Unplanned and Planned Suicide Behavior in China

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DESCRIPTION (provided by applicant): Available data indicate that unplanned versus planned acts have different correlates and may require different prevention strategies. However, data are limited by small samples, uncontrolled data, inadequate measures of planning, and samples of attempted suicide (as opposed to suicide). The proposed study overcomes these limitations in a rigorous, controlled investigation. Aim 1 tests the hypotheses that unplanned (versus planned) acts of suicidal behavior are associated with greater acute stress, are more likely to be preceded by a severe life event, but are associated with lower depressive symptoms and lower chronic stress. Aim 2 tests the hypotheses that unplanned acts are associated with younger age and rural (versus urban) residency. In Aim 3, a multivariate model of attempted suicide will be constructed, and correlates of planned versus unplanned suicide attempts will be identified based on the model. To address these aims, in this secondary analysis grant, two large, case-control datasets will be analyzed: 1) 519 suicide decedents and 536 nonsuicide injury death controls, and 2) 312 suicide attempters and 312 living community controls. All data were gathered in China (Phillips, PI). Data on suicides and their injury death controls were gathered to reflect the sociodemography of the general population. Suicide attempters were sampled from a general hospital, and controls were community members matched for gender, age, and location. Data were gathered using rigorous methods. The data sets will be analyzed separately although with the same basic approach - unordered multinomial logistic regression. The study represents a rare opportunity to examine the heterogeneity in attempted suicide and particularly in suicide, with implications for prevention in China where the suicide rate is very high, but also in the U.S. as a continuum of suicidal planning, as well as numerous risk factors, transcend cultures.