal behavior. Knowledge of these features is important for improving the effectiveness of individual work and medical suicide prevention. Non-medical prevention measures (setting restrictive barriers, helplines on bridges, etc.) are also of great importance, and they have already proven to be highly effective in many countries. In conclusion, the authors believe that the problem cannot be solved only by medical workers and psychologists, but requires the involvement of specialists in various fields, including architects and designers, whose tasks, when designing bridges, should include the necessary principles and systems of general security, in including taking into account the restriction of free access to open high platforms for jumping. These issues need to be addressed in the modernization of existing bridges. Thematic training on the issues of suicide prevention for police officers (especially those working near "hot spot" bridges), the Ministry of Emergency Situations, social services, as well as work with the media and Internet resources is also important. Such an integrated approach as a whole will make it possible to minimize the number of such tragedies, as well as prevent the formation of iconic places from individual bridges that attract new people who want to commit suicide by jumping from the bridge.
Keywords: suicide, suicidal bridge jump, bridge fall, bridge, bridge jump prevention, suicide prevention, non-medical suicide prevention
Golenkov A.V., Zolnikov Z.I. Influence of the alcohol intoxication and type of alcoholic beverage on the features of homicide. Suicidology. 2023; 14 (2): 104-116. (In Russ / Engl) doi.org/10.32878/suiciderus.23-13-02(51)-104-116
Alcoholic intoxication is closely connected to homicide. Features of alcohol consumption vary greatly in the regions of Russia. Aim of the article – to study the influence of the state of intoxication and the type of alcoholic beverages on the characteristics of murders. Materials and Methods. We analyzed 485 murders committed by 504 killers (men – 406, women – 98) in Chuvashia in 2011-2020 and passed a forensic psychiatric examination in the Republican Psychiatric Hospital of Cheboksary. The age of the killers ranged from 15 to 83 years (mean age 35.8±13.4 years). Clinical-social and forensic-psychiatric indicators were taken into account. Mathematical and statistical processing was carried out using descriptive statistics and χ2 -distribution using the SPSS program. Results. 82.9% were in a state of alcoholic intoxication at the time of the murder, including 12.2% in a mild degree, 83.3% in an average degree, and 4.5% in a severe degree. In women, a mild degree of intoxication was more often observed, while in men it was medium. In 94% of cases, homicide were committed in three ways: with the help of piercing objects (61.3%), by beating (“blunt object”) (19.8%) and strangulation (12.9%). The victims were acquaintances (50%), spouses (22.8%), relatives (15.7%), strangers (6.3%) and children (5.2%). Predominantly strong alcoholic beverages (mainly vodka) were used by 60.1% of the aggressors before the murder, alcohol surrogates – 32.5%, only beer – 5.5%, fortified wine (port wine) – 1.9%. Those who used strong alcoholic beverages and surrogates were more often in moderate and severe intoxication, and beer and wine were in light (100% of their victims were intoxicated). Among the beer drinkers there were more young and mentally healthy individuals, women and city dwellers. Wine drinkers were more likely to live in rural areas and suffer from mental retardation. Criminals suffering from alcohol addiction, compared with other groups of murderers, were more often in a severe degree of intoxication. They more often killed their acquaintances by strangulation, who themselves were in a state of extreme intoxication. 73% were in a state of simple alcohol intoxication; dysphoric variant was observed in 18.7% of killers, paranoid – in 3.4%, alcohol intoxication with hysterical features – in 4.9%. Alcohol surrogates were significantly more often accompanied by a dysphoric form of intoxication and intoxication with hysterical features, and the use of beer and wine by aggressors less often led to altered patterns of intoxication. The paranoid form was more often observed in patients with alcohol dependence, the dysphoric form - in organic mental disorders (MD) and comorbid MD, the usual form of intoxication – in mentally healthy subjects; intoxication with hysterical traits was significantly more often found in aggressors with comorbid MD. In a state of intoxication, murders were significantly more often committed by patients with alcoholism, mental retardation, and comorbid MD; patients with schizophrenia and mentally healthy people were more sober. The group of criminals who committed murders while intoxicated more often had a hereditary burden, criminal experience, repeated convictions (including for murders and grievous bodily injuries with a fatal outcome); they killed their acquaintances more often. The aggressors, who were in a sober state when committing murders, were more often recognized as insane, sent to a stationary examination, committed so-called post-homicidal suicides, killed fathers and children, and killed two or more victims. Among the sober killers were more minors and people with higher education. Conclusion. The study confirmed the significant role of alcohol intoxication, its degree and form, in the commission of murders, which depends on the dose of alcohol consumed and the type (quality) of the drink. The formation of violent behavior that ended in death is influenced by the presence of MD and their structure, gender, age, criminal experience and organic brain deficiency of the offender. The victims of murders are most often acquaintances of the aggressor (drinking buddies), who at the time of the crime are often also intoxicated, which increases the risk of conflict and its fatal outcome.
