Ct'I.LIFORNIA STATE Ui'JIVERSITY, NORTHRIDGE
YOU'IH SUICIDE
/c
SIX COl1PARATIVE CASE STUDIES
A thesis submitted in partial satisfaction of the
requir-ements for the degr-ee of t-fas ter of f\rts 1n
Education, Educational Psychology
Counseling and Guidance
by
-
Julie Diller
January, 1980
p
The Thesis of Julie Diller is approved:
Ezra Wyeth, Ph.D.
Robert E. Litman, M.D.
Loren Grey, Ph:D.
California State University, Northridge
'
TABLE OF CONTENTS
Page
ABSTRACT.
ii
Chapter
I.
II.
III.
IV.
V.
VI.
VII.
VIII.
IX.
XI.
INTRODUCTION TO THE PROBLEM .
1
REVIEW OF THE LITERATURE . .
3
THEORY . .
13
HYPOTHESES.
17
HETHODS OF PROCEDURE. .
20
CASE PRESENTATIONS AND EVALUATIONS.
.
27
CONCLUSIONS AND DISCUSSION.
66
RECOMMENDATIONS .
73
REFERENCES .
76
TABLES . .
80
APPENDIX.
.
82
ABSTRACT
YOUTH SUICIDE
SIX COMPARATIVE CASE STUDIES
by
Julie Diller
Masters of Arts in Educational Psychology
Youth suicide has increased markedly in the past ten
years.
.r-1u1 tiple suggestions have been offered by national
and international researchers regarding why the young people
of today are killing themselves.
I have chosen to study and evaluate six case studies
in depth concerning how the factors of early family history
and childhood development/ peer relationships, birth order
factor, and future orientation may have played a role in
these young personSs choosing suicide.
In addition, I dis-
cussed the communications that were expressed by the victims who were contemplating suicide and how these communications were all too often ignored by the significant
others in the victim's lives.
To add interest and comparative information to my
study, I also investigated the life circumstances of a
living peer of each suicide victim, ·in order to learn hov;r
significant circumstances differed and may have been critical reasons why that living peer was not suicide oriented
ii
even though he or she may have shared similar stresses and
problems with the suicidal youth.
Finally,.I offered recommendations for prevention
and intervention techniques that can be useful guidelines
in helping family and community .alleviate the youth suicide
problem.
iii
CHAPTER I
HlTRODUCTION TO THE PROBLEM
Suicide rates for young people have risen dramatically in recent years.
In a comprehensive review of cur-
rent trends in suicidal behavior in the United States,
Frederick (1978) called special attention to the striking
increase in suicide occurring among young age groups, emphasizing the need for extensive research, training, and
intervention programs,.
In the United States, the suicide rate for the age
groups 15-24 years, including both sexes, was 6 per 100,000
in 1920, and has fluctuated since then between a high of 7
per 100,000 in 1932, and a low of 4 per 100,000 in 1957.
Since 1960, there has been a persistent rise in the suicide
rate of young persons to an all-time high in 1975 of 12.2
per 100,000 (National Center, Health Statistics, 1976).
For the United States as a whole, in 1975, there
were no suicides of children under age 10 years.
Recorded
suicides by age are as follows:
.Ages
10-14 years
170 suicides
Ages
15-19 years
1,594 suicides
Ages
20-24 years
3,142 suicides
1
2
Cor.sistent with national statistics, the suicide
rate in Los Angeles County rose precipitously in 1965-1970
in the adolescent and young adult age group.
A good pro-
portion of that rise seemed to be attributable to an increase in suicide in young females and Blacks.
By 1976,
that high rate of increase for these two populations had
tapered off.
be very high.
The rate of White male suicides continues to
In addition, the numbers of very young per-
sons (those under age 14 years) who have committed suicide
seem to have increased in the last ten years.
(Peck, 1978).
CHAPTER II
REVIEW OF THE LITERATURE
European Studies
Detailed investigations of completed suicides in
young persons were conducted in Europe.
ported on
~5
Pales (1974) re-
youthful suicides in Switzerland.
Eighty-five
per cent of these suicides occurred in families that were
divorced.
The proportion of males to females was twenty-two
to three.
Pales emphasized the role of puberty crisis in
sensitive youths.
Milcinsky (1974) in Yugoslavia, interviewed the parents of twenty young people who had committed suicide, and
twenty who had attempted suicide.
Among the suicides he
noted frequent alcoholism in the fathers and a history of
suicidal behavior in both parents.
National Studies
Weissman (1976) discussed self-destructive youth as
a problem in primary prevention.
She pointed out that on an
individual basis, suicide is often preceded by loss of personal relationships and attachments, and by the development,
clinically, of a depressive syndrome.
Presumably, modern
I
4
industrial society provides a high risk environment.
The
institutions of the family, church, and school serve less
than before to integrate young persons into social groups
and to provide models of behavior and values.
have been weakened.
Family bonds
Also, community relationships have been
weakened, and increased geographic mobility leads to social
isolation and lack of integration into social groups.
Why should this impact be the greatest on young
people?
Reports from Coleman (1973) , a leader of the White
House panel on youth, suggest that the post-war baby boom,
which drastically increased the number of young people in
relationship to other age groups, accelerated the trends
towards isolation of youth.
Also, the weakness of the
family and other institutions added to the isolation of
youth.
Coleman and others have linked a variety of self-
destructive behaviors in the young (drug addiction, crime,
delinquency, and suicide attempts) to family breakdown,
social isolation, and protracted emotional identity problems.
Robert J. Lifton (1973) expressed the concept that
the image of technological violence and absurd death has
become a central theme of modern culture.
There is a numb-
ing and deadening of the faith in the continuity of life.
According to these observations, an important factor in the
5
increase in youthful suicide is a lack of hopeful optimism
associated with the loss of confidence in the continuity of
life.
Studies of youthful suicide attempters, for example,
those by Toolen (1968) and by Jacobs (1971), indicated
strongly that suicide attempts usually marked the end of a
long process of family disruption and psychiatric disorder.
More recently, Toolen (1978), along with Glaser (1978) and
Motto (1975) have emphasized the role of overt depression,
as well as disguised or masked depression as being much more
frequent in young persons than was thought, requiring energetic and informed treatment efforts.
For an overview of
the literature on suicide among youth through 1967, reference is made to Seiden, 1969.
Corder (1974) summarized a number of studies and
reported the following as significantly associated with adolescent suicide attempts:
absence of warm parental figure
with whom to identify, lack of future goals, lack of environmental control; high activity level, low impulse control,
and active parental conflict with a negative attitude openly
expressed toward the child by the parent.
It has been difficult to obtain information about
young persons who have committed suicide.
Warren (1976),
after reviewing the psychoanalytic literature on youth suicide, was impressed by the difficulty in getting therapists
to publish accounts of their cases who committed suicide.
6
However, ·important information regarding suicide in adults
has been gained through interviews with surviving relatives,
friends, and associates.
Classic studies of committed sui-
cides were reported by Robins et al (1959), Dorpat and Ripley (1960), Breed (1966) and by Farberow (1969).
In reviewing the literature for studies of a series
of suicides of young persons, I noted reference by Seiden
(1969) and by Jacobs (1971) to a study of suicides among
New Jersey school children by James Jan-Tausch, who compiled a total of 41 case histories during 1960-1963.
Jan-
Tausch emphasized that the children who committed suicide
had no close friends with whom they shared confidences or
from whom they received psychological support.
Los Angeles County Research
Studies of suicide attempters by Schrut (1964, 1968)
suggest that if the history of an adolescent is one of progressive or continued isolation from early childhood to the
time of the suicidal behavior, the prognosis for completed
suicide is more serious than if the history is one of adequate interpersonal relationships.
Schrut further suggests
that children who have poor emotional relationships with
significant others in early childhood were more likely to
become suicidal in their adolescence.
He pointed out par-
ticularly in his 1968 article that adolescent girls who
7
attempted suicide were often victims of chaotic, disrupted
families and suffered personal condemnation and isolation.
Peck and Schrut (1971) reported on a major study of
college students, which was conducted for two years, 19671969.
This study was both a statistical study and an in
depth psychodynamic study.
four groups, namely:
The subjects were divided into
committed suicides, suicide attempt-
ers, suicide threateners, and a non-suicidal control group.
Although the total sample was small, considerable information emerged from the study.
A profile of a "typical"
student who had committed suicide was constructed as follows:
male, withdrawn, isolated, and unable to communicate
well with his peers.
Parents of this sub-group were not
necessarily grossly disturbed.
Tapping into the area of
tity, Peck and Schrut (1971)
co~flict
~ound
over sexual iden-
that among the college
population there is frequently a quality in the male student who commits suicide which suggests that he has not
lived up to his own expectations of masculine accomplishment.
Sometimes a young male in that state of mind is
struggling with homosexual conflicts, and few emotions are
more devastating to a young man in transition from adolescence to adulthood than the fear that he has failed his
family and himself by perhaps having a homosexual orientation.
8
Litman's study of adolescent suicide in Los Angeles
County for the period of the year 1962 (1963) revealed,
among many things, that the male suicides outnumbered the
females by more than two to
on~,
and that the modes of
death chosen by male adolescents were more violent.
The
majority of boys used guns or hanging as the suicide
method; most of the girls used pills.
Statistics presented
in other studies generally agree with these findings.
(Bakwin, 1957)
(Bruyn and Seiden, 1965) .
In my work investigating equivocal suicide deaths
for the Office of the Chief Medical Examiner-Coroner of
Los Angeles County, I, too, have found that males, even
as their age increases, tend to use more violent means in
accomplishing their suicide acts.
Overdosing on drugs is
significantly most usually used in female suicides.
still lead the methods for men.
Guns
(Diller, 1976).
In a more recent study of youth suicide, Peck and
Litman (1974) reported on a number of recent trends in
youth suicide, including increases in the suicide rates of
females and non-Whites.
In addition, this paper reported
on investigations done in 1973 by Heilig, Peck, and Litman.
The 1973 study used a detailed interview questionnaire.
From the 1973 study, it was learned that there was an increase in drug and alcohol usage among youthful committed
9
suicides, as well as an increase in the number of arrests
and assaultive behaviors on the part of the suicide victims and their families.
Birth Order Factor
Of particular interest to some researchers, when
studying and evaluating the relation between childhood experiences and suicidality, is the issue of the birth order
factor.
Loren Grey, Ph.D. of California State University
Northridge, pointed out that Adler found sibling positions
to be significant in terms of who is most likely to commit
suicide.
I made a special literature review of the birth
order factor and included a hypothesis thereof in my thesis
project.
Lester (1966) speculated that there might be an
association between suicidal behavior and sibling position.
The evidence hints of such an association.
Jan-Tausch
(1963) studied school children who killed themselves and a
binominal test on his data shows that there was a significantly greater proportion of first-borns than second barns
( z=2. 3 0, p
< . 01) •
Pafferbarger and Asnes (1966) in a follow-up study
of male college students found no differences in sibling
position between those who had subsequently killed
10
themselves and those who had not.
Kallman et al (1949)
found no excess of only children or first-borns in a sample
of completed suicides.
Toolen (1968) found a significant excess of firstborns in a sample of adolescents who had attempted suicide.
However, Achte and Ginman (1966), in a study of adults who
had attempted suicide with drugs found no significant differences in the number of first and last-borns, nor in the
number of first and second-borns.
Lawler et al (1963) concluded from their study of
suicide attempters that a disproportionate number of suicidal children occupy special sibling positions.
Fourteen
of the twenty-two children in the study occupied special
positions, as follows:
Three were only children; seven
were first-borns; four were born in the youngest position.
But, the sample was too small for adequate reliable conclusions.
The studies clearly conflict.
Both excesses of
first and last-borns have been reported.
However, no ex-
cess of middle-borns has ever been noted.
It may be, of
course, that all psychologically disturbed patient samples
contain an excess of first-borns or last-borns and the
association may not be unique to suicidal patients.
Lester (1966) predicted an excess of first-borns
among suicides, based on the assumption that suicide is an
act of affiliation, a cry for help, a communication with
11
significant others.
Since psychological work has shown a
greater need for affiliation in first-borns and only children than in later borns, Lester predicted an over-representation of first-born and only children attempting suicide.
He evaluated that suicide attempts are a communication.
His data did not bear out his prediction.
Seiden (1974) points out that attempts are associated with impulsivity, that more attempts are made by first
borns and, that frequent moves, school changes, and conflict with parents and siblings are all reaated to suicide
attempts.
Adler (1958) also has provided evidence of an excess of first and last-borns in samples of suicides.
He
saw these sibling positions as producing children with
pampered life styles and he saw a pampered life style as
conducive to suicidal behavior.
Forer (1976) found that first-born women usually
feel strongly about traditional morals and values, especially in relation to their role as caretakers.
Threat to
loss of love relationships would all the more threaten the
security the first-born women need to maintain good self
esteem.
When the first-born woman is not successful in
maintaining self esteem, suicide may be an option.
Birth order is only one of many environmental factors important in developing and maintaining life roles.
It is not the position of birth that is important but
12
rather your experience with other members of your family
as a result of being the oldest, middle, youngest, or only
child.
According to all prior studies, there are many and
varied reasons why young people kill themselves.
conclusions are offered by different researchers.
Various
My
study will explore some causal factors of youth suicide.
Universality in identifying such causal factors can provide generalized guidelines that can be used for intervention and prevention of suicide among young people.
