- Email: [email protected]
Attempted suicide—Its social significance and effects
Book
rev1ews
61
As httle worthwhile came out from factors of a soc1omed1cal nature m certain groups of diseases” “detaded systematic information on the family the data, the same material was used to provide conditions and entire environments during childhood of a certain group of patients” 1n the Damsh provincial town of Aarhus A major defect 1s that no proper control groups were obtamed for the bulk of the results, and recourse to other recent or contemporary social investigations had to be made The study nevertheless contains some mterestmg information The material consists of 1066 patients (819 adults, 247 children) adm1tted for the first time during 1950-1953 to a skin and venereal diseases hospital In addition to the 1066 patients, 381 parents of the hospitalized chddren were Interviewed The series of adult patients was divided into rl larger group with skin diseases (698 1ndlr1duals) and a smaller group with venereal diseases (121 subjects) The series was contrasted with the general population of Aarhus (for which recent census figures were available) and found comparable with regard to age, marital status, occupational conditions and membership of the healthinsurance societies who are admitted to a hospltdl The author was able to dnsvver such questions as “Do patients department represent an ordinary cross-section of the community, viz those who fall 111 and need treatment, or do they, on essential points differ from the population in general vv1th regard to growth concht1ons social status, family affairs. education and housing during childhood ’ He found that patients adm1tted to the parttcular hospital 1ep1esented an ordinary cross-sect1on Surprisingly 1t of the commumty More specnically the relation to ‘broken homes’ was considered was tound that 40 per cent of both the patients and the parents of the hosp1tahzed children came from It was ‘assumed ’ that this reflected the state of affairs prevaihng 1n the general broken homes population It was also noted that irrespective of broken or unbroken homes, there 1s a definite relation between emotional traumata and nervous complaints of dll types The only data quoted from the or1gmal investigation IS thdt children wrth Besnler’s prur1go (atopic dermatitis) come principally from unbroken homes and women with leg ulcers ha11 chiefly from poor homes Of some interest 1s the finding that the incidence of behav1our disorders (enures1s, na1Lb1t1ng and paver nocturnus) was identical (60-70 per cent) 1n both the hosp1tahzed children and 1n a normal control series of school childlen The high incidence of behav1our disorders 1n so-called normal children may come as a surprise to many readers The monograph 1s agreeably produced and uell tabulated For a subject so large, there are strikingly few references E MARLEY
E STENGEL and NANCY G COOK Monographs No 4 Published 136 pp ,25s
Attempted Smclde-Its Sonal Slgmficance for the Institute of Psychiatry by Chapman
and Effects Maudsley &Hall, London, 1958
STUDIES of attempted suicide have tended to adhere to a rather stereotyped recital of psychlatrlc diagnoses and alleged causes of the attempt in d series of cases This book mtloduces a refreshmg change of approach, new notions regardIn: attempted sulclde and some brand xw facts The alms of Professor STENGEL s 1esearch we1e to examine h1s contention that the1e a1e problems pecuhar to attempted sulclde by which this act may be dlstmgulshed fi om suicide, and m particular , he undertook to study the social circumstdnces and effects of the suicide attempt and to compare these ulth sulclde The method 1s chmcal and descrlptlte, statlstlcs being dehberately shunned although most of the lmpol tant data are, In fact, tabulated Among the many admirable features of the design of this enqun-y were first, that a number of samples of attempted suicide v,ere examined, so that the authors amassed a composite group of attempted sulclde which might reasonably be expected to reflect more tl uthfully the characterlstlcs of the attempted suicide population Secondly, that each sample was chosen and studled so as to elucidate d particular aspect of the problem The first two samples, therefore, were follow-ups of suicide &tempts which had been ddmitted some years pre\~ously to an obserbatlon ward and to the Bethlem Royal and Maudsley Hospltdk these samples here well suited to Investigate the social consequences of the orlgmal attempt, the mcldence of subsequent suicide 01 The third and fourth samples were patients admitted to two observasuicide attempt, and of Illness tion wards serving two different ptipulations They enabled the social circumstances and behavlour
62
Book
reviews
of the patient at the time of the attempt to be studied, and also the degree of danger and Intent among attempted suicides The fifth sample was of admissIons to a genera1 hospital, and these sulclde attempts were compared with those sent to the observation wards The third and most slgmficant feature of their design was that many of these characterlstlcs of attempted sulclde were compared with a sample of suicides Detaded mtervlews were obtained with the relatives and patients composmg the fin st tuo samples The authors found that the suicide attempt resulted m a very defimte and often salutary change m the patient’s relatlonshlps with others These observations led STENGEL to formulate the mterestmg notton that the sulclde attempt 1s m the nature of an appeal to the human emlronment and that this IS one of the primary functions of the sulcldal attempt Considerable evidence IS adduced for this blew, among which was the valuable finding that remarkably few sulclde attempts are folloued by fatal sulcldal acts, although subsequent trlfer~pjs were not uncommon The authors’ analysis of the site of the sulcldal dct m relation to the social field, the extent to whrch the would-be sulclde was alone or movmg towards others a? the time of the attempt, and of the agent interkenmg, 1s of great interest Slmdarly, there Is a \Juable assessment of intent and dangerousness m the different samples and dragnostlc groups The comparisons made between sulcldes and attempted suicides are particularly important Flgutes for age, sex, marital status, social class, Isolation, methods, site of the sulcldal act, movement and degree of lsolatlon durmg It and dlagnosls are given for both groups but no analysis of these findings 1s made I do not agree with the authors’ kery diffident attitude towards these figures The consequence of their posltlve averston to then- statlstlcs has been that their data are presented less effectively than they deserve, and that their findmgs are deprlked of their full value For example, they stress that because then samples are not representatne no general conclusion should be drawn from their figures, although it seems to me that It 1s lustlfidble to do so If the age dlstrlbutlons of four of their samples are compared-see Table 30 and omlttmg the Mdudsley group as it IS selected for age--lt IS found that the differences between them ate not slgndicant, but there IS a highly slgmficdnt dlfferer,ce between the ages of these samples and those of the suicides It IS likely, therefore (a)that their samples truly represent thdt population of attempted suicides whtch are viewed sufficiently seriously by the commumty to warrant tahmg some positive action-to establish this 1s most relevant to their whole text, (b) the differences betKeen the suicides and attempted sulcldes m age dlstrlbutlon 1s concrete evidence for one of the crucial problems they are examining (that the two sulclde populations are dlstmct) S~m&trly, the differences m the sex dlstnbutlon, the degrees of bemg alone, and of categories of mental disorder as melI ds the mcldence of psychoses, reactive depression and psychopathy In the sulclde and attempted suicide groups here, on my calculations, all ~u@icantly different, eken when those samples are included m which the selectton IS known to be acting contrary to the hypothesis that the two populations dre different It IS, perhaps, mapposlte to make these points when the authors affirm that a statistical analysis of the samples was not one of their putposes, but the thirty-three very mterestmg tables they pubhsh lnvlte exploration I believe this IS an outstandmg and stlmulatmg contrlbutlon to the subJect of sulclde which wdl certamly be very widely read and commented upon P SAJNSBURY
J B RHINE and .I G PRATT Parapsychology 1951 IX -1 220 pp , 37s 6d
Frontier
Sclence
of the Mmd
Blackwell,
Oxford,
THIS latest survey of experlmentnl work on extra-sensory perception deserves careful conslderdtlon The authors are respectively Du-ector and Assistant as coming straight from the horses’ mouth Director of the Parapsychology Laboratory dt Duke Umverslty, N Carolma The book sets out to explam the methods of card guessing and dice thro\\mg thdt have now been m regular use for years by those concerned with PSI effects It 13 not so much a survey of the evidence as a text book of methods, a sot-t of do-It-yourself mstructlon book Readers accustomed to deslgnmg psychologlcdl experiments will find It elementary m the extreme, but at the end of each chapter there dre useful lists of references to orlginal reports
rev1ews
61
As httle worthwhile came out from factors of a soc1omed1cal nature m certain groups of diseases” “detaded systematic information on the family the data, the same material was used to provide conditions and entire environments during childhood of a certain group of patients” 1n the Damsh provincial town of Aarhus A major defect 1s that no proper control groups were obtamed for the bulk of the results, and recourse to other recent or contemporary social investigations had to be made The study nevertheless contains some mterestmg information The material consists of 1066 patients (819 adults, 247 children) adm1tted for the first time during 1950-1953 to a skin and venereal diseases hospital In addition to the 1066 patients, 381 parents of the hospitalized chddren were Interviewed The series of adult patients was divided into rl larger group with skin diseases (698 1ndlr1duals) and a smaller group with venereal diseases (121 subjects) The series was contrasted with the general population of Aarhus (for which recent census figures were available) and found comparable with regard to age, marital status, occupational conditions and membership of the healthinsurance societies who are admitted to a hospltdl The author was able to dnsvver such questions as “Do patients department represent an ordinary cross-section of the community, viz those who fall 111 and need treatment, or do they, on essential points differ from the population in general vv1th regard to growth concht1ons social status, family affairs. education and housing during childhood ’ He found that patients adm1tted to the parttcular hospital 1ep1esented an ordinary cross-sect1on Surprisingly 1t of the commumty More specnically the relation to ‘broken homes’ was considered was tound that 40 per cent of both the patients and the parents of the hosp1tahzed children came from It was ‘assumed ’ that this reflected the state of affairs prevaihng 1n the general broken homes population It was also noted that irrespective of broken or unbroken homes, there 1s a definite relation between emotional traumata and nervous complaints of dll types The only data quoted from the or1gmal investigation IS thdt children wrth Besnler’s prur1go (atopic dermatitis) come principally from unbroken homes and women with leg ulcers ha11 chiefly from poor homes Of some interest 1s the finding that the incidence of behav1our disorders (enures1s, na1Lb1t1ng and paver nocturnus) was identical (60-70 per cent) 1n both the hosp1tahzed children and 1n a normal control series of school childlen The high incidence of behav1our disorders 1n so-called normal children may come as a surprise to many readers The monograph 1s agreeably produced and uell tabulated For a subject so large, there are strikingly few references E MARLEY
E STENGEL and NANCY G COOK Monographs No 4 Published 136 pp ,25s
Attempted Smclde-Its Sonal Slgmficance for the Institute of Psychiatry by Chapman
and Effects Maudsley &Hall, London, 1958
STUDIES of attempted suicide have tended to adhere to a rather stereotyped recital of psychlatrlc diagnoses and alleged causes of the attempt in d series of cases This book mtloduces a refreshmg change of approach, new notions regardIn: attempted sulclde and some brand xw facts The alms of Professor STENGEL s 1esearch we1e to examine h1s contention that the1e a1e problems pecuhar to attempted sulclde by which this act may be dlstmgulshed fi om suicide, and m particular , he undertook to study the social circumstdnces and effects of the suicide attempt and to compare these ulth sulclde The method 1s chmcal and descrlptlte, statlstlcs being dehberately shunned although most of the lmpol tant data are, In fact, tabulated Among the many admirable features of the design of this enqun-y were first, that a number of samples of attempted suicide v,ere examined, so that the authors amassed a composite group of attempted sulclde which might reasonably be expected to reflect more tl uthfully the characterlstlcs of the attempted suicide population Secondly, that each sample was chosen and studled so as to elucidate d particular aspect of the problem The first two samples, therefore, were follow-ups of suicide &tempts which had been ddmitted some years pre\~ously to an obserbatlon ward and to the Bethlem Royal and Maudsley Hospltdk these samples here well suited to Investigate the social consequences of the orlgmal attempt, the mcldence of subsequent suicide 01 The third and fourth samples were patients admitted to two observasuicide attempt, and of Illness tion wards serving two different ptipulations They enabled the social circumstances and behavlour
62
Book
reviews
of the patient at the time of the attempt to be studied, and also the degree of danger and Intent among attempted suicides The fifth sample was of admissIons to a genera1 hospital, and these sulclde attempts were compared with those sent to the observation wards The third and most slgmficant feature of their design was that many of these characterlstlcs of attempted sulclde were compared with a sample of suicides Detaded mtervlews were obtained with the relatives and patients composmg the fin st tuo samples The authors found that the suicide attempt resulted m a very defimte and often salutary change m the patient’s relatlonshlps with others These observations led STENGEL to formulate the mterestmg notton that the sulclde attempt 1s m the nature of an appeal to the human emlronment and that this IS one of the primary functions of the sulcldal attempt Considerable evidence IS adduced for this blew, among which was the valuable finding that remarkably few sulclde attempts are folloued by fatal sulcldal acts, although subsequent trlfer~pjs were not uncommon The authors’ analysis of the site of the sulcldal dct m relation to the social field, the extent to whrch the would-be sulclde was alone or movmg towards others a? the time of the attempt, and of the agent interkenmg, 1s of great interest Slmdarly, there Is a \Juable assessment of intent and dangerousness m the different samples and dragnostlc groups The comparisons made between sulcldes and attempted suicides are particularly important Flgutes for age, sex, marital status, social class, Isolation, methods, site of the sulcldal act, movement and degree of lsolatlon durmg It and dlagnosls are given for both groups but no analysis of these findings 1s made I do not agree with the authors’ kery diffident attitude towards these figures The consequence of their posltlve averston to then- statlstlcs has been that their data are presented less effectively than they deserve, and that their findmgs are deprlked of their full value For example, they stress that because then samples are not representatne no general conclusion should be drawn from their figures, although it seems to me that It 1s lustlfidble to do so If the age dlstrlbutlons of four of their samples are compared-see Table 30 and omlttmg the Mdudsley group as it IS selected for age--lt IS found that the differences between them ate not slgndicant, but there IS a highly slgmficdnt dlfferer,ce between the ages of these samples and those of the suicides It IS likely, therefore (a)that their samples truly represent thdt population of attempted suicides whtch are viewed sufficiently seriously by the commumty to warrant tahmg some positive action-to establish this 1s most relevant to their whole text, (b) the differences betKeen the suicides and attempted sulcldes m age dlstrlbutlon 1s concrete evidence for one of the crucial problems they are examining (that the two sulclde populations are dlstmct) S~m&trly, the differences m the sex dlstnbutlon, the degrees of bemg alone, and of categories of mental disorder as melI ds the mcldence of psychoses, reactive depression and psychopathy In the sulclde and attempted suicide groups here, on my calculations, all ~u@icantly different, eken when those samples are included m which the selectton IS known to be acting contrary to the hypothesis that the two populations dre different It IS, perhaps, mapposlte to make these points when the authors affirm that a statistical analysis of the samples was not one of their putposes, but the thirty-three very mterestmg tables they pubhsh lnvlte exploration I believe this IS an outstandmg and stlmulatmg contrlbutlon to the subJect of sulclde which wdl certamly be very widely read and commented upon P SAJNSBURY
J B RHINE and .I G PRATT Parapsychology 1951 IX -1 220 pp , 37s 6d
Frontier
Sclence
of the Mmd
Blackwell,
Oxford,
THIS latest survey of experlmentnl work on extra-sensory perception deserves careful conslderdtlon The authors are respectively Du-ector and Assistant as coming straight from the horses’ mouth Director of the Parapsychology Laboratory dt Duke Umverslty, N Carolma The book sets out to explam the methods of card guessing and dice thro\\mg thdt have now been m regular use for years by those concerned with PSI effects It 13 not so much a survey of the evidence as a text book of methods, a sot-t of do-It-yourself mstructlon book Readers accustomed to deslgnmg psychologlcdl experiments will find It elementary m the extreme, but at the end of each chapter there dre useful lists of references to orlginal reports