Keywords: alcohol intoxication, degrees and forms of intoxication, alcoholic beverages, homicide (murder), mental disorders
Lyubov E.B. The joys and tortures of Ludwig Boltzmann, or permanence of a chance. Part III: Boltzmanniad. Suicidology. 2023; 14 (2): 117-139. (In Russ / Engl) doi.org/10.32878/suiciderus.23-14-02(51)-117-139
Part III: Boltzmanniad. The triumph and tragedy of Ludwig Boltzmann, romantic thoughts, the luminary of physics and man for all time, are embodied in the cataclysms of science and the end of the world of the 19th - early 20th century. The stages of great paths in science and life are traced with signs of suicidal behavior ripening for years against the background of cumulation of chronic mental and somatic damage, a vicious circle of multiplying psychosocial distress. Mutual devotion to family and purpose (creativity) served as protective (anti-suicidal) factors and brightened up the darkest days. If possible, it is appropriate to identify the personalities of contemporaries, biographers, excerpts from the letters and speeches of Professor Boltzmann, emphasizing the incarnations of a unique personality: the subverter of dogma and condemnation, the rebel-demon of the most tender quivering soul and the passion-bearer.
Keywords: Boltzmann, life history, illness, suicide
«Suicidology» № 3 – 2023
Lyubov E.B. A rural teacher: a personal matter. Suicidology. 2023; 14 (3): 3-26. (In Russ / Engl) doi.org/10.32878/suiciderus.23-14-03(52)-3-26
Based on the story of the Russian classic with the use of relevant scientific and artistic references, the process of suicidal behavior is shown as a sociocultural phenomenon. Psychopathological and psychological interpretations of suicidogenesis in the prism of suicidolological concepts and experience are proposed. Typical features of “literary” and/or “female” suicides are highlighted.
Keywords: story, suicidal behavior, process, crisis
Kozlov V.A., Golenkov A.V., Orlov F.V. Epigenetics, genetics and biochemistry of suicide. Suicidology. 2023; 14 (3): 27-50. (In Russ / Engl) doi.org/10.32878/suiciderus.23-14-03(52)-27-50
The development of molecular biology methods has made it possible to identify new, previously unknown mechanisms of the formation of the suicidal phenotype and suicidal behavior. This allowed specialists in the field of suicidology to regard the suicidal phenotype as an independent polygenic and multifactorial pathology that can accompany mental illness as a comorbid condition. The aim of the publication is to systematize the known literature data on persistent biochemical changes associated with the suicidal phenotype. Epigenetic, genetic and biochemical markers associated with suicidal behavior and suicides of persons without previous mental illnesses, as well as molecular biological analysis of suicide cases in patients with major depressive disorder are considered. Analysis of modern literature – publications of direct studies of biological material obtained from individuals with suicidal behavior and suicide victims, as well as meta-analyses – gives grounds to consider the main cause of the suicidal phenotype to be neuroinflammation and/or penetration into the cerebrospinal fluid through the genetically compromised blood-brain barrier of inflammatory cytokines formed in individuals with long-term debilitating chronic inflammatory diseases (latent Toxoplasma infection gondii, rheumatoid diseases, atopic dermatitis, bronchial asthma). Neuroinflammation, which forms the suicidal phenotype, is realized as a result of single nucleotide polymorphisms of genes associated with homeobox and immune response genes, such as interleukins -2, -4, 6, tumor necrosis factor. While interleukin-8 may have a protective effect. In addition, the suicidal phenotype is most likely associated with a genetically determined disorder of tryptophan metabolism caused by activation of the kynurenine pathway with concomitant depletion of the serotonin pool and induction neuroinflammation of the kynurenine type. Chronic neuroinflammation changes psychotype and behavior towards the formation of a suicidal phenotype. As a result, the individual creates a social environment around himself that contributes to the aggravation of neuroinflammation and suicide as the final outcome of the disease. It was concluded that the suicidal phenotype is formed by neuroinflammation.