CHAPTER III
THEORY
At present there is no unitary theory of suicide or
suicidal behaviors, for much the same reasons that there is
no unitary theory of human behaviors in general.
sation of suicide is multi-factoral.
acting important
fac~ors
The cau-
Some of the inter-
include the individual's psycho-
physiological endowment, family histories, interpersonal
relationships, various traumatic occurrences, deviant life
styles, and coping reactions to stress.
Other important
factors involve the social milieu, especially the family,
but also the prevailing social and cultural attitudes as
transmitted to youngsters by schools, clergy, peers, and
perhaps the media.
The lives of young persons seem, on the whole, to
have become less stable and less hopeful.
The stablizing
influences of family, church and schools have diminished.
Young people are less connected with older persons who
could serve as role models and less sure of their futures.
There is an increased emphasis on the sensations of the
moment (e.g. drugs and alcohol) and increased feelings
that anything is possible and permissible, increased
13
14
opportunities for choices and disappointments.
I hypothe-
size that stable, positive, personal relationships and
hopeful commitments to the future, diminish suicide risk.
Factors leading to personal isolation and to loss of faith
in the future increase vulnerability to suicide.
More instability and perturbation in the early
lives of suicide victims would be expected.
Hypotheti-
cally, there is more family disruption, more geographic
mobility, more physical and mental illness, and more school
problems in the lives of young people who have killed themsetves.
Suicide seldom occurs as a totally impulsive, unpremeditated act.
Rather, there tends to be a fairly long
road to suicide in which people consider it, then turn
away to try other alternatives, returning to the suicide
plan more and more when other attempted solutions fail.
Clues to suicide plans in past communications and behaviors
must be taken seriously.
Three important factors which are necessary for
suicides to occur are hopelessness, helplessness, and feelings of worthlessness.
follow.
Suicide intention and plan often
These factors may vary in degree in different per-
sons at different times.
Hopelessness is related to power-
lessness, lack of self-esteem, and failure to attain
achievement goals.
Worthlessness deals with the individ-
ual's feeling about what he/she deserves, how important
15
he/she is to him/herself and others.
Suicidal intention is
related to fantasies, plans, previous suicide attempts,
choice of method, and refusal to accept help.
Together,
these are important risk factors.
The concept of "suicidal careers" (Maris and Lazerwitz) suggests that deviant behaviors precede the development of suicidal crises.
I hypothesize that in the last
year period prior to the suicide, the subject's life style
will include more deviant behaviors than the comparison
group I studied.
These behaviors would include deviance
in the use or abuse of alcohol, drugs, poor school attendance, more depressive or counter-depressive behavior and
withdrawal from friends and activities.
Personal relationships are important factors in
the causation hypothesis of suicide.
Positive personal
relationships provide an antidote to despair and hopelessness and ultimately, to suicide.
Absent, disruptive or
negative personal relationships almost always precede
suicide in youth.
It is my evaluation that there are sub-
groups or "careers" leading towards suicide as follows:
1.
The absent relationships, with a history of
isolation and non-involvement, described as
shy, withdrawn, a misfit, a loner.
2.
The negative relationships, with a history of
interpersonal turmoil, destructive, violent interactions.
16
3.
The "classical crisis case", with a history
of relatively normal relationships.
The person
then becomes suicidal after a recent sudden
loss of a love relationship.
These categories are important because they form part of
the basis for treatment and intervention recommendations.
Causal relationships of various factors have been
evaluated by several researchers as making important contributions to youthful suicide.
This thesis project will
discuss the findings from my in-depth investigation of six
completed suicides of young people under age twenty-four
years which occurred in Los Angeles County from September
15, 1977 to March 15, 1978.
Similar information will be
obtained for a matched group of living peers.
Using the aforementioned factors on the first page
of Chapter 3 of this paper as guidelines for causations of
youth suicides, I developed five hypotheses I wished to investigate.
The first, second, and fifth hypotheses includ-
ed sub-categories because of the complexity of the issues
of family and peer relationships, and of the descriptions
of crisis clues.
CHAPTER IV
HYPOTHESES
Hypothesis I:
The suicide group had more disruption and
perturbation in their family setting than
the non-suicide group studied.
A.
Parent/parents were absent during rearirig
years.
Absence could be due to death or aban-
donment.
This definition does not include
separation where contact
was maintained.
B.
Parents were separated or divorced.
C.
Nuclear family members had significant psychiatric problems.
1.
Alcoholism
2.
Drug abuse
3.
Severe depression, suicide problem.
4.
Serious, disabling physiological illness.
5.
Intrafamilial physical fighting.
6.
Physical abuse or neglect of victim.
17
18
Hypothesis II.
Suicide group had negative, absent or
disruptive interpersonal peer relationships.
A.
Destructive relationships, counter-depressive
activities, negative interaction.
B.
1.
Alcohol and/or drug abuse activities.
2.
Street fights
3.
Arrests
Loner characteristics.
1.
Unpopular--few or no friends
2.
Few interests and little to no involvement in activities.
C.
Classic crisis case -- loss of love relationship.
Hypothesis III.
Suicide group had little to no goal direction or future orientation.
Hypothesis IV.
Suicide group were more likely to be
first-borns than were the non-suicide
group studied.
Hypothesis V.
Suicide group exhibited more crisis clues
the last six months than did the nonsuicide group studied.
A.
Withdrawal from school/work, more absences,
significantly less positive performance.
B.
Withdrawal from social action.
19
C.
Felt downhearted or sad frequently or most of
the time.
D.
Separation (physically and/or psychologically)
from close relationships.
CHAPTER V
METHODS OF PROCEDURE
While every suicide remains in the end, something
of a mystery, extensive and important knowledge concerning
the death can be learned by obtaining information about the
decedent's previous life crises, character, and life style,
developmental history and the family history, through interviews with those who knew the suicide victims, i.e.,
parents and relatives, neighbors, physicians, therapists,
school personnel, and peers.
This type of comprehensive
investigation .is entitled the "psychological autopsy".
Since 1959, the Suicide Prevention Center {SPC)
staff, of which I am an active participant, has been actively engaged in youth suicide research and in the methodology which I used in the present study, the psychological
autopsy.
A pioneering article describing the development
and use of the psychological autopsy as both a clinical
and research tool was published by Litman, Curphey, et al,
(1963).
Dr. Curphey was, at.that time, the Chief Medical
Examiner-Coroner for Los Angeles County.
The article dis-
cussed in detail the procedure by which the psychological
autopsy is conducted, and the kinds of results which, at
20
21
that time, were found through this method.
The SPC staff
has conducted a series of investigationsof consecutive
suicides(with no selection for age) by this investigative
procedure, e.g.:
Farberow and Simon (1969); Farberow and
Neuringer (1971); Litman and Tabachnick (1967); Litman
(1968); and Diller (1979).
Interviewing Instrument
Using the psychological autopsy concept of learning about a person by means of interviewing survivors who
had a relationship with the decedent, I constructed a
questionnaire as the fact finding instrument.
(See
Appendix).
The questionnaire is divided into major areas:
developmental history, including family disruption; peer
relationships; drug and alcohol abuse; other deviant behaviors; suicide and depression; current lifestyles; and
recent stress.
Case Selection
To obtain cases I went to the office of the Medical
Examiner-Coroner of Los Angeles County, surveyed the "daily
log sheets", and selected cases of young persons under age
twenty-four years that were recently deceased and had been
classified as suicide or probable suicide.
I obtained data
for the period of September 15, 1977 through March 15, 197&
22
During this period there were 140 such cases.
The ratio
of male to female suicides in this age group was two to
one, consistent with national statistics for all
agegroup~
I randomly chose six of these cases for my study,
and proceeded to telephone the initial informant, the parent, and arranged an interview.
On two occasions the par-
ent in the suicide case told me he/she was not yet ready
to be interviewed because he/she was still too upset to
talk about the life and death circumstances of their deceased youngster.
I then chose two more cases for study.
Conducting the Interview
Interviews were normally conducted at the residence
or place of employment of the respondent.
On rare occa-
sions, I conducted the interview by telephone (with a
doctor or school official).
All interviews with family
members of both the suicide group and the comparison group
(living peer's family member) were conducted in person.
The telephone interviews did yield significant data.
It
was far better to use the telephone than to lose the information by not having the interview at all.
Comparison Group
For each case of suicide I studied, I investigated
a comparable case.
The comparable case was that of a liv-
ing peer (a friend), matched for age, sex, and ethnicity
23
to the suicide case.
In each case the subjects were aged
within two years of each other; the living peer was the
same sex as the decedent, and in all except one had exact
ethnicity.
The study of the Indian male (Case #6) was corn-
pared to his friend who was Mexican/American.
In my sam-
ple, the socio-economic level was highly similar between
each suicide case and its comparable case.
The comparison group provided individuals who were
similar in social class and life style to the suicide victim, and provided fairly good homogeniety between these
groups.
Presumably, many of the same pressures were pres-
ent in the comparison group as in the committed suicide
group.
I will address the issues regarding what special
circumstances were present in the suicided young person
which may have led him/her to suicide that differentiated
him/her from the living peer at the end of each comparative case presentation.
Because of the homogeneity the
items that will be significantly different will have great
importance and may aid in the strategic concern of intervention and prevention of suicide in young people.
Reliability
I tested the reliability of the questionnaire by
having another trained interviewer (a psychologist) accompany me to the horne of the informants and
simultaneous~y
24
complete a questionnaire while I asked the questions and
completed my own questionnaire independent of him.
Four interviews were done on one case:
two were
recorded, listened to by an additional staff member, and
scored by that staff member.
Reliability, as measured by
percentage of agreement was 85 per cent and 87 per cent in
the two interviews.
Items yielding a high percentage of
"don't know" or disagreement, were dropped or reworded, resulting in a revision of the questionnaire that was somewhat shorter.
This revision was field tested on three cases,
each having a suicide subject and a comparison subject,
with a total of fifteen interviews.
Five of these inter-
views were reviewed in the same manner as above in order
to determine the percentage of agreement.
The average per-
cent agreement for these five interviews was 92 per cent,
and the proportion
of "don't know" responses was smaller
than the previous, the original questionnaire.
The extent of testing for reliability in the six
cases I studied for this project was somewhat excessive
when considering that I was the only interviewer for these
cases.
However, should this study be funded for extensive
research of the youth suicide problem, reliability must be
tested thoroughly.
In the event of extended research I
would train personnel for the purpose of conducting the
interviews.
f
.
25
For that potentiality the test instrument, the
questionnaire, was constructed in such a way so that no
matter who uses it, all interviewers will obtain the same
answer to each question.
The goal of reliability is for
all interviewers to hear the respondents the same way and
to record their answers identically.
The reliability will
be as successful as the construction of the test instrument.
The revised questionnaire eliminated much of the
ambiguity of the first questionnaire.
The percentage of
agreement in the first questionnaire was 86 per cent.
revised questionnaire had a 92 percent
agreement.
The
I con-
sidered the revised questionnaire as a reliable test instrument, and used it for my study.
Enclosed in the Appendix of this paper is the revision of the questionnaire.
Interview Procedure and Respohse
The intervie\v procedure was as follows:
For each
suicide case, I conducted three interviews and completed a
questionnaire for each informant.
One interview was with
a parent, one interview was with a peer, and one interview
was with a physician, school official, employer, or other
such person who knew the subject.
For the comparison case,
I interviewed and completed questionnaires for two respondents:
a parent of the living peer and a significant other,
26
not a peer.
I found it too confusing to explain to the
young friends of the peer, the purpose of the interview,
and indeed, of the study itself.
In addition, the parents
of the peer were extremely hesitant to give names of
friends of the peers.
In many cases the peer was still
trying to cope with the sudden, suicide death of his/her
friend.
I felt the cooperation I received from the survivors of the suicide victim was due to their sincere interest in trying to help with the problem of the increasing
numbers of youthful suicides.
Furthermore, the interview
gave them an opportunity to express their feelings of guilt
over what role they may have played in the death of the
victim.
Often the interviews included my engaging in be-
reavement counseling with these survivors.
All informants
were grateful that some attempt was being made to deal with
the youth suicide problem and that they were asked to participate in the study.
CHAPTER VI
Case #1
Chris---suicide victim
Bert----living peer
Chris was a seventeen year old male Caucasian, a
high school senior, when he hanged himself with his mother's stockings.
Chris was born when his mother was forty years old.
He had three older sisters with whom he never had much contact.
Two years after the birth, the father abandoned the
household.
Upon abandonment of the father, the sisters left
the house also and established independent lives.
This
left Chris and his mother as an interdependent twosome.
She was overprotective of her son and instilled strict
religious values and ethics of moral behavior.
Church and
religion became an important focus for the mother and for
her manner in rearing her son.
He went to church as a
youngster, according to his mother's desires, but by the
time he was a teenager he no longer attended religious services or church activities.
When Chris entered elementary school he did not
adjust well.
He was anxious and hesitant and became a
get for teasing by the other students.
27
ta~
He did not seem to
- - - - j. -
-- -
28
fit in.
These social problems, always being a target for
harrassment by peers, plagued him through his school years.
The mother was upset over her son's lack of adjustment and was further concerned over a slight speech impediment that developed.
His speech problem, along with his
excessive feelings of anxiety over possible failure in
testing situations, prompted her to request psychological
counseling for Chris at school.
