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Life trajectories and burden of adversity: mapping the developmental profiles of suicide mortality

Published online by Cambridge University Press:  18 June 2007

MONIQUE SÉGUIN ,
ALAIN LESAGE ,
GUSTAVO TURECKI ,
MÉLANIE BOUCHARD ,
NADIA CHAWKY ,
NANCY TREMBLAY ,
FRANCE DAIGLE  and
ANDRÉE GUY
MONIQUE SÉGUIN*
Affiliation:
Department of Psychology, Université du Québec en Outaouais, Canada McGill Group for Suicide Studies, Douglas Hospital, McGill University, Canada
ALAIN LESAGE
Affiliation:
Fernand-Seguin Research Centre, Hôpital Louis-H. Lafontaine, Université de Montréal, Canada
GUSTAVO TURECKI
Affiliation:
McGill Group for Suicide Studies, Douglas Hospital, McGill University, Canada
MÉLANIE BOUCHARD
Affiliation:
McGill Group for Suicide Studies, Douglas Hospital, McGill University, Canada
NADIA CHAWKY
Affiliation:
McGill Group for Suicide Studies, Douglas Hospital, McGill University, Canada
NANCY TREMBLAY
Affiliation:
McGill Group for Suicide Studies, Douglas Hospital, McGill University, Canada
FRANCE DAIGLE
Affiliation:
Mental Service Division, New Brunswick, Canada
ANDRÉE GUY
Affiliation:
Mental Service Division, New Brunswick, Canada
*
*Address for correspondence: Monique Séguin, Ph.D., McGill Group for Suicide Studies, Douglas Hospital, Frank B. Common pavilion, 2nd floor, 6875 LaSalle Blvd, Verdun (Quebec), H4H 1R3Canada. (Email: [email protected])
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Abstract

Background

Little is known about differential suicide profiles across the life trajectory. This study introduces the life-course method in suicide research with the aim of refining the longitudinal and cumulative assessment of psychosocial factors by quantifying accumulation of burden over time in order to delineate distinctive pathways of completed suicide.

Method

The psychological autopsy method was used to obtain third-party information on consecutive suicides. Life-history calendar analysis served to arrive at an adversity score per 5-year segment that was then cluster-analysed and correlated to define victim profiles.

Results

Two distinct life trajectories emerged: (1) individuals who experienced childhood traumas, developmental adversity and little protection were more likely to present concurrent psychiatric and Axis II disorders; and (2) individuals who experienced less adversity but seemed more reactive to later major difficulties.

Conclusions

The life calendar approach presented here in suicide research adds to the identification of life events, distal and recent, previously associated with suicide. It also quantifies the burden of adversity over the life course, defining two distinct profiles that could benefit from distinct targeted preventive intervention.

Type
Original Article
Information
Psychological Medicine , Volume 37 , Issue 11 , November 2007 , pp. 1575 - 1583
Copyright
Copyright © Cambridge University Press 2007

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References

REFERENCES

Angst, F., Stassen, H. H., Clayton, P. J. & Angst, J. (2002). Mortality of patients with mood disorders: follow-up over 34–38 years. Journal of Affective Disorders 68, 167–181.CrossRefGoogle ScholarPubMed
Arsenault-Lapierre, G., Kim, C. & Turecki, G. (2004). Psychiatric diagnoses in 3275 suicides: a meta-analysis. BMC Psychiatry 4, 37.CrossRefGoogle ScholarPubMed
Bifulco, A., Brown, G. W. & Harris, T. O. (1994). Childhood experience of care and abuse (CECA): a retrospective interview measure. Child Psychology and Psychiatry 35, 1419–1435.CrossRefGoogle ScholarPubMed
Bifulco, A., Moran, P., Baines, R. & Brown, G. W. (2002). Exploring psychological abuse in childhood. II. Association with other abuse and adult clinical depression. Bulletin of the Menninger Clinic 66, 241–258.Google Scholar
Brent, D. A., Perper, J. A., Moritz, G., Allman, C. J., Roth, C., Schweers, J. & Balach, L. (1993). The validity of diagnoses obtained through the psychological autopsy procedure in adolescent suicide victims: use of family history. Acta Psychiatrica Scandinavica 87, 118–122.Google Scholar
Brière, J. & Runtz, M. (1990). Differential adult symptomatologies associated with three types of childhood abuse. Child Abuse and Neglect 14, 357–364.CrossRefGoogle Scholar
Brown, G. W., Andrews, B., Bifulco, A. & Harris, T. O. (1990). Self-esteem and depression: I. Measurement issues and prediction of onset. Social Psychiatry and Psychiatric Epidemiology 25, 200–209.Google Scholar
Brown, G. W. & Harris, T. O. (1978). Social Origins of Depression: A Study of Psychiatric Disorder in Women. Tavistock: London.Google Scholar
Bryant, S. & Range, M. L. (1995). Suicidality in college women who report multiple versus single types of maltreatment by parents: a brief report. Journal of Child Sexual Abuse 4, 87–94.Google Scholar
Burgess, P., Pirkis, J., Morton, J. & Croke, E. (2000). Lessons from a comprehensive clinical audit of users of psychiatric services who committed suicide. Psychiatric Services 51, 1555–1560.Google Scholar
Caspi, A., Moffitt, T. & Thornton, A. (1996). The life history calendar: a research and clinical assessment method for collecting retrospective event-history data. International Journal of Methods in Psychiatric Research 6, 101–114.Google Scholar
Cassells, C., Paterson, B., Dowding, D. & Morrison, R. (2005). Long- and short-term risk factors in the prediction of inpatient suicide: a review of the literature. Crisis 26, 53–63.Google Scholar
Cheng, A. T., Chen, T. H., Chen, C. C. & Jenkins, R. (2000). Psychosocial and psychiatric risk factors for suicide: case-control psychological autopsy study. British Journal of Psychiatry 177, 360–365.Google Scholar
Conner, K. R., Conwell, Y. & Duberstein, P. R. (2001). The validity of proxy-based data in suicide research: a study of patients 50 years of age and older who attempted suicide. Acta Psychiatrica Scandinavica 104, 204–209.CrossRefGoogle ScholarPubMed
Dohrenwend, B. P. (2006). Inventoring stressful life events as risk factors for psychopathology: toward resolution of the problem of intracategory variability. Psychological Bulletin 132, 477–495.CrossRefGoogle Scholar
Dumais, A., Séguin, M., Tousignant, M., Lesage, A., Lalovic, A., Chawky, N. & Turecki, G. (2005). Is violent method of suicide a behavioral marker of lifetime aggression? American Journal of Psychiatry 162, 1375–1378.Google Scholar
Ensel, W., Peek, M. & Lin, N. (1996). Stress in the life course: a life history approach. Journal of Aging and Health 8, 389–416.Google Scholar
First, M. B., Spitzer, R. L. & Gibbon, M. (1995). The Structured Clinical Interview for DSM-III-R personality disorders (SCID-II). Part I: Description. Journal of Personality Disorders 9, 83–91.CrossRefGoogle Scholar
Forest, K., Moen, P. & Dempster-McKain, D. (1996). The effects of childhood family stress on women's depressive symptoms: a life course approach. Psychology of Women Quarterly 20, 81–100.Google Scholar
Forrest, C. & Riley, A. (2004). Childhood origins of adult health: a basis for life-course health policy. Health Affairs 23, 155–164.CrossRefGoogle Scholar
Hawton, K., Appleby, L., Platt, S., Foster, T., Cooper, J., Malmberg, A. & Simkin, S. (1998). The psychological autopsy approach to studying suicide: a review of methodological issues. Journal of Affective Disorders 50, 269–276.Google ScholarPubMed
