Skip to main content
Search
Search
    Quick Search anywhere
    Quick search in Citations
Advanced Search
Skip main navigationClose Drawer MenuOpen Drawer Menu
Previous article
Next article
Research Trends

The Effect of Sudden Death Bereavement on the Risk for Suicide

The Role of Suicide Bereavement

Published Online:December 20, 2019https://doi.org/10.1027/0227-5910/a000635

Abstract

Abstract.Background: Bereavement after a sudden death is associated with psychiatric sequelae including suicidal ideation and behavior. However, there is still uncertainty about whether bereavement due to suicide increases the risk for suicidal behavior more than bereavement due to other causes of death does. Aims: This study aimed to evaluate suicidal risk among sudden death-bereaved participants and to identify risk factors for suicidality that may be over-represented in those who are suicide-bereaved. Method: In total, 180 adult participants, half of whom had experienced the sudden death of a first-degree relative within the previous 5 years, completed self-report questionnaires assessing suicidal risk, symptoms of depression, somatization, posttraumatic stress disorder (PTSD), complicated grief, perceived social support, and demographic information. Results: Sudden death bereavement was associated with increased suicide risk even after adjusting for psychiatric symptomatology. Within the bereaved groups, the highest risk for suicide was among those bereaved by suicide, with additional contributions from depressive symptomatology, PTSD, somatization, lower perceived social support, and secular religious orientation. Limitations: The study was cross-sectional and bereaved participants had lost their loved one an average of 5 years before the assessment. Conclusion: These results are consistent with the conclusion that suicide bereavement is a risk factor for suicidal behavior.

References

  • Agerbo, E. (2002). Familial, psychiatric, and socioeconomic risk factors for suicide in young people: Nested case-control study. BMJ, 325(7355), 74. 10.1136/bmj.325.7355.74 First citation in articleCrossref Medline, Google Scholar

  • Batterham, P. J., Calear, A. L., & Christensen, H. (2013). The stigma of suicide scale: Psychometric properties and correlates of the stigma of suicide. Crisis, 34, 13–21. 10.1027/0227-5910/a000156 First citation in articleLink, Google Scholar

  • Bolton, J. M., Au, W., Leslie, W. D., Martens, P. J., Enns, M. W., Roos, L. L., … Sareen, J. (2013). Parents bereaved by offspring suicide: A population-based longitudinal case-control study. JAMA Psychiatry, 70(2), 158–167. 10.1001/jamapsychiatry.2013.275 First citation in articleCrossref Medline, Google Scholar

  • Bonanno, G. A., Neria, Y., Mancini, A., Coifman, K. G., Litz, B., & Insel, B. (2007). Is there more to complicated grief than depression and posttraumatic stress disorder? A test of incremental validity. Journal of Abnormal Psychology, 116(2), 342–351. 10.1037/0021-843X.116.2.342 First citation in articleCrossref Medline, Google Scholar

  • Bottomley, J. S., Burke, L. A., & Neimeyer, R. A. (2017). Domains of social support that predict bereavement distress following homicide loss. Omega, 75(1), 3–25. 10.1177/0030222815612282 First citation in articleCrossref Medline, Google Scholar

  • Brent, D., Melhem, N., Donohoe, M. B., & Walker, M. (2009). The incidence and course of depression in bereaved youth 21 months after the loss of a parent to suicide, accident, or sudden natural death. American Journal of Psychiatry, 166(7), 786–794. 10.1176/appi.ajp.2009.08081244 First citation in articleCrossref Medline, Google Scholar

  • Burke, L. A., & Neimeyer, R. A. (2013). Prospective risk factors for complicated grief. In M. StroebeH. SchutJ. Van Den Bout (Eds.), Complicated Grief: Scientific Foundations for Health Care Professionals (pp. 145–161). New York, NY: Routledge. First citation in articleGoogle Scholar

