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Published in: International Journal of Mental Health and Addiction 2/2021

01-04-2021 | Suicide | Original Article

Gender Characteristics in Methods of Chinese Rural Young Suicides

Authors: Xiaomei Xu, Jie Zhang, Qin Zhou, Long Sun

Published in: International Journal of Mental Health and Addiction | Issue 2/2021

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Abstract

Suicidal men and women tend to use different means for suicide, but there has been a lack of studies on how Chinese male and female suicides are distributed on the various lethal methods. We studied 392 suicides (214 males and 178 females) consecutively sampled from selected rural areas of China, with the psychological autopsy (PA) design. It was found that majority of the Chinese rural young suicides died of swallowing pesticides or other farming chemicals (73.5%), and there was not much difference between men and women in all the suicide means as expected. Contrary to the findings in the USA, firearm was not available to Chinese civilians and was not the number one suicide means for the Chinese male suicides. In rural China, suicides with less violent methods outweighed those with violent methods in numbers, with more females that chose less violent suicide methods than males. However, results of logistic regression showed that there was no significant association between gender and suicide methods in rural China. Mental disorders and impulsivity were also not associated with violent or less violent suicide methods. Our findings indicated that access to suicide means might be most important explanation of suicide methods. These findings may have certain implications on suicide prevention, and researchers and policy makers should take into consideration the contexts of the people at risks of suicide.
Literature
go back to reference Ajdacic-Gross, V., Weiss, M. G., Ring, M., Hepp, U., Bopp, M., Gutzwiller, F., & Rössler, W. (2008). Methods of suicide: international suicide patterns derived from the WHO mortality database. Bulletin of the World Health Organization, 86(9), 726–732.CrossRef Ajdacic-Gross, V., Weiss, M. G., Ring, M., Hepp, U., Bopp, M., Gutzwiller, F., & Rössler, W. (2008). Methods of suicide: international suicide patterns derived from the WHO mortality database. Bulletin of the World Health Organization, 86(9), 726–732.CrossRef
go back to reference Beck, A. T., Weissman, A., Lester, D., & Trexler, L. (1974). The measurement of pessimism: the hopelessness scale. Journal of Consulting and Clinical Psychology, 42(6), 861–865.CrossRef Beck, A. T., Weissman, A., Lester, D., & Trexler, L. (1974). The measurement of pessimism: the hopelessness scale. Journal of Consulting and Clinical Psychology, 42(6), 861–865.CrossRef
go back to reference Beskow, J., Runeson, B., & Asgard, U. (1990). Psychological autopsies: methods and ethics. Suicide and LifeThreatening Behavior, 20, 307–323. Beskow, J., Runeson, B., & Asgard, U. (1990). Psychological autopsies: methods and ethics. Suicide and LifeThreatening Behavior, 20, 307–323.
go back to reference Callanan, V. J., & Davis, M. S. (2011). Gender and suicide method: do women avoid facial disfiguration? Sex Roles, 65(11–12), 867–879.CrossRef Callanan, V. J., & Davis, M. S. (2011). Gender and suicide method: do women avoid facial disfiguration? Sex Roles, 65(11–12), 867–879.CrossRef
go back to reference Callanan, V., & Davis, M. (2012). Gender differences in suicide methods. Social Psychiatry and Psychiatric Epidemiology, 47(6), 857–869.CrossRef Callanan, V., & Davis, M. (2012). Gender differences in suicide methods. Social Psychiatry and Psychiatric Epidemiology, 47(6), 857–869.CrossRef
go back to reference Cavanagh, J. T., Carson, A. J., Sharpe, M., & Lawrie, S. M. (2003). Psychological autopsy studies of suicide: a systematic review. Psychological Medicine, 33(3), 395–405.CrossRef Cavanagh, J. T., Carson, A. J., Sharpe, M., & Lawrie, S. M. (2003). Psychological autopsy studies of suicide: a systematic review. Psychological Medicine, 33(3), 395–405.CrossRef
go back to reference Centers for Disease Control and Prevention. (2004). Suicide and attempted suicide--China, 1990-2002. MMWR: Morbidity and mortality weekly report, 53(22), 481–484. Centers for Disease Control and Prevention. (2004). Suicide and attempted suicide--China, 1990-2002. MMWR: Morbidity and mortality weekly report, 53(22), 481–484.
go back to reference Denning, D. G., Conwell, Y., King, D., & Cox, C. (2000). Method choice, intent, and gender in completed suicide. Suicide and Life-threatening Behavior, 30(3), 282–288.PubMed Denning, D. G., Conwell, Y., King, D., & Cox, C. (2000). Method choice, intent, and gender in completed suicide. Suicide and Life-threatening Behavior, 30(3), 282–288.PubMed
go back to reference Gao, Q., Zhang, J., & Jia, C. (2011). Psychometric properties of the Dickman impulsivity instrument in suicide victims and living controls of rural China. Journal of Affective Disorders, 132(2011), 368–374.CrossRef Gao, Q., Zhang, J., & Jia, C. (2011). Psychometric properties of the Dickman impulsivity instrument in suicide victims and living controls of rural China. Journal of Affective Disorders, 132(2011), 368–374.CrossRef
go back to reference Gunnell, D., Fernando, R., Hewagama, M., Priyangika, W. D. D., Konradsen, F., & Eddleston, M. (2007a). The impact of pesticide regulations on suicide in Sri Lanka. International Journal of Epidemiology, 36(6), 1235–1242.CrossRef Gunnell, D., Fernando, R., Hewagama, M., Priyangika, W. D. D., Konradsen, F., & Eddleston, M. (2007a). The impact of pesticide regulations on suicide in Sri Lanka. International Journal of Epidemiology, 36(6), 1235–1242.CrossRef
go back to reference Gunnell, D., Eddleston, M., Phillips, M. R., & Konradsen, F. (2007b). The global distribution of fatal pesticide self-poisoning: systematic review. BMC Public Health, 7(1), 357.CrossRef Gunnell, D., Eddleston, M., Phillips, M. R., & Konradsen, F. (2007b). The global distribution of fatal pesticide self-poisoning: systematic review. BMC Public Health, 7(1), 357.CrossRef
go back to reference Hawton, K., & van Heeringen, K. (2009). Suicide. The Lancet, 373(9672), 1372–1381.CrossRef Hawton, K., & van Heeringen, K. (2009). Suicide. The Lancet, 373(9672), 1372–1381.CrossRef
go back to reference Hepp, U., Stulz, N., Unger-Koppel, J., & Ajdacic-Gross, V. (2012). Methods of suicide used by children and adolescents. European Child & Adolescent Psychiatry, 21(2), 67–73.CrossRef Hepp, U., Stulz, N., Unger-Koppel, J., & Ajdacic-Gross, V. (2012). Methods of suicide used by children and adolescents. European Child & Adolescent Psychiatry, 21(2), 67–73.CrossRef
go back to reference Hjelmeland, H., Knizek, B. L., & Nordvik, H. (2002). The communicative aspect of nonfatal suicidal behavior--are there gender differences? Crisis, 23(4), 144–155.CrossRef Hjelmeland, H., Knizek, B. L., & Nordvik, H. (2002). The communicative aspect of nonfatal suicidal behavior--are there gender differences? Crisis, 23(4), 144–155.CrossRef
go back to reference Jeon, H. J., Lee, J. Y., Lee, Y. M., Hong, J. P., Won, S. H., Cho, S. J., Kim, J. Y., Chang, S. M., Lee, H. W., & Cho, M. J. (2010). Unplanned versus planned suicide attempters, precipitants, methods, and an association with mental disorders in a Korea-based community sample. Journal of Affective Disorders, 127(1), 274–280.CrossRef Jeon, H. J., Lee, J. Y., Lee, Y. M., Hong, J. P., Won, S. H., Cho, S. J., Kim, J. Y., Chang, S. M., Lee, H. W., & Cho, M. J. (2010). Unplanned versus planned suicide attempters, precipitants, methods, and an association with mental disorders in a Korea-based community sample. Journal of Affective Disorders, 127(1), 274–280.CrossRef
