Contagion from peer suicidal behavior in a representative sample of American adolescents

Is Cumulative Exposure to Suicide Attempts and Deaths a Risk Factor for Suicidal Behavior Among Firefighters? A Preliminary Study

“…While the present study and the study by Stanley et al. did not include any nonfirefighters for comparative purposes, it is clear that the rates of exposure reported by firefighters are substantially higher than those observed among nonfirefighter samples, where rates have generally ranged from 7% to 64% (e.g., Cerel et al., , ; Crosby & Sacks, ; Leonard & Flinn, ; Randall et al., ).…”

“…Prior research suggests that 7% to 47% of individuals in the general population have been exposed to at least one suicide death (e.g., Cerel, Maple, Aldrich, & van de Venne, ; Cerel et al., ; Crosby & Sacks, ; Leonard & Flinn, ) and that 19% to 64% have been exposed to at least one suicide threat or attempt (Cerel et al., ; Leonard & Flinn, ; Randall, Nickel, & Colman, ). Furthermore, multiple studies suggest that exposure to suicide attempts and deaths increases risk for suicidal behavior (Cerel et al., ; Pitman, Osborn, King, & Erlangsen, ; Stanley et al., ; Van Orden et al., ).…”

“…There are currently approximately 1.1 million firefighters in the United States (National Fire Protection Association, 2015). These brave men and women routinely respond to life-threatening situations, such as fires, motor vehicle accidents, and medical emergencies, including suicide attempts and deaths (Corneil, Beaton, Murphy, Johnson, & Pike, 1999;Stanley, Hom, Hagan, & Joiner, 2015). While the prevalence of death by suicide among firefighters is not currently known, there is growing concern that firefighters may be at increased risk for suicidal behavior due to (1) multiple instances of suicide clustering among firefighters during the past 5 years (Finney, Buser, Schwartz, Archibald, & Swanson, 2015); (2) recent survey findings indicating high rates of suicidal behavior among firefighters (Stanley et al, 2015); and (3) prior research suggesting that firefighters are at elevated risk for mental health conditions known to increase risk for suicide and suicidal behavior (e.g., Corneil et al, 1999;North et al, 2002).…”

“…An additional risk factor for suicidal behavior that has only recently begun to be explored among firefighters is exposure to suicide attempts and deaths (Stanley et al, 2015). The interpersonal theory of suicide suggests that cumulative exposure to suicide attempts and death should increase firefighters' risk for suicidal behavior by increasing their acquired capability for suicide (Joiner, 2005;Van Orden et al, 2010).…”

“…Acquired capability can be defined as increased tolerance of physical pain as well as decreased fear of death and/or bodily harm (Joiner, 2005;Nock, Joiner, Gordon, Lloyd-Richardson, & Prinstein, 2006). Consistent with the interpersonal theory of suicide, there is substantial evidence that repeated exposure to painful and provocative experiences (e.g., nonsuicidal self-injury, exposure to suicide) is associated with both acquired capability for suicide and suicidal behavior (e.g., Stanley et al, 2015;Van Orden et al, 2010;Willoughby, Heffer, & Hamza, 2015).…”