The Impact of Suicide on the Family Julie Cerel1, John R. Jordan2, and Paul R. Duberstein3 1 College of Social Work, University of Kentucky, Lexington, KY, USA, 2 The Family Loss Project, Pantucket, RI, USA, 3 University of Rochester Medical Center, Rochester, NY, USA Abstract. Little research has examined the consequences of a suicide for social or family networks. Because suicide occurs within families, the focus on the aftermath of suicide within families is an important next step to determine exactly how to help survivors. In this article, we review and summarize the research on the impact of suicide on individuals within families and on family and social networks. We begin with a discussion of family changes following suicide. Next, we discuss the effects of suicide on social networks overall and responses of children and the elderly to a suicide in the family. Finally, we identify key issues that remain to be resolved in family survivor research and make recommendations for future studies. Keywords: suicide, survivor, bereavement While an individual suicide is often a solitary act, family and friends are almost always left behind to grieve, try to understand the reasons for the death, and learn to carry on with their lives. Only recently have their needs been addressed (Clark, 2001; Jobes, Luoma, Hustead, & Mannuzza, 2000), as exemplified by a workshop sponsored by the American Foundation for Suicide Prevention (AFSP) and the National Institutes of Health (NIH; American Foundation for Suicide Prevention, 2004). A product of that workshop, this article reviews and summarizes the research on the impact of suicide on individual family members, family dynamics, and social networks. We begin with a discussion of family changes following suicide. Next, we discuss the effects of suicide on social networks overall and responses of children and the elderly to a suicide in the family. Finally, we identify key issues that remain to be resolved in family survivor research and make recommendations for future studies. Family Members as Survivors Before reviewing the literature on the impact of suicide on the family, one must first consider two problems inherent to family research on suicide survivors. First, most studies examine only one type of survivor (i.e., parent, child, spouse) and do not take into account how reactions of family members influence each other and the tone of family communication. Second, the quality of the previous relationships within the family is rarely determined, making it difficult to comment on the specific implications of the death for family relationships and communications in the aftermath of the suicide. In a longitudinal study of parents bereaved by the sudden violent death (including suicide, accident, or homicide) of their child, Lohan and Murphy (2002) [in refs only Lohan]used the Family Adaptability and Cohesion Evaluation Scales (FACES; Lohan, 2002) to document difficulties with family functioning after a child’s suicide. These difficulties included decreases in cohesion (defined as “emotional bonding that family members have toward one another”) and adaptation (defined as “the ability of a marital or family system to change its power structure, role relationships, and relationship rules in response to situational and developmental stress”). While few changes in family factors were unique to suicide, the authors hypothesize that families do not actively make changes following a violent death to help the family as a unit effectively cope. Parental functioning may influence surviving family members, especially children at home who may be faced with parents who are less emotionally available to them (Lohan, 2002). Likewise, in a study of 13 widows whose husbands had died by suicide compared with 13 widows whose husbands had died in accidents, McNiel, Hatcher, and Reubin (1988) found some differences in family communication, support, and intimacy following both types of death. While widows in...
