July 13, 2001 -- It's happened before. A celebrity overdoses, and fans nationwide make suicide attempts of their own. At least that's the current thinking, but a new study from the CDC says we could be wrong -- that knowledge of, or exposure to, a suicide really protects against copycat attempts.
"Contrary to our expectations, we found that exposure [to suicide] may have beneficial consequences under certain circumstances," says author James Mercy, MD, of the division of violence prevention at the National Center for Injury Prevention and Control.
In a study published in the July 15 American Journal of Epidemiology, Mercy and colleagues compared exposure to suicide among 153 suicide attempters, aged 13-34, in Harris County, Texas, and 513 people randomly selected from the same community. Exposure to suicide included suicides by friends, family, and media icons.
They found that exposure actually appears to protect people from committing suicide -- providing the exposure was not recent or emotionally close, Mercy says.
If people are far enough removed from the suicide -- both emotionally, and in terms of time -- Mercy suggests they gain an objective perspective on the death that allows them to think about the full consequences of suicide.
"The most likely interpretation is that the [suicide] will be seen as inappropriate or incomprehensible, the less close one is to the person [with] the suicidal behavior," he says.
Conversely, being emotionally close to the suicide victim -- in combination with glorification of the suicide -- could prompt some at-risk individuals to imitate the behavior. For that reason, Mercy says the findings may not so much contradict previous studies as provide a more rounded picture of the relationship between suicide and exposure.
According to the study, people who were exposed to the suicide of a parent were more likely to attempt to kill themselves. But even in those situations, the association disappeared when researchers took into account prominent risk factors for suicide. These risk factors include depression, alcoholism, and having recently moved from one geographic location to another.
Suicide attempters in the study had tried what researchers call "nearly lethal" suicides -- attempts that are deemed as serious efforts to kill oneself. Mercy says the study did not look at suicide attempts that were more cries for help than serious attempts at killing oneself.
According to the CDC, the number of completed suicides reflects only a small portion of the impact of suicidal behavior. In 1994, an estimated 10.5 million adults (about 6% of the adult population in the U.S.) reported having seriously considered suicide during the previous year, according to the agency. Over 30,000 people die by suicide, and it is the third-leading cause of death among people aged 15-24.
Mercy suggests that people who witness or are exposed to suicide need to reflect on all of the terrible consequences -- for family, friends and others -- of the act.
"People tend to talk about the positive aspects of the person who committed suicide," Mercy tells WebMD. "A vulnerable person hearing that may choose to imitate the behavior, whereas if they fully understand the negative consequences they are less likely to."
Psychiatrist Alvin Poussaint, MD, says the study results are surprising and indicate a need for more research.
Poussaint, professor of psychiatry at Harvard Medical School in Boston, says he wonders if there could be crucial differences between "near-lethal" suicides that were averted by emergency medical care and successful suicides that never made it to the ER. "It's a good study, but you can't say from this that there is no relationship between successful suicides and previous exposure," he says.