Repetition of attempted suicide among immigrants in Europe

Objectives: To compare frequencies of suicide attempt repetition in immigrants and local European populations, and the timing of repetition in these groups. Method: Data from 7 European countries, comprising 10 574 local and 3032 immigrant subjects, were taken from the World Health Organization European Multicentre Study on Suicidal Behaviour and the ensuing Monitoring Suicidal Behaviour in Europe (commonly referred to as MONSUE) project. The relation between immigrant status and repetition of suicide attempt within 12-months following first registered attempt was analyzed with binary logistic regression, controlling for sex, age, and method of attempt. Timing of repetition was controlled for sex, age, and the recommended type of aftercare. Results: Lower odds of repeating a suicide attempt were found in Eastern European (OR 0.50; 95% CI 0.41 to 0.61, P < 0.001) and non-European immigrants (OR 0.68; 95% CI 0.51 to 0.90, P < 0.05), compared with the locals. Similar patterns were identified in the sex-specific analysis. Eastern European immigrants tended to repeat their attempt much later than locals (OR 0.58; 95% CI 0.35 to 0.93, P < 0.05). In general, 32% of all repetition occurred within 30 days. Repetition tended to decrease with age and was more likely in females using harder methods in their index attempt (OR 1.29; 95% CI 1.08 to 1.54, P < 0.01). Large variations in the general repetition frequency were identified between the collecting centres, thus influencing the results. Conclusions: The lower repetition frequencies in non-Western immigrants, compared with locals, in Europe stands in contrast to their markedly higher tendency to attempt suicide in general, possibly pointing to situational stress factors related to their suicidal crisis that are less persistent over time. Our findings also raise the possibility that suicide attempters and repeaters constitute only partially overlapping populations

Influence of Emotion Processing and Affect Intensity on the Engagement of Inhibitory Control in Young Adults with Attention-Deficit/Hyperactivity Disorder

How individuals process different affective cues, as well as how intensely they experience different emotions, may influence how efficient they are at engaging inhibitory control. To date, it is unclear if these influences differ among young adults with and without ADHD. The current study tested the variation in young adults’ inhibitory control to three affective cues (i.e., fear, happy, and neutral) in an Emotion Go/Nogo task. Results suggest better inhibitory control in response to more distinct cues (i.e., fear Nogo/happy Go). The order in which cues were presented also mattered, such that participants displayed enhanced inhibitory control when first presented with expressions that had similar valence. This task order was particularly helpful for inhibitory control engagement among young adults with ADHD. Furthermore, self-report measures suggest that young adults with ADHD were associated with higher levels of affect intensity. However, no additional relations were found in the processing of affective cues, affect intensity, and inhibitory control between young adults with and without ADHD. Results provide evidence for how affective cues and contexts differentially influence behavioral responses in young adults. Individuals with and without ADHD also appear to differ in the intensity with which they experience different emotions. Overall, the current study provides a framework for how to further explore how emotional cues and affect intensity influence inhibitory control

Immigration and recommended care after a suicide attempt in Europe: equity or bias?

This report describes the investigation of care recommendations in the medical system across European countries to immigrants who attempted suicide. Data from seven European countries with 8865 local and 2921 immigrant person-cases were derived from the WHO/EURO Multicentre Study on Suicidal Behaviour and ensuing MONSUE (Monitoring Suicidal Behaviour in Europe) project. The relationship between immigrant status and type of aftercare recommended was analysed with binary logistic regression, adjusting for gender, age, method of attempt and the Centre collecting the data. Clear disparities were identified in the care recommendation practices toward immigrants, compared with hosts, over and above differing policies by the European Centre

Recommended care for young people (15-19 years) after suicide attempts in certain European countries

Abstract Data on recommended care for young people aged 15±19 years after attempted suicide from nine European research centres dur- ing the period 1989±1992 were ana- lysed in terms of gender, history of previous suicide attempt and meth- ods used. Altogether 438 suicide attempts made by 353 boys and 1,102 suicide attempts made by 941 girls were included. Analyses of the total data from all centres showed that young people with a history of previous suicide attempt and those using violent methods had signi®- cantly higher chance of being rec- ommended aftercare than ®rst-time attempters or those choosing self- poisoning. There were no signi®cant di erences of being recommended care between genders. Logistic re- gression analyses of the material were performed and the results were similar. Both having previous at- tempted suicide (odds ratio 2.0, 95% CI 1.53±2.61) and using ``hard'' methods (odds ratio 1.71, 95% CI 1.49±1.96) were signi®cantly associ- ated with increased possibility of being recommended aftercare. When individual centres were analysed, large disparities of recommended care after suicide attempts were found and there were no uniform criteria of recommending care for young suicide attempters in Europe. Key words Young people ± attempted suicide ± method ± recommended car

Gender distribution of suicide attempts among immigrant groups in European countries—an international perspective

Background: Studies report high rates of suicide attempts for female immigrants. This study assesses variations in the distribution of suicide attempts across gender in immigrant and non-immigrant groups in Europe. Method: Data on 64 native and immigrant groups, including 17 662 local and 3755 immigrant person-cases collected, between 1989 and 2003, in 24 million person-years were derived from the WHO/EURO Multicentre Study on Suicidal Behaviour. Female-to-male ratios of suicide attempt rates (SARs) were calculated for all groups. Results: The cases were combined into four major categories: hosts; European and other Western immigrants; non-European immigrants; and Russian immigrants. The non-European immigrants included higher female SARs than the Europeans, both hosts and immigrants. Unlike the other groups, the majority of suicide attempters among the Russian immigrants in Estonia and Estonian hosts were male. This was also true for immigrants from Curaçao, Iran, Libya and Sri Lanka. When the single groups with a male majority were excluded, the correlation between female and male SARs was relatively high among the European immigrants (r = 0.74, P < 0.0005) and lower among the non-European immigrants (r = 0.55, P < 0.03). Generalized estimating equation analysis yielded a highly significant difference (P < 0.0005) in gender ratios of suicide attempts between hosts (ratio 1.52) and both non-European immigrants (ratio 2.32) and Russian immigrants (0.68), but not the European immigrants. Conclusions: The higher suicide attempt rates in non-European immigrant females compared with males may be indicative of difficulties in the acculturation processes in Europe. Further understanding of factors underlying suicidal behaviour in immigrant and minority groups is necessary for planning effective prevention strategie

Religion and the Equal Protection Clause

This article argues that state action that discriminates on the basis of religion is unconstitutional under the Equal Protection Doctrine even if it does not violate the Establishment Clause or the Free Exercise Clause as incorporated by the Fourteenth Amendment. State action that discriminates on the basis of religion should be subject to strict scrutiny and should almost always be held unconstitutional. We thus challenge the Supreme Court\u27s recent decision in Christian Legal Society v. Martinez in which a 5 to 4 majority of the Court wrongly allowed a California state school to discriminate against a Christian Legal Society chapter on the basis of religion. We defend our argument that the Fourteenth Amendment bans discrimination on the basis of religion as being: 1) consistent with and mandated by the original meaning of the Fourteenth Amendment; 2) as following logically from the seminal logic in United States v. Caroline Products Footnote Four which specifically mentions religion as a suspect classification; 3) as not being precluded by any prior Supreme Court caselaw; 4) as reflecting the fact that religious affiliation is in some faiths hereditary and immutable; and 5) as being consistent with the ban on discrimination on the basis of religion in almost every equal protection clause in every foreign constitution or international human rights document that we have surveyed. We analyze the impact our equal protection argument might have on Establishment Clause and Free Exercise Clause caselaw, and we explain why in our view State constitutional Blaine amendments forbidding government money from going to religious entities violate the Fourteenth Amendment. We conclude, perhaps most strikingly, by arguing that the Fourteenth Amendment\u27s ban on discrimination on the basis of religion renders the current system of funding the public schools unconstitutional. In our view, the Fourteenth Amendment obligates the states to provide students with education vouchers that they can redeem either at a secular or at a religious school depending on parental choice. Forcing religious students to attend a state funded school that is permeated with an atmosphere that is hostile to religion violates the Fourteenth Amendment

Religion and the Equal Protection Clause: Why the Constitution Requires School Vouchers

Ask anyone whether the Constitution permits discrimination on the basis of religion, and the response will undoubtedly be no. Yet the modern Supreme Court has not recognized that the antidiscrimination command of the Fourteenth Amendment protects religion in the same way that the Amendment protects against discrimination on the basis of race or gender. In fact, the Supreme Court has permitted the legislature to facially discriminate against religion in funding programs. To make matters worse, thirty-seven state constitutions and the District of Columbia’s Code openly discriminate on the basis of religion in so-called Blaine Amendments