go back to reference Kann, L., McManus, T., Harris, W. A., Shanklin, S. L., Flint, K. H., Hawkins, J., Queen, B., Lowry, R., O'Malley Olsen, E., Chyen, D., Whittle, L., Thornton, J., Lim, C., Yamakawa, Y., Brener, N., & Zaza, S. (2016). Youth risk behavior surveillance - United States, 2015. MMWR Surveillance Summaries, 65(6), 1–174.CrossRef Kann, L., McManus, T., Harris, W. A., Shanklin, S. L., Flint, K. H., Hawkins, J., Queen, B., Lowry, R., O'Malley Olsen, E., Chyen, D., Whittle, L., Thornton, J., Lim, C., Yamakawa, Y., Brener, N., & Zaza, S. (2016). Youth risk behavior surveillance - United States, 2015. MMWR Surveillance Summaries, 65(6), 1–174.CrossRef
go back to reference Kposowa, A., & McElvain, J. (2006). Gender, place, and method of suicide. Social Psychiatry and Psychiatric Epidemiology, 41(6), 435–443.CrossRef Kposowa, A., & McElvain, J. (2006). Gender, place, and method of suicide. Social Psychiatry and Psychiatric Epidemiology, 41(6), 435–443.CrossRef
go back to reference Kraemer, H. C., Measelle, J. R., Ablow, J. C., Essex, M. J., Boyce, W. T., & Kupfer, D. J. (2003). A new approach to integrating data from multiple informants in psychiatric assessment and research: mixing and matching contexts and perspectives. American Journal of Psychiatry, 160(9), 1566–1577.CrossRef Kraemer, H. C., Measelle, J. R., Ablow, J. C., Essex, M. J., Boyce, W. T., & Kupfer, D. J. (2003). A new approach to integrating data from multiple informants in psychiatric assessment and research: mixing and matching contexts and perspectives. American Journal of Psychiatry, 160(9), 1566–1577.CrossRef
go back to reference Li, F., Jia, H., Zeng, J., et al. (2016). Analysis of the differences of gender and age in six suicide methods in 548 cases. Chin J Forensic Med, 31(5), 482–484. Li, F., Jia, H., Zeng, J., et al. (2016). Analysis of the differences of gender and age in six suicide methods in 548 cases. Chin J Forensic Med, 31(5), 482–484.
go back to reference Lin, H.-C., Chen, C.-S., Xirasagar, S., & Lee, H.-C. (2008). Seasonality and climatic associations with violent and nonviolent suicide: a population-based study. Neuropsychobiology, 57(1/2), 32–37.CrossRef Lin, H.-C., Chen, C.-S., Xirasagar, S., & Lee, H.-C. (2008). Seasonality and climatic associations with violent and nonviolent suicide: a population-based study. Neuropsychobiology, 57(1/2), 32–37.CrossRef
go back to reference Paykel, E. S., Prusoff, B. A., & Uhlenhuth, E. H. (1971). Scaling of life events. Archives of General Psychiatry, 25(4), 340–347.CrossRef Paykel, E. S., Prusoff, B. A., & Uhlenhuth, E. H. (1971). Scaling of life events. Archives of General Psychiatry, 25(4), 340–347.CrossRef
go back to reference Phillips, M. R., & Yang, G. (2004). Suicide and attempted suicide in China, 1990-2002. MMWR, 53(22), 481–484. Phillips, M. R., & Yang, G. (2004). Suicide and attempted suicide in China, 1990-2002. MMWR, 53(22), 481–484.
