Studying Chinese Suicide With Proxy-Based Data: Reliability and Validity of the Methodology and Instruments in China

Zhang, Jie; Conwell, Yeates; Wieczorek, William F.; Jiang, Chao Qiang; Jia, Shuhua; Zhou, Li

doi:10.1097/01.nmd.0000081613.03157.d9

Cited by 115 publications

(131 citation statements)

References 71 publications

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“…Each of the eight questions has a response range from 0 to 2, and the total score could be from 0 to 16. The Chinese version of the SIS has been validated in an earlier study with good reliability and validity scores (Zhang et al, 2003). In the present sample, the abbreviated Chinese SIS demonstrated acceptable internal consistency (Cronbach's α = 75).…”

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confidence: 74%

Characteristics of Chinese Suicide Attempters: An Emergency Room Study

et al. 2006

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Studying the characteristics of attempted suicide is helpful in knowing the background of some completed suicides and improving prevention or intervention strategies. This current study analyzed data of 74 suicide attempters and 92 accident injured patients admitted to 6 hospital emergency rooms in an area of North-eastern China and found both similarities and differences between Chinese and Western suicide attempters. The data show that more women than men attempted suicide. Perhaps because of the unavailability of firearms to Chinese civilians, pesticide was the most lethal means of suicidal behavior. The stressful life events that account for the majority of suicidal incidents were mostly familial or marital problems. Compared with accident victims, these Chinese suicide attempters were younger, poorer, more likely to believe in a religion/superstition, more likely to perceive gender inequality, and less likely to experience support from either family or community. The traditional culture downplaying the status of women coupled with a belief in the transmigration of life may play an important role in the suicide of Chinese young women.Suicide in China has been a focus of study in recent years partially because of its uniqueness in the demographic structure of the rates-more women than men, more rural people than urban residents, and an astonishing prevalence among youth ages 15-34 (Phillips et al., 2002;Zhang et al., 2004). An optimal way to obtain first-hand knowledge about risk factors and cultural influences would be directly interviewing serious attempters of suicide. In this current study, we try to understand the characteristics and risk factors of Chinese suicide through assessing the overall background of a sample of serious attempters.In the West, it has been estimated that the ratio of suicide attempts to completed suicides is between 6-8 to 1 and 8-25 to 1 (Maris et al., 2000;McIntosh, 1998), and some overlap has been observed between attempts and completed suicides in terms of psychiatric diagnoses and care, history of previous suicide attempts, social disadvantage, and exposure to stressful life events (Beautrais, 2001). However, in the West there are also some differences between suicide attempts and completed suicides. For example, more men than women kill themselves via suicide, but more women than men attempt suicide (Maris et al., 2000). Although only about Few studies have been published on suicide attempters in China. One study (Ran et al., 2003) was based on data collected from a psychiatric elderly sample. To know more about the Chinese suicide, we need also to study the attempters from a general population, because a much lower percentage of completed suicides in China have been observed with psychiatric disorders than that found in the West (Phillips et al., 2002;Zhang et al., 2004). This current research project explores the characteristics of Chinese suicide attempters from non-psychiatric populations Method RespondentsRespondents were consecutively sampled serious attempters...

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Characteristics of Chinese Suicide Attempters: An Emergency Room Study

et al. 2006

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Section: Instrumentsmentioning

confidence: 99%

“…Previous studies have tried to account for this uniqueness in Chinese suicide through physiological and psychological differences between men and women (Zhang et al, 2003;Zhang, Yeates, Li, & Chao, 2004), the means employed in the fatal act (Phillips et al, 2002), as well as the low status of Chinese women in Chinese societies (Ji, 2000). However, those studies have offered either incomplete or biased explanations on why Chinese women are more likely than Chinese men to kill themselves.…”

Section: Introductionmentioning

confidence: 99%

“…Each of the eight questions has a response range from 0 to 2, and the total score of the SIS could be from 0 to 16. The Chinese version of the Suicide Intent Scale we use in the current study has been earlier validated in China (Zhang et al, 2003).Religiosity is measured by two items. For the question "Do you believe in any of the following religions," a respondent's choice can be "None," or "Buddhism," Daoism," "Islam," "Protestant," "Catholicism," or "Other."…”

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The Effects of Religion, Superstition, and Perceived Gender Inequality on the Degree of Suicide Intent: A Study of Serious Attempters in China

Zhang

2007

Omega (Westport)

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Previous studies have tried to account for the uniqueness of gender ratios in Chinese suicide through physiological and psychological differences between men and women, and the means employed in the fatal act. From the point of view of the socio-psychological traits, this study examines the effects of religion (religiosity), superstition, and perceived gender inequality among Chinese women on the degree of their suicide intent. A four-page structured interviews were performed to the consecutively sampled serious attempters of suicide hospitalized to emergency rooms immediately after the suicidal act in Dalian areas, China. Both univariate analyses and the multiple regression model have found that the higher the degree the religiosity and superstition on metempsychosis, the stronger the suicide intent Chinese women had. The perceived gender inequality is positively correlated with suicide intent, and it is especially true for Chinese women. The socio-psychological traits and traditional culture values and norms have important impacts on suicide patterns in Chinese societies.Chinese suicide rates are distinguishable in the gender ratios: Chinese women are at higher risk of suicide than Chinese men (Phillips, Li, & Zhang, 2002;Zhang, 2000), while the reverse is found elsewhere in the world (Brockington, 2001;Pritchard, 1996). Previous studies have tried to account for this uniqueness in Chinese suicide through physiological and psychological differences between men and women (Zhang et al., 2003;Zhang, Yeates, Li, & Chao, 2004), the means employed in the fatal act (Phillips et al., 2002), as well as the low status of Chinese women in Chinese societies (Ji, 2000). However, those studies have offered either incomplete or biased explanations on why Chinese women are more likely than Chinese men to kill themselves. In this current study, we aim at providing another perspective to understand the Chinese phenomenon.We test our research hypotheses in suicidology by studying people who have seriously attempted suicide in the absence of suicide cases, based on the evidence that suicides and attempters are from two tightly overlapping populations (Beautrais, 2001) and it is greatly possible to assess the characteristics of suicides by studying attempters from the same general population. Maris et al. (2000) proposed a 10-level continuum of suicidality from the lowest to the highest suicidality, in which a serious suicide attempt that requires emergency room treatment is just one step before completed suicide. However, the degree of NIH Public AccessAuthor Manuscript Omega (Westport). Author manuscript; available in PMC 2011 November 1. suicide intent of all those admitted to emergency rooms may vary and the intensity of suicide intent may relate to some socio-psychological traits.In a study on race, religion, and female suicide attempters, Kok (1988) compared suicide attempt rates in Chinese, Malay, and Indian women in Singapore and did not find that a comparatively low rate of attempted suicide in Chinese women was ...

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“…1.3.4 Personality traits Since unplanned and "impulsive" suicide was common in China [37] and proxy (informant)-based personality assessments were reliable [38][39] ,variables related to personality traits were also collected in the second-round interview with the Chinese version of E and N domains from the 88-items of Eysenck's personality questionnaire (EPQ). Using these two domains, we defined four quadrants of personality traits, i.e., stable extraverts, unstable extraverts, stable introverts, and unstable introverts.…”

Section: Psychiatric Factorsmentioning

confidence: 99%

Prevalence and risk factors of suicide in a rural area of Shandong province in mainland China: a case control study

Liu

Sun

et al. 2015

国际公共卫生杂志

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Objective: Suicide is a major public health problem in China, particularly in rural areas. This study aimed to examine the rate and the risk factors for suicide in a rural area of China. Methods: The mortality data of two counties in Shandong Province from January 1st, 2004 to December 31st 2005 were used. Death information was collected via face-to-face interview with informant(s). Psychological autopsy was conducted on 137 completed suicides and 137 matched controls died from other illnesses. Chisquare/Fisher exact and multiple logistic regression were used for bivariate analyses and predictor analyses, respectively. Results: The suicide rate was 20.90 per 100,000 persons per year with almost equal rates of males and females. Among those with the age over 40 years old, the suicide rate in males was significantly higher than that in females. The peak of suicide fell in the age group of 70-79 years for males and the age group of ≥ 80 years for females. The most commonly used method for suicide was pesticide ingestion (76.7%). Poor interpersonal relationship (OR=12.79), childhood adversities (OR=7.26), a history of mental illness (OR=5.95), adverse life event(s) within 1 year prior to death (OR=3.19), and unstable extravert personality traits (OR=6.12) were independent risk factors for suicide. Male gender positively interacted with majority of these risk factors, especially with a history of mental illness (OR=17.89). Advanced age positively interacted with all independent risk factors, with a history of mental illness having the largest OR of 1.51 as every 10 year of age advancement. In bivariate analyses, a history of previous suicide attempt (OR=13.06), a family history of suicide (OR=7.08), and unstable introvert personality trait (OR=1.83) were also associated with increased risk for suicide; and stable extravert personality trait (OR=0.21) was associated with decreased risk for suicide. Conclusions: In this rural population of mainland China, the risk for suicide was almost equal in both males and females with the elderly having the highest risk. The positive interactions of advanced age and male gender with independent risk factors suggest that suicide prevention strategies targeting specific groups with different risk factors are essential.

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Studying Chinese Suicide With Proxy-Based Data: Reliability and Validity of the Methodology and Instruments in China

Cited by 115 publications

References 71 publications

Characteristics of Chinese Suicide Attempters: An Emergency Room Study

Characteristics of Chinese Suicide Attempters: An Emergency Room Study

The Effects of Religion, Superstition, and Perceived Gender Inequality on the Degree of Suicide Intent: A Study of Serious Attempters in China

Prevalence and risk factors of suicide in a rural area of Shandong province in mainland China: a case control study

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