This was conducted on a
short time, inefficient basis.
Understandably, Chris experienced a low self-image.
He was depressed and spent much time alone.
During his junior high school years, the decedent
attended school regularly, performed adequately, and generally followed the rules of good behavior at home and at
school.
He never engaged in the use of drugs or alcohol,
nor did he talk about sex.
At one point during his last year of junior high
school Chris lived with an aunt while his mother moved out
of the area for some unknown, secret illness.
There was
some suspicion that her illness was due to emotional decompensation.
During that period of time Chris' school
performance and physical appearance deteriorated markedly.
In the last year of high school, circumstances improved for Chris.
He had one girlfriend, though it was
asexual, and he did have one boyfriend also.
Both of these
friends were loners with severe emotional problems.
29
During this last year Chris and his mother were
quite distanced.
She worked days, he had a job evenings
and they rarely saw each other and even less often communicated.
The mother described her son as sociable, having a
lot of "rich" friends who shared good times with him.
Her
description of his social activities was a fantasy.
The last school year Chris did participate in more
activities.
Behaviorally, he exhibited great mood swings.
He often acted overly enthusiastic, way beyond what a situation might warrant.
though forced.
His highs seemed inappropriate, as
He was described as almost pathetic in his
efforts to please adults.
He seemed extremely needy of
human contact and approval, and this very drive created
distancing between himself and others.
Chris killed himself after school, at his home.
His school day had been uneventful.
No one observed any
clues in his behavior which would have indicated stress or
extreme depression.
Bert, age seventeen years was the living peer in
the control group of this case.
He was Chris' only male
friend.
Bert was raised in a household where his parents'
marriage was intact and he lived with his sister also.
was five years older than he.
There was minimal relationship between siblings.
The sister was energetic, achievement oriented, a
She
30
successful person for the value system of the household.
Bert was a disappointment, had no energy or achievement
goals and barely got by in school.
The
marr~age
of Bert's parents was not good and
there was much verbal and physical fighting between the
parents.
Both were alcoholics.
The mother was severely
depressed, most likely suicidal from time to time.
The
father was hard driving, rigid, structured, obsessive, and
had high achievement goals for himself and his children as
well.
From ages six to fourteen years, Bert had no self
confidence, was hyperactive, angry, and a major disruption
in the classrooms at school.
He was apathetic about
school work and performed poorly.
teasing by his peers.
He was a target for
He was a loner.
Bert had no future orientation and felt highly pessimistic about his life circumstances' improving.
He be-
came more active in school the last, his senior, year, however, for the most part was depressed and alone most of
the time.
The living peer, Bert, suffered a severe acute depressive reaction to the suicide death of his friend.
identified with him and his depression strongly.
boy was familiar with having a close friend.
He
Neither
They shared
many similar experiences in their early and current life
31
circumstances, especially regarding peer relationships,
the loneliness and rejection thereof.
Bert's own suicidality surfaced when his friend
died, the manifestation of which was his inability to leave
his bed.
His parents became aware of the degree of their
son's depression by his evincing this direct suicide crisis
clue.
They answered his cry for help and after ten days
of being bedridden he consented to begin psychological
counseling.
He was still in therapy t\vice a week at the
time of the interview, four months after his friend's suicide.
Evaluation
As I predicted earlier in this paper, the suicide
group and their living peer counterparts will share many
similar life circumstances, behaviors, and pressures.
This
homogeneity was certainly the case for Chris and Bert.
Both were reared in households of strict adherence
to society rules of proper behavior.
rules as their behavior patterns.
They adopted those
They were both vehement-
ly against use of drugs or alcohol and experienced no acting out sexuality.
Neither performed well scholastically.
However, they attended classes regularly and had peripheral
involvement in school activities.
Both experienced nega-
tive, poor peer relationships and were "loners", who were
considered misfits and rejects by their peers.
Their
32
households were disrupted by absence of a father for Chris,
and an alcohol, abusive father for Bert.
depressed, with emotional disturbances-.-
Both mothers were
Neither boy was
goal-oriented toward his future, nor however, even with all
these stresses, did either show behavior change or exhibit
crisis clues before the death.
I evaluated both boys as potential suicide candidates.
Perhaps, "luck" would have it that Chris suicided
first.
The response to Chris' suicide led to Bert's enter-
ing psychological counseling.
Hopefully, the intervening
therapy will alter Bert's depressive course before he makes
a suicide attempt.
Case #2
Bill----suicide victim
Dean----living peer
Bill died at age 16 years, while in 11th grade in
high school, as a result of a self-inflicted gunshot wound.
Beside his body was a suicide note that read:
me do this except me.
friends.
"Nobody made
I love you all a lot and I love my
Tell them it was an accident.
Love, Bill."
Bill was the youngest child in this rigid Japanese/
American family.
His parent's marriage was intact after 23
years and there was no overt display of emotion in the
household.
The father was a responsible head of household,
present physically, yet psychologically preoccupied with
earn1ng a living as an engineer.
Bill's mother had a history of emotional problems.
She had periods of being severely depressed and suicidal.
She had had :.,one year of regular psychiatric treatment,
but the stigma of such treatment provoked her to focus her
activities outside the horne by attending school to an excessive degree.
The mother's depression emerged after the birth of
her second child and was diagnosed as post-partum distress.
33
34
Suicide thoughts were often present, however she never made
an overt suicide attempt.
When the mother was pregnant with Bill she was
highly nervous and taking many medications:
Barbiturates
for sleep, tranquilizers for her anxiety, and antihistamines for exzema.
When Bill was born he was initially an extremely
inactive baby.
This "drugged" behavior lasted for five
weeks after which time the mother ceased to breast feed
him.
Aware that her drug use may have affected her baby's
behavior, the mother withdrew from drugs completely, however, she engaged in frenetic activities as a counter-depressive action.
From age two to four years Bill was in and out of
hospitals due to severe, chronic asthma.
adrenalin and oxygen as aids.
He often needed
Many times there were con-
cerns about his being able to withstand another severe
asthma a·ttack.
Bill internalized these concerns and even
as a very young boy asked his parents if he was going to
die during one of his asthma attacks.
He feared for his
own health to the degree that he made visits to a psychiatrist during age five years in an attempt to allay his fear
that he would die imminently.
As he grew, Bill was hyper-active.
He always
pushed himself to his physical limits during sports.
35
He often came home exhausted, winded, unable to move.
He
did not allow his peers to see his physical distress.
He
needed medication daily for his asthma and in addition,
acquired headaches often.
Bill felt he had no really close
friends, only acquaintences for his different activities.
During the summer of 1976, a few months before his
death Bill underwent some very stressful experiences:
1)
A dark pigmentation developed on his shoulder and seemed to be growing.
His mother took him to a dermatolo-
gist when Bill became obsessed that this dark pigmentation would grow to the point of covering his entire
body.
At the doctor's office he refused to remove any
of his clothing stating that the doctor was "gay" and
he did not want him to look at his body.
The mother
made an appointment for the pigment to be removed by
means of an abrasion method, but Bill refused to keep
that appointment.
2)
Bill had nasal surgery for removal of a maxullary tumor
for the purpose of alleviating his heavy breathing.
At
the hospital he confided to a friend that he.thought
that the surgery was really for cancer of the nose and
he felt he was going to die.
He did not believe any-
one who told him to the contrary.
3)
Bill's last experience dealt with his behavior that
last summer.
He went out of his neighborhood to dances
36
in a rougher part of town and was provocative with
other boy's girl friends.
when fights were imminent.
He provoked fights but fled
His older brother had to
handle the situation on more than one occasion.
This
did not prevent Bill from continuing to behave in this
manner.
This kind of activity can be identified as
deviant, self-destructive behavior.
He set himself up
in a risky situation, perhaps for the purpose of someone else killing him.
When a homicide results from
this kind of provocative behavior it is said to be victim precipitating homicide, and is tantamount to suicide.
However, Bill did not get hurt during these an-
tics.
Eight months prior to his death, Bill was involved
in a close relationship with a particular girl.
It is un-
certain if the relationship included sexual intercourse,
or if sexual performance was an issue of failure.
might speculate on this issue.
One
Be that as it may, a few
weeks before his death, there was evidence that the relationship was not going well.
He was horne early from dates
with her and on a couple occasions he looked as though he
had been crying.
ings with anyone.
He did not discuss these personal feelThis was his first experience where a
girl dissolved a relationship with him.
The night before the death on their date, Bill was
very self deprecating.
He said he was not good enough for
37
Sharon (girlfriend).
He felt he cried too easily and that
he was not "manly" enough for her.
He cried on this date.
When the date ended he said to her, "I'll call you tomorrow if I'm not dead".
Then he laughed and Sharon did not
take that statement seriously.
When Bill carne horne that night from the date he
arrived an hour past his curfew.
had been crying.
He looked as though he
His parents disregarded his apparent dis-
tress and instead were focused on their anger over his
staying out so late.
a week.
They forbade him to use his car for
He responded in an apathetic, depressed manner
saying he didn't care about anything anymore.
The next morning the decedent would not get up for
school.
This was not the first time he had missed school
due to his lack of interest, but this time his mother,
still being angry over the night before, yelled at him
over his irresponsibility and poor performance in school.
He was very depressed and responded, "I don't even have
Sharon anymore".
He talked about the fact that he wouldn't
be around much longer.
The mother left the house to attend
to her busy schedule.
Early in the afternoon, while alone in the house,
Bill took the family revolver out of the drawer and shot
himself.
38
Comparison case
Dean was likewise reared in the strict household
in a second generation Japanese/American family.
His par-
ents marriage was intact, and again the father, though a
strong figurehead., wa.s absent from the home psychologically.
The father was also an engineer.
Dean was the oldest in a two child family, having
a younger sister.
The parents described their family and
marriage life as having its "ups and downs" but always
staying together.
family.
They also talked of a strong extended
The first two years of Dean's years his mother
worked out of the home.
She experienced no depressive be-
havior.
Dean experienced early years of dependence whereby
he would not leave home for a long period of time.
By age
eleven years he proved more adventurous and "weaned" away
from the confines of home.
Dean always was a person who kept feelings to himself, even verbalizing to be left alone when questioned by
his mother after his well being.
He said he would work
out his own problems.
Dean was popular with both boys and girls.
actively busy with them.
He kept
His physical health was good and
he had no restrictions on his activities nor did he feel
his body let him down.
He was well integrated with his
39
peers.
He was comfortable being one of the group.
never was targeted as a person to be teased.
He
Regarding
his relationships with girls, he had not, as yet, had an
experience whereby the girl ended the relationship.
Evaluation
Bill and Dean's cultural and ethnic orientation was
the same.
Likewise, these cases depicted two boys whose
family life style included stability, with very little disruption of perturbation.
However, the households were
different in the area of the mother's interaction with the
family.
Bill's mother was severely depressed and suicidal
much of the time he was growing and developing.
In addition to having a depressed mother, Bill had
to contend with having to deal with his own acute health
problems.
Often he was rushed to the hospital from in-
fancy into late childhood, in a respiratory crisis.
The
family all feared that he would die during one of those
asthmatic crises.
They related to him as though death was
imminent, and it is no wonder that Bill, himself, was always death oriented.
These two dramatic characteristics in Bill's life
circumstances were not present in Dean's life whatsoever.
His circumstances did not provide fear or uncertainty for
his physical well being and he did not have a depressed
mother after whom he would learn to model himself.
._
.:_
-
-·-·-.'
40
Bill dealt with his poor physical condition by
denying the seriousness of its existence.
He seemed to
have to prove his physical fitness by overexerting himself,
often to the point of exhaustion, and usually to the point
of his having an asthmatic attack.
He did not want his
peers to see him in a weakened condition and he would run
home when ill, and collapse in the privacy of his room.
Because of his mother's fragile emotional state, Bill kept
the seriousness of some asthmatic episodes to himself.
Also, I feel he viewed himself as less manly than his peers
and overcompensated by overexerting himself:
Dean, on the other hand, was confident with his·
body performance and had no need to continually prove his
prowess.
He did not feel his body ever let him down.
In
addition, he felt well integrated with his peers and confident with himself.
Dean evaluated Bill as being a target
for teasing by his peers, probably because of his overcompensating behavior.
Sometimes, death-oriented young people will identify and glorify dead heroes.
In Bill's bedroom there were
many posters on the wall of Bruce Lee and Freddie Prinze.
These posters were clues that Bill was focused on death
and an astute observer would see them as potential suicide clues.
Also, the evening before his death Bill ver-
balized fairly direct suicide communications to his family
-'---
_-L--.-
41
and his girlfriend.
These clues were not identified as
suicide communications.
The need for education of family
and community in this regard will be fully discussed in
the recommendations of this paper.
Dean gave no indications of being preoccupied with
death either in his talk or the decorations in his room.
The contrary factors of Dean's enjoying good health and
having a family who had good mental and physical health
were counter-conducive to his being a suicide candidate.
Dean was lucky enough at the time of the interviewing to have had only successful relationships with
girls.
They had never rejected him.
The precipitating
event of Bill's suicide was that of the epitome of being
rejected, that of the loss of his girlfriend's love.
The two boys shared a lack of goal direction or
future orientation in the field of achievement.
However,
whereas Bill performed poorly in school and cut many
classes, Dean worked to maintain at least average grade
performance and had good attendance in school.
An interesting sideline of this case occurred with
a classmate of Bill's.
