Suicide has emerged as a prominent public health issue in recent years because of the stubbornly high rate of such deaths in the United States. But the announcement Tuesday of the MacArthur Fellowships will provide a boost in research aimed at preventing people from taking their own lives.
Suicide is the 10th-leading cause of death in the United States, accounting for about 100 deaths per day. The most recent data, for 2008, show rates are inching upward despite the fact that more people with mental illnesses are treated today, Nock said.
"I think we need to get more creative about trying to understand the complex factors that are involved in suicidal behavior," said Nock, who earned his doctorate at Yale University before joining Harvard in 2003.
Some of the recent research by Nock and others has upended traditional thinking on the issue. People have viewed suicide as a result of major depression. "But what our data show is depression isn't a strong predictor of suicide," Nock said. "What does predict it are disorders characterized by anxiety, agitation, poor impulse control, post traumatic stress disorder and alcohol and substance abuse."
Nock and his colleagues have also helped correct the idea that "cutting" and other forms of self-injury among children and adolescents indicates suicidal thinking. Instead, the majority of youths who self-injure are not suicidal but are engaging in a behavior that helps them regulate their feelings.
Yet there are still no reliable tools to help identify which people are suicidal or treatments to prevent suicide.
"Suicide is not an easy thing to predict," Nock said. "Historically, we've relied on a person's self-report about whether they are thinking about hurting themselves. But people are motivated to deny that."
Nock's recent studies have identified an objective, behavioral marker that could be used to help predict suicide attempts. Using a simple computer game, the research showed that people who are suicidal respond differently when they see certain words on a computer screen than do non-suicidal individuals. When asked to click on a computer key when they see a word, people who are suicidal tend to linger a fraction longer over the words "death" or "suicide."
Those particular words "captures their thinking and slows down their response," he said. "It's an objective marker. It doesn't require them to tell you whether they are suicidal."
Nock works with an international consortium of researchers addressing suicide prevention in countries around the world. His research has been published in the British Journal of Psychiatry, Molecular Psychiatry and the Journal of Clinical Psychiatry, among other publications.
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