Elsevier

Journal of Affective Disorders

Volume 150, Issue 2, 5 September 2013, Pages 540-545
Journal of Affective Disorders

Preliminary communication
Social support as a protective factor in suicide: Findings from two nationally representative samples

https://doi.org/10.1016/j.jad.2013.01.033Get rights and content

Abstract

Background

Suicide is a problem of worldwide concern and research on possible protective factors is needed. We explored the role of social support as one such factor. Specifically, we hypothesized that increased social support would be associated with decreased likelihood of a lifetime suicide attempt in two nationally representative samples as well as a high-risk subsample.

Methods

We analyzed the relationship between social support and lifetime history of a suicide attempt, controlling for a variety of related psychopathology and demographic variables, in the National Comorbidity Study Replication (NCS-R), a United States sample and the Adult Psychiatric Morbidity Study (APMS), an English sample.

Results

Results indicate that social support is associated with decreased likelihood of a lifetime suicide attempt controlling for a variety of related predictors in both the full US sample (OR=0.68, p<.001) and the full English sample (OR=0.93, p<.01).

Limitations

The cross-sectional data do not allow true cause and effect analyses.

Conclusions

Our findings suggest social support is associated with decreased likelihood of a lifetime suicide attempt. Social support is a highly modifiable factor that can be used to improve existing suicide prevention programs worldwide.

Section snippets

Social support as a protective factor in suicide: two studies from American and English nationally representative samples

Suicide is a problem of great concern worldwide. For example, among all age groups it is the tenth leading cause of death in the United States (Centers for Disease Control and Prevention, 2012) and the fifth leading cause of death in England and Wales (Office for National Statistics, 2012). Moreover, it is the number one preventable (non-accidental) cause of death in some age groups in these countries. Furthermore, suicide currently represents 1.8% of the total worldwide burden of disease (

Participants

Data for the study come from the National Comorbidity Study-Replication (NCS-R; Kessler et al., 2004a, Kessler et al., 2004b, Kessler and Ustün, 2004c), a United States nationally representative sample conducted between 2001 and 2003 of English speaking residents over the age of 17. Weighting procedures for the study data were used according to the guidelines of Kessler et al., 2004a, Kessler et al., 2004b, Kessler and Ustün, 2004c. Of the participants, 4.1% had attempted suicide at some point

Results and discussion

Table 1 presents the results of a logistic regression analysis predicting lifetime suicide attempter status after covarying relevant demographic variables, psychiatric history, family of origin variables, and help seeking behaviors. First, lower age, lower education, and female gender were all associated with higher likelihood of a lifetime suicide attempt. With the exception of drug dependence and specific phobia, all psychiatric disorders were associated with higher likelihood of a lifetime

Participants

Data for the study come from the 2007 Adult Psychiatric Morbidity Survey (APMS; McManus et al., 2009), an English nationally representative sample conduced from October, 2006 to December, 2007 of residents over the age of 16. Weighting procedures for the study data were used according to the guidelines of McManus et al. (2009). The participants in the study were 56.8% female and ranged from 16 to 95 years of age (M=46.35, SD=18.60). The ethnic origin of the sample was 89.6% White, 3.0% Black,

Results and discussion

Table 2 shows the results of a logistic regression analysis predicting lifetime suicide attempts controlling for relevant demographics, psychiatric history, family of origin variables, and help seeking behaviors. Lower age and female gender predicted greater likelihood of a lifetime suicide attempt. With the exception of eating disorders, social phobia, and anti-social personality disorder, all psychiatric history variables were associated with greater likelihood of a lifetime suicide attempt.

General discussion

Suicide is a problem of worldwide concern and there is a need for more research on protective factors in suicide. One such potential factor is social support. We presented a series of studies using nationally representative data that examine the role of social support as a protective factor in suicide. We found that controlling for a variety of relevant predictors, social support was associated with lower likelihood of having a lifetime suicide attempt. In the first study using an American

Role of funding source

The funding sources did not influence study design, analysis or interpretation of data, or the writing of this manuscript.

Conflict of interest

The authors declare no conflicts of interest.

Acknowledgements

We wish to thank the US National Institute of Mental Health (NIMH) for providing the funding for the initial collection of the NCS-R data and the UK Department of Health for funding the initial collection of the APMS data.

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