Bill had told this boy, who was
not really that good a friend, that he was very depressed
and desperate.
He further told this boy to tell this in-
formation to no one.
This revelation occurred several
weeks before Bill's suicide.
The boy felt increasingly
42
burdened by what Bill had revealed to him and more upset
that he could share this information with no one.
The
boy became troubled and irritable in his feelings of helplessness.
The mother of this boy,feeling confused and
afraid over her own son's change in behavior that she set
up appointments with her son with the school psychiatrist.
The boy went regularly to the therapist during the time
Bill was still alive, although he still did not talk about
Bill.
~his
boy was able to deal with his feelings of des-
pair, helplessness, guilt after the death, with his therapist.
The most frustrating issue was the boy's feeling of
inadequacy in this situation.
Fortunately, this boy had
a mother who was ·observant enough to notice changes in her
son's behavior and make some positive moves to help her
son.
43
Case #3
Diane-----suicide victim
Phyllis---living peer
At age 21 years Diane killed herself my ingesting
cyanide.
She was living alone in an apartment at the time
of her death.
From approximately the age of five years, Diane's
personality precluded her being able to have satisfactory
interpersonal relationships.
She experienced extreme
inner rage that displayed itself in a hostile, demanding
personality that aliented others.
She seemed to genuinely
want and need close friendships but she could rarely attract relationships and if she did, she could not sustain
the relationship.
She was described as physically unat-
tractive and a person who bragged of achievements she
never accomplished.
Diane's mother had a long term history of emotional
instability, depression, and often threatend suicide.
She
made one mildly lethal attempt by overdosing on sleeping
pills five years before her daughter's death.
As a result
of the mother's being unable to take the role of mother and
caretaker, Diane, the first born, took on the role in relation to her sister who was three years younger than she.
44
In Diane's role of mother to her younger sister,
she was the protector, the disciplinarian, and literally
cared for her.
She was loving and non-critical.
Diane
enjoyed her role as mother and the sister enjoyed the attention and concern she received.
Diane, always being an
excellent student and high achiever, helped her sister,
who performed poorly in school, with her studies.
The last few years before Diane's death, her sister pulled away from the closeness they had previously
felt toward each other.
She no longer wanted a "mother",
and furthermore, the sister lost respect for Diane, who by
this time, had suffered so much personal rejection and
emotional neglect, that Diane's need for closeness became
smothering.
In addition, physical appearance meant a lot
of the sister's evaluation of others and Diane's lack
i~
good personal hygiene and poor self-care was embarrassing
to the sister who no longer wanted to be seen \vi th her.
The sister joined the ranks of all former acquaintances by
verbally debasing, criticizing, and withdrawing from Diane.
Du~ing
school years the decedent maintained a good
attendance and a high scholastic record despite suffering
from chronic asthma and also struggling to deal with the
stress, loneliness, and pain of always being a target for
teasing and rejection.
She did have one girlfriend in high
school, but she had no boyfriends.
45
More often than not, when finally asked out on a
date, she was jilted by the boy.
a poor self image.
Understandably, she held
She never experimented with drugs, and
only drank beer or wine in small amounts.
Her favorite
past-time was watching television game shows and situation
comedies and going into Westwood to a movie alone.
The decedent's horne life interaction was chaotic.
When Diane was 16 years old her father left the household
and took up the homosexual life style in another city.
His
brother, Diane's uncle, moved into the horne, married his
own sister-in-law (Diane's mother) and went from being
Diane's boisterous uncle to being her step-father.
She
despised him, as did her father, and threatened to run away
often, but never did so.
She did move out of the home at
age 19 years, returned in a year, only to move out permanently six months later.
She lived alone thereafter.
Diane held many jobs, and was fired from most because of personality problems with co-workers and supervisors.
She held her last job for well over a year, but
was fired and rehired twice the last three months.
Near
the time of death it was apparent that she was no longer
wanted at \vork.
She had gone from an ambitious, dynamic
worker to one of apathy, poor personal hygiene, and an antagonistic attitude toward employer and customers.
was absent frequently.
She
46
Proximate to her death, tp.i..a__lo.s.s~o~__ iol;:>.,,§tnd the
loss
of__;the.~~r,.el,atj,pnship
X,._.- •.• -c;'•_.,,r;-'7•...-•'''""'''"' -'
'
..
she had had with her employer, \vho
~ •- '•· •--..'"<<-!'"''"'"f!J··•·>•··"\.!'l•·;·'C)~o>::~-
,•·· •
'·"''~~'"-""'' ~~-,~-/ _,_,_
.••
.__,.,-,,.~.,..--><•""""<:•·':'-'•' '• -·"
c.~EA:t9:t ip.g,~.. ll~r'"...sJJ.ic. ide,."
Diane's life circumstances were illustrations of
chronic self destructiveness in her preclusion of being
able to form successful, sustaining interpersonal relationships.
Because of the emotional neglect she experienced,
her already poor self-image deteriorated to a point of her
being unable to cope with he:t loneliness and feelings of
hopelessness and worthlessness.
Diane's
~~E-~
to
g_~ye
loyg~}.vas
and receive
.,>.~'"'''~ •-.o-o.•,>:-~..-.....r""-""';-~·vc•
--
poignantly illustrated in her relationship with her
.___,...-....-~------. ~--~--~-.-
,<
--~
· - · · · · · •••
~
~-
most
~-
•• _ , .. .,.-- . ,
•
-
•'
~i~~er
--"~"'"~···-·· ~--·
.
Lacking stable parental models, the sisters developed a
mother/child relationship, with Diane, the eldest, as the
mother.
Diane attempted to teach good academic skills and
achievement goals to her sister.
successful for Diane.
These areas were the most
In spite of their mother/child in-
teraction, they both still vied for parental attention.
Diane's method of attention seeking by means of hostile
demands was not favored.
When the sister became 16 years
of age she sought her own independence and soon joined the
ranks of the rejecters of Diane.
Diane eventually felt that she would never be able
to satisfy her need to be loved, needed, or wanted.
her emotional needs were enormous due to years of
Indeed,
47
unfulfillment.
seling.
At no time did she seek psychological coun-
She was alone and felt helpless about being able
to alter her unhappy life.
Comparison Case
Phyllis, the living peer in Case #3 was likewise
a first born, having a brother three years younger than
she.
Her childhood years held little disruption.
parent's marriage remained intact.
Her
There was vague men-
tion of some physical fighting between the parents and
emotional problems suffered by the mother.
Phyllis was reared in and adopted the middle class
values of working hard in school and business to achieve
success. $Phyllis was a high achiever and a goal-oriented
person.
At age 23 years, when I interviewed her, she had
been running a successful business for the past two years.
Her interpersonal relationships were disappointing.
She had already experience two marriages and had two divorces by age 22 years.
She dealt with these failures by
focusing her efforts on her successful business.
Phyllis
did engage in sporadic sexual relationships, mostly with
married men.
Although her interpersonal relationships
were poor, she did not succumb to the loner life style.
She was energetic and involved in business and community
related activities.
She was always busy and felt good
about herself and her accomplishments.
48
Evaluation
Diane and Phyllis, first barns in a two child
family, were both highly achievement oriented as first
barns most likely are.
In both cases the mothers were
emotionally disturbed, Diane's mother's being almost nonfunctioning at times.
Phyllis was able to model herself after her father
in a successful way in performance achievement and was always rewarded with praise and support for her successes.
Because her brother was the pampered son he had no goal
orientation and Phyllis was able to obtain the rewards
without having to share them.
Diane achieved, but was so
angry that in her household being a pleasant person vlas rewarded, where achievement was not.
Diane's sister won the
favored spot as the pleasant personality.
Whereas Phyllis'
family unit remained intact, Diane's became highly perturbated, chaotic, and intolerable in which to live.
Phyllis did not suffer the long history of peer rejection that Diane experienced.
As a result, although they
both had difficulties with their interpersonal relationships, Phyllis had strengths and successes from which to
draw.
Phyllis absorbed herself in her business and held
optimistic future goals.
Diane deteriorated steadily and
lost her achievement motivation.
Her repeated failures
49
rendered her feeling hopeless and pessimistic over her
future.
She became severely depressed.
Phyllis' obsessive drive in business will probably
be able to sustain her feelings of good self-worth for
several years.
I suspect that when her drive subsides, or
if she experiences failure in this regard, she will have
to face her depressive feelings that will surface.
Her
defense mechanism of driving, hard work may not last forever.
The depressed feelings will result from her unsat-
isfactory interpersonal relationships.
will seek intervening psychotherapy.
Hopefully, she
50
Case #4
Kevin----suicide victim
Gil------living peer
Kevin was a 17 year old male who intentionally ended his life when he drove his automobile at high speed into
a truck that was parked on the shoulder of a freeway.
The deceased was the eldest child, the only-son of
a family with six children.
ic.
Kevin's father was an alcohol-
Further, he was authoritarian and dogmatic about his
'-
children'i following society's rules of behavior and the
"Christian" work ethic.
He assumed the role of head of
household rigidly and always maintained two jobs in his
effort to support his family.
However,' their socio-econ-
omic status remained at the upper/lower or lower/middle
class levels.
The rnotherwas passive, depressed, and
placed no achievement demands on her children.
not care if they attended school or not.
She did
There was much
yelling and expressed anger in the household between mother
and father and between parents and children.
One year before Kevin's death, the mother, dissatisfied with her husband and his frequency of being away
from home, abandoned him, taking the children with her.
51
She made the children promise not to contact their father
for fear he would find out.their whereabouts.
Kevin kept
in telephone contact with the father without revealing
where they lived.
Soon, the father moved to another state, increased
his already heavy drinking habits, and in general deteriorated emotionally.
Within one month's time of the family dissolution
an older man joined Kevin's family and the mother bore him
twin daughters.
The mother did not care if the children
went to school, in fact she preferred that they either work
to earn money for the family or to work around the house
taking care of the younger children.
Kevin was severely distressed over the disintegration of the family and the aftermath of disruption.
He
continued to telephone his father and pleaded with the
father to allow him to live with him.
The father responded
that he was barely keeping himself and his own life together, and could not handle living with his son or hearing
of his son's distress.
Kevin felt truly alone.
He was rejected by his
father and by his mother who seemed to relate to him as she
had her husband.
The decedent's phy·sical appearance was
similar to that of his father.
In fact, Kevin had assumed
the head of household position in his relationships with
52
his younger sisters.
He urged them to go to school and
follow earlier demands of responsibility that had been the
prior values instilled.
They ignored him and of course,
he received no emotional support from his mother or from
her common-law husband.
The deceased felt neglected and
psychologically abused.
He felt he was being forced out of
the family, as had been his father.
Three months before he died, Kev.funmoved out of his
family home and moved in with a single adult male, a
friend of his father's.
The chaos and pressure of no
family unity and contrary values was too much for him to
endure.
The decedent enrolled in a continuation school six
months before he died but usually did not attend.
Three
weeks prior to death he officially dropped out of this
school.
He engaged in several telephone conversations with
his father the month he died, the last of which was three
days before death.
The content of the conversation in-
·volved Kevin's wanting to know when his father was coming back to Los Angeles and assume some family responsibility.
Kevin complained of his being harrassed by his
mother and her boyfriend and was most upset that his sisters were not being cared for.
He was frustrated over his
53
father's making no commitment to return and he felt helpless about his being able to exist in or alter the current
situation.
Kevin's main interest was working on automobiles.
It was almost as though he was able to "hide" under the
hood of a car~ He had few friends, though he was described
as likeable.
No doubt, the stress and disturbances in his
life circumstances the last year precluded his having the
energy or motivation to relate to peers. Even prior to the
last year he was a loner, on the periphery of social interaction and activity.
He had one brief sexual experience
v-lith a girl .that he described as "not much fun 11
•
He exper-
ienced no meaningful relationships.
Kevin participated in no
vague to no future orientation.
dru~or
alcohol.
He had
He liked to work with
automobiles but did not give thought to what he would do in
the future.
It was all he could do to try to survive his
present circumstances.
Interesting enough, he used his one
pleasure, the automobile, as the tool to kill himself.
Comparison Case
Gil was the 16 year old living peer in Case #4.
was reared in a upper/lower socio/economic setting.
He
He was
the only child in a marriage that was still intact.
Gil had early school behavior and learning problems
which continued through junior high school years at which
5~
time he became involved in
§P9rsdi~
psychological counsel-
ing at school.
The household in which Gil was reared was depicted
by disruption in the form of physical fighting between his
parents, followed by frequent separations and returns by
the father.
His father traveled in his t,vork quite often.
When he was home there was chaos and tension.
In the last four years the father suffered from
severe heart disease and was homebound.
From that time
the household settled~/Into a more stable, less disturbed
atmosphere.
Although basically a loner, Gil always had one or
two close boyfriends and enjoyed some popularity and suecess in relating tp girls.
He enjoyed sexual experiences
and used marijuana only in a social setting.
Gil eventually went to a continuation school and
i
was still attending, with some measure of performance improvement at the time of this interview with his father.
He also continued sporadic psychological counseling.
He,
too, was interested in working on automobiles and hoped to
carry out this work in some future endeavor.
Evaluation
Both boys in this case had early learning disability problems but, whereas Kevin's performance and attendance deteriorated due to added stress in his life and
55
subsequent depression, Gil improved and eventually enjoyed
some success.
Very likely, the counseling intervention was
significant in Gil's academic improvement, as well as in
his social interaction and consequential self esteem.
