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Journal o j1969,not oj Consulting an d Clinical Psychologyi, Vol. 33, No. 1, 46-50

SUICIDE AND AGE:A SUICIDE NOTE ANALYSI S

A L L E N R.DARBONNElVeterans Administration Center, Los Angeles

The present study tested the hypothesis that suicidal ideation varies with age.259 suicide notes were analysed. This represented all of the suicide notes writtenby individuals w ho committed suicide during a 3-year period w ho resided inthe 34 moderately advantaged natural communities of Los Angeles County.The method of analysis involved categorizing each note according to a schemeof five general categories: (a) Addressee, (6) Reasons Stated, (c) Affect Indi-cated, (d) Specific Content, an d (e ) General Focus of Note . The notes weredivided into four age groups20-39, 40-49, 50-59, and 60 and over, an d com-pared with reference to the five general categories. Differences between agegroups were found significant at the .05 level for Categories b an d e. Specificitems within each category were discussed when such items were found sta-tistically more or less often in the notes of one age group than in the notes ofthe other ag e groups. Suggestions fo r t rea tment an d prevention of suicide wereoffered.Despite effort an d theory which began longbefore Freud and Durkheim, one of the most

pressing questions of society remains un-answered. W hy does man so often choose totake his own life? Each year in the UnitedStates at least 25,000 persons make thischoice, resulting in suicide ranking among thetop 10 causes of adult deaths.

There seems to be a growing agreementamong current investigators of suicide thatpresent theories do not adequately handle thedata. A need has been expressed for an ampli-fication of current conceptual systems to bet-ter account for the many variables related tothis phenomenon. Among these variables isthe factor of age. Statistics clearly indicatethat suicide is not restricted to any specificage group. Farberow and Shneidman (1957)pointed out in a theoretical review that therehas been no differentiation in suicide theoriesfor age of the suicidal person and indicatedthe need for this on the basis of their re-searches.A n understanding of the role of age in sui-cide would seem to be a desirable early step

1Also at Reiss-Davis Child Study Center, LosAngeles, California. Requests for reprints should besent to Allen R. Darbonne, Central Research UnitBuilding 13 , Second Floor West, Veterans Adminis-tration Center, Wilshire an d Sawtelle Boulevards,L os Angeles, California 90073.

in the development of an adequate theory.Suicide is frequently viewed as a result of acombination of the individual's psychic drivesand environmental factors. Inasmuch as bothintrapsychic needs and environmental stressescan be reasonably expected to vary fo r differ-ent age groups, it can be assumed that sui-cidal ideation within the groups will reflectthese differences.

The present study is an attempt to test thisassumption and to investigate further the re-lationship of age to behavior in suicidal indi-viduals. T he analysis of suicide notes (writtenshortly before individuals take their lives andsometimes as they die) has proved itself animportant method in obtaining data regardingideation and affect of suicidal persons. Thenecessarily projective quality of such a com-munication lends itself well to psychodynamicinterpretation. Although only about one sui-cide in three leaves a note, studies by Shneid-man and Farberow (1960) and Tuckman,Kleiner, and Lavell (1959) indicated no sig-nificant differences between persons w ho leavenotes and those who do not. Tuckman et al.(1960) investigated the validity of notes andreported an agreement with information froman informant in over 90% of the cases. Reli-ability of suicide note analysis has also beenreported to be acceptably high.

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S U I C I D E A N D A G E 4 7METHOD

The suicide note analysis technique is the methodused in the present investigation. Two hundred andfifty nine notes written by 156 individuals w ere ana-lyzed. This number represents the total number ofsuicide notes written by men and women who com-mitted suicide during a 3-year period and who re-sided in the 34 moderately advantaged natu ral com -munities of Los Angeles County.The use of socio-cultural-economic area types asstudy areas is described in detail by Shneidman an dFarberow in their 1960 report of a socio-psychologicalinvestigation of suicide. Therefore, only a brief de-scription will be given here. Based on the census dataof L os Angeles County, the Los A ngeles WelfarePlanning Council (1958) studied the county anddivided it into 100 relatively stable, hom og eneo us"study areas." Basis for division was average educa-t ion, income, home ownership, population, andnumber of people living alone. These 100 areas wereredistributed among nine area types on the basis of"urbanization and social rank."The group of moderately advantaged natural com-

mu nities, designated A rea Type V, was selected fo rthis investigation. Its 34 communities seemed to rep-resent best the average community of Los Angeles.The total Area Type V population was roughly 1,700,-000, which represented 31 % of the county's popu-lation. It is composed of 31% under age 20, 62%aged 20-65, an d 1% over age 65. The annual ratio ofnumber of suicides to population in this area was 14per 100,000, which w as identical with the averagesuicide ratio for the county.The suicide note writers were divided into fourage groups, 20-39, 40-49, 50-59, and 60 and over.The age group s were selected in an attem pt to re-flect different stress periods in a lifetime.The technique employed in note analysis is aminor modif icat ion of that used previously byFarberow and Shneidman (1960). The method ofanalysis involved categorizing each note according toa scheme of five general categories: (a) To whomthe note was addressedinterpersonal involvements,dyadic relationships, etc.; (6) Reasons for suicideexplicitly stated in the noteconscious reason fo rvictim killing himself; (c) Affect indicated or im-pliedvaried emotional expressions; (d) Content

