Suicidal Gestures at Princeton: A Staggering Increase

A friend of mine knows a former (retired) head of psychological services at Princeton University. She told him that in the 1970s, there were one or two suicidal gestures per year. Recently, however, there have been one or two per day.

Something is terribly, horribly wrong. Maybe the increase is due to something at Princeton. For example, maybe new dorms are more isolating than the old dorms they replaced. Or maybe the increase has nothing to do with Princeton. For example, maybe the increase is due to antidepressants, much more common now than in the 1970s.

Whatever the cause, tt would help all Princeton students, present and future, and probably millions of others, if the problem were made public so that anyone, not just a vanishingly small number of people, could try to solve it. It isn’t even clear that anyone is trying to explain/understand/learn from the increase.

Princeton almost surely has records that show the increase. If, as is likely, Princeton administrators never allow the increase to be documented, it will be a tragedy. It is an extraordinary and unprecedented clue about what causes suicidal gestures. Nothing in all mental health epidemiology has found a change by factor of a hundred or more — much less a mysterious huge change.

The increase is an unintended consequence of something else, but what? Because it is so large, there must be something extremely important that most people, or at least Princeton administrators, don’t understand about mental health. The answer might involve seeing faces at night. I found that seeing faces in the morning produced an enormous boost in mood and that faces at night had the opposite effect. I cannot say, however, why seeing faces at night would have increased so much from the 1970s to now.

16 Responses to “Suicidal Gestures at Princeton: A Staggering Increase”

  1. Three Pipe Problem Says:

    Seth do you know what the Werther effect is? Perhaps that is why Princeton’s administration is not so forthcoming. When publicizing suicide predictably leads to more suicides of a similar nature, the ethical question is a complex one.

    Seth: Yes, I know about the Werther effect. Given the size of the increase and the amount of suffering implied (including people elsewhere), I don’t think that whether to do something about it — to do the utmost possible — is a complex or difficult ethical question. The benefits of figuring out what caused the increase would be enormous.

  2. dearieme Says:

    Is it possible that they are admitting more students who suspect that they are not up to it? Is there any correlation between suicidal gestures and lack of academic success? How do their figures compare with, say, Yale or Oxford?

    Seth: Good questions I cannot answer. However, I doubt that admissions changes could produce such a big change

  3. Alex Chernavsky Says:

    I’m not particularly suprised by the dramatic increase in suicidal gestures. Our society seems to be experiencing an epidemic of mental illness in general. It’s interesting to note that PTSD didn’t seem to exist for soldiers who underwent traumatic experiences during the American Civil War.

    A study just published in the Journal of Anxiety Disorders looked at the extensive medical records for soldiers in the American Civil War, whose mortality rate was about 50-80 [times] greater than modern soldiers fighting in Iraq and Afghanistan.

    In other words, there would have been many more having terrifying experiences but despite the higher rates of trauma and mentions of other mental problems, there is virtually no mention of anything like the intrusive thoughts or flashbacks of PTSD.

    In a commentary, psychologist Richard McNally makes the point that often these symptoms have to be asked about specifically to be detected, but even so, he too admits that the fact that PTSD-like symptoms virtually make no appearance in hundreds of thousands of medical records suggests that PTSD is unlikely to be a ‘universal timeless disorder’.

    Taking an even longer view, a study published in Stress and Health looked at historical accounts of traumatic experiences from antiquity to the 16th century.

    The researchers found that although psychological trauma has been recognised throughout history, with difficult events potentially leading to mental disorder in some, there were no consistent effects that resembled the classic PTSD syndrome.

    Various symptoms would be mentioned at various times, some now associated with the modern diagnosis, some not, but it was simply not possible to find ‘historical accounts of PTSD’.

    http://mindhacks.com/2012/08/11/a-very-modern-trauma/

  4. Alex Chernavsky Says:

    So, to follow-up on my comment above: Investigative reporter Robert Whitaker wrote a book about this huge increase in the incidence of psychiatric disease. Whitaker attributes the epidemic to the toxic effects of psychotropic drugs. The evidence he presents is impressive. The book is fascinating (if disturbing) and is worth a read: Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America.

    Seth: If I remember correctly, nothing in that book came anywhere close to a hundred-fold increase.

  5. dearieme Says:

    “PTSD didn’t seem to exist for soldiers who underwent traumatic experiences during the American Civil War.” Is PTSD the same thing as the “shell shock” of the First World War?

  6. Ashish Says:

    The selectivity of elite schools is much greater than it was in the 1970s, the pressure is greater (from the cost, and a tougher job marketplace), and the ethnic and socioeconomic composition of students is much different.

    So while the data this psychologist relates is shocking, I think the meaningful comparison is to contemporary institutions. Of course, universities have no incentive to make this information public.

  7. nansen Says:

    “The answer might involve seeing faces at night.”

    What about not seeing faces during the day, due to concentration on gadgets?

  8. BRW Says:

    I think a number of factors could be at play here. One is certainly diet. I’m sure the food served at Princeton has changed quite a bit since the 70′s. Another is probably, sunlight exposure. More competitive = more indoor studying. I also think folks are way up on the pill usage and most likely drinking more alcohol. I doubt one factor is at play here.

  9. Alex Chernavsky Says:

    Seth, with regard to increases in the rates of mental illness, Whitaker argues that the epidemic has hit young people disproportionately hard. Citing US government statistics, Whitaker shows that among children, the rate of disability due to mental illness increased 35-fold between 1987 and 2007. During that same time, adult disability due to mental illness increased by a bit under 4-fold. 35-fold isn’t so far removed from the 100-fold increase you described in your blog post.

    The rates of juvenile bipolar disorder have increased about 40-fold since 1987. Our old friend Dr. Joseph Biederman (about whom you’ve blogged) is partly (or perhaps mostly) responsible for this iatrogenic tragedy.

  10. Tom Says:

    The demographic makeup of the student bodies of elite universities has also changed considerably in that timeframe.

    There may be more “tiger mothers” now.

  11. dearieme Says:

    Hang on, we’ve all forgotten the obvious question. What proportion are girls?

  12. Christopher Burd Says:

    There are more suicidal gestures, but are there more suicides?

  13. Tom Says:

    Good point.

    According to Wikipedia at least, females make far more “suicidal gestures” than males. But males actually kill themselves far more often than females.

    Which raises the question of whether the rise in suicidal gestures might be an upbeat sign. :-)

  14. ChristianKl Says:

    Maybe the psychological counselling got more trustworthy over time so there’s better reporting going on.

    Looking at the number of real suicides would be a much better way to see whether there a real problem going on.

    Seth: The number of actual suicides might be less sensitive, since there are far fewer of them.

  15. B.B. Says:

    I will relate a personal observation.

    I once taught part-time at Wharton in the mid-1980s. In a class midterm exam, an Asian female student folded during the exam. I took her outside the class and talked to her. She was clearly suffering extreme test anxiety. I told her I would drop the midterm and base her grade on the final, but only if she went to Penn’s counseling center to get treatment for text anxiety.

    The same thing happened on the final. I asked if she had done as I told her. She related that the counseling center was so overwhelmed with students that it could not give her immediate counseling and only offered medication instead. Truly sad.

    And that was almost 30 years ago. I am sure the situation has gotten worse.

    Partly, that student’s issue were related to familial and ethnic expectations (she told me that), female anxiety, and competitve pressure. Those factors likely increasingly apply to the entire student population at the Ivies.

  16. sa Says:

    Maybe its due to an increase in the numbers of people infected by a parasite ?

    http://www.theatlantic.com/magazine/archive/2012/03/how-your-cat-is-making-you-crazy/308873/?single_page=true

    “In a 2011 study of 20 European countries, the national suicide rate among women increased in direct proportion to the prevalence of the latent Toxo infection in each nation’s female population. “