In
addition, Gil's family setting improved in recent years
instead of deteriorating as did Kevin's.
Both boys were directed in their field of interest
in auto mechanics.
In comparing the life circumstances of
these two young men, I learned that both were reared in
chaotic home settings.
Kevin's became worse.
Gil's home
life improved.
As these settings changed for each boy, each displayed behavior changes.
Kevin exhibited the crisis clues
found in young people who are in a suicidal decline.
He
withdrew from school, from his family, and ·from activities.
Gil became more integrated and active in school and social
interaction.
cide.
Gil's behaviors are counter-conducive to sui-
_·
- - - - - .___:_ '.
-
56
Case #5
Mark----suicide victim
Allen---living peer
Mark was a 15 year old boy who killed himself by
means of a self-inflicted gunshot wound.
Mark was born illegitimately and never knew his
fathe~.
The mother worked to support them and talked often
about Mark's father's abandonment and refusal to take responsibility.
The mother's goal for her son was that he
achieve in school and go to college--to have a better life
than financial struggling and low social status.
In earlier years Mark attended Catholic schools and
his performance was only average.
By the end of junior
high school levels, his grades were so poor he did not
qualify to attend the Catholic high school.
He was disin-
terested in school, had no goals or future direction.
He
was pessimistic and had no particular hope for a future
for himself.
He enrolled in public high school eight
months before his death but his attendance and performance
were poor until such time he did not go to school at all,
the last three months.
Mark's mother assumed he was attending school.
contact was made to the contrary.
He stayed home and
No
57
watched television daily.
The last two months he was very
irritable and often lied regarding his whereabouts and
activities.
The lies were "macho" and activity-oriented
in nature and he no doubt used this technique to build his
self image.
Use of drugs or alcohol was not part of his
life style.
The decedent's disinterest in school was always a
critically distressing issue at home because his mother was
obsessed with his going to school to have a better life
than they had.
She berated
...,.._,..,""".,_ him severely for his apathy.
~·-,._....,
As the pressure increased, with his mother pushing for
school attendance and performance, and Mark's withdrawing
from it, he discontinued attending completely and stopped
participating in any social activities.
His feelings of
entrapment and his not wanting to hear his mother nag at
him any more, led him to run away from home on one occasion, three months before he died.
He came back after one
night away due to lack of money.
Mark always felt deprived and angry over his not
having a father.
As he got older his anger turned to
severe depression, so when his mother was upset with him
over his lack of future educational goals, he made suicide
threats as a communication to her of his desperate feelings
of unhappiness, emotional neglect, and hopelessness.
Five months before the death, Mark's mother bought
a gun (ultimately the lethal weapon) for the purpose of
_\i_
-'-
_L-
58
home protection.
This gun was Mark's prized possession.
He went target practice shooting regularly, cleaned and
took apart the gun continually and thoroughly taught himself the workings of the weapon.
He felt sure of himself
and powerful when he handled the gun.
Several days prior to the self-inflicted gunshot
wound, Mark verbally threatened to commit suicide while he
and his mother were involved in an argument, again over his
not wanting to go to college and her insisting that he do
so.
After the suicide threat, the mother took the gun
away from her son, but then returned it to him the next
day.
He killed himself two days later while alone in the
house.
Comparison Case
Allen is the living peer in Case #5.
He and Mark
were friends as a result of their attending a church group
together.
Allen is 16 years old, the eldest of three boys
in a close knit Catholic family.
The family is stable and
unified through religious belief and involvement in community church activities.
Allen continued to attend Catholic school into the
high school level and performed adequately, although not
above average.
He had no future goals or orientation, but
the family made no demands on their sons to make early
decisions about their future lives.
_l_
59
Allen, likewise, did not use alcohol or drugs.
He
lived in an almost protective cocoon-like atmosphere and
passively accepted his life.
He had sufficient friends, good health, and did
not question the purpose or circumstances of his life.
On
the other hand, he had no crises with which to deal and
received total support from his family and church.
Evaluation
The two boys in this case were reared under almost
opposite family circumstances.
Where Allen always received
support from two solid institutions (family and church),
Mark was alone and floundering.
He did not have a support
system in the family--having never known his father, and
experiencing conflict and disappointment in him from his
mother.
In addition, Mark's mother's obsessive demands for
her son's achievement indicated her own feelings of poor
self worth, depression, and sense of failure.
She was
Mark's only model.
The absence of a father and the harrassment of
Mark's mother produced a home setting conducive to depression and feelings of hopelessness and feelings of worthlessness.
These characteristics are criteria for suicide
behavior.
Family solidarity and community involvement are
counter-conducive to suicide.
6(}
Case #6
Tom----suicide victim
Mike---living peer
Tom was a 17 year old American Indian who hanged
himself with a rope in the garage of his home.
He lived in small living quarters with his parents
whose marriage was intact and with his four siblings.
was the second eldest, the second son.
usually employed at labor positions.
Tom
The father was
The family was poor
and disadvantaged.
Tom's father was an alcoholic and would often become verbally, sometimes physically, abusive to his sons
when under the influence of alcohol.
sive, accepting, the caretaker.
The mother was pas-
She did not work outside
the home.
Tom and his brother who was two years older than he,
engaged in physical combativeness.
The brother, although
somewhat involved in drug abuse and crime, was achievement
oriented in terms of seeking and obtaining employment.
had no achievement focus and no hopes or aspirations regarding his future.
Tom
61
Torn saw himself in a lesser position than his
brother and the fighting was probably their way of jockeying for a power position in the family.
The eldest son did
have more successes and Torn eventually gave into his frustrations, gave up the power struggle, and chose substance
abuse and crime to deal with his feelings of failure and
worthlessness.
The parents assimilated and adhered to White society values.
They did not sustain pride or identification
with their Indian heritage.
During some summer vacations
Torn spent three months with his grandparents in Indian
country.
He felt comfortable there, enjoyed the outdoors,
and his Indian identity.
belonging.
There, he felt some sense of
He did not carry these feelings back to Los
Angeles with him.
Torn had learning disabilities.during school years.
His speech was rapid and unintelligible.
He was humiliated
often as people could not understand what he was saying.
He felt stupid.
He eventually entered a school at the Bur-
eau of Indian Affairs.
He excelled in art and the theme of
his work was of Indian art and culture.
Torn stopped at-
tending classes after two months of poor attendance.
He
never allowed himself to become integrally involved there.
He was a loner and isolated.
education he attended.
This was the last place of
62
Tom was popular with peers in the neighborhood and
very active in sports activities with them.
a one on one relationship with a girl.
He never had
He had a few sexual
experiences.
In the last three years Tom slowly but surely withdrew from the peers that adhered to traditionally "establishment" values.
He became involved in a neighborhood
gang that eventually engaged in crime.
fourteen times on robbery charges.
Tom was arrested
The gang in which he
belonged also recklessly rode motorcycles and began sniffing glue to maintain a high.
Tom's glue and paint sniffing caused his decline
and emotional deterioration.
He was under the influence of
this substance on a regular basis.
During his last year of
continued paint sniffing he withdrew from school, friends,
activities, and was isolated and alone.
Also, this con-
tinuous glue sniffing ultimately caused his family to withdraw and then reject him.
He was virtually non-functioning
the last six months, always being heavily under the influence of paint fumes.
In the mother's frustration, she told her son that
if he continued to sniff paint he would ruin his life and
that of his family.
She told him he might as well be dead.
He hanged himself one hour after she made this statement
to him.
_j
63
Comparison Case
Mike was the 19 year old living peer in Case #6.
He was born in Mexico and left with his mother and his two
younger sisters to live in Los Angeles when he was seven
years of age.
The father remained in Hexico and out of
contact with his family.
One year later the mother married
the step-father and that marriage remained intact.
Mike, likewise, lived in a household where their
own heritage was ignored and the American society values
were adopted and adhered to.
There was no feeling of pride
of identification with Mexican culture.
The family was poor, but there was no sense of
chaos or disruption in the household; however, poverty was
present and they were an economically disadvantaged family.
Mike was popular and active with neighborhood
peers.
He was in the same neighborhood gang as was Torn,
but Mike dropped out when they entered into criminal acts.
Mike was arrested twice for being drunk and he did engage
in occasional street fighting.
Mike also experimented with
paint sniffing with Tom for several months, but eventually
he decided he did not like it and he quit using this substance.
Their friendship waned as Torn became involved in
more violent activities.
Mike was strongly goal directed.
He completed his
high school education and then joined the army as a means
__,')_
_ ____ L
to attain his goals of acquiring saleable skills.
He was
still in the armed services when this interview took place,
apparently doing well and continuing with his planned
goals.
Evaluation
Both these young men were reared in households that
ignored, even rejected their original heritage in an effort
to assimilate in the culture in which the family chose to
live.
Neither male had a sense of cultural identity.
The
neighborhood in which they lived was economically disadvantaged and crime and police interaction was prevalent.
Both had been arrested as part of their life style.
The significant difference between these two
friends was the fact that Mike had goal direction and took
steps to reach his goals.
In that choice, he withdrew
from the negative, destructive peer interaction in the immediate neighborhood and rejected glue sniffing activity.
Tom 1 s stresses were greater and he had no coping
skills.
His self-image was danaged from years of feeling
inept and stupid at school.
He felt worthless and that
there was no future with hope for him.
He chose negative
peer relationships and reckless, counter-depressive activities to ease the emotional pain he felt.
Most signifi-
cantly, he chose to continue sniffing paint, which ultimately resulted in his non-functioning in social relationships and activities, and increased his immobility and
65
depression.
Tragically, he also lost the support of his
family and they psychologically divorced themselves from
him because of his unacceptable self-destructive behavior.
CHAPTER VII
CONCLUSIONS AND DISCUSSION
For my thesis project I investigated and reported
on six cases of youth suicide and compared various aspects
of their life styles with those of six living peers.
My
in depth study of the six experimental cases provided intensive, detailed insight into intricacies of these youth
suicides.
It is probable that some of the complexities
would have gotten lost, or not been developed, had I merely presented questionnaire results.
Hopefully, I may use
this project as a pilot study for future research on a
larger scale for a possible Ph.D. dissertation or for a
proposal for government funding for extensive, much needed,
research on youth suicide.
Even with my small sample, differences were found
between the suicide group and the non-suicide group studied
in three of the five hypotheses presented.
Due to my only
using six experimental cases, I cannot state that these
results would be universal, but merely suggestive of contributing factors for youth suicide.
It appears that a null hypothesis for Hypotheses I
and II was rejected at the .01 level and that Hypothesis V
66
67
was rejected at the .001 level.
For Hypotheses III and
IV a level of confidence was not achieved (.10), although
there ·appears to be a slight tendency, from the results of
these latter two hypotheses, that suggests these hypotheses
might also be confirmed if a larger sample were to be used.
(See Table I.)
Table II charts the breakdown of the totalled responses of each main hypothesis statement and all the subcategories that contributed to the hypothesis definition.
For example, all sub-categories such as abandonment, alcoholism, emotional distress in a parent, etc., contributed
to the definition of Hypothesis I.
Some cases included
several "yes" responses to the various sub-categories.
Disruption in a family setting can take many forms,
from total abandonment of a parent to a household where
alcoholism and/or fighting is the norm.
I cannot make a
judgment as to what kind of disruption is most likely to
cause severe depression in a young person.
I did note,
however, that there was less fathering in the suicide group
than in the non-suicide group studied and that in five or
the six cases of suicided youths, severe depression, some
to the point of suicide expression, was evident in at least
one parent.
This problem was present in only a total of
one parent in the non-suicide youth group studied.
I feel
that expressed depression and/or suicidality by a parent,
-
l
68'
very likely has a major influence on a child's choice of
how to cope with life's stresses.
The parent's coping
mechanism provide for children's behavior choice.
Severe
depression may be genetic or learned, but in any event
would seem to negatively effect the offspring.
Several researchers, as presented in the literature
review, discussed the current phenomenon of isolation between young people and institutions which used to provide
models of behavior and values.
Certainly, disruption and
perturbation in a family would detach a youth from his/her
most important institution, the family.
Progressive and
continued feelings of isolation often result in suicide.
The family is the first interpersonal relationship to be
experienced by anyone.
Disruption and undevelopment in
this relationship offers the young person no skills in
developing or sustaining future relationships nor offers
the developing young person, an identity of who they are
and where they fit in.
Without ability to form relation-
ships or development of a sense of identity, poor selfesteem results.
A feeling of worthlessness is a criteria
for suicide ideation.
Continuing with the theme that good relationships
counter-indicate suicide, I studied the interpersonal relationships between the suicide group and their peers.
I
learned that all the suicided youth had critical problems
in this area.
This finding was not unexPected.
69
Case number 1, 3, 4 and 5 of the suicide group
youth, and even some of the non-suicide group studied,
lived historical life styles as loners, those who experienced absence of meaningful relationships with peers.
One case in the sample, combining the total of the
suicide and non-suicide groups studied, fit into the destructive, negative (actingout) group that Peck and Litman
(1974) found prevalent in their 1973 study of recent trends
of youth suicide.
That was Case #6, as depicted by this
youth's multiple arrests for violent acts, his gang participation, and his substance abuse by means of glue sniffing.
Surprising enough, he was the only youth studied that was
involved in any kind of substance abuse.