T A B L E 1OUTLINE FOR SUICIDE NOTE ANALYSIS

A . Addressee of suicide note1. Personal affiliation (family or friend)2. Impersonal affiliation or no addressee (police,to whom it may concern, or other)

B. Reasons stated in suicide note11. No reason stated12. Ill health, illness, physical disability, symptoms,pain13. Rejection by another, jilted, unloved, notunderstood, can't live without you, love tri-angle (other man, woman)14. Finances, money, bills, debts, job, occupation,unemployment15. Enn ui, tired of life, as a way ou t, reached end,couldn't go on16. No point in living, not worth trying17. Interest in death, other w orld, hereafter18. To "join" a (deceased) loved one19. Isolation, loneliness20. Confusion, depression, fear, an xiety21. Being persecuted, hearing voices, losing mind22. Sex23. Other (specify)

C . Affect indicated in suicide no te31. No affect32 . Hostility, criticism, blame, revenge33. Absolution of other, giving forgiveness (of

specific person)34. Sorrow, seeking forgiveness (from specificpersons)35. Seeking forgiveness from deity

C. Affect indicated in suicide note (Continued)36. Self-depreciation, self-derogation, self-criticism,guilt, self-blame (fault)37. Love, idealization, praise, defense38. Other (specify)

D. Specific content other than affect51. N o specific content, other than affect5 2 . M ention of religion, fate, life, world, death(abstraction)53. Goodbye, farewell54. Reference to suicidal act, no one responsible55. Reference to suicide note5 6. Instructions re money, business, power of at-torney, funera l expenses5 7 . Instructions re insurance58. Instructions re material possessions59. Instructions re children60 . Instructions re own remains61. Instructions re notification of others62 . Instructions re message to others63. Other (specify)

E. General focus of the suicide note71. Primarily reason fo r suicide72 . Primarily affect73. Primarily instructions74. Primarily abstractions75 . Primarily content other than affect76. Primarily reflecting own confusion77. Extremely short, cryptic, enigmatic78. Other (specify), no content


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4 8 ALLEN R. D A R B O N N Eother than affectvictim's main concern just beforekilling himself; an d (e ) General focus of the noteoverall tenor of the last written communication.Each general category was subdivided into severalmor e specific descriptive scoring categories by whichthe notes were analyzed. Table 1 lists these scoringcategories. Every note was scored according to allfive general categories. The four age groups were thencompared with respect to the characteristics of eachcategory.

RESULTSAfter each note was assigned a score accord-

ing to the five general categories listed inTable 1, a chi-square analysis was done to de-termine the relationship between the four agegroups and each of the five general categories.Where a specific item had a frequency so smallas to be misleading, it was combined with the"other" category before computation of thedegrees of freedom and the chi-square value.The result of this analysis was that "reasonsfor suicide" and "general focus of the suicidenote" were found to be related to age at the.OS level of significance. Table 2 indicates the

TABLE 2RELATIVE FREQUENCIES OF CATEGORIES WITHINSUICIDE NOTES OF DIFFERENT A GE GROUPS

Category

Reasons statedNoneHealthRejection or love tri-angleTired of life as a wayou tIsolation or lonelinessOtherAffect indicated:NoneHostilityAbsolution of othersSorrowSeeking deity's for-givenessSelf -depreciationAffectionOtherGeneral focus of note:Primarily reasonPrimarily affectPrimarily instructionsOther

A ge group

20-39

LowHigh

LowHighHigh

HighLow

40-49

High

High

Low

Low

50-59

High

HighHighLow

LowHighHigh

60 andover

LowHighLow

High

High

LowHighHigh

specific scoring items (of the statistically sig-nificant categories) which were found in arelatively high frequency or a relatively lowfrequency in one age group as compared to allother age groups.

DISCUSSIONA comparison within each age group of the

notes suggests that the categories which arestatistically related to age have a certain de-gree of consistency in meaning. They permitinterpretation which may have further impli-cations for suicide prevention and therapeuticapproach. In some of the statements whichfollow, the affect category is also mentionedin relationship to the categories of specificreason and general focus of the suicide note.The affect category is considered in this dis-cussion because there was a very strong trendtoward establishment of a relationship betweenage and affect in the suicide note (p < .10).Because of the exploratory nature of the note-analysis technique and the critical nature ofthe problem under study, it was felt that somereference should be made of this observedtrend.

The problems which seem to overwhelm theyoung adults (20-39) more frequently thanthe older individuals were related to feelingsof rejection and especially problems concern-ing heterosexual love objects and competitionfor them. There is a notable absence of rea-sons related to illness and pain. They couldprobably cope with the world physically butseemed unable to cope with their problemsconcerning interpersonal relations, and someof the deeper psychic problems related to sex-ual needs. At their dying moments these peo-ple seemed both willing and able to expressaffect in their suicide notes. A closer look atthis affect indicates it is primarily the in-ternalization of blame and guilt and self-depreciation. At the same time they expresslove and praise for others. Seeking forgivenessfrom the deity was less frequent in their notesthan in the notes of older suicides. Suicideprevention with this type of individual mightbe best accomplished through dynamic psy-chotherapy. This could help the individualgain insight into feelings which stem fromearly object relationships and which precipi-tate his recