Skip to main content Accessibility help
×
×
Home

Characteristics of young rural Chinese suicides: a psychological autopsy study

  • J. Zhang (a1), W. Wieczorek (a1), Y. Conwell (a2), X.-M. Tu (a2), B. Y.-W. Wu (a3), S. Xiao (a4) and C. Jia (a5)...
Abstract
Background

Patterns of suicide rates in China differ in many ways from those in the West. This study aimed to identify the risk factors characteristic for young rural Chinese suicides.

Method

This was a case-control psychological autopsy (PA) study. The samples were suicides and living controls (both aged 15–34 years) from 16 rural counties of China. We interviewed two informants for each suicide and each control with pretested and validated instruments to estimate psychosocial, psychiatric and other risk factors for suicides.

Results

The prevalence of mental disorders was higher among the young Chinese who died by suicide than among the living controls, but was lower than among suicides in the West. Marriage was not a protecting factor for suicide among young rural Chinese women, and never-married women who were involved in relationships were about three times more likely to commit suicide than single women who were unattached. Religion/religiosity was not a protecting factor in Chinese suicide, as it tended to be stronger for suicides than for controls. Impulsivity was significantly higher for suicides than for controls. Psychological strain, resulting from conflicting social values between communist gender equalitarianism and Confucian gender discrimination, was associated significantly with suicide in young rural Chinese women, even after accounting for the role of psychiatric illness.

Conclusions

Risk factors for suicide in rural China are different from those in the West. Psychological strain plays a role in suicide. Suicide prevention programs in China should incorporate culture-specific considerations.

Copyright
Corresponding author
*Address for correspondence: Dr J. Zhang, Professor of Sociology, Department of Sociology, State University of New York College at Buffalo, 1300 Elmwood Avenue, Buffalo, NY 14222, USA. (Email: zhangj@buffalostate.edu)
References
Hide All
Agnew, R (2001). Building on the foundation of general strain theory: specifying the types of strain most likely to lead to crime and delinquency. Journal of Research in Crime and Delinquency 38, 319361.
Breault, KD (1986). Suicide in America: a test of Durkheim's theory of religious and family integration, 1933–1980. American Journal of Sociology 92, 628656.
Canetto, SS, Sakinofsky, I (1998). The gender paradox in suicide. Suicide and Life-Threatening Behavior 28, 123.
Cheng, ATA, Chen, THH, Chen, C-C, Jenkins, R (2000). Psychosocial and psychiatric risk factors for suicide: case-control psychological autopsy study. British Journal of Psychiatry 177, 360365.
Cook, JM, Pearson, JL, Thompson, R, Black, BS, Rabins, PV (2002). Suicidality in older African Americans: findings from the EPOCH study. American Journal of Geriatric Psychiatry 10, 437446.
Dervic, K, Oquendo, MA, Grunebaum, MF, Ellis, S, Burke, AK, Mann, JJ (2004). Religious affiliation and suicide attempt. American Journal of Psychiatry 161, 23032308.
Dickman, SJ (1990). Functional and dysfunctional impulsivity. Journal of Personality and Social Psychology 58, 95–102.
Durkheim, E (1897/1951). Suicide: A Study in Sociology (trans. J. Spaulding and G. Simpson). Free Press: New York.
Gu, J, Chen, Y (1993). Instruction Manual for the Structured Clinical Interview for DSM-III-R (Chinese edition). Kaohsiung Medical College, Taiwan: Kaohsiung.
Henry, AF, Short, J (1954). Suicide and Homicide. Free Press: Glencoe, IL.
Ji, J, Kleinman, A, Becker, AE (2001). Suicide in contemporary China: a review of China's distinctive suicide demographics in their sociocultural context. Harvard Review of Psychology 9, 112.
Kleinman, AM (1986). Social Origins of Distress and Disease: Depression, Neurasthenia, and Pain in Modern China. Yale University Press: New Haven, CT.
Kraemer, HC, Measelle, JR, Ablow, JC, Essex, MJ, Boyce, WT, Kupfer, DJ (2003). A new approach to integrating data from multiple informants in psychiatric assessment and research: mixing and matching contexts and perspectives. American Journal of Psychiatry 160, 15661577.
Merton, RK (1957). Social Theory and Social Structure, revised edn. Free Press: New York.
Phillips, MR, Li, X, Zhang, Y (2002 a). Suicide rates in China, 1995–99. Lancet 359, 835840.
Phillips, MR, Yang, G, Zhang, Y, Wang, L, Ji, H, Zhou, M (2002 b). Risk factors for suicide in China: a national case-control psychological autopsy study. Lancet 360, 17281736.
Pritchard, C (1996). Suicide in the People's Republic of China categorized by age and gender: evidence of the influence of culture on suicide. Acta Psychiatrica Scandinavica 93, 362367.
Spitzer, RL, Williams, JBW, Gibbon, M, First, AB (1988). Instruction Manual for the Structured Clinical Interview for DSM-III-R (SCID, 6/1/88 Revision). Biometrics Research Department, New York State Psychiatric Institute: New York.
Stack, S (1983). The effect of religious commitment on suicide: a cross-national analysis. Journal of Health and Social Behavior 24, 362374.
Taiwan Government (2003). Taiwan Yearbook 2003 (www.stat.gov.tw/bs2/2002YearBook.pdf).
Timmreck, TC (2002). An Introduction to Epidemiology, 3rd edn. Jones and Bartlett Publishers: Boston, MA.
United Nations (1996). Prevention of Suicide: Guidelines for the Formulation and Implementation of National Strategies. United Nations: New York.
Wang, S, Li, Y, Chi, G, Xiao, S, Ozanne-Smith, J, Stevenson, M, Phillips, M (2008). Injury-related fatalities in China: an under-recognised public-health problem. Lancet 372, 17651773.
WHO (1999). The World Health Report. World Health Organization: Geneva, Switzerland.
Wu, F (2005). ‘Gambling for Qi’: suicide and family politics in a rural North China county. China Journal 54, 7–27.
Yeh, J, Xirasagar, S, Liu, T, Li, C, Lin, H (2008). Does marital status predict the odds of suicidal death in Taiwan? A seven-year population-based study. Suicide and Life-Threatening Behavior 38, 302310.
Younger, SC, Clark, DC, Oehmig-Lindroth, R, Stein, RJ (1990). Availability of knowledgeable informants for a psychological autopsy study of suicides committed by elderly people. Journal of the American Geriatrics Society 38, 11691175.
Zhang, J (1996). Suicide in Beijing, China, 1992–1993. Suicide and Life-Threatening Behavior 26, 175180.
Zhang, J, Conwell, Y, Wieczorek, WF, Jiang, C, Jia, S, Zhou, L (2003). Studying Chinese suicide with proxy-based data: reliability and validity of the methodology and instruments in China. Journal of Nervous and Mental Disease 191, 450457.
Zhang, J, Conwell, Y, Zhou, L, Jiang, C (2004). Culture, risk factors and suicide in rural China: a psychological autopsy case control study. Acta Psychiatrica Scandinavica 110, 430437.
Zhang, J, Jia, S, Wieczorek, WF, Jiang, C (2002). An overview of suicide research in China. Archives of Suicide Research 6, 167184.
Zhang, J, Norvilitis, JM (2002). Measuring Chinese psychological well-being with Western developed instruments. Journal of Personality Assessment 79, 492511.
Zhang, J, Song, Z (2006). A preliminary test of the Strain Theory of Suicide. Chinese Journal of Behavioral Medical Science 15, 487489.
Zhang, J, Xu, H (2007). The effects of religion, superstition, and perceived gender inequality on the degree of suicide intent: a study of serious attempters in China. Omega: Journal of Death and Dying 55, 185197.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed