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The undiscovered country: Can suicide be predicted?

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Re: The undiscovered country: Can suicide be predicted?

#101

Post by LorenPechtel »

autoexec wrote: post #94
jsmith45 wrote: post #60

Earlier quoted context omitted.

One flaw with the analogy is that a pretty significant portion of suicides (successful or attempts) are impulsive. Many people who attempt it have literally no idea they will when they wake up that morning. A 2001 University of Houston study of survivors of near lethal attempts showed that 70% of them had only decided to do it an hour or less before the attempt, and 24 percent had only spent 5 minutes before the atte…

> Of 515 people prevented by police from jumping off the Golden Gate Bridge between 1937 and 1971, by the end of the 70s only 6% of them had committed suicide by other means. Perhaps much of that is because they got the help they needed following the incident. It probably also helps that they were a group made up of those who were able to be persuaded by police to not jump in the first place already showing at least…

Note, also, the prerequisite: For the police to talk them down they must have been on the brink but not jumped for some time, otherwise the police wouldn't be there to talk them down.

I don't think the ones that are talked down are a remotely representative sample.

Re: The undiscovered country: Can suicide be predicted?

#102

Post by LorenPechtel »

autoexec wrote: post #89
pmoriarty wrote: post #34

In "Why do people die by suicide" , Dr Paul Thomlinson goes over the research on predicting suicide.[1] First, he talks about a well supported model called Joiner's Model, based on research which shows that people who are most likely to commit suicide have all three of these factors: - Thwarted belongingness ("I am alone") - Perceived burdensomeness ("I am a burden") - Ability to commit suicide ("I am not afraid to d…

Joiner's Model seems to exclude people who are candidates for assisted suicide. They often don't feel alone, don't feel like a burden, but are terminally ill, in constant pain, feel they've lived long enough, seeing significant mental/physical decline etc. You can shoehorn them into "IS PATH WARM" under hopelessness, trapped, or anger I guess.

Yeah, it's looking at mental illness suicide.

The terminally ill ones are more like the people who jump from a burning building--life has legitimately become more painful than death. That's not something a psychiatrist can change.

Re: The undiscovered country: Can suicide be predicted?

#103

Post by AKSucks »

pmoriarty wrote: post #45
hashhar wrote: post #35

The lack of empathy in the comments is scary. No wonder the situation is so bad. Let me present a scenario which might seem more relatable since it seems people understand physical pain but have no "scale" of what mental pain could be like. You have a chronic pain (maybe one of wrists is broken in a way that there is no solution). No painkillers help. Every doctor you go to doesn't have a quick-fix. People around you…

This reminds me of the case of Dax Cowart[1][2], who as a young man suffered tremendous burns from an accident which he survived but which killed his father who was with him. He lost his eyes and face, had both of his hands amputated, and was forcibly given agonizing treatments for 14 months. At his request a documentary video was made about him, which he titled "Please Let Me Die"[3]. It was shown to lawmakers and j…

> He lost his eyes and face, had both of his hands amputated, and was forcibly given agonizing treatments for 14 months.

I bet this was because doctors and surgeons saw him as challenge and a career/resume builder.

Re: The undiscovered country: Can suicide be predicted?

#104

Post by LorenPechtel »

s1artibartfast wrote: post #64
aeturnum wrote: post #58

Earlier quoted context omitted.

> people with disorders negatively impacting their cognition and decision making. I think we should be really careful about how we think & talk about this. There are a few situations (like psychotic breaks) where people fully believe delusions that, in a short time, they will reject. We can cleanly call those experiences "irrational." On the other hand, people who experience long term depression literally experience…

I totally agree that it is a very tricky subject, especially regarding depression. Having some experience with it myself, I would argue that irrational pessimism is a major feature of depression. For example, people cannot accurately asses actions and activities that would in fact make them happier if they were to follow through. In this way, I think they are clearly distinct from those with terminal illness or chron…

I think the fundamental issue comes down to whether the cause of the desire is fixable. If there's a fixable problem, fix it. If there isn't I think they should be allowed to (and even provided painless means to do so--say, a mask connected to a nitrogen tank.) Whether we agree with the reason or not I don't think enters into the picture.

Re: The undiscovered country: Can suicide be predicted?

#105

Post by s1artibartfast »

LorenPechtel wrote: post #104
s1artibartfast wrote: post #64

Earlier quoted context omitted.

I totally agree that it is a very tricky subject, especially regarding depression. Having some experience with it myself, I would argue that irrational pessimism is a major feature of depression. For example, people cannot accurately asses actions and activities that would in fact make them happier if they were to follow through. In this way, I think they are clearly distinct from those with terminal illness or chron…

I think the fundamental issue comes down to whether the cause of the desire is fixable. If there's a fixable problem, fix it. If there isn't I think they should be allowed to (and even provided painless means to do so--say, a mask connected to a nitrogen tank.) Whether we agree with the reason or not I don't think enters into the picture.

And what if the person doesn't want to fix it? Do you force them?

Re: The undiscovered country: Can suicide be predicted?

#106

Post by paulcole »

LorenPechtel wrote: post #102
autoexec wrote: post #89

Earlier quoted context omitted.

Joiner's Model seems to exclude people who are candidates for assisted suicide. They often don't feel alone, don't feel like a burden, but are terminally ill, in constant pain, feel they've lived long enough, seeing significant mental/physical decline etc. You can shoehorn them into "IS PATH WARM" under hopelessness, trapped, or anger I guess.

Yeah, it's looking at mental illness suicide. The terminally ill ones are more like the people who jump from a burning building--life has legitimately become more painful than death. That's not something a psychiatrist can change.

I always wonder about a 3rd group. Those without mental illness or terminal illness who just want to die. Or is the assumption that someone who wants to die but isn’t terminally ill must be mentally ill?

Re: The undiscovered country: Can suicide be predicted?

#107

Post by LorenPechtel »

giantg2 wrote: post #54

'Poté explained that the basic mechanism is comparable to the process “used in lie-detector tests, like you see in the movies.”' And yet polygraphs are known to be unreliable, to the point that they are generally not admissible in court. It would probably be better marketing if they don't imply that their product is comparable to an qn existing tech that is unreliable.

The basic problem with lie detectors is that if you know what you're doing you can trick the machine. Also, people tend to react to the sensitive questions, producing false positives.

While they aren't used for it they can in certain circumstances produce results with an accuracy quite sufficient for the courtroom, and there isn't even any Fifth Amendment problems with the approach:

You need things which the criminal will know but which others will not--you have to keep a bunch of details out of the press. The suspect is not asked any questions, but rather asked to read a bunch of statements about the crime--"she was wearing a red blouse", "she was wearing a green blouse", "she was wearing a white blouse", "she was wearing a blue blouse", each statement is innocent and thus will not trigger a reaction in the person who doesn't know the details. There is a 1 in 4 chance that someone will show the strongest reaction to the true statement--but what happens when you do the same thing with a bunch of details? Show the strongest reaction to the true one on 20 such 4-choice questions and now what are the odds it's a random?

An innocent can't incriminate themselves because they don't know which are the sensitive answers. Note that you can't exonerate someone this way--someone who doesn't remember the details being asked about will look the same as someone who is innocent. However, if it fingers you to a sufficiently high degree of certainty guilt is assured.

Re: The undiscovered country: Can suicide be predicted?

#108

Post by LorenPechtel »

anonymouse008 wrote: post #18
spywaregorilla wrote: post #3

I would tend to assume suicide is fairly predictable with high sensitivity and the data many corporations have from surveillance of customers tbh.

Let's just say I get really concerned about my fairly stable, committed household when I get therapy and dating app ads...

The targeting isn't all that good. We note the dramatic hits, we don't note the far larger number of misses.

I used to get a lot of dating and foreign-matchmaking ads stemming from the fact I like chess. Never mind that I have been off the market since before there was a www.

Re: The undiscovered country: Can suicide be predicted?

#109

Post by kelnos »

dalmo3 wrote: post #86
Jare wrote: post #72

Earlier quoted context omitted.

> One flaw with the analogy [...] Many people who attempt it have literally no idea they will when they wake up that morning. Can you elaborate? That sounds pretty much like the people in the analogy to me. They jump because the alternative they face right now is more terrifying for some reason. It makes sense that not all methods of suicide fulfill that criteria (being less terrifying than the alternative), even if…

I reacted the same way when I read that part too, but the rest of the comment illustrates it well with the failed attempts data. To go back to the analogy, it's as if they try to jump from the window, but there's a safety net that blocks them. They're stuck inside and the fire is mysteriously gone.

I don't think the fire is mysteriously gone in this imagining of the analogy. More like it is still there, but is survivable: still very hot, still very scary, but not clearly moving to inevitably consume you. I think this is just another place where the analogy breaks down. But that's ok, no analogy is perfect, but I think this one does have its uses.

Re: The undiscovered country: Can suicide be predicted?

#110

Post by haswell »

s1artibartfast wrote: post #105
LorenPechtel wrote: post #104

Earlier quoted context omitted.

I think the fundamental issue comes down to whether the cause of the desire is fixable. If there's a fixable problem, fix it. If there isn't I think they should be allowed to (and even provided painless means to do so--say, a mask connected to a nitrogen tank.) Whether we agree with the reason or not I don't think enters into the picture.

And what if the person doesn't want to fix it? Do you force them?

This is the first question that comes to my mind. I’m on a long depression journey and when I was at my worst, I had absolutely no desire to fix things. I just wanted to stop hurting, or do things that helped me not feel the pain.

Looking back on that version of me, I wouldn’t really trust myself to make decisions about life and death.

But on the flip side, I know not all circumstances are equal, and so all I can conclude is that this is incredibly complicated and I don’t have the answer.

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