Isometsa, E. T. (2001). Psychological autopsy studies: a review. European Psychiatry 16, 379–385.Google Scholar
Jones, B., Nagin, D. & Roeder, K. (2001). A SAS procedure based on mixture models for estimating developmental trajectories. Sociological Methods and Research 29, 374–393.CrossRefGoogle Scholar
Kelly, T. M. & Mann, J. J. (1996). Validity of DSM-III-R diagnosis by psychological autopsy: a comparison with clinician ante-mortem diagnosis. Acta Psychiatrica Scandinavica 94, 337–343.CrossRefGoogle ScholarPubMed
Kendler, K., Gardner, C. & Prescott, C. (2002). Toward a comprehensive developmental model for major depression in women. American Journal of Psychiatry 159, 1133–1145.Google Scholar
Kim, C., Lesage, A., Séguin, M., Vanier, J., Lipp, O., Chawky, N. & Turecki, G. (2003). Patterns of comorbidity in male suicide completers. Psychological Medicine 33, 299–1309.CrossRefGoogle ScholarPubMed
Lesage, A. D., Boyer, R., Grunberg, F., Loyer, M. & Chawky, N. (1994). Suicide and mental disorders: a case-control study of young men. American Journal of Psychiatry 151, 1063–1068.Google Scholar
Lin, N., Ensel, W. & Lai, W. (1997). Construction and use of the life history calendar: reliability and validity recall data. In Stress and Adversity over the Life Course. Trajectories and Turning Points (ed. Gotlib, I. H. and Wheaton, B.), pp. 178–204. Cambridge University Press: New York.Google Scholar
Mann, J. J., Watermaux, C., Haas, G. L. & Malone, K. M. (1999). Toward a clinical model of suicidal behaviour in psychiatric patients. American Journal of Psychiatry 156, 181–189.Google Scholar
McEwen, B. (1998). Protective and damaging effects of stress mediators. Seminars in Medicine of the Beth Israel Deaconess Medical Center 338, 171–179.Google ScholarPubMed
McGinnis, J. M. & Foege, W. H. (1993). Actual causes of death in the United States. Journal of the American Medical Association 270, 2207–2212.CrossRefGoogle ScholarPubMed
Nagin, D. & Tremblay, R. (2001). Analyzing developmental trajectories of distinct but related behaviors: a group-based method. Psychological Methods 6, 18–34.CrossRefGoogle ScholarPubMed
Nagin, D. & Tremblay, R. (2005). What has been learned from group-based trajectory modeling? Examples from physical aggression and other problem behaviors. Annals of the American Academy of Political and Social Sciences 602, 82–117.CrossRefGoogle Scholar
Powers, C. & Peckham, C. (1990). Childhood morbidity and adulthood ill health. Journal of Epidemiology and Community Health 44, 69–74.Google Scholar
Rutter, M. (2002 a). Nature, nurture, and development: from evangelism through science toward policy and practice. Child Development 73, 1–21.CrossRefGoogle ScholarPubMed
Rutter, M. (2002 b). The interplay of nature, nurture and developmental influences: the challenge ahead for mental health. Archives of General Psychiatry 59, 996–1000.CrossRefGoogle ScholarPubMed
Schneider, B., Maurer, K., Sargk, D., Heiskel, H., Weber, B., Frolich, L., Georgi, K., Fritze, J. & Seidler, A. (2004). Concordance of DSM-IV Axis I and II diagnoses by personal and informant's interview. Psychiatry Research 127, 121–136.Google Scholar
Séguin, M., Lesage, A., Guy, A., Daigle, F., Girard, G. & Turecki, G. (2006). Study of suicide cases in New Brunswick from April 2002 to May 2003: the importance of better recognizing substance and mood disorder comorbidity. Canadian Journal of Psychiatry 51, 561–579.Google Scholar
Spitzer, R. L., Williams, J. B., Gibbon, M. & First, M. B. (1992). The Structured Clinical Interview for DSM-III-R (SCID). I: History, rationale, and description. Archives of General Psychiatry 49, 624–629.CrossRefGoogle ScholarPubMed
Tousignant, M., Séguin, M., Lesage, A., Chawky, N. & Turecki, G. (2003). Suicide among men 18 to 55 years of age: life trajectories [in French]. Revue Québécoise de Psychologie 24, 145–159.Google Scholar
Zhang, J., Conwell, Y., Wieczorek, W. F., Jiang, C., Jia, S. & Zhou, L. (2003). Studying Chinese suicide with proxy-based data: reliability and validity of the methodology and instruments in China. Journal of Nervous and Mental Disorder 191, 450–457.Google Scholar
Zouk, H., Tousignant, M., Séguin, M., Lesage, A. & Turecki, G. (2006). Characterization of impulsivity in suicide completers: clinical, behavioural and psychosocial dimensions. Journal of Affective Disorders 92, 195–204.Google Scholar