Keywords: suicide, single nucleotide polymorphisms, epigenetics, genetics, biochemistry, neuroinflammation, kynurenine, Toxoplasma gondii, ketamine, lithium salts, cholecalciferol
Zhilyaeva T.V., Kasyanov E.D., Chekanina O.M., Maso G.E. Cumulative effect of genetic factors of folate metabolism on suicidality indicators in schizophrenia. Suicidology. 2023; 14 (3): 51-68. (In Russ / Engl) doi.org/10.32878/suiciderus.23-14-03(52)-51-68
Suicide is one of the most common causes of premature death in patients with schizophrenia. There are several prerequisites for this: some genetic risk factors for suicide are common to genetic risk factors for schizophrenia; Patients with schizophrenia are more likely than the general population to experience depression, the association of which with suicidality has been confirmed in numerous studies. Suicide is a complex multifactorial behavioral phenotype that is associated with a large number of genetic and environmental factors. Hypothetically, disorders of folate metabolism, including genetic factors affecting folate metabolism, may contribute to the development of depressive symptoms and suicidality in schizophrenia. Genetic polymorphism of the key enzyme of folate metabolism, methylenetetrahydrofolate reductase (MTHFR 677 C>T), is a risk factor for both schizophrenia and depression. At the same time, there are studies demonstrating the connection between folate deficiency and the risk of suicide and the connection of this genetic factor with the presence of a suicide attempt in schizophrenia. At the same time, a number of other genetic factors of folate metabolism, the influence of which on folate metabolism and the development of pathology has been confirmed outside the context of this topic, have not yet been studied from the point of view of their influence on suicidality in schizophrenia. The aim of this work was to study the association of combined carriage of polymorphic variants in folate metabolism genes with suicidality and depressive symptoms in schizophrenia. Materials and methods: in 119 patients with schizophrenia, the carriage of alleles in 10 polymorphic loci associated with folate metabolism was studied using real-time PCR. Patients were assessed clinically using the Columbia Suicide Risk Scale, the Positive and Negative Syndrome Scale for Schizophrenia, the Calgary Depression in Schizophrenia Scale, and the Snight-Hamilton Anhedonia Scale, blinded to laboratory results. Results: 9 out of 10 studied genetic factors were weakly associated with indicators of suicidal risk, however, the total number of polymorphic genotypes and the total allelic load for 9 out of 10 studied loci makes a statistically highly significant contribution to most indicators of suicidality. The severity of depression and the PANSS scale of productive symptoms and general psychopathology in patients is also associated with indicators of suicidal risk, but the genetic factor is not associated with clinical indicators at the time of examination. It is likely that the clinical and genetic factors studied in this work make independent contributions to suicide risk in schizophrenia. Conclusion: The total carriage of polymorphic homozygous genotypes at one-carbon metabolism loci may have a cumulative effect on suicidality rates in schizophrenia, regardless of the actual mental status, which requires replication in further studies.
Keywords: schizophrenia, suicide, depression, folate metabolism, genetic polymorphism
Merinov A.V., Gazaryan Z.E., Kramoreva A.S., Uslontsev D.N. Analysis of the representation of a number of causes of suicidal mortality in Ryazan, Ryazan and Rybnovsky districts of Ryazan region in 2013-2015 and 2019-2021. Suicidology. 2023; 14 (3): 69-83. (In Russ / Engl) doi.org/10.32878/suiciderus.23-14-03(52)-69-83
Suicide, unfortunately, remains one of the most common causes of death in many countries around the world. Analysis of variability in the structure of causes and methods of suicide makes it possible to more effectively plan preventive strategies, including restrictions on access to means of suicide, as well as personalization of psychosocial prevention. Aim of the study: to analyze the dynamics of suicide mortality in the city of Ryazan, Ryazan and Rybnovsky districts of the Ryazan region in 2013-2015 and 2019-2021, the gender and age composition of the deceased, the frequency of using self-hanging, self-cutting and jumping from heights as a method of committing suicide. Materials and methods: on the basis of the State Budgetary Institution of the Russian Federation “Bureau of Forensic Medical Examination named after. D.I. Mastbaum " (Ryazan) analyzed about 20 thousand death reports, of which those meeting the inclusion criteria were selected for the periods 2013-2015 and 2019-2021, which included, respectively, the financial crisis (2014-15) and the pandemic COVID-19 (2019-21). ICD-10 codes listed as causes of death: Y20, X78, X80. Mathematical processing of the data was carried out using the STATISTICA program using the χ2 criterion. Results: Among men who committed suicide from 2019 to 2021, the proportion of falls from height increases by 53.5% and the number of hangings decreases by 39.4%. In the female group, the same trend is observed: an increase in the frequency of falls from a height by 61.5% with a simultaneous decrease in the number of hangings by 120%. There is a tendency for those who committed suicide to grow older by an average of five years: during 2013-2015 regardless the influence of gender, mean age is about 45, while during 2019-2021 mean age is 50. The average values for the two time periods studied in relation to falls from height were 37.0 and 47.8 years in the male group, the same for the age of men who hanged themselves – 42.6 and 49.5 years. In the female group, similar values were: 56.2 and 54.63 years for falls from a height, and 52.1 and 52.9 years for self-hangings, which demonstrates the absence of any significant age dynamics. That is, the noted “maturing” of suicide attempters in 2019-21 is mainly explained by the increase in the age of the dead men. A comparative analysis of the standardized suicide mortality rate (SMR) and the data obtained in the study likely indicates the existence of a paradoxical medical-legal situation that makes it difficult to truly understand the prevalence of the suicidal phenomenon. Conclusions: Neither the financial turmoil of 2014-15 nor the response to the COVID-19 pandemic of 2019-21 led to noticeable surges in suicidal activity in relation to the methods under consideration. Between 2019-2021 there is an increase in the number of falls from heights, which is accompanied by a decrease in the number of people who commit suicide through self-hanging. The discovered trends may be related to the conditions created by the lockdown during the pandemic, as well as the increase in the number of floors in buildings in modern cities.
Keywords: suicidology, auto-aggressive behavior, dynamics of suicidal mortality, falls from a height, self-hanging
Lyubov E.B., Zotov P.B. Intentional self-harming behavior in borderline personality disorders. Part I: statics and dynamics. Suicidology. 2023; 14 (3): 84-95. (In Russ / Engl) doi.org/10.32878/suiciderus.23-14-03(52)-84-95
The aim of a narrative review using the keywords “borderline personality disorder” and “self-injurious behavior” in MEDLINE and PsycINFO articles published after 2000 (along with seminal early articles) is to provide evidence on the prevalence, dynamics of non-suicidal and suicidal behavior in relation to borderline disorder personality (BPD) in general and its individual symptoms in non-clinical and clinical samples. The diagnosis of BPD initially requires attention to the risk of self-harm and the use of special measures to prevent it.
Keywords: borderline personality disorder, suicidal and non-suicidal self-harm
Kozlov M.Y. What does attachment theory say about suicidal behavior? brief overview of modern research. Suicidology. 2023; 14 (3): 96-106. (In Russ / Engl) doi.org/10.32878/suiciderus.23-14-03(52)-96-106
This narrative review presents data, mainly from foreign studies in recent years, on the role of insecure attachment types in the development of suicidal thoughts and behavior. Factors influencing the development of so-called “unsafe internal working models” (according to J. Bowlby), which increase the risk of a suicide attempt, are formulated and brought together. Currently known mediator factors are listed, namely cognitive, behavioral and personality characteristics that mediate the relationship between insecure attachment types and suicidal intentions. The data presented are taken from major international scientific repositories (ScienceDirect, ResearchGate, CORE), mainly for the period from 2000 to 2023. Data on the role of attachment patterns are in good agreement with the interpersonal model of suicide, neurobiological studies and can be used as targets in psychotherapy of suicidal behavior.