  • Burke, L. A., & Neimeyer, R. A. (2014). Complicated spiritual grief I: Relation to complicated grief symptomatology following violent death bereavement. Death Studies, 38(4), 259–267. 10.1080/07481187.2013.829372 First citation in articleCrossref Medline, Google Scholar

  • Burrell, L. V., Mehlum, L., & Qin, P. (2017). Risk factors for suicide in offspring bereaved by sudden parental death from external causes. Journal of Affective Disorders, 222, 71–78. 10.1016/j.jad.2017.06.064 First citation in articleCrossref Medline, Google Scholar

  • Chapple, A., Ziebland, S., & Hawton, K. (2015). Taboo and the different death? Perceptions of those bereaved by suicide or other traumatic death. Sociology of Health and Illness, 37(4), 610–625. 10.1111/1467-9566.12224 First citation in articleCrossref Medline, Google Scholar

  • Cheng, C. C. J., Yen, W. J., Chang, W. T., Wu, K. C. C., Ko, M. C., & Li, C. Y. (2014). Risk of adolescent offspring's completed suicide increases with prior history of their same-sex parents' death by suicide. Psychological Medicine, 44(9), 1845–1854. 10.1017/S0033291713002298 First citation in articleCrossref Medline, Google Scholar

  • Cleiren, M. (1993). Bereavement and adaptation: A comparative study of the aftermath of death. New York, NY: Routledge. First citation in articleGoogle Scholar

  • Dyregrov, K., Nordanger, D., & Dyregrov, A. (2003). Predictors of psychosocial distress after suicide, sids and accidents. Death Studies, 27(2), 143–165. 10.1080/07481180302892 First citation in articleCrossref Medline, Google Scholar

  • Feigelman, W., Jordan, J. R., & Gorman, B. S. (2009). How they died, time since loss, and bereavement outcomes. OMEGA – Journal of Death and Dying, 58(4), 251–273. 10.2190/OM.58.4.a First citation in articleCrossref, Google Scholar

  • Foa, E. B., McLean, C. P., Zang, Y., Zhong, J., Powers, M. B., Kauffman, B. Y., … Knowles, K. (2016). Psychometric properties of the posttraumatic diagnostic scale for DSM-5 (PDS-5). Psychological Assessment, 28(10), 1166–1171. 10.1037/pas0000258 First citation in articleCrossref Medline, Google Scholar

  • Foa, E. B., Riggs, D. S., Dancu, C. V., & Rothbaum, B. O. (1993). Reliability and validity of a brief instrument for assessing post-traumatic stress disorder. Journal of Traumatic Stress, 6(4), 459–473. 10.1007/bf00974317 First citation in articleCrossref, Google Scholar

  • Guldin, M. B., Li, J., Pedersen, H. S., Obel, C., Agerbo, E., Gissler, M., … Vestergaard, M. (2015). Incidence of suicide among persons who had a parent who died during their childhood a population-based cohort study. JAMA Psychiatry, 72(12), 1227–1234. 10.1001/jamapsychiatry.2015.2094 First citation in articleCrossref Medline, Google Scholar

  • Hamdan, S., Melhem, N., Orbach, I., Farbstein, I., El-Haib, M., Apter, A., & Brent, D. (2012). Protective factors and suicidality in members of Arab Kindred. Crisis, 33(2), 80–86. 10.1027/0227-5910/a000116 First citation in articleLink, Google Scholar

  • Hamdan, S., Melhem, N. M., Porta, G., Walker Payne, M., & Brent, D. A. (2012). The phenomenology and course of depression in parentally bereaved and non-bereaved youth. Journal of the American Academy of Child and Adolescent Psychiatry, 51(5). 10.1016/j.jaac.2012.02.021 First citation in articleCrossref Medline, Google Scholar

  • Jakobsen, I. S., & Christiansen, E. (2011). Young people's risk of suicide attempts in relation to parental death: A population-based register study. Journal of Child Psychology and Psychiatry and Allied Disciplines, 52(2), 176–183. 10.1111/j.1469-7610.2010.02298.x First citation in articleCrossref Medline, Google Scholar

