Suicide and suicidal risk in a rural context : social and psychological factors
In a series of studies, rural and urban suicides were compared and the psychological factors underlying suicidal behaviour investigated. In the first study suicides in a Nfid-Wales county were examined and contrasted with a group of urban suicides. The pattern of rural suicides was found to differ from the urban suicides. Rural suicides were more evenly spread through the age bands, mostly married and used more violent means of death. Farmers comprised a large proportion of rural suicides and seem to differ from rural suicides in general in that 88% were over 45 years of age, most died of hanging, only 13% left notes and they had no record of previous suicide attempts. The factors that might cause farmers stress were examined. This showed that farmers found form filling and adjusting to government policy most stressful. Isolation was relatively unimportant as a stressor. In the third study the role of mood and problem solving in suicidal behaviour was investigated in three matched groups (suicidal, psychiatric control and non-psychiatric control). The suicidal group was found to display a careless and impulsive problem solving style and unique deficits in decision making and generation of alternative solutions. They were also more depressed, angry and confused. The problem solving deficits remained even when the effects of the mood differences were removed. The last study investigated the relationship between autobiographical memory and problem solving and found the suicidal group to be significantly more overgeneral in their memories, they produced fewer means and less effective problem solving solutions and these deficits were found to persist over time. These results were interpreted as support for these factors being trait features or alternatively requiring more time to recover. The findings were incorporated into a revised version of the "Cry of Pain" model of suicidal behaviour (Williams, 1997).