Keywords: attachment theory, suicidal thoughts, suicidal behavior, childhood psychological trauma, interpersonal theory of suicide
Golenkov A.V., Zotov P.B., Kozlov V.A., Filonenko A.V. Mass murders with gun weapons in modern Russia. Suicidology. 2023; 14 (3): 107-118. (In Russ / Engl) doi.org/10.32878/suiciderus.23-14-03(52)-107-118
In the last 30 years, there has been increased interest in mass murders (with three or more victims) among a wide range of specialists in many countries of the world. The aim is to study MM with the use of firearms in the Russian Federation (RF) and compare various types of MM, including MM weapons with each other. Materials and methods. We analyzed 129 crimes (142 men, 1 women) committed with the use of firearms in the Russian Federation in 1991-2022. The age of the killers ranged from 16 to 70 (mean age is 34.3±15.1). Most of the cases of “mass shooting” were taken from https://en.wikipedia.org/wiki/List_of_mass_shootings_in_Russia, as well as from electronic media of 59 regions of RF. The comparison groups included 288 cases of MM, 177 cases committed with piercing objects (PO), 36 cases of arson, and 75 other instruments, including a combination of these. The latter group also included 11 cases of the use of firearms in combination with PO (6), blunt weapons (2) and arson (3). Mathematical and statistical processing was carried out using descriptive statistics and χ2 distribution. Results. Over the time period studied, electronic media began to cover incidents with multiple victims significantly more frequently. Approximately every fourth (24.8%) case out of 129 incidents occurred in security forces (armed forces, law enforcement agencies, penitentiary services) using a Kalashnikov assault rifle while on combat duty or guard duty. In most cases, murders were committed with civilian firearms (most often hunting rifles), in isolated cases – with unregistered civilian firearms, service firearms, and military handguns; seven cases occurred in groups of 2–4 people. There were 593 victims (on average 4.59±3.6 victims), the majority of cases had three deaths (53.2%). In our proposed working typology of MM, we distinguish: corporate MM (in law enforcement agencies; in educational institutions; in other organizations), non-corporate MM (acquaintances, friends, neighbors, etc.; strangers; acquaintances and strangers), family MM (relatives and friends (family members), blood and non-blood relatives) and mixed MM (victims from two or three of the above groups). Corporate MM is distinguished by the use of firearms, most often committed in law enforcement agencies and educational institutions. The largest number of victims (6.0±3.7) occurred in corporate MM, especially those that occurred in the academic environment 13.3±5.9 victims). Non-corporate MM was more often committed by PO and other instruments. Among aggressors who used firearms, there were more people aged 19 and younger (20.3% vs 5.9% in the comparison group), they were less likely to drink alcohol (22.0% vs 56.3%) but more likely to commit suicides after MM (31.4% vs 7.3%). Conclusion. Cases of MM with the use of firearms in the Russian Federation were more often observed in security (paramilitary) and training (educational) corporations with the largest number of victims (from 3 to 18, on average – 6). They were less likely than other aggressors to be intoxicated, but more often committed suicide after MM. Media coverage increased significantly from 1991 to 2022 cover incidents with multiple victims, which may indicate an increase in the number of MM in Russia.
Keywords: mass murders, typology of mass murders (executions), firearms, sharp objects, arson, suicides after mass murders, Russia
«Suicidology» № 4 – 2023
Kozlov V.A., Golenkov A.V. Biology of suicidality. Twins and suicides. Suicidology. 2023; 14 (4): 3-38. (In Russ / Engl) doi.org/10.32878/suiciderus.23-14-04(53)-3-38
Freely available information in the PubMed database on suicidal behavior of twins was collected and analyzed. In the literature review, data are stratified into thematic sections on the difficulties of determining heritability when assessing the suicidality of twins, predictors of their suicidal behavior, analysis and comparison of registry studies of suicidal behavior and its associations with genetic factors, gender stratification of suicidal behavior, suicidal behavior in twins with mental disorders, results case-control gene association studies and genome-wide studies of their suicidality. The genetic and epigenetic causes of discordance in monozygotic twins are considered. The pool of studies that has been formed to date allows us to conclude that suicidal behavior in twins is heritable and early manifests itself as a complex of verbal behavioral predictors. The basis for the formation of suicidal behavior is the accumulation of single nucleotide polymorphisms in the genome, the expression of which is associated with the formation of personality and its traits such as increased aggressiveness, hyperactivity, and attention disorder. Suicidal behavior and severe mental disorders (bipolar depression, schizophrenia) are comorbid, but generally not associated.
Keyword: suicidal behavior, mental disorders, twins, monozygotes, dizygotes, heredity, genome
Lyubov E.B., Zotov P.B. Intentional self-harming behavior in borderline personality disorders. Part II: risk factors. Suicidology. 2023; 14 (4): 39-56. (In Russ / Engl) doi.org/10.32878/suiciderus.23-14-04(53)-39-56
The literature review is based on keyword searches of borderline personality disorder (BPD), non-suicidal self-harm, and suicidal behavior in MEDLINE and PsycINFO for articles since 2000. The review focuses on articles most relevant to the following topics: risk factors non-suicidal (nSB) and suicidal behavior (SB) in patients with borderline personality disorder (BPD); Features of nSB and SB in patients with BPD.
Keywords: borderline personality disorder, suicidal and non-suicidal self- harm
Merinov A.V., Shishkova I.M., Zavalova E.R., Vasil’eva D.M., Provotorova А.О. Self-aggressive profile in adolescence and early youth of young women currently with actual suicidal ideas. Suicidology. 2023; 14 (4): 57-70. (In Russ / Engl) doi.org/10.32878/suiciderus.23-14-04(53)-57-70
The period of adolescence and youth represent a rather stressful time in the development of any person's personality. It is associated with going through many normative and non-normative crisis periods, which, in turn, is associated with the manifestation of anti-vital experiences. The aim of this research is to substantiate the possibility of the end-to-end presence of self-aggressive patterns in individuals of the study group from adolescence and youth to the present time. Objectives: to study the self-aggressive profile of adolescence and youth in young women who currently have active suicidal thoughts; to substantiate the need to develop early options for identifying anti-vital aspirations. Materials and methods. The study involved 63 young women who sought help because of their suicidal thoughts they currently had with the consideration of a specific plan for the implementation of a suicide attempt. The presence of self-aggressive patterns of suicidal and non-suicidal nature at the age of 14-17 years was assessed. We used a questionnaire aimed at identifying self-aggressive patterns and their predictors in the past and present, as well as the Childhood Trauma Questionnaire (CTQ). Statistical analysis and data processing were carried out using the χ2 criterion and the Student's t-test. Mathematical processing was carried out using the SPSS program. Results and their discussion: the studied group is statistically significantly characterized by the presence of suicidal attempts (9.52% vs 0.68%; p<0.05). Suicidal thoughts with consideration of the method of their realization were noted in 71.42% of young women (6.12% in the control group). Self–harm was observed in 20% of the study group (2.04% in the control group). Similar patterns related to the most significant predictors of self-aggressive behavior: obsessive feelings of guilt and shame, periods of hopelessness and low mood (p<0.05 in all cases). Statistically significant differences were also found on the CTQ scales. "Emotional violence" (10.34±2.87 and 6.29±2.07, study and control groups, respectively; p<0.05) and "Physical violence" (7.47±1.37 and 5.91±1.20; p<0.05), which may be related to the formation of the "starting point" of the future self-aggressive trajectories. Conclusions: when suicidal phenomena are detected in the present in young women of student age, similar experiences and patterns are often found in the adolescence and early youth. The formation of a self-aggressive trajectory often occurs much earlier than it is assumed. This fact is not always established, creating a "blind spot" of people with a high suicide risk. It is logical to assume the existence of at least two separate groups of young women who currently have suicidal thoughts: with the presence of a high anamnestic load of anti-vital patterns, and without it, with a predominantly situationally reactive nature of suicidal aspirations.