References: American Foundation for Suicide Prevention. (2004). AFSP and NIMH Propose Research Agenda for Survivors of Suicide. Retrieved on April 1, 2006, from http://www.afsp.org/index. cfm?fuseaction=home.viewpage&page_id=2D9DF73E-BB2 5-0132-3AD7715D74BFF585. Barlow, C.A., & Coleman, H. (2003). The healing alliance: How families use social support after a suicide. Omega: Journal of Death and Dying, 47, 187–202. Barrett, T.W., & Scott, T.B. (1989). Development of the Grief Experience Questionnaire. Suicide and Life-Threatening Behavior, 19, 201–215. Brent, D.A., Perper, J., Moritz, G., Allman, C., Friend, A., Schweers, J. et al. (1992). Psychiatric effects of exposure to suicide among the friends and acquaintances of adolescent suicide victims. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 629–639. Cain, A. (1972). Survivors of suicide. Springfield, IL: Charles C. Thomas. Cain, A.C., & Fast, I. (1966). Children’s disturbed reactions to parental suicide. American Journal of Orthopsychiatry, 47, 196–206. Callahan, J. (2000). Predictors and correlates of bereavement in suicide support group participants. Suicide and Life-Threatening Behavior, 30, 104–124. Cerel, J., Fristad, M.A., Verducci, J., Weller, R.A., & Weller, E.B. (2006). Childhood bereavement: Psychopathology in the 2 years postparental death. Journal of the American Academy of Child and Adolescent Psychiatry, 45, 681–690. Cerel, J., Fristad, M.A., Weller, E.B., & Weller, R.A. (1999). Suicide-bereaved children and adolescents: A controlled longitudinal examination. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 672–679. Cerel, J., Fristad, M.A., Weller, E.B., & Weller, R.A. (2000). Suicide-bereaved children and adolescents: II. Parental and family functioning. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 437–444. Cerel, J., & Roberts, T.A. (2005). Suicidal behavior in the family and adolescent risk behavior. Journal of Adolescent Health, 36, 352–16. Clark, S. (2001). Bereavement after suicide – How far have we come and where do we go from here? Crisis, 22, 102–108. Colt, G.H. (1991). The enigma of suicide. New York: Simon & Schuster. Dunn, R.G., & Morrish-Vidners, D. (1987). The psychological and social experience of suicide survivors. Omega: Journal of Death and Dying, 18, 175–215. Farberow, N.L., Gallagherthompson, D., Gilewski, M., & Thompson, L. (1992). Changes in grief and mental-health of bereaved spouses of older suicides. Journals of Gerontology, 47, 357–366. Goode, E (2003, October 28). And still, echoes of a death long past. The New York Times, D1. Harwood, D., Hawton, K., Hope, T., & Jacoby, R. (2002). The grief experiences and needs of bereaved relatives and friends of older people dying through suicide: a descriptive and casecontrol study. Journal of Affective Disorders, 72, 185–194. Jobes, D.A., Luoma, J.B., Hustead, L.A.T., & Mannuzza, S. (2000). In the wake of suicide: Survivorship and postvention. In R.W. Maris, A.L. Berman, & M.M. Silverman (Eds.), Comprehensive textbook of suicidology (pp. 536–561). New York: Guilford. Jordan, J., & McMenamy, J. (in press). Interventions for suicide survivors: A review of the literature. Suicide and Life-Threatening Behavior. Jordan, J.R. (2001). Is suicide bereavement different? A reassessment of the literature. Suicide and Life-Threatening Behavior, 31, 91–102. Jordan, J.R., Kraus, D.R., & Ware, E.S. (1993). Observations on loss and family development. Family Process, 32, 425–440. Kiecolt-Glaser J.K., & Glaser, R. (1999). Chronic stress and mortality among older adults. Journal of the American Medical Association, 282, 2259–2260. Lohan, J.A. (2002). Family functioning and family typology after an adolescent or young adult’s sudden violent death. Journal of Family Nursing, 8, 49. McIntosh, J.L. (1987). Survivor family relationships: Literature review. In E.J. Dunne, J.L. McIntosh, & K. Dunne-Maxim (Eds.), Suicide and its aftermath: Understanding and counseling the survivors (pp. 73–84). New York: Norton. McNiel, D.E., Hatcher, C., & Reubin, R. (1988). Family survivors of suicide and accidental death: Consequences for widows. Suicide and Life-Threatening Behavior, 18, 137–148. Pfeffer, C.R., Conte, H.R., Plutchik, R., & Jerrett, I. (1980). Suicidal behavior in latency-age children. An outpatient population. Journal of the American Academy of Child and Adolescent Psychiatry, 19, 703–710. Pfeffer, C.R., Karus, D., Siegel, K., & Jiang, H. (2000). Child survivors of parental death from cancer or suicide: Depressive and behavioral outcomes. Psycho-Oncology, 9, 1–10. Pfeffer, C.R., Martins, P., Mann, J., Sunkenberg, M., Ice, A., Damore, J.P.J. et al. (1997). Child survivors of suicide: Psychosocial characteristics. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 65–74. Range, L.M. (1998). When a loss is due to suicide: Unique aspects of bereavement. In J.H. Harvey (Ed.), Perspectives on loss: A sourcebook (pp. 213–220). Philadelphia, PA: Brunner/Mazel. Range, L.M., Bright, P.S., & Ginn, P.D. (1985). Public reactions to child suicide: Effects of age and method used. Journal of Community Psychology, 13, 288–294. Range, L.M., & Calhoun, L.G. (1990). Responses following suicide and other types of death – The perspective of the bereaved. Omega: Journal of Death and Dying, 21, 311–320. Reynolds, F.M.T., & Cimbolic, P. (1988). Attitudes toward suicide survivors as a function of survivors relationship to the victim. Omega: Journal of Death and Dying, 19, 125–133. Segerstrom, S., & Miller, G.R. (2004). Psychological stress and the human immune system: A meta-analytic study of 30 years of inquiry. Psychological Bulletin, 130, 601–630. Seguin, M., Lesage, A., & Kiely, M.C. (1995). Parental bereavement after suicide and accident: A comparative study. Suicide and Life-Threatening Behavior, 25, 489–492. J. Cerel et al.: The Impact of Suicide on the Family 43 © 2008 Hogrefe & Huber Publishers Crisis 2008; Vol. 29(1):38–44Shepherd, D.M., & Barraclough, B.M. (1976). The aftermath of parental suicide for children. British Journal of Psychiatry, 129, 267–276. Stillion, J. (1996). Survivors of suicide. In K.J. Doka (Ed.), Living with grief after sudden loss: Suicide, homicide, accident, heart attack, stroke (pp. 41–51). Washington, DC: Hospice Foundation of America. Stylianos, S.K., & Vachon, M.L.S. (1993). The role of social support in bereavement. In M.S. Stroebe, W. Stroebe, & R.O. Hansson (Eds.), Handbook of bereavement: Theory, research, and intervention (pp. 397–410). New York: Cambridge University. Thompson, K.E., & Range, L.M. (1991). Recent bereavement from suicide and other deaths – Can people imagine it as it really is. Omega: Journal of Death and Dying, 22, 249–259. van Hooff, A.J.L. (2000). A historical perspective on suicide. In R.W. Maris, A.L. Berman, & M. Silverman (Eds.), Comprehensive textbook of suicidology (pp. 96–126). New York: Guilford. Vitaliano, P.P., Zhang, J., & Scanlan, J.M. (2003). Is caregiving hazardous to one’s physical health? A meta-analysis. Psychological Bulletin, 129, 946–972. Wagner, K.G., & Calhoun, L.G. (1992). Perceptions of social support by suicide survivors and their social networks. Omega: Journal of Death and Dying, 24, 61–73. Walsh, F., & McGoldrick, M. (1991). Living beyond loss: Death and the family. New York: Norton. About the authors Julie Cerel, PhD, is a child clinical psychologist currently on the faculty of the College of Social Work at the University of Kentucky. She earned her doctoral degree at Ohio State University and completed an internship and clinical fellowship at West Virginia University as well as a postdoctoral fellowship in suicide prevention at the University of Rochester. Dr. Cerel’s work focuses on suicide survivors, suicide prevention, and bereavement. John R. Jordan, PhD, is a licensed psychologist and marriage and family therapist. He provides training nationally for therapists, healthcare professionals, and clergy through the American Academy of Bereavement and AFSP. He has published clinical and research articles in the areas of bereavement after suicide, support group models, the integration of research and practice in thanatology, and loss in family and larger social systems. Paul Duberstein, PhD, is a clinical and community psychologist. He earned his PhD from SUNY Buffalo and completed an internship in clinical psychology at McLean Hospital/Harvard Medical School and a postdoctoral research fellowship at Rochester. He has written or co-authored more than 100 scientific papers and co-edited (with Joseph Masling) the volume Psychodynamic Perspectives on Sickness and Health (2000). Julie Cerel University of Kentucky College of Social Work 627 Patterson Office Tower Lexington, KY 40506 USA Tel. + 1 859 257–8602 E-mail email@example.com
Please join StudyMode to read the full document