One suicided youth, Bill, in Case #2, fit into the
category of "sudden loss of love relationshtb", the classically often final event to push a person to commit ·the
suicide act.
This caasal factor for suicide is likewise
widespread in the adult population.
Hypothesis III was concerned with the young persons' future orientation.
The findings from the responses
revealed a lack of significance between the suicide group
and the non-suicide group regarding their future orientation or goal direction.
My feeling, upon learning about
the twelve youths I studied, was that, for the most part,
they either had no achievement goals or were at best
70
confused about their future direction.
I had the sense
that these young people were floundering.
They were phys-
ically and/or psychologically isolated from their family,
their community, their peers, and seemed without self
identity or life purpose.
Perhaps many youth of today are
in this same confused, lonely place.
As with Hypothesis III, the null hypothesis was
confirmed in Hypothesis IV also.
It is probable that my
small sample negated any significant findings regarding
the birth order factor.
However, I found it interesting
to note that of the six living peers (non-suicide group)
studied, five were either first born or only children.
Does that abundant number in the non-suicide group mean
anything?
Perhaps, I might submit a theory that first
borns may be more likely to take the role of caretaker in
a relationship.
If so, some first borns may choose the
depressed, downtrodden, "loser', as a friend to care for
and try to rehabilitate.
An extended study of the birth
order factor in a larger sample would provide more significant data in this regard.
I was most impressed with the findings of Hypothesis V.
Many crisis clues were either directly or indir-
ectly communicated by the suicide oriented youths.
Most
clues went unheeded.
This
They were not heard or seen.
issue provokes the awareness of needed education for
____ j, --;:-
--
71
significant others so that suicide clues can be picked up
and acted upon before the suicide ideation becomes an attempt.
I will discuss this topic more fully under the
Recommendations portion of this paper.
The value of crisis intervention as a suicide prevention technique was dramatically illustrated in the case
of the living peer in Case #1 and may have been significant in the life circUmstances of the living p€er in Case
#4.
These two members of the non-suicide group underwent
psychological counseling when they exhibited crisis clues.
In both instances, at least at the time this study took
place, the youths in question were moving away from feelings of hopelessness and lack of self worth.
The peer in
Case #4 was headed toward a future oriented direction and
the peer in Case #l did verbalize feeling better about himself and no longer feeling acutely suicidal.
On the basis of the findings of my small sample of
a suicide group of youths and a non-suicide group of living
peers, those who were reared in family settings with disruption and perturbation, and those young people who had
absent, destructive, or sudden loss of meaningful relationships with peers, were more likely to kill themselves.
In
addition, another hypothesis finding revealed that crisis
clues were directly or indirectly exhibited by severely
72.
depressed young persons who had ideated, had formulated a
suicide plan, and eventually committed a suicide act.
The purpose of the research was to explore causal
factors in youth suicide by comparing their life circumstances with their peers, a non-suicide group at the time
of the study.
The findings from the research suggest that
most of my hypotheses concerning the relationship between
suicide and non-suicide groups were confirmed.
CHAPTER VIII
RECOMMENDATIONS
The most significant differences between the suicide group and the comparison group studied were in the
findings under hypotheses I, II, and V.
These hypotheses
dealt with family pathology and disruption, interpersonal
relationships with peers, and the victim's communication
of crisis
clues~
The results of these three hypotheses clearly illustrated the need for development and utilization of prevention and intervention skills at the family, school, and
community levels.
1.
True prevention of youth suicide must occur
with parent education at an early age.
The
ideal model would begin with something akin
to parent sensitivity and effectiveness courses
for those persons who are contemplating parenthood,of those persons who are in the process
of having a baby,or have an infant at home.
My
first recommendation for youth suicide prevention advises, effective parenting
programs.
73
education
74
2.
The second recommendation involves education
and training of the children during early
school years.
Children should be taught about
feelings of unhappiness, discomfort, and difficulty with communication, not in senior high
school health classes, but at the elementary
school level.
This early education would both
prepare them for the emerging adolescent feelings and for the other kinds of feelings they
may have begun to struggle_with.
Films as well
as lectures, and discussion groups on depression, unhappiness, discomfort, and suicide
could become a regular part of a primary grade
education sequence.
3.
To facilitate the above recommendations new
education materials,
book~,
pamphlets and films
for school, community and family education in
suicide prevention must be created.
4.
The next major phase of education, training,
and prevention which comes under treatment
would focus on training family and community
members for recognition and emergency first
aid.
Primary among these could be the parents,
teachers and counselors, youth workers, police,
physicians, and clergymen.
A great effort
75
needs to be made on recognition and identification of what constitutes early suicidal feelings in adolescents.
Once this is detected,
people must learn to talk to the youngster, get
the feelings out of him and then direct him to
some sort of help.
Once this young person gets
into the appropriate kind of help at an early
age, more serious suicide rroblems, in most
cases, can be avoided.
5.
A final recommendation is that there be more
research and better understanding of suicide
in young people as elements leading toward improved school education programs and innovative family counseling and group experience
projects.
Expanding the research conducted
for this to encompass a study of a larger sample of completed youth suicides would provide
more reliable findings from which prevention
and intervention guidelines can be developed.
All these recommendations would need financial and
community support and more trained experts in the field of
suicidology.
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Suicidal Intent: A Study of 134 Consecutive Cases
of Successful (Completed) Suicides. American
Journal of Psychiatry. 1959, 115: 724-733.
Schrut, A. Suicidal Adolescents and Children. Journal of
The American Medical Association, 1964, 188 (13)!
1103-1107.
Schrut, A. Some Typical Patterns in the Behavior and Background of Adolescent Girls who Attempt Suicide.
American Journal of Psychiatry, 1968, 125 (1) 69-74.
Seiden, R. Suicide among Youth: A Review of the Literature. 1900-1967. Bulletin of Suicidology (Supplement), Dec. 1969.
Seiden, R. Studies of Adolescent Suicidal Behavior:
Etiology.
In R.J. Maris's (ed.)
Perspectives in
Abnormal Behavior. New York: Pergamon Press, 1974.
Tabachnick, N., Gussen, J., Litman, R., Peck, M., Tiber, N.
and Wold, C. Destruction by Automobile. Accident
or Suicide: 1973, Charles C. Thomas, publisher.
Toolen, J.M. Suicide in Childhood Adolescence. In,Resnick,
H.L.P. (ed.)
Suicidal Behaviors: Diagnosis and
Management: 1968, Boston: Little, Brown, and Co.
Toolen, J.M. Therapy of Depressed and Suicidal Children.
American Journal of Psychotherapy. 1978, 32 (2)
243-251.
Weissman, M.M. Self-destructive Youth: A Problem in Primary Prevention. Current Concepts in Psychiatry,
January, 1976, 2 (1) 2-4.
~
'
TABLES
80
Table
I
Responses to Quest:l.onnai_re from Suicide and Non-suicide Groups
Hyp
"'"f<'frt<> <'ronn
nnn-sui.ci.dr>- gz:o.up..
I
2 0
7
6.26
1
(.01
II
l 1
2
6.22
1
<: .01
II I
5
3
2
1
) .10
IV
3
5
2
1
) .10
1 8
1
1
<(.001
v
f
15.20
.1?.
81
Table
II
Category Breakdown of Hypotheses Responses
H::z:::eotheses
I.
c.
B.
c.
IV:
Absent parent
Parents separated
Family pathology
1. Alcoholism
2. Drug abuse
3. Depression/suicidality
4. Physical illness
5. Combativeness
6. Abuse/neglect
Destructive relationships
l. Substance abuse
2. Street fights
3. Arrests
Loner Characteristics
1. Unpopular
2. No activities
Loss of love
1
1
2
1
5
3
1
0
1
0
0
0
2
2
4
20
1
1
1
0
0
1
3
3
2
1
0
0
ll
-2-
The suicide group had little to no
goal direction or future orientation.
5
3
The suicide group were more likely to
be first-borns than were the nonsuicide group studied.
3
5
H::z:::eotheses
V.
2
3
The suicide group had negative,
absent or disruptive interpersonal peer relationships.
A.
III.
Non-Suicide Grou:e
The suicide group had more
disruption and perturbation
in their family setting than
the non-suicide group studied.
A.
B.
II.
Suicide Grouo
Suicide Grouo
Hon-Suicide Grouo
The suicide group exhibited
more crisis clues the last six
months than did the non-suicide
group studied.
A.
B.
C.
D.
Performance withdrawal
Social isolation
Depressed
Relationship detachment
5
3
5
5
18
0
1
0
0
l
APPENDIX
82
CASE NUMBER:
DATA FROM CORONER'S FILE:
DCD'S BIRTH DATE: _______________________DCD'S RACE: __________
DCD'S SEX: ____________~DCD'S RELIGION: __________________
DCD'S DEATH DATE:
AGE AT DEATH: ______
CAUSE OF DEATH=------------------~---------------------IF DRUG(S) IlfVOLVED, SPECIFY DRUG(S) IN ORDER OF STRENGTH:
WHERE DEATH OCCURRED=-------------------------------------INTERVIEWER: _________________________________________________
CENSUS TRACT NUMBER OF DCD' S LAST KNOWN ADDRESS:------------
83
CASE
NUMBER:
Your name, address, and all other identifying information is
recorded on this page and on this page only. This page will
be separated from the rest of the questionnaire and filed in
a locked box.
q)
Only one or two members of our staff will have
access to this information.
At the conclusion of the study
ItT>
I
<U
10.
I
this identifying information will be d"estroyed.
I til
I ..-I
I..C:
I+J
I
I Sol
I
0
I'l-l
I
I qJ
I S::
I . ...;.
1..-4
I
I Sol
I ll$
I Q)
I .+J
I
RESPONDENT'S NAME=------------------------------------RELATIONSHIP (TO DCD}: _______________________________
I Q)
I+J
RESPONDENT'S PHONE NO.=--------------------------------
RESPONDENT'S ADDRESS=------~------------------------_______________CITY______________________ZIP
~-------
1'0
I Ill
I
I
Sol
0
I '-H
I ~
I Q)
10.
II
I
I
I
I
I
DECEASED'S NAME:
------------------------------------
DECEASED'S ADDRESS=----------------------~----------_____________CITY ____------------------ZIP # _______
{consent info. here}
84
l.
Was
{DCD)
----~~~-------
ever in a hospital for any reason?
Yes
2.
How
No
{Skip to Q.S)
Don't know
(Skip to Q.S)
old was he/she when he/she was hospitalized?
(ENTER DCD'S AGE BELOW FOR EACH TEru1 OF HOSPITALIZATION
STARTING WITH THE EARLIEST)
3.
How many days was he/she in the hospital?
(ENTER THE NUMBER OF DAYS OF HOSPITALIZATION FOR EACH
4.
TER~)
What was the problem that led to his/her going to the hospital?
(ENTER THE REASON FOR DCD' S HOSPITALIZATION FOR EACH TERM)
Table 1.
Years of Age
a.
b.
c.
d.
e.
HISTORY OF HOSPITALIZATION
Number of Days
in Hospital
Reason for Going to Hospital
85
5.
To what extent was (DCD'S} life disrupted or perturbed by
illness, hospitalization, hyperactivity, learning disorder,
accidents, or other problems?
To a great extent
To some extent
To a slight extent
6a.
Not at all
(SKIP TO Q. 7}
Don't know
(SKIP TO Q. 7}
What was the problem (s}?
(SPECIFY):-------------------------------------------
6b.
At what age did this occur?
_________________________ (years of age(s}
PARENTS ONLY 7-8
7.
How many different schools did
--~(~D~C~D~l~----
attend?
(RECORD THE NUMBER OF DIFFERENT SCHOOLS DCD ATTENDED FOR EACH
AGE RANGE IN TABLE 2, COLUa~ 1}
a.
How many different places of residence did (DCD}
over one month duration)?
have (of
RECORD THE NUMBER OF DIFFERENT PLACES OF RESIDENCE DCD HAD
DUR!NG EACH AGE RANGE IN TABLE 2 , COLUMN 2}
TABLE 2.
CHANGE OF SCHOOL AND RESIDENCE
COLUMN 1
DCD's Age
# of Schools
COLUMN 2
itof Residences
0 - 5 (Nursery and PreSchool
6 - 12 (Elem. School)
3-15 Jr. Hiah School
6-1-8 Sr. High School
Over 18 lcollecrel
-
86
9.
What sort of grades did
(DCD)
get in school?
(v1
{CHECK
ONE CATEGORY FOR EACH AGE RANGE DCD ATTENDED SCHOOL
IN TABLE 3)
TABLE 3
.
School Performance (grades)
DCD's age
Above
Avera ere
Averag~e
Below
Average
Don't Know
No Answer-
6 - 12
(elem. School
13 -15 Jr.Hig
16-la Sr. Hig
over 18
(college
10.
How often was
(DCD)
absent from school?
(CHECK
( / ) ONE CATEGORY FOR EACH AGE RANGE IN WHICH DCD
ATTENDED SCHOOL IN TABLE 4)
TABLE 4
.
DCD's age
6 - 12
(elem. school)
13 .-15 Jr. HigJ
16-18 Sr. High
~
.
over 18
{college)
Absent from school
.
Frequently
Occasionally
Seldom
Dont
Know
87
11.
Did
(DCD)
or part time?
ever work as a salaried employee e·i ther full
Yes
No
Don't know
12.
In terms of attitude and performance on the job, what sort
of worker was he/she?
Very good
Good
Fair
Poor
Don't know
13.
How long was (he/she) employed on (his/her) last job?
More than one year
6 - 12 months
2 - 6 months
Less than 2 months
14.
Was
(DCD)
ever fired from a job?
More than twice?
Twice
Once
Never
Don't know
15.
Some parents are permissive in raising their children and believe
that children should be allowed a good deal of freedom. Other parents are more strict in traising their children and believe that
children should have firm rules to follow.
In what way was
(DCD)
raised? Would you say (his/her) parents were very permissive, somewhat permissive, somewhat strict, or very strict?
Very permissive
Somewhat permissive
Somewhat strict
Don't know
88
16.
Young people often see their own homelife and family in a way
that is different from how others might view it. How did (DCD)
tend to look u~on (his/her) parents and the way (he/she was being
raised? Did (he/she) feel that (his/her) parents were too permissive, too strict or just the way (he/she) wanted them to be?
Too permissive
Too strict
Just right
Don't know
17 ..
Some young people have little or no direction in terms of future
goals or ambitions. Other young people have a fairly good idea
of the future goals that wish to achieve and the kind of work
they want to do.
In terms of future goals and ambitions, would
you say that (DCD)
was strongly directed towards future goals,
somewhat directed towards future goals, or had no direction in
terms of (his/her) own future?
Strongly directed
Somewhat directed
No direction
Don't know
18.
Some parents have high goals and expectations for their children.
Other parents more or less let their children go their own way.
Compared to other parents you know of, did
(DCD's)
parents
have higher goals for (his/her) future; goals and expectations
that were the same as other parents; or lower. goals and expectations?
Higher goals
About the same
Lower goals
Don't know
89
19.
Sometimes parents have high goals and expectations for one or
more of their children but not for their other children. Did
(DCD's)
parents tend to have higher ambitions for (him/her)
than for their other children, expect about the same from (DCD)
as they expected from their other children, or have lower ambitions for
(him/her) than for their other children?
Higher ambitions
About the same
Lower ambitions
Don't know
20,.
Was there any change in the amount of time
(DCD)
was involved
in extra-curricular activities at school dur1ng (his/her) last year?
More than before
About the same
Less than before
Don't know
21.
How about during (his/her) last three months?
More
About the same
Less
Don't know
22.
Was there any change in the number of friends
school during (his/her) last year?
More than before
About the same
Less than before
Don't know
(DCD)
had at
90
23.
How about during (his/her) last three months?
More
About the same
Less
Don't know
PARENTS ONLY
28-35
m10
raised (DCD)
? (ENTER "YES FOR EACH PERSON THAT HELPED TO
RAISE DCD U! TABLE 5 , COULJ.'1N 1 , ENTER .. "NO OR DK FOR THE OTHERS)
II
25.
II
When was that? In what vears?
(INDICATE THE CALENDAR YEARS THAT
APPLY FOR EACH "YES" ANSWER TO ABOVE QUESTION IN TABLE 5, COLUMN 2)
TABLE 5.
PERSONS WHO HELPED TO RAISE DCD
COLUHN 2
COLUMN 1
PERSONS
26.
II
a.
Natural Mother
b.
c.
Natural father
Stepmother
d.
Stepfather
e.
other relative
Specifv:
f.
Foster Homes
YES
NO
DK
YEARS
Was
(DCD)
ever separated from either {his/her) mother
or father or the person (s) who raised (him/her) for more than
two months in (his/her) life?
{DEFINE"SEPARATION" AS LIVING APART FOR OVER TlvO HONTHS FRmi A
PARENT OR GUARDIAN FOR ANY REASON)
'Jes
No
Don't' know
91
27.
How old was
(DCD)
~~-'----
when(this/these) separation (s) occurred?
(INDICATE AGE RANG9! (S) IN NHICH SEPARATION (S) OCCURRED IN
TABLE 6. CHECK
(v0 WHETHER ONE SEPARATION OR REPEATED SEPARATIONS)
TABLE 6.
Senarated
DCD' s Age
0 -
Once
Repeatedly
5
6 - 12
13 - 18
over 18
2·8.
Did either of
(DCD' s)
from
(his/her) life?
parents die or disappear permanetly
Yes
No
Don't know
29.
What happened?
(When and for which parent)
(CHECK ( ) BELOW THE AGE RANGE IN DCD's LIFE WHEN THIS OCCU~~D,
WHICH PARENT (S) lf1AS INVOLVED, AND NHETHER THAT PARENT DIED OR
DISAPPEARED.
"DISAPPEARANCE" MEANS NO FURTHER CONTACT BET~·1EEN
DCD AND THAT PARENT.)
TABLE ·7.
DCD's Age
Died
0
-
5
12
18
over 18
6
13
-
Mother
Disappeared
Died
Father
Disaoneared
92
30 •
Did
(DCD)
her) own?
ever leave home permanently to live on (his/
Yes
No
Don't know
31
At what age did (he/she) leave horne permanently?
Years of age.
32
Did
(DCD)
ever run away from home?
Yes
No
Don't know
l~
At what age (s) did (he/she) run away from home?
(CHECX (/, BELOW THE AGE RANGES IN l'lliiCH DCD RAN AWAY FROH
HOHE.
"RUNNING AVIAY" DOES NOT INCLUDE LEAVING HOHE PER."!ANENTLY TO LIVE ONE ONE'S ONN-)-
DCD's AGE:
0 - 5
6 - 12
13 - 1~
16- 18
34.
Did either of
or sisters:
'TABLE 8
.
!
35.
--~(~D_C_D__
's~)___,parents,
or any of
(his/her) brothers
FAMILY PROBLEMS
Problem
I
Yes
a.
Have a drinking problem?
b.
Have a problem with illegal
drugs?
c.
Have a problem with prescription
drugs?
d.
Have a serious illness while
(DCD) was growing_ uo?
e.
Receive psychiatric treatment or
suffer from mental illness?
f.
Have a suicide problem?
g.
Have financial problems?
h.
Go through a separation or divorce?
i.
Get into physical fights often
with other family members?
Do you feel that (DCD)
I
No
DK
I
was neglected?
Yes
36.
No
(SKlP TO Q. 37)
Don't know
(SKIP TO Q. 37)
At what age(s) was (he/she) neglected and to what extent was
(he/she) neglected at that age?
(INDICATE IN TAB"LE 9 AT 1-JHAT AGE (S) DCD NAS NEGLECTED AND THE
EXTENT TO NHICH (HE/SHE NAS NEGLECTED AT THAT AGE)
Extent of Neglect
TABLE 9
DCD's Age
0
6
13
-
5
12
- 15
- 18
16
over 18
Slight
Hoderate
Severe
94
37
Were there ever any signs of
(DCD's)
being
_..:..;;;..;:;;..;;;...._;;;...:_.....;
physically abused?
Yes
38.
No
(SKIP TO Q. 39 )
Don't know
(SKIP TO Q. 39.,)
At what age(s) was (he/she) physically abused and to what extent
was (he/she) abused at that age?
(INDICATE IN TABLE 10 AT iiHAT AGE(S) DCD WAS PHYSICALLY ABUSED
AND TO lvHAT EXTENT (HE?SHE) \vAS ABUSED AT THAT AGE)
TABLE 10.
Extent of Abuse
DCD's Age
Slight
Moderate
Severe
0 - 5
6 - 12
13 -15
16-la
39.
Has there one thing
(his/her) spare time?
(DCD)
liked to do most of all in
Yes
No
(SKIP TO Q. 42)
Don't know
40.
41.
(SKIP TO Q. tU)
'<Vhat was it?
About how many hours per week would (he/she) spend in this
activity?
HOURS PER WEEK: __________________
42 •
Did
__
(DCD)
___
._.:..;....;;...;;;...:._
Yes
No
Don't know
like to read any books or magazines?
.
95
43.
What types of books or magazines did (he/she) like to read?
(PROBE FOR SPECIFIC TITLES AND SUBJECT MATTER)
4~.
Did
(DCD)
belong to any clubs, fraternities (or sororities),
fan clubs, scoutinq orqanizations, church groups, motorcycle
gangs, car clubs, neighborhood-youth gangs or any other organized
activity?
Yes
No
(SKIP TO Q. 48 I
Don't know
(SKIP TO Q. 46-}
4-:!.
What group(s) did (he/she) belong to?
46.
About how many hours a day did
Approx. No. of hours:
(DCD)
spend watching T.V.?
--~----------------
47.
~fuat
4~.
What movies or types of movies was
(DCD)
in going to see?
(LIST UP TO THREE)
were the programs or types of programs that (he/she) liked
to watch on T.V.?
(LIST UP TO THREE)
most interested
96
49.
Was there anything that
(DCD)
liked to collect?
Things such as stamps, posters, guns, books, pictures, or
anything else at all?
(PROBE AND LIST BELOW OR
i'7RITE "NONE)
97
I
50
Was (he/she) ever involved in any of these activities, sports
or pastimes? Any others?
(CIRCLE THOSE THINGS DCD WAS INVOLVED IN)
Baseball
Partying
Baby sitting
Basketball
reading
Football
Watching TV
Boyscouts or
Girlscouts
Tennis '
Track and Field
Disco Dancing
Golf
Swimming
'cruising
Fashions in clothes
Weight Lifting
Sailing
Collecting things
Hunting and shooting
Backpacking
Fixing things
Fishing
Horseback Riding
Electronics
Surfing
Motorcycles
Mod~l
Shopping
Skiing
skateboarding
Gang-Gliding
Listening to music
Photography
Scuba Diving
Sewing or needlepoint
Gymnastics
Motor Mechanics
Cooking
building
Other: _____________
51·
Did
----~(D~C~D~)______ have
any friends?
Yes
52
No
(SKIP TO Q. 54.)
Don't know
(SKIP TO Q. 54 )
Would you say that (he/she) had many friends, some friends,
or just a few friends?
Many
Some
Just a few
Don't know
•
98
53.
How many of these friends do you feel were reallv close friends-friends that
(DCD)
saw often and shared (his/her) feelings
with?
NUMBER OF CLOSE FRIENDS:
54.
Was
(DCD)
ever ipvolved in dances, parties, dating, or
other activities with persons of the opposite sex?
Yes
No
(SKIP TO Q. 5-6
Don't know
(SKIP TO Q. 56
55 . Would you say that (he/she) was very involved, somewhat involved,
or rarely involved in such activities?
Very involved
Somewhat involved
Rarely involved
Don't know
56. How popular would you say
(DCD)
when (he/she) was in high school?
was with the (girls/boys)
Very popular
Fairly popular
Not too popular
Not at all popular
Don't know
~7.
Some people see themselves differently from the way others see them.
How did
(DCD)
see (himself/herself)? Would you say (he/
she).felt very good about (himself/herself), fairly good about
(himself/herself), not too good about (himself/herself), or didn't
like (himself/herself) at all?
Veri good about self
Fairly good about self
Not too good about self
Didn't like self at all
Don't know
99
58.
Do you think
(DCD)
should have thought more of (himself/
herself), less of (himself/herself), or that (h~s/her) feelings
about (himself/herself) were just about right?
Should have thought more of self
Feelings just about right
Should have thought less of self
Don't know
'·
PEER RESPONDENTS ONLY Q. 59-66
59.
.
Did
(DCD)
run around with one group of friends or did
(he/she) do things with more than one group?
(NOTE "GROUP" IS DEFINED HERE AS ONE OR MORE PERSONS IN
ADDITION TO (DCD)
More than one group
DCD had no friends
(SKIP TO Q. 65)
Don't know
(SKIP TO Q. 65)
100
60 •
How did this group of friends feel about using street drugs?
They generally approved of using drugs
They didn't really care
They disapproved of using drugs
Don't know
61.
How did this group feel about doing well in school?
They were very concerned
They were somewhat concerned
They didn't really care
Don't know
62
How did this group feel about listening to the advice of parents
and other adults in authority?
They would usually listen
They would sometimes listen
They didn't want any advice
Don't know
63.
How did the members of this group feel about doing things for
one another and helping each other out when there was trouble?
They really looked out for one another
They would sometimes look out for one another
They felt that each person should look out for
himself/herself
Don't know
64
How did this group feel about the idea of getting married and
taking on family responsibilities?
They looked forward to this in the future
They didn't really think about it
They thought it was a stupid thing to do
Don't know
101
6~.
Were these separate groups of friends made up of pretty much
the same kinds of people with similar interests or were they
into different kinds of things?
The groups were different
6b.
The groups were similar
(SKIP TO Q. 67)
Don't know
(SKIP TO Q. 67)
In what ways were the groups and the people in them different
from one another?
6 7 • Did
and
p~ck
(DCD)
ever stop doing things with one group of friends
up with another group?
Yes
No
Don't know
68. Why did (he/she) stop doing thing with (his/her) old group of
friends?
89. Thinking back to the group of friends that
(DCD)
was most
involved with, what were the things that they most liked to do
together?
(LIST UP TO THREE GROUP ACTIVITIES)
102
70.
Did the members of this group tend to give much thought to
their futures?
A great deal
Some
Little or none
Don't know
71.
Some young people think the future holds a better life for them
while other young people feel that things will only get worse.
How did
(DCD's)
friends feel about the future.
Things would get better
Uncertain about the future
Things would get worse
Don't know
(END "PEER ONLY" QUESTIONS)
72.
Did
_
(DCD)
__.:.;;;...;;;;"-"----
ever go out on dates?
Regularly
Occasionally
Little
73.
Never
{SKIP TO Q. 75)
Don't know
(SKIP TO Q. 75)
Did (he/she) get on well with the people {he/she) dated or were
there problems?
Many problems
Some problems
No problems
(SKIP TO Q. 75 J
Don't know
(SKIP TO Q. 75)
103
:4.
Did these problems mainly have to do with
(DCD's)
parents not approving or were they personal problems
between
(DCD)
and the (girls/boys) (he/she) dated?
Parents not approving
Personal problems
Don't know
75.
How often was
(DCD)
involved in petting and other sexual
activity short of Lntercourse?
Often
Occasionally
Rarely
Never
Don't know
76.
Do you know if ____(~D_c_o~>~____ever had sexual intercourse?
Yes
77.
No
(SKIP TO Q. 79)
Don't know
(SKIP TO Q. 79)
At approximately what age did (he/she) start having sexual intercourse?
YEARS OF AGE:
78.
About how many (boys/girls) would you say (DCD) had sexual
intercourse with in (his/her) life?
NUMBER OF PEOPLE=----------~---------
79.
Had ____(:..:D~C:.;D:;..;l:..________ever had any sexual problems?
Yes
No
(S~IP
Don't know
(SKIP TO Q. 81)
TO Q. 81)
104
~0
What were the problems and how old was
(DCD)
•.vhen
the problem first developed? (LIST AND DESCRIBE EACH PROBLEM
AND DCD's AGE IN TABLE 11)
Sexual Problems
TABLE 11.
PROBLEMS
YEARS OF AGE
a.
b.
c.
d.
le·
~1.
Nere there any problems or concerns with homosexuality?
(IF "YES", DESCRIBE ABOVE IN TABLE 11, AND ASK AT WHAT AGE?)
Yes
No
Don·t know
82.
Did ___!.;(D:..;C~D:;..:_)_ __;;:.ever "go steady" with another person?
More than once
Once
83-.
Never
(SKIP TO
Q. 84 )
Don't know
(SKIP TO
Q.
81.)
Did (he/she) get on well with (his/her) steady date(s) or were
there problems?
Many problems
Some problems
No problems
-Don't know
105
84,
Was
(DCD)
ever engaged to be married?
More than once
Once
8~
Never
(SKIP TO Q. 8_7)
Don't know
(SKIP TO Q. 87)
Did (he/she) get on well with the oerson(s}
engaged to or were there problems?-
(he/she) was
Many problems
Some problems·
No problems
Don't know
86.
Was there ever a broken engagement?
Yes
No
Don't know
87
iias ____(~D~C~D~l~-- ever married?
More than once
Once
88
Never
(SKIP TO Q. 8 9 · i
Don't know
(SKIP TO Q. 89,)
Did (he/she) get on well with· (his/her)
were there problems?
Many problems
Some problems
No problems
Don't know
(wife/husband) or
106
89<
Drugs are a widespread problem among youth today. Did
(DCD)
ever use or experiment with non-prescription
drugs?
Yes
90
No
(SKIP TO Q. 93)
Don't know
(SKIP TO Q •. U)
At what age did (he/she) begin to experiment with drugs?
EARLIEST AGE OF DRUG USE: __________________~years
91. About how often did (he/she) use drugs? (any non-prescription drugs.)
Daily
Weekly
Honthly
Less than once a month
Don't know
107
92 •
(GIVE CARD
~
TO RESPONDENT)
Here is a list of non-prescription drugs commonly used by
young people today. Could you look over the drugs on this
list and tell me which drugs
(DCD)
used?
(CHECK EACH DRUG NENTIONED)
---~Marijuana
(also known as Grass, Weed, or Pot}
Barbiturates {Downers or Reds)
------'
·Amphetamines (Uppers, Whites or Speed)
---~
-----·Cocaine (Coke)
---~LSD
(Acid)
______PCP {Angel Dust)
_____Qualudes (Ludes)
------Glue or Gasoline or Paint
(sniffing)
Amyl Nitrite
------'
______Valoum
__
.......;Heroin
____Peyote or Mescaline {Hagic Mushrooms)
_ _ _Other (Specify: ________________________
93
(DCD)
drink beer, wine or other
About how often did
alcoholic beverages? ----=-~'---Daily
Weekly
Monthly
Less than once a month
Never
(SKIP TO
Don't know
{SKIP TO Q•. 95)
Q. 95}'
108
Y4.
At what age did (he/she) begin to use alcohol?
EARLIST AGE OF ALCOHOL USE _ _ _ _ _yrs.
9~.
Did
(DCD)
ever have trouble with or get into trouble
with either drugs or alcohol?
Yes
96.
No
(SKIP TO Q. 101
Don't know
(SKIP TO Q. 101
What kind of trouble?
(CHECK (/) IN TABLE 12 THE KIND(S) OF TROUBLE (DCD) HAD AND
'IVHETHER IT 'IVAS WITH DRUGS AND/OR WITH ALCOHOL. -~SO INDICATE
THE NUMBER OF TIY..ES (DCD) WAS IN THIS KIND OF TROUBLE.
TABLE 12.
Drugs
cted Crazy
agitation
obs (absenteeism or loss)
Schools (truancy,apathy)
arnily disruption
Alcohol
109
103.
The following is a list of problems in the world today. Some
people worry about these problems in a way that causes them to
lose hope for the future, while other people either don't
worry about them or assume that they will be solved before
they get out of hand. Do you think that any of these problems
caused
(DCD's)
friends
to lose hope ave~ their
own futures?
World Problems
I
Yes
threat of
terrorism, v<ar or nuclear
arfare
Unemployment or lack of job opportunities
Crime and Violence
Racial conflict
No trust in government or society
Energy shortages or environmental
pollution
Inflation or economic uncertainty
No
DK
i
110
I04.
Did
(DCD)
ever talk aboutwanting-to commit suicide?
--..!.::..=~--
Often
Occasionally
Once
Never
Don't know
105..
Did (he/she) ever directly threaten suicide?
Often
Occasionally
Once
Never
Don't know
106.
Prior to (his/her) death, did
---~(~D~CD~)___
ever attemot suicide?
Yes
107.
No
(SK!l? TO Q. llL)'
Don't know
(SKIP TO Q. 111},
At what age(s) did (he/she) attempt suicide?
(LIST DCD' s. AGE AT THE TII1E OF EACH SUICIDE ATTEMPT IN TABLE
COLUMN 1. START NITH THE EARLIEST AND '1-lORK FORlilARD. )
lOS_;.
F ,
What method did (he/she) use in the attempt?
(FOR EACH AGE LISTED IN COLUMN 1, LIST THE HETHOD USED IN THAT
ATTEMPT IN COLUMN 2. RECORD SPECIFIC METHOD SUCH AS GUNSHOT,
BARBITURATES, HANGING, ETC.)
109.;
Was medical treatment required for this attempt?
(FOR EACH ATTEM,f'T LISTED, INDICATE I.N COLUMN 3 ~·iHETHER THAT
ATTEHPT REQUIRED HEDICAL TREATMENT OR ATTENTION. RECORD "YES"
OR "NO" AS APPROPRIATE)
111
110.
--~(~D~C~D~)______
hospitalized as a result of this attempt?
(FOR EACH ATTEMPT LISTED, INDICATE IN COLUNN 4 WHETHER THAT
ATTEMPT REQUIRED THAT DCD BE HOSPITALIZED FOR TREATMENT. RECORD
"YES" OR "NO" AS APPROPRIATE.
TABLE H.
COLUMN 1.
Prior. SiJ.ic.i.de. Attempts
COLUMN 2
COLUMN 3
med~cal
DCD's Age
treatment
required?-
Method Used
(SPECIFY)
COLUHN 4
fnosp~ta.J.~-
zation
required?
1st.
2nd.
--
3rd.
4th.
5th.
111.
Did ______(~D~C~D~)~_______ever have psychotherapy or counseling?
Yes
112.
ll3:
Ll4.
No
(SKIP TO Q. 116)
Don't know
(SKIP TO Q. 116).
How old was
(DCD)
when (he/she) received psychothexapy
or counseling?
(ENTER DCD' s AGE FOR EACH TEID-1 OF PSYCHOTHERAPY
OR COUNSELING STARTING vliTH EARLIEST IN TABLE 15 . )
For how many months was (he/she) receiving psychotherapy or
counseling?
(ENTER THE NUMBER OF t•!ONI'HS, THAT DCD RECEIVED
PSYCHOTHERAPY OR COUNSELING SEPARATELY· FOR EACH TER.."1 IN TABLE J5 )
What was the problem that led up to
{DCD)
needing psychotherapy or counseling?
(PROBE FOR DIAGNOSTIC CATEGORY.
IF R
doesn't know, PROBE FOR BEHAVIOR. ENTER IN TABLE 15)
112
TABLE 15.-
History of Psychotherapy or counseling
Number of
Months
Years of
Age
Diagnosis or Behavior
a.
b.
c.
d.
e.
115.
What was
(DCD'sl
attitude towards receiving professional
help in the form of counseling and psychotherapy?
Very positive
Accepting
Skeptical
Refused
Don't know
116.
Was
(DCD)
a disciplinary problem in school?
Often
Sometimes
Rarely
Never
Don't k!\OW
117.
Was
(DCD)
ever arrested?
Yes
No
(SKIP TO Q.
il9)
Don't know
(SKIP TO Q.
119}
113
118.
Approximately how many times would you say that
was arrested in (his/her) life?
APPROXIMATE NUMBER OF ARRESTS:
OFFENSE FOR MOST ARRESTS
119.
(DCD)
-------
Did
(DCD)
ever get into physical fights with people
outside of (his/her) immediate family?
Often
Sometimes
Rarely
Never
Don't know
1.20.
Did
(DCD)
ever threaten to attack or kill anyone?
------~~~-----
Yes
No
Don't know
121.
Did
(DCD)
ever stab or shoot anyone?
Yes
No
Don't know
122.
Did
(DCD)
suffer a sudden loss or the threat of a loss
of a parent in the last three months of (his/her) life?
Yes
No
Don't know
123.
Did
(DCD)
suffer a sudden loss of the threat of a loss
of a close relationship or relative (OTHER THAN A PARENT) in
the last three months of (his/her) l.ife?
Yes
No
Don't know
114
124.
Did
(DCD)
suffer failure or the threat of failure in
school during the last three months of (his/her) life?
Yes
No
Don't know
12.::)-..
Did
(DCD)
change (his/her) place of residence at any
time dur~ng the last three months of (his/her) life?
Yes
No
Don't know
l~o_.
Did
(DCD)
suffer the loss or the threat of the loss
of a job in the last three months of (his/her) life?
YesNo
Don't know
Ln.
(DCD)
Did
suffer a loss of health or the threat of a
loss of health in the last three months of (his/her) life?
Yes
12a..
No
(SKIP TO Q. 129)
Don't know
(SKIP TO Q. 1"29)
Could you describe the nature of this loss of ·health or threat
of a loss?
115
129.
Could you please describe
(DCD's) most usual beha~ior and
style of life during the last three months in terms of the
following statements
(STATEMENTS A-F IN TABLE lo. Answer
"None or little of the time", "some of the time",
"good part
of the time" or "most of the time" for each statement.
TABLE 16.
Most recent behavior and style of life
Statements
a.
..
(DCD. felt down-hearted
elue and sad
b.
(DCD) had trouble sleeping at night.
c.
(DCD) got tired for no
reason.
d.
(DCD) found it easy to do
·things (he/she) was used to
e.
{DCD) was restless and
couldn't keep still.
f.
(DCD) still enjoyed the
things (he/she) used to do.
none or some of good' most o
little the time part of the
!n-1= t-im"'
t~me
t-imP
116
130.
Here is a list of words and phrases which are commonly used to
describe people.
(HAND CARD C
TO RESPONDENT)
Please look over this list and tell me which words or phrases
you think best described {DCD)
?
(CHECK THOSE WORDS AND PHRASES MENTIONED BY RESPONDENT IN THE
LIST BELOW)
Rebel
__Aggressive
Loner
___Moody
__Impulsive
Likeable
__l·1ama' s boy (or girl)
Didn't-fit in
__outgoing
_Shy
__Argumentative
__Delinquent
Sociable
All-American Boy {or girl)
__Fighter
Withdrawn
_Intellectual
Athletic
_._Easy going
Serious
__Popular
Passive
Decisive
117
LAST SCHOOL (DCD) ATTENDED: ____________________________________
Transiency Index (for above school): _ _ _ _ _ _ _ _ _ _ _ __
THE FOLLOWING QUESTIONS-- Q.l31-134
RESPONDENTS ONLY
131..
ARE TO BE GIVEN TO TEACHER
What is the name if the school where you teach?
NAME OF SCHOOL: ___________________________
132
Overall, how would-you compare this school with others in
the Los Angeles area?
Better than most
Better than some
Average
Worse than some
Worse than most
Don't know
133';
The morale of teachers is· higher in some schools, lower in
others. How is teacher morale at your school compared to
other schools in Los Angeles?
·
Exttemely high
High
Average
Low
Extremely low
Don't know
118
1~4-.
Some schools have more problems with student disruption and
'truancy than others. How much student disruption and truancy
does your school have compared with others in the Los Angeles
area?
More than most
More than some
Average
Less than some
Less than most
Don't know