Keywords: self-aggression, suicidology, suicidal trajectory, suicidogenesis, adolescence and early youth, young women, preventology
Golenkov A.V., Egorova K.A., Taykina Ya.D., Orlov F.V. Suicides among children and adolescents in Russia. Suicidology. 2023; 14 (4): 71-81. doi.org/10.32878/suiciderus.23-14-04(53)-71-81 (In Russ / Engl)
Despite a slight decrease in the number of suicides in the Russian Federation (RF) in recent years, their share in the structure of mortality, especially among the young population, remains significant. For suicide prevention, information about the methods and reasons for voluntary death is important. The aim is to study suicide in children and adolescents in the Russian Federation. Materials and methods. In electronic media published in 70 regions of the Russian Federation in 2003-2022 we managed to collect information on 479 cases of suicides committed by persons aged 8 to 18 (mean age – 14.98±2.38 years), among whom there were 205 girls (15.3±2.01), 274 boys (14.75±2.59). For each case of suicide, socio-demographic indicators of the suicide victim, methods of death, the presence of mental disorders, alcohol (psychoactive substance) use, probable causes and motives were recorded. In the comparative group, information was used on 400 suicide victims aged 19 to 87 (mean age – 38.1±17.9), collected in 79 regions of the Russian Federation in 2002-2021. Mathematical and statistical processing was carried out using descriptive statistics and χ2 distributions. Results. The largest number of adolescent suicides cases (45-199) were collected in the media of the Central, Southern, Northwestern and Volga Federal Districts. Reports describing children suicides (aged 8 to 11) were found in 46 articles (36 boys and 10 girls). The most common methods of suicide among adolescents in the Russian Federation were hanging (56.2%) and falling (jumping) from a height (32.6%). Boys more often committed self-hanging (60.9% vs 49.8% for girls) and self-shooting (4.7% vs 1.0%), while girls resorted to jumping (falling) from a height (39.0% vs 27.7%) and self-poisoning (5.8% vs 0.7%). The most common (57%) causes of suicide in children and adolescents were studies (failed state final exams – Unified State Examination, Unified State Examination, reluctance to study) and conflicts (quarrels) with parents. Differences between gender groups concerned only problems in relationships with the opposite sex (unrequited love), which were more often typical for girls (12.2% vs 5.1%). Mental disorders were indicated in adolescents in isolated reports, as were states of intoxication. Posthumous notes were found in 9.6%, almost three times more often in girls compared to boys (15.1% vs 5.5%). Conclusion. Cases of teenage suicides collected in electronic media in the regions of the Russian Federation confirmed that the main methods (about 90% of all cases) of death are hanging and falling (jumping) from a height. The main causes of suicide among teenagers which account for about 70% of suiceides are: failure to pass state exams, quarrels with parents and bullying (mobbing). Suicides among adolescents and children in the Russian Federation differ from suicides among the adult population.
Keywords: suicide, children, adolescents, methods and causes of suicide, final exams, media, Russia
Garagashev G.G., Mateikovich E.A., Shevlyukova T.P., Fedorov N.M., Zhmurov V.A., Sakharov S.P., Abramova A.V., Topchiu I.F., Umansky E.M. Suicidal behavior in women with breast cancer. Suicidology. 2023; 14 (4): 82-107. (In Russ / Engl) doi.org/10.32878/suiciderus.23-14-04(53)-82-107
А review of the literature on suicidal behavior in patients with breast cancer (BC) is presented. It is noted that breast cancer is a serious disease, in which, from the moment of detection, treatment and the entire subsequent period of observation, many women have an increased risk of suicide, usually twice the population average. Factors associated with the disease (traumatic surgery and its consequences, changes in body image, and, with progression, somatic symptoms such as pain, shortness of breath, decreased ability to self-care), as well as those traditionally characterizing suicidal activity in the population (mental illnesses, loneliness, divorce, etc.), with a minimal role of alcohol and surfactants. The authors draw attention to the fact that despite the high relevance of issues of suicide prevention in cancer patients, there are currently no systematically developed prevention programs implemented at the state and other levels. With the exception of certain initiative territories, a system for identifying, registering and recording suicidal actions of this contingent has not been developed, which does not allow assessing the scale of the problem and calculating the necessary volume and nature of preventive measures. All this indicates the relevance and importance of a deeper study of the issues of suicidal behavior of breast cancer patients, the development and improvement of prevention measures, and their implementation in clinical practice.
Keywords: breast cancer, suicide, suicide attempt, suicidal thoughts, suicide prevention
Zotov P.B., Nevzorova D.V. Suicidal behavior of palliative care patients. Part II: assistance and prevention. Suicidology. 2023; 14 (4): 108-126. (In Russ / Engl) doi.org/10.32878/suiciderus.23-14-04(53)-108-126
The article is devoted to the suicidal behavior of patients in the palliative stage of observation for various diseases. In Part II issues of assessing suicidal risk, features of communication with patients, including sample questions and rules for constructing a conversation during suicidal behavior, forms of psychological support, as well as general and specific preventive measures are considered. The presented materials are in the nature of methodological materials for the practical work of medical personnel with this category of patients.
Keywords: palliative care, palliative patient, suicide, suicidal behavior, suicide prevention