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Objective: The aim of this study was to assess associations of various content areas of Twitter posts with help-seeking from the US National Suicide Prevention Lifeline (Lifeline) and with suicides. Methods: We retrieved 7,150,610 suicide-related tweets geolocated to the United States and posted between 1 January 2016 and 31 December 2018. Using a specially devised machine-learning approach, we categorized posts into content about prevention, suicide awareness, personal suicidal ideation without coping, personal coping and recovery, suicide cases and other. We then applied seasonal autoregressive integrated moving average analyses to assess associations of tweet categories with daily calls to the US National Suicide Prevention Lifeline (Lifeline) and suicides on the same day. We hypothesized that coping-related and prevention-related tweets are associated with greater help-seeking and potentially fewer suicides. Results: The percentage of posts per category was 15.4% (standard deviation: 7.6%) for awareness, 13.8% (standard deviation: 9.4%) for prevention, 12.3% (standard deviation: 9.1%) for suicide cases, 2.4% (standard deviation: 2.1%) for suicidal ideation without coping and 0.8% (standard deviation: 1.7%) for coping posts. Tweets about prevention were positively associated with Lifeline calls (B = 1.94, SE = 0.73, p = 0.008) and negatively associated with suicides (B = −0.11, standard error = 0.05, p = 0.038). Total number of tweets were negatively associated with calls (B = −0.01, standard error = 0.0003, p = 0.007) and positively associated with suicide, (B = 6.4 × 10−5, standard error = 2.6 × 10−5, p = 0.015). Conclusion: This is the first large-scale study to suggest that daily volume of specific suicide-prevention-related social media content on Twitter corresponds to higher daily levels of help-seeking behaviour and lower daily number of suicide deaths. Preregistration: As Predicted, #66922, 26 May 2021. [ABSTRACT FROM AUTHOR]

Objective: The suicides of Kate Spade and Anthony Bourdain, two major American icons, in a span of days in June 2018 represent a unique and tragic natural experiment to characterize associations with actual suicides in the aftermath of celebrity suicides. The aim of this study was to identify changes in suicide counts after their deaths. Methods: Suicide data were obtained from the United States' Centers for Disease Control and Prevention's public-use mortality file. A time-series analysis was performed, examining monthly suicide data by age group (⩽19, 20–44, 45–64 and ⩾65 years), for both men and women, for all suicide methods and for hanging versus non-hanging methods, from January 1999 to December 2018. Seasonal autoregressive integrated moving-average models were fitted to the pre-June 2018 period, estimating suicides in subsequent months and identifying deviations from expected values. The volume of Twitter posts about Kate Spade and Anthony Bourdain was used as a proxy of societal attention. Results: Tweets about the celebrities were mainly concentrated in June 2018 and faded quickly in July. Total suicides exceeded the 95% confidence interval for June and approximated the upper limit of the 95% confidence interval in July. Over this 2-month span, there were 418 (95% confidence interval = [184, 652]) more suicides than expected, including 275 (95% confidence interval = [79, 471]) excess suicides in men and 182 (95% confidence interval = [93, 271]) in women. These equate to 4.8%, 4.1% and 9.1% increases above expected counts. There were 392 (95% confidence interval = [271, 514]) excess suicides by hanging, a 14.5% increase, with no significant increase in all other methods combined. Conclusion and Relevance: These findings demonstrate that mortality following celebrity suicides can occur at a similar magnitude to that observed for other public health emergencies. They underscore the urgency for interventions to mitigate imitation effects after celebrity suicide reporting. [ABSTRACT FROM AUTHOR]

Importance: On March 31, 2017, Netflix released the show 13 Reasons Why, sparking immediate criticism from suicide prevention organizations for not following media recommendations for responsible suicide portrayal and for possible suicide contagion by media. To date, little research has been conducted into the associations between the show and suicide counts among its young target audience.Objective: To analyze the changes in suicide counts after the release of 13 Reasons Why.Design, Setting, and Participants: For this time series analysis, monthly suicide data for the age groups 10 to 19 years, 20 to 29 years, and 30 years or older for both US males and females from January 1, 1999, to December 31, 2017, were extracted from the Centers for Disease Control and Prevention's WONDER (Wide-ranging Online Data for Epidemiologic Research) database. Twitter and Instagram posts were used as a proxy to estimate the amount of attention the show received through social media from April 1, 2017, to June 30, 2017. Autoregressive integrated moving average time series models were fitted to the pre-April 2017 period to estimate suicides among the age groups and to identify changes in specific suicide methods used. The models were fitted to the full time series with dummy variables for (1) April 2017 and (2) April 1, 2017, to June 30, 2017. Data were analyzed in December 2018 and January 2019.Main Outcomes and Measures: Suicide data before and after the release of the show in 2017.Results: Based on social media data, public interest in the show was highest in April 2017 and was negligible after June 2017. For 10- to 19-year-old males and females, increases in the observed values from April to June 2017 were outside the 95% confidence bands of forecasts. Models testing 3-month associated suicide mortality indicated 66 (95% CI, 16.3-115.7) excess suicides among males (12.4% increase; 95% CI, 3.1%-21.8%) and 37 (95% CI, 12.4-61.5) among females (21.7% increase; 95% CI, 7.3%-36.2%). No excess suicide mortality was seen in other age groups. The increase in the hanging suicide method was particularly high (26.9% increase; 95% CI, 15.3%-38.4%).Conclusions and Relevance: Caution must be taken in interpreting these findings; however, the suicide increase in youth only and the signal of a potentially larger increase in young females all appear to be consistent with a contagion by media and seem to reinforce the need for collaboration toward improving fictional portrayals of suicide. [ABSTRACT FROM AUTHOR]

Objective: To assess changes in daily call volumes to the US National Suicide Prevention Lifeline and in suicides during periods of wide scale public attention to the song "1-800-273-8255" by American hip hop artist Logic., Design: Time series analysis., Setting: United States, 1 January 2010 to 31 December 2018., Participants: Total US population. Lifeline calls and suicide data were obtained from Lifeline and the Centers for Disease Control and Prevention., Main Outcome Measures: Daily Lifeline calls and suicide data before and after the release of the song. Twitter posts were used to estimate the amount and duration of attention the song received. Seasonal autoregressive integrated moving average time series models were fitted to the pre-release period to estimate Lifeline calls and suicides. Models were fitted to the full time series with dummy variables for periods of strong attention to the song., Results: In the 34 day period after the three events with the strongest public attention (the song's release, the MTV Video Music Awards 2017, and Grammy Awards 2018), Lifeline received an excess of 9915 calls (95% confidence interval 6594 to 13 236), an increase of 6.9% (95% confidence interval 4.6% to 9.2%, P<0.001) over the expected number. A corresponding model for suicides indicated a reduction over the same period of 245 suicides (95% confidence interval 36 to 453) or 5.5% (95% confidence interval 0.8% to 10.1%, P=0.02) below the expected number of suicides., Conclusions: Logic's song "1-800-273-8255" was associated with a large increase in calls to Lifeline. A reduction in suicides was observed in the periods with the most social media discourse about the song., Competing Interests: Competing interests: All authors have completed the ICMJE uniform disclosure form at http://www.icmje.org/disclosure-of-interest/ and declare: MG, TN, and BT had financial support from Vibrant Emotional Health for not directly related work in the same area, which was the basis for development of this research project; MS reports a grant from the American Foundation for Suicide Prevention (grant No SRG-0-153-19) for not directly related work in the same area in the past three years; SM, FG, and JD have been employees of Vibrant Emotional Health, the non-profit organisation that administers the National Suicide Prevention Lifeline and is funded by the Substance Abuse and Mental Health Services Administration, USA, in the past three years; BT reports consulting fees in the past three years from Suicide Awareness Voices of Education (SAVE) for not directly related work in the same area; MG reports membership in the Steering and Standards, Training and Practices committees of the National Suicide Prevention Lifeline; TN reports being a current board member of the International Association for Suicide Prevention as vice president., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: The U.S. suicide rate has increased 35% since 1999. The role of the Internet has not been thoroughly investigated despite Internet use more than doubling from 1999 to present. The majority of U.S. suicide deaths are by firearm; however, there is no examination of the association between trends in firearm Internet searches and overall and firearm monthly suicide rates. We hypothesized that search strings related to firearm suicide would be significantly associated with monthly suicide rates (both all methods and firearm)., Methods: Google Trends provides data on request frequencies of searches. Twenty-four search strings were examined representing possible searches by individuals considering firearm suicide and compared to U.S. suicide rates with time-series modeling., Results: In the time series with higher search volumes, consistent associations were found of negative cross-correlation at lag +1., Conclusions: Several searches appeared at least sensitive enough to consistently show associations with overall and firearm suicide rates in the following month. This novel finding should be followed up as the potential exists to predict suicide trends., (© 2021 The American Association of Suicidology.)

Stöber's Social Desirability Scale (SDS-17) was examined psychometrically in 5 samples (N=2817) from Austria, Canada, and the U.S.A. Rasch and Mokken scaling analyses attested the SDS-17 is not strictly unidimensional. Age, agreeableness, and conscientiousness were notable positive correlates of SDS-17 scores. There were signs of non-normal score distributions, acquiescence bias, and sex and country differences (higher scores among Austrians than North Americans). Items with higher ratings of social desirability according to previous research were particularly prone to show sex effects. The SDS-17 appears suitable in cross-cultural settings, but may benefit from substituting its true-false response format with a rating-scale format. A formative-indicators view regarding the social desirability construct and the SDS-17 is discussed.

Psychometric properties and demographic correlates of a German form of R. W. Hubbard and J. L. McIntosh's (1992) Revised Facts on Suicide Quiz (RFOS), an inventory for assessing overall knowledge about suicide, were investigated in a sample of 1,093 Austrian medical and psychology students. Internal consistency of the RFOS was weak, as were many of the item-total correlations, indicating a fair amount of item-content heterogeneity. Demographic variables (sex, age, field of study, and study level) were significant predictors of RFOS scores and item responses. On the whole, women, advanced, older, and medical students outperformed men, junior, younger, and psychology students. Various directions for further inquiry are discussed