go back to reference Phillips, M. R., Li, X., & Zhang, Y. (2002a). Suicide rates in China. 1995-99. The Lancet, 359, 835–840.CrossRef Phillips, M. R., Li, X., & Zhang, Y. (2002a). Suicide rates in China. 1995-99. The Lancet, 359, 835–840.CrossRef
go back to reference Phillips, M. R., Yang, G., Zhang, Y., Wang, L., Ji, H., & Zhou, M. (2002b). Risk factors for suicide in China: a national case-control psychological autopsy study. The Lancet, 360(9347), 1728–1736.CrossRef Phillips, M. R., Yang, G., Zhang, Y., Wang, L., Ji, H., & Zhou, M. (2002b). Risk factors for suicide in China: a national case-control psychological autopsy study. The Lancet, 360(9347), 1728–1736.CrossRef
go back to reference Shenassa, E. D., Catlin, S. N., & Buka, S. L. (2003). Lethality of firearms relative to other suicide methods: a population based study. Journal of Epidemiology and Community Health, 57(2), 120–124.CrossRef Shenassa, E. D., Catlin, S. N., & Buka, S. L. (2003). Lethality of firearms relative to other suicide methods: a population based study. Journal of Epidemiology and Community Health, 57(2), 120–124.CrossRef
go back to reference Spitzer, R. L., Williams, J. B. W., Gibbon, M., & First, M. B. (1988). Instruction manual for the structured clinical interview for DSM-III-R (SCID, 6/1/88 revision). New York: Biometrics Research Department, New York State Psychiatric Institute. Spitzer, R. L., Williams, J. B. W., Gibbon, M., & First, M. B. (1988). Instruction manual for the structured clinical interview for DSM-III-R (SCID, 6/1/88 revision). New York: Biometrics Research Department, New York State Psychiatric Institute.
go back to reference Sun, J., Guo, X., Ma, J., Zhang, J., Jia, C., & Xu, A. (2011). Seasonality of suicide in Shandong China, 1991–2009: associations with gender, age, area and methods of suicide. Journal of Affective Disorders, 135(1–3), 258–266.CrossRef Sun, J., Guo, X., Ma, J., Zhang, J., Jia, C., & Xu, A. (2011). Seasonality of suicide in Shandong China, 1991–2009: associations with gender, age, area and methods of suicide. Journal of Affective Disorders, 135(1–3), 258–266.CrossRef
go back to reference Swanson, J. W., McGinty, E. E., Fazel, S., & Mays, V. M. (2015). Mental illness and reduction of gun violence and suicide: bringing epidemiologic research to policy. Annals of Epidemiology, 25(5), 366–376.CrossRef Swanson, J. W., McGinty, E. E., Fazel, S., & Mays, V. M. (2015). Mental illness and reduction of gun violence and suicide: bringing epidemiologic research to policy. Annals of Epidemiology, 25(5), 366–376.CrossRef
go back to reference Värnik, A., Kõlves, K., van der Feltz-Cornelis, C. M., Marusic, A., Oskarsson, H., Palmer, A., Reisch, T., Scheerder, G., Arensman, E., Aromaa, E., Giupponi, G., Gusmäo, R., Maxwell, M., Pull, C., Szekely, A., Sola, V. P., & Hegerl, U. (2008). Suicide methods in Europe: a gender-specific analysis of countries participating in the European Alliance Against Depression. Journal of Epidemiology and Community Health, 62(6), 545–551.CrossRef Värnik, A., Kõlves, K., van der Feltz-Cornelis, C. M., Marusic, A., Oskarsson, H., Palmer, A., Reisch, T., Scheerder, G., Arensman, E., Aromaa, E., Giupponi, G., Gusmäo, R., Maxwell, M., Pull, C., Szekely, A., Sola, V. P., & Hegerl, U. (2008). Suicide methods in Europe: a gender-specific analysis of countries participating in the European Alliance Against Depression. Journal of Epidemiology and Community Health, 62(6), 545–551.CrossRef
go back to reference Värnik, A., Kõlves, K., Allik, J., Arensman, E., Aromaa, E., van Audenhove, C., Bouleau, J. H., van der Feltz-Cornelis, C. M., Giupponi, G., Gusmão, R., Kopp, M., Marusic, A., Maxwell, M., Óskarsson, H., Palmer, A., Pull, C., Realo, A., Reisch, T., Schmidtke, A., Sola, V. P., Wittenburg, L., & Hegerl, U. (2009). Gender issues in suicide rates, trends and methods among youths aged 15–24 in 15 European countries. Journal of Affective Disorders, 113(3), 216–226.CrossRef Värnik, A., Kõlves, K., Allik, J., Arensman, E., Aromaa, E., van Audenhove, C., Bouleau, J. H., van der Feltz-Cornelis, C. M., Giupponi, G., Gusmão, R., Kopp, M., Marusic, A., Maxwell, M., Óskarsson, H., Palmer, A., Pull, C., Realo, A., Reisch, T., Schmidtke, A., Sola, V. P., Wittenburg, L., & Hegerl, U. (2009). Gender issues in suicide rates, trends and methods among youths aged 15–24 in 15 European countries. Journal of Affective Disorders, 113(3), 216–226.CrossRef
go back to reference Wang, S., Li, Y., Chi, G., Xiao, S. Y., Ozanne-Smith, J., Stevenson, M., & Phillips, M. R. (2008). Injury-related fatalities in China: an under-recognised public-health problem. The Lancet, 372(9651), 1765–1773.CrossRef Wang, S., Li, Y., Chi, G., Xiao, S. Y., Ozanne-Smith, J., Stevenson, M., & Phillips, M. R. (2008). Injury-related fatalities in China: an under-recognised public-health problem. The Lancet, 372(9651), 1765–1773.CrossRef
go back to reference WHO. (2014). Preventing suicide: a global imperative. Geneva: World Health Organization. WHO. (2014). Preventing suicide: a global imperative. Geneva: World Health Organization.
go back to reference Yip, P., Liu, K., Hu, J., & Song, X. (2005). Suicide rates in China during a decade of rapid social changes. Social Psychiatry and Psychiatric Epidemiology, 40, 792–798.CrossRef Yip, P., Liu, K., Hu, J., & Song, X. (2005). Suicide rates in China during a decade of rapid social changes. Social Psychiatry and Psychiatric Epidemiology, 40, 792–798.CrossRef
go back to reference Zhang, J., & Ma, Z. (2012). Patterns of life events preceding the suicide in rural young Chinese: a case control study. Journal of Affective Disorders, 140(2012), 161–167.CrossRef Zhang, J., & Ma, Z. (2012). Patterns of life events preceding the suicide in rural young Chinese: a case control study. Journal of Affective Disorders, 140(2012), 161–167.CrossRef
go back to reference Zhang, J., Jia, S., Wieczorek, W. F., & Jiang, C. (2002a). An overview of suicide research in China. Archives of Suicide Research, 6, 167–184.CrossRef Zhang, J., Jia, S., Wieczorek, W. F., & Jiang, C. (2002a). An overview of suicide research in China. Archives of Suicide Research, 6, 167–184.CrossRef
go back to reference Zhang, J., Wieczorek, W. F., Jiang, C., Li, Z., Jia, S. H., Sun, Y. J., Jin, S. H., & Conwell, Y. (2002b). Studying suicide with psychological autopsy: social and cultural feasibilities of the methodology in China. Suicide and Life-threatening Behavior, 32(4), 370–379.CrossRef Zhang, J., Wieczorek, W. F., Jiang, C., Li, Z., Jia, S. H., Sun, Y. J., Jin, S. H., & Conwell, Y. (2002b). Studying suicide with psychological autopsy: social and cultural feasibilities of the methodology in China. Suicide and Life-threatening Behavior, 32(4), 370–379.CrossRef
go back to reference 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. The Journal of Nervous and Mental Disease, 191(7), 450–457.CrossRef 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. The Journal of Nervous and Mental Disease, 191(7), 450–457.CrossRef
go back to reference Zhang, X., Hai-Shan, L. I., Qiu-Hong, Z. H. U., et al. (2008). Trends in suicide by poisoning in China 2000-2006: age, gender, method, and geography. Biomedical and Environmental Sciences, 21(3), 253–256.CrossRef Zhang, X., Hai-Shan, L. I., Qiu-Hong, Z. H. U., et al. (2008). Trends in suicide by poisoning in China 2000-2006: age, gender, method, and geography. Biomedical and Environmental Sciences, 21(3), 253–256.CrossRef
Metadata
Title
Gender Characteristics in Methods of Chinese Rural Young Suicides
Authors
Xiaomei Xu
Jie Zhang
Qin Zhou
Long Sun
Publication date
01-04-2021
Publisher
Springer US
Keywords
Suicide
Suicide
Published in
International Journal of Mental Health and Addiction / Issue 2/2021
Print ISSN: 1557-1874
Electronic ISSN: 1557-1882
DOI
https://doi.org/10.1007/s11469-019-00078-1

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