  • Jeon, H. J., Hong, J. P., Fava, M., Mischoulon, D., Nyer, M., Inamori, A., … Cho, M. J. (2013). Childhood parental death and lifetime suicide attempt of the opposite-gender offspring in a nationwide community sample of Korea. Suicide and Life-Threatening Behavior, 43(6), 598–610. First citation in articleCrossref Medline, Google Scholar

  • Jordan, J. R., & McIntosh, J. L. (2011). Suicide bereavement: Why study survivors of suicide loss? In J. R. JordanJ. L. McIntosh (Eds.), Grief after suicide: Understanding the consequences and caring for the survivors (pp. 33–48). New York, NY: Routledge. 10.4324/9780203886045 First citation in articleCrossref, Google Scholar

  • Kaltman, S., & Bonanno, G. A. (2003). Trauma and bereavement: Examining the impact of sudden and violent deaths. Journal of Anxiety Disorders, 17(2), 131–147. 10.1016/S0887-6185(02)00184-6 First citation in articleCrossref Medline, Google Scholar

  • Kaplow, J. B., Howell, K. H., & Layne, C. M. (2014). Do circumstances of the death matter? Identifying socioenvironmental risks for grief-related psychopathology in bereaved youth. Journal of Traumatic Stress, 27(1), 42–49. 10.1002/jts.21877 First citation in articleCrossref Medline, Google Scholar

  • Kessing, L. V., Agerbo, E., & Mortensen, P. B. (2003). Does the impact of major stressful life events on the risk of developing depression change throughout life? Psychological Medicine, 33(7), 1177–1184. 10.1017/S0033291703007852 First citation in articleCrossref Medline, Google Scholar

  • Keyes, K. M., Pratt, C., Galea, S., McLaughlin, K. A., Koenen, K. C., & Shear, M. K. (2014). The burden of loss: Unexpected death of a loved one and psychiatric disorders across the life course in a national study. American Journal of Psychiatry, 171(8), 864–871. 10.1176/appi.ajp.2014.13081132 First citation in articleCrossref Medline, Google Scholar

  • Kocalevent, R. D., Hinz, A., & Brähler, E. (2013). Standardization of a screening instrument (PHQ-15) for somatization syndromes in the general population. BMC Psychiatry, 13, 91. 10.1186/1471-244X-13-91 First citation in articleCrossref Medline, Google Scholar

  • Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9. Validty of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606–613. 10.1046/j1525-14972001016009606x First citation in articleCrossref Medline, Google Scholar

  • Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2002). The PHQ-15: Validity of a new measure for evaluating the severity of somatic symptoms. Psychosomatic Medicine, 64(2), 258–266. 10.1097/00006842-200203000-00008 First citation in articleCrossref Medline, Google Scholar

  • Kroenke, K., Spitzer, R. L., Williams, J. B. W., & Löwe, B. (2010). The Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales: A systematic review. General Hospital Psychiatry, 32(4), 345–359. 10.1016/j.genhosp​psych.2010.03.006 First citation in articleCrossref Medline, Google Scholar

  • Kroenke, K., Strine, T. W., Spitzer, R. L., Williams, J. B. W., Berry, J. T., & Mokdad, A. H. (2009). The PHQ-8 as a measure of current depression in the general population. Journal of Affective Disorders, 114(1–3), 163–173. 10.1016/j.jad.2008.06.026 First citation in articleCrossref Medline, Google Scholar

  • Lawrence, R. E., Oquendo, M. A., & Stanley, B. (2016). Religion and suicide risk: A systematic review. Archives of Suicide Research, 20(1), 1–21. 10.1080/13811118.2015.1004494 First citation in articleCrossref Medline, Google Scholar

  • Leahy, J. M. (1992). A comparison of depression in women bereaved of a spouse, child, or a parent. Omega: Journal of Death and Dying, 26(3), 207–217. 10.2190/YLG9-P4R7-W2VW-KAFR First citation in articleCrossref, Google Scholar

  • Litman, J. A. (2006). The COPE inventory: Dimensionality and relationships with approach- and avoidance-motives and positive and negative traits. Personality and Individual Differences, 41(2), 273–284. 10.1016/j.paid.2005.11.032 First citation in articleCrossref, Google Scholar

  • Ljung, T., Sandin, S., Långström, N., Runeson, B., Lichtenstein, P., & Larsson, H. (2014). Offspring death and subsequent psychiatric morbidity in bereaved parents: Addressing mechanisms in a total population cohort. Psychological Medicine, 44(9), 1879–1887. 10.1017/S0033291713002572 First citation in articleCrossref Medline, Google Scholar

  • Melhem, N. M., Day, N., Shear, M. K., Day, R., Reynolds, C. F., & Brent, D. (2004). Traumatic grief among adolescents exposed to a peer's suicide. American Journal of Psychiatry, 161(8), 1411–1416. 10.1176/appi.ajp.161.8.1411 First citation in articleCrossref Medline, Google Scholar

  • Melhem, N. M., Moritz, G., Walker, M., Shear, M. K., & Brent, D. (2007). Phenomenology and correlates of complicated grief in children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 46(4), 493–499. 10.1097/chi.0b013e31803062a9 First citation in articleCrossref Medline, Google Scholar

  • Melhem, N. M., Porta, G., Shamseddeen, W., Walker Payne, M., & Brent, D. A. (2011). Grief in children and adolescents bereaved by sudden parental death. Archives of General Psychiatry, 68(9), 911–919. 10.1001/archgenpsychiatry.2011.101 First citation in articleCrossref Medline, Google Scholar

  • Melhem, N. M., Walker, M., Moritz, G., & Brent, D. A. (2008a). Antecedents and sequelae of sudden parental death in offspring and surviving caregivers. Archives of Pediatrics and Adolescent Medicine, 162(5), 403–410. 10.1001/archpedi.162.5.403 First citation in articleCrossref Medline, Google Scholar

  • Melhem, N. M., Walker, M., Moritz, G., & Brent, D. A. (2008b). Antecedents and sequelae of sudden parental death in offspring and surviving caregivers. Archives of Pediatrics & Adolescent Medicine, 162(5), 403. 10.1001/archpedi.162.5.403 First citation in articleCrossref Medline, Google Scholar

  • Mitchell, A. M., Kim, Y., Prigerson, H. G., & Mortimer, M. K. (2005). Complicated grief and suicidal ideation in adult survivors of suicide. Suicide and Life-Threatening Behavior, 35(5), 498–506. 10.1521/suli.2005.35.5.498 First citation in articleCrossref Medline, Google Scholar

  • Neria, Y., Gross, R., Litz, B., Maguen, S., Insel, B., Seirmarco, G., … Marshall, R. D. (2007). Prevalence and psychological correlates of complicated grief among bereaved adults 2.5–3.5 years after September 11th attacks. Journal of Traumatic Stress, 20(3), 251–262. 10.1002/jts.20223 First citation in articleCrossref Medline, Google Scholar

  • Niederkrotenthaler, T., Floderus, B., Alexanderson, K., Rasmussen, F., & Mittendorfer-Rutz, E. (2012). Exposure to parental mortality and markers of morbidity, and the risks of attempted and completed suicide in offspring: An analysis of sensitive life periods. Journal of Epidemiology and Community Health, 66(3), 233–239. 10.1136/jech.2010.109595 First citation in articleCrossref Medline, Google Scholar

  • Nolen-Hoeksema, S., & Larson, J. (1999). Coping with loss. Mahwah, NJ: Lawrence Erlbaum Associates. First citation in articleGoogle Scholar

  • O'Connor, M., Lasgaard, M., Shevlin, M., & Guldin, M. B. (2010). A confirmatory factor analysis of combined models of the Harvard Trauma Questionnaire and the Inventory of Complicated Grief-Revised: Are we measuring complicated grief or posttraumatic stress? Journal of Anxiety Disorders, 24(7), 672–679. 10.1016/j.janxdis.2010.04.009 First citation in articleCrossref Medline, Google Scholar

  • Osman, A., Bagge, C. L., Gutierrez, P. M., Konick, L. C., Kopper, B. A., & Barrios, F. X. (2001). The Suicidal Behaviors Questionnaire-Revised (SBQ-R): Validation with clinical and nonclinical samples. Assessment, 8(4), 443–454. ​10.1177/107319110100800409 First citation in articleCrossref Medline, Google Scholar

  • Pfister, T., & Friedrich, D. (2015). Editorial to the forum "International Relations of science and knowledge." Innovation: The European Journal of Social Science Research, 28(1), 1–2. 10.1080/13511610.2014.967665 First citation in articleCrossref, Google Scholar

  • Pham, S., Porta, G., Biernesser, C., Walker Payne, M., Iyengar, S., Melhem, N., & Brent, D. A. (2018). The burden of bereavement: Early-onset depression and impairment in youths bereaved by sudden parental death in a 7-year prospective study. American Journal of Psychiatry, 175(9), 887–896. 10.1176/appi.ajp.2018.17070792 First citation in articleCrossref Medline, Google Scholar

  • Pitman, A. L., Osborn, D. P. J., Rantell, K., & King, M. B. (2016). Bereavement by suicide as a risk factor for suicide attempt: A cross-sectional national UK-wide study of 3432 young bereaved adults. BMJ Open, 6(1). 10.1136/bmj​open-2015-009948 First citation in articleCrossref Medline, Google Scholar

  • Prigerson, H. G., Frank, E., Kasl, S. V., Reynolds, C. F., Anderson, B., Zubenko, G. S., … Kupfer, D. J. (1995). Complicated grief and bereavement-related depression as distinct disorders: Preliminary empirical validation in elderly bereaved spouses. American Journal of Psychiatry, 152(1), 22–30. 10.1176/ajp.152.1.22 First citation in articleCrossref Medline, Google Scholar

  • Qin, P., & Mortensen, P. B. (2003). The impact of parental status on the risk of completed suicide. Archives of General Psychiatry, 60(8), 797. 10.1001/archpsyc.60.8.797 First citation in articleCrossref Medline, Google Scholar

  • Nadorff, M. R., Nazem, S., & Fiske, A. (2013). Insomnia symptoms, nightmares, and suicide risk: Duration of sleep disturbance matters. Suicide and Life-Threatening Behavior, 43(2), 139–149. 10.1111/sltb.12003 First citation in articleCrossref Medline, Google Scholar

  • Randy, C., Peters, D. K., & Range, L. M. (1995). Psychometric properties of the suicidal behaviors questionnaire. Death Studies, 19(4), 391–397. 10.1080/07481189508252740 First citation in articleCrossref Medline, Google Scholar

  • Schomerus, G., Schwahn, C., Holzinger, A., Corrigan, P. W., Grabe, H. J., Carta, M. G., & Angermeyer, M. C. (2012). Evolution of public attitudes about mental illness: A systematic review and meta-analysis. Acta Psychiatrica Scandinavica. 10.1111/j.1600-0447.2012.01826.x First citation in articleCrossref Medline, Google Scholar

  • Sisask, M., Värnik, A., Kõlves, K., Bertolote, J. M., Bolhari, J., Botega, N. J., … Wasserman, D. (2010). Is religiosity a protective factor against attempted suicide: A cross-cultural case-control study. Archives of Suicide Research, 14(1), 44–55. 10.1080/13811110903479052 First citation in articleCrossref Medline, Google Scholar

  • Snarr, J. D., Heyman, R. E., & Slep, A. M. S. (2010). Recent suicidal ideation and suicide attempts in a large–scale survey of the U.S. Air Force: Prevalences and demographic risk factors. Suicide and Life-Threatening Behavior, 40(6), 544–552. 10.1521/suli.2010.40.6.544 First citation in articleCrossref Medline, Google Scholar

  • Stroebe, M., Stroebe, W., & Abakoumkin, G. (2005). The broken heart: Suicidal ideation in bereavement. American Journal of Psychiatry, 162(11), 2178–2180. 10.1176/appi.ajp.162.11.2178 First citation in articleCrossref Medline, Google Scholar

  • Sudak, H., Maxim, K., & Carpenter, M. (2008). Suicide and stigma: A review of the literature and personal reflections. Academic Psychiatry. 10.1176/appi.ap.32.2.136 First citation in articleCrossref Medline, Google Scholar

  • Sveen, C.-A., & Walby, F. A. (2008). Suicide survivors' mental health and grief reactions: A systematic review of controlled studies. Suicide and Life-Threatening Behavior, 38(1), 13–29. 10.1521/suli.2008.38.1.13 First citation in articleCrossref Medline, Google Scholar

  • Szanto, K., Shear, M. K., Houck, P. R., Reynolds, C. F., Frank, E., Caroff, K., & Silowash, R. (2006). Indirect self-destructive behavior and overt suicidality in patients with complicated grief. Journal of Clinical Psychiatry, 67(2), 233–239. 10.4088/JCP.v67n0209 First citation in articleCrossref Medline, Google Scholar

  • VanderWeele, T. J., Li, S., Tsai, A. C., & Kawachi, I. (2016). Association between religious service attendance and lower suicide rates among US women. JAMA Psychiatry, 73(8), 845–851. 10.1001/jamapsychiatry.2016.1243 First citation in articleCrossref Medline, Google Scholar

  • Villacieros Durbán, M., Serrano, I., Bermejo Higuera, J. C., Magaña Loarte, M., & Carabias Maza, R. (2014). Social support and psychological well-being as possible predictors of complicated grief in a cross-section of people in mourning. Anales de Psicología, 30(3), 944–951. 10.6018/analesps.30.3.154691 First citation in articleCrossref, Google Scholar

  • Wertheimer, A. (2013). A special scar: The experiences of people bereaved by suicide. New York, NY: Routledge. First citation in articleCrossref, Google Scholar

  • Wilcox, H. C., Arria, A. M., Caldeira, K. M., Vincent, K. B., Pinchevsky, G. M., & O'Grady, K. E. (2010). Prevalence and predictors of persistent suicide ideation, plans, and attempts during college. Journal of Affective Disorders, 127(1–3), 287–294. 10.1016/j.jad.2010.04.017 First citation in articleCrossref Medline, Google Scholar

  • Wilcox, H. C., Mittendorfer-Rutz, E., Kjeldgård, L., Alexanderson, K., & Runeson, B. (2015). Functional impairment due to bereavement after the death of adolescent or young adult offspring in a national population study of 1,051,515 parents. Social Psychiatry and Psychiatric Epidemiology, 50(8), 1249–1256. 10.1007/s00127-014-0997-7 First citation in articleCrossref Medline, Google Scholar

  • World Health Organization. (2011). ICD-10 international statistical classification of diseases and related health problems. Geneva, Switzerland: Author. 10.1016/j.jclinepi.2009.09.002 First citation in articleCrossref, Google Scholar

  • Young, I. T., Iglewicz, A., Glorioso, D., Lanouette, N., Seay, K., Ilapakurti, M., & Zisook, S. (2012). Suicide bereavement and complicated grief. Dialogues in Clinical Neuroscience, 14(2), 177–186. 10.1093/eurheartj/ehn278 First citation in articleCrossref Medline, Google Scholar

  • Young, R., Sweeting, H., & Ellaway, A. (2011). Do schools differ in suicide risk? The influence of school and neighbourhood on attempted suicide, suicidal ideation and self-harm among secondary school pupils. BMC Public Health, 11. 10.1186/1471-2458-11-874 First citation in articleCrossref, Google Scholar

  • Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988). The multidimensional scale of perceived social support. Journal of Personality Assessment, 52(1), 30–41. 10.1207/s15327752jpa5201 First citation in articleCrossref, Google Scholar