Executions

[random]

Yes 99 times out of 100 a shotgun blast of either buckshot or slug is gonna do the job possibly your thinking bird shot?

 

I take great offence to the claim about schizophrenics being fanatically determined to die............Sounds like an uninformed misconception based on irrational fear. Or just plain ignorance about schizophrenics in general.

 

I look forward to seeing some documentation to back your statements up please.

[rktpro]

Inquiring minds want to know, a fatal dose of what drugs will it take for the express purpose of causing the immediate death of the subject? I want to know the drugs that will cause the easiest death, rather than other methods which are considered to be more painful.

 

I know the subject could be applied in a broad sense to suicide, but I'm just curious, I do not have the intention of killing myself.

 

 

 

I didn't read all replies to your question but still I could give some different answer.

An easy and cheap way is to Drink a full bottle of Cola Drink(which consist of caffeine) and eating a full pack of Mentos (sugar, wheat glucose syrup, hydrogenated coconut oil, rice starch, gum arabic, sucrose esters of fatty acides, gellan gum, natural flavors). The person would die withing 5 minutes. This is because the above diet makes cyanide inside the body.

[ewmon]

the above diet makes cyanide

No it doesn't. Mixing soda and Mentos only causes the carbon dioxide to come out of solution.

 

With guns, the blast from the gunpowder alone (no bullet) is sometimes enough to kill.

[Marat]

I can't back up the evidence I cited in my previous observations with any cited sources, since it just comes from my personal experience of working for the last 20 years in a major urban hospital.

[TonyMcC]

What? How on earth is a spray of pellets a disadvantage at point-blank range? Most people don't attempt suicide with a gun that's twenty yards away. There are few things civilians have access to with more stopping power at point-blank or standoff ranges than a shotgun. Any weapon can miss. I see absolutely no reason why a shotgun in particular would make a miss more survivable. That doesn't stand to reason. Back up your claim.

 

 

Uhhhh... a history of past attempts is widely known to be among the strongest predictors for future attempts. Do you have any data whatsoever to support this claim?

 

 

Do you have any data whatsoever to support this claim?

I'm afraid that it is a sad fact that suicide attempts by schizophrenics are much more numerous than non-schizophrenics. http://www.schizophrenia.com/suicide.html

Edited April 27, 2011 by TonyMcC

[PhDwannabe]

I can't back up the evidence I cited in my previous observations with any cited sources, since it just comes from my personal experience of working for the last 20 years in a major urban hospital.

The making of scientific inferences--whether observations of, descriptions of, or predictions of behavior or relationships between variables of any kind--based off of personal experience is the antithesis of what science is about. This is exactly the sort of thinking that the scientific method is there to mitigate. It's there to protect us from our casual observations, which delude more often than they inform.

 

PhDwannabe, on 26 April 2011 - 01:49 PM, said:

 

What? How on earth is a spray of pellets a disadvantage at point-blank range? Most people don't attempt suicide with a gun that's twenty yards away. There are few things civilians have access to with more stopping power at point-blank or standoff ranges than a shotgun. Any weapon can miss. I see absolutely no reason why a shotgun in particular would make a miss more survivable. That doesn't stand to reason. Back up your claim.

 

 

Uhhhh... a history of past attempts is widely known to be among the strongest predictors for future attempts. Do you have any data whatsoever to support this claim?

 

 

Do you have any data whatsoever to support this claim?

 

I'm afraid that it is a sad fact that suicide attempts by schizophrenics are much more numerous than non-schizophrenics. http://www.schizophr...om/suicide.html

 

Yes, the suicide rate is obviously higher among those with major mental illnesses. Schizophrenia included. What does that have to do with what you quoted from me?

[TonyMcC]

PHDwannabe - Perhaps I have got hold of the wrong end of the stick but your post No.25 seemed to be looking for evidence that schizophrenic patients are at greater risk from suicide and suicide attempts. My apologies if I misunderstood.

[rigney]

I wonder about the effectiveness of this Marat, I have seen up close and personal a stuntman place himself in a box with 2 sticks of dynamite and emerge unscathed. granted the box was styrofoam and he of course wore hearing protection. The organization this man worked for is called the hell drivers so you may be able to find a video online somewhere.

I think it is kind of like lighting a firecracker in your hand, if your hand is open you only burn the palm if you close your hand around it well now you only have 1 hand. Granted the percussion from dynamite is what? 1000 fold stronger?

 

They may not be as quick as other methods mentioned here, but taking a big overdose of Crack, Meth or Black Tar will definitely get the job done just as effectively. What may be even better, you could possibly get a huge euphoric rush just before it kicks your ass. But then, don't take my word foi it, I'm an old grandpa past 78 and have never given any of these a thought. Edited April 27, 2011 by rigney

[PhDwannabe]

Tony, no big deal. In response to:

 

PHDwannabe - Perhaps I have got hold of the wrong end of the stick but your post No.25 seemed to be looking for evidence that schizophrenic patients are at greater risk from suicide and suicide attempts. My apologies if I misunderstood.

 

#25 was asking, among other things, for some evidence for this claim of Marat's:

 

The great exception to this rule are schizophrenics, who are often so fanatically determined to die that after admission to the hospital after an unsuccessful attempt they will resort to even the most fantastic, implausible, and painful means to die

 

The claim is not that schizophrenics have a higher rate of suicide. That's patently obvious and can be accepted without evidence--I have no argument and offered no argument there. Marat's claim is that schizophrenics, apparently, once admitted to the hospital after an unsuccessful attempt, are somehow primed to then complete the act later on by whatever means necessary. This desire to die was characterized as "fanatical." I asked for some evidence for this and Marat already admitted that it comes from nothing more than a single person's individual experience (his own). It's an unsupported junk claim.

[Marat]

When you get some clinical experience you'll see what I mean. In the hospitals where I have worked, there is always a standard instruction for special precautions when post-suicide attempt schizophrenics are brought in, based on decades of experience with the way they persist in their intention. I saw one patient once who had an array of positive schizophrenic symptoms and who was admitted to the ICU after a suicide attempt and then started to cut himself with a butter knife from a meal tray. Then, after that was taken away, he took a chair and crashed it through a supposedly shatter-proof window and threw himself out to his death. Schizophrenics can act with apparently superhuman strength to kill themselves, and they often resort to methods which are among the most horrific and painful imaginable, such as one patient I saw who drove two knives through his eyes.

 

Just talk to any mental institution attendant and they will all confirm what I'm saying about the persistence in suicidal motivation in schizophrenia. Or try thinking logically about it. Someone who attempts suicide out of a neurosis still has intact thinking and so can respond to the shock of having closely approached death in an inital, failed suicide attempt. He can reflect on the significance of his act, think further about the pros and cons, and revise his original intention given all the new anti-suicide influences which will come streaming in from the clinical environment he finds himself in after his attempt.

 

But with a schizophrenic acting on the basis of irresistable instructions from external voices, what could make him ALTER his original intention to commit suicide? The voices are not going to stop on their own because they have been corrected by emotional shock, maturation, more mature reflection, acute clinical intervention, deeper analysis of the problems motivating the first suicide attempt, etc. No, in the case of a schizophrenic, there is no reason why the failed attempt could change the intention, so repetition is logically likely.

[SMF]

PhDwannabe, I share your concern regarding unsupported opinions, so here is a little science. Suicide among schizophrenics is greater than the general public, but not as much as is commonly thought, and the rate is less than, for example, individuals with alcoholism or affective disorder-- http://bjp.rcpsych.org/cgi/content/abstract/172/1/35

 

Further, this analysis-- http://bjp.rcpsych.org/cgi/reprint/187/1/9.pdf found that "Active psychotic symptoms were not associated with increased risk; indeed, hallucinations were associated with a reduced risk of suicide, as were delusions when the studies of more robust design were examined."

 

SM

[Ringer]

Marat are you sure these people weren't suffering from a different disorder? There are many other disorders that cause people to do damage to themselves, even some that cause an addiction to the harm. What you are describing sounds like some sort of self-mutilation disorder which can be co-morbid with a list of different disorders.

[PhDwannabe]

When you get some clinical experience you'll see what I mean.

Well, there's my belly laugh for the day. Your experiential fallacy is not going to take you places with me. I have clinical experience in both inpatient and outpatient mental health environments, including experience with individuals suffering from psychotic disorders. Being a normal human, it confuses and deludes me often. Being a decent scientist, when I sense myself beginning to make large inferences from it, I wag my finger at myself in the mirror and tell myself I'm entering very dangerous territory.

 

Just talk to any mental institution attendant and they will all confirm what I'm saying about the persistence in suicidal motivation in schizophrenia. Or try thinking logically about it.

I try not to use too much logic in the service of what are essentially empirical questions. As much as I try not to resort to empiricism for what are essentially logical questions. Your claims are perfectly amenable to empirical investigation. They deserve more than a priori reasoning and the silly, biased pleas to personal clinical experience or judgment.

 

Furthermore:

 

PhDwannabe, I share your concern regarding unsupported opinions, so here is a little science. Suicide among schizophrenics is greater than the general public, but not as much as is commonly thought, and the rate is less than, for example, individuals with alcoholism or affective disorder-- http://bjp.rcpsych.o...stract/172/1/35

 

Further, this analysis-- http://bjp.rcpsych.o...int/187/1/9.pdf found that "Active psychotic symptoms were not associated with increased risk; indeed, hallucinations were associated with a reduced risk of suicide, as were delusions when the studies of more robust design were examined."

Absolutely. All perfectly informative findings that I'm somewhat aware of already. The public's (and sadly, many professionals') predictions of both suicidality and violence/risk of harm to others from individuals with psychotic disorders is completely disproportionate to the real rates. A really important finding. Additionally, as the study you cite does an excellent job of demonstrating, empirically, factors which predict suicide among individuals with schizophrenia are not always obvious, and certainly not always what "clinical experience," or some sort of "logical" reasoning process might helpfully suggest. Great citations, SMF.

 

Finally:

 

Marat are you sure these people weren't suffering from a different disorder? There are many other disorders that cause people to do damage to themselves, even some that cause an addiction to the harm. What you are describing sounds like some sort of self-mutilation disorder which can be co-morbid with a list of different disorders.

Well, there is no "self-mutilation disorder," per se. Non-suicidal self-injury (NSSI) is a behavior not currently enshrined as a distinct diagnosis, but frequently found as part of larger patterns of behavior that we do classify as disorders, the really common ones being Borderline Personality Disorder, Major Depression or other mood disorders, eating disorders or Body Dysmorphic Disorder, or psychotic disorders, and to some extent, many major mental illnesses. You can also see the behavior in lower-to-moderate-functioning disorders of the autistic spectrum and various other developmental conditions, but that's kind of a different animal. I have little doubt that the people Marat is describing did indeed meet criteria for schizophrenia or a similar condition. NSSI, as well as gestures with higher degrees of suicidal intent, are certainly not unknown among those disorders--indeed, rates of them are higher within them than in the normal population. That's not really anything I'd dispute, or have disputed. The contention that schizophrenics, once they make a suicide attempt, will then do anything they can to complete it--that's something I wanted to see some data for, and have so far received nothing but one guy's report of his personal experiences. Which is worthless. Less than worthless, because it so often misleads.

 

Look, I'll be really clear: I'm not even saying that this particular narrow claim of Marat's is impossible. I register my suspicion of it, because it seems to smack of some clinical biases people have about schizophrenics which I know that empirical findings have not borne out. I don't have any evidence against it. Since negative evidence really isn't evidence in most cases, I'm not really even making an affirmative stance to the contrary. I just think it's suspect, I want to see some real data, and in the absence of it (or worse, in the presence of only anecdote) I have no reason to accept it. If that data were out there, I'd be 1) surprised, 2) happy to accept it, and 3) happy to admit I'm surprised. I'm surprised often. It's a glorious thing to be wrong. Welcome to science, kids.

[Marat]

Here is one way more objectively to approach the question of the persistence of suicidal intention in schizophrenics in opposition to the comparative lack of persistence in non-schizophrenics. A very large percentage of suicide attempts are actually 'cry for help' suicides, especially among females. That is why female suicide attempts are very much less successful than male attempts: they are not really designed to succeed, but are just pathological attempts at communicating with the community, telling people that the person playing at committing suicide is very serious about needing intervention. Of this large subset of people attempting suicide, most of them will not try to kill themselves again, or not try it again seriously enough to succeed, because their initial communication via the 'cry for help' suicide attempt has alerted the community sufficiently and they have received the intervention desired.

 

However, a key feature of schizophrenics is that they are detached from the surrounding human community and do not communicate with it in any effective way. As a result, their suicide attempts are not 'cry for help' attempts, which will cease once they have communicated the need for intervention, but are genuine efforts to die. Thus, since these schizophrenic suicide attempts are not cries for help but genuine endeavors to die, they will be repeated, as the cry for help pseudo-suicide attempts will not be.

[SMF]

Marat, in saying-

 

Here is one way more objectively to approach the question of the persistence of suicidal intention in schizophrenics in opposition to the comparative lack of persistence in non-schizophrenics.

 

- you are expressing yet more unsupported opinions and have failed to read any of the research provided for you. Most suicide attempts by schizophrenics occur soon after the beginning of their disease when they realize something is wrong. Please provide some credible evidence for the rest of this last post. I thought that this was a science forum. SM

[PhDwannabe]

Marat, to echo SMF's sentiments, I'm going to again respond to your "new" post--if it can be called new:

 

Here is one way more objectively to approach the question of the persistence of suicidal intention in schizophrenics in opposition to the comparative lack of persistence in non-schizophrenics. A very large percentage of suicide attempts are actually 'cry for help' suicides, especially among females. That is why female suicide attempts are very much less successful than male attempts: they are not really designed to succeed, but are just pathological attempts at communicating with the community, telling people that the person playing at committing suicide is very serious about needing intervention. Of this large subset of people attempting suicide, most of them will not try to kill themselves again, or not try it again seriously enough to succeed, because their initial communication via the 'cry for help' suicide attempt has alerted the community sufficiently and they have received the intervention desired.

 

However, a key feature of schizophrenics is that they are detached from the surrounding human community and do not communicate with it in any effective way. As a result, their suicide attempts are not 'cry for help' attempts, which will cease once they have communicated the need for intervention, but are genuine efforts to die. Thus, since these schizophrenic suicide attempts are not cries for help but genuine endeavors to die, they will be repeated, as the cry for help pseudo-suicide attempts will not be.

 

...with something I already said...

I try not to use too much logic in the service of what are essentially empirical questions. As much as I try not to resort to empiricism for what are essentially logical questions. Your claims are perfectly amenable to empirical investigation. They deserve more than a priori reasoning and the silly, biased pleas to personal clinical experience or judgment.

 

We have little business sitting around and trying to reason through fundamentally empirical questions. You simply don't have the data to support your claims. You cover this by talking in circles. There's nothing wrong with logical reasoning--you can't form good hypotheses or design good studies without it, and it's as much a part of science as empiricism is (indeed, it's something that often seems sadly missing from many of my colleagues, who possess a lot of empirical acumen). But some claims simply sit further on one side or the other. This issue is substantially empirical. Continuing to try to make relatively decisive statements about it in the absence of empirical data is a waste of breath or keystrokes. You've already admitted where your inferences come from:

I can't back up the evidence I cited in my previous observations with any cited sources, since it just comes from my personal experience of working for the last 20 years in a major urban hospital.

This horse is dead. I'm done helping you beat it.

[Marat]

The continuing resolve of schizophrenics to persist in their suicide attempts is well-documented in the psychiatric literature. Some sources to consider might be: F. Fujimori and M. Sakaguchi, "Suicide by Schizophrenic Patients in Psychiatric Hospitals," Fortschritte der Neurologie-Psychiatrie, 54 (1) 1 (1986); S. Shrivastava, et al, "Persistent Suicide Risk in Clinically Improved Schizophrenia Patients," Neuropsychiatric Disease and Treatment, 6, 633 (2010). The abstract of the article by J. Harkavy-Friedman and E. Nelson, "Management of the Suicidal Patient with Schizophrenia," Psychiatric Clinics of North America, 20 (3) 625 (1997), has a telling phrase that summarizes the situation: "Clinicians working with individuals with schizophrenia are often aware of the persistence of suicidal behavior ... ."

[Cap'n Refsmmat]

The abstract of the article by J. Harkavy-Friedman and E. Nelson, "Management of the Suicidal Patient with Schizophrenia," Psychiatric Clinics of North America, 20 (3) 625 (1997), has a telling phrase that summarizes the situation: "Clinicians working with individuals with schizophrenia are often aware of the persistence of suicidal behavior ... ."

With my institutional access I have the full-text of this article. Perhaps we can settle some of the points in your previous posts using it:

 

But with a schizophrenic acting on the basis of irresistable instructions from external voices, what could make him ALTER his original intention to commit suicide? The voices are not going to stop on their own because they have been corrected by emotional shock, maturation, more mature reflection, acute clinical intervention, deeper analysis of the problems motivating the first suicide attempt, etc. No, in the case of a schizophrenic, there is no reason why the failed attempt could change the intention, so repetition is logically likely.

Not the case:

 

There has been little evidence that psychosis in and of itself precipitates suicidal behavior. Suicidal behavior is rarely directly precipitated by command hallucinations. There is strong evidence, however, to suggest that a much greater period of risk for suicidal behavior in schizophrenia is during the postpsychotic period following the treatment of psychotic symptoms. It is unclear whether this increased risk reflects a postpsychotic depression, a change in status related to neuroleptic medications and their side effects (e.g., akathisia), or clinical decline resulting from noncompliance with medication.

 

It is not the hallucinated voices telling patients to commit suicide, so your logical effort to analyze their suicides is based on a false premise.

 

Repetition is similarly not as common as you imply:

 

In people with schizophrenia, as in other groups, the single best predictor of suicidal behavior is past suicidal behavior. Although most people who make suicide attempts do not go on to commit suicide, more than 50% of individuals who commit suicide have made previous attempts.

 

This is why empirical data is important. Logical analysis will fail when your premises are false.

[PhDwannabe]

Real data? Real citations? Back to the dead horse we go! Let me, Marat, charitably distill the initial claims which you made which I took some issue with:

 

1) After a first suicide attempt, most people don't make another.

2) The exception is schizophrenics, who'll do whatever they can to finish if an attempt is not completed or interrupted.

 

I called both of those into question. With regard to #1, I spoke up because past history of suicidality is one of the huge predictors of present or future suicidality. As Carlborg, Winnerback, Jonnson, Jokinen, and Nordstrom (2010) note: "In most studies, a history of self-harm or suicide attempts is the strongest risk factor for suicide (Cavanagh, Carson, Sharpe, & Lawrie, 2003)" (p. 1155).

 

You haven't really responded to #1--I'm not asking you to, because the contrary point is so excessively well-supported by the literature--but you've responded to my questions about #2. First, with personal anecdote, followed by an (admirable) admission that it was personal anecdote. So, we already know why you think what you think. Now, post hoc, you've attempted to find some literature to support your anecdote-based inference. Let's take your citation that's got some decent data in it. I don't really want to deal with this:

 

The abstract of the article by J. Harkavy-Friedman and E. Nelson, "Management of the Suicidal Patient with Schizophrenia," Psychiatric Clinics of North America, 20 (3) 625 (1997), has a telling phrase that summarizes the situation: "Clinicians working with individuals with schizophrenia are often aware of the persistence of suicidal behavior ... ."

Because it's the kind of boilerplate, nodding shop-talk dreck that acts as filler in so many scholarly articles, and frequently it doesn't have anything to do with any sort of data. There's no data in this article, by the way; it's a review.

 

So, let's look at the newer study with some data in it. What's really astounding is that the results here (Shrivastata et al., 2010), taken grossly, don't really support your claim at all...

 

Fully 100% of their sample reported some amount of suicidality by the end of the study--48.3% of whom actually displayed attempts. Between 5 and 10% of schizophrenia patients eventually die by suicide. Where's this heroic effort to stop them once the attempt is initiated? The authors don't mention it. In fact, initial attempts, prior to or at the onset of treatment did not predict--as you claim would suggest they would--continued or further attempts: "Because most patients experienced emerging suicidality (suicidal behavior or ideation), a prior suicide attempt was not a good predictor of suicidality during the treatment phase" (p. 635). I thought schziophrenics were the only ones for whom history of attempts was predictive! The exception to the rule! Look: most schizophrenics are probably at some time suicidal, and making suicidal gestures. Most schizophrenics are not receiving adequate care of the sort that is always there to interrupt suicidality. Most schizophrenics (although certainly at a higher rate than normals--never disputed) are not dying by their own hand. Where's that "fanatacism" at? We don't need elaborate stats to doubt your claims here--simple baserates don't square with them.

 

Indeed, the study actually casts doubt on your proffered explanation for your anecdotal hypothesis. When attempting to "reason through" your hypothesis "logically", you suggested the following:

But with a schizophrenic acting on the basis of irresistable instructions from external voices, what could make him ALTER his original intention to commit suicide? The voices are not going to stop on their own because they have been corrected by emotional shock, maturation, more mature reflection, acute clinical intervention, deeper analysis of the problems motivating the first suicide attempt, etc. No, in the case of a schizophrenic, there is no reason why the failed attempt could change the intention, so repetition is logically likely.

 

So, positive symptoms of schizophrenia are to blame for the persistence of suicidality, because they interfere with/are not amenable to the normal process by which other people are set right by the jarring experience of a suicide attempt. Let's see what Shrivistata and colleages have to say about it: "baseline severity of symptomatology, positive and negative symptoms, and global functioning in daily life (as well as gender, age, and duration of untreated illness before first hospitalization) may not help clinicians predict suicidality in schizophrenia patients. The mean positive symptoms score was reduced by more than 65% between baseline and the end of the study" (p. 636). Positive symptoms decreased quite a bit during the study--during a time when suicidality actually increased. Their schziophrenia symptoms--remember, the ones your dataless a priori reasoning process regarded as so important?--turned out not to have the effects you'd seem to have thought. Again, the authors: "patients who improved in the psychopathologic components of their disorder were at high risk of suicide" (p. 636). Again: "The results of the present study indicate that clinical improvement is not a key element in decreasing suicide risk. On the contrary, improvement in schizophrenia symptoms may increase suicidality" (p. 637). It's not the symptoms that are doing it. Look at the tables in the article. Read the stats.

 

Isn't it wonderful how empirical data can show us these sorts of things, rather than just having to sit around and think about how it "logically" happens, based on our own biased and limited experiences?

 

 

 

 

 

Edit: Looks like me and the Capn were simultaneously hard at work responding to this one. Happy to make some of the same points, Capn. We'll make a psychologist out of you yet.

Edited May 3, 2011 by PhDwannabe

[griffithsuk]

Mate don't give up, it's only schitzophrenia, your clever! I have it too.

 

What's probably happening is you have an ability like mine which is to speak to yourself in your own mind in any sounding voice you like, you can make your inner voice sound nothing like your own, your creative. You may also have an expiance of your voice sounding outside your head, from somewhere else. If this is so, like me your get better, its about understanding and controlling your condition, then everyting is great. In a few months time you may never hear voices again, there is hope, just belive in this. I know your doctor did not tell you this but thet did not tell you this either : http://www.sciencefo...sure-so-simple/

 

Chill out, stop smoking weed for a few weeks if thats what your doing(i do)

 

See your doctor about a drug called aripiprazole, it's new, ive been a guinne pig testing it for a few years now, it's prety good mate.

 

The good part is that you acept your condition, i know someone that doesnt believe they have the condition, thats why i know your clever.

Edited May 11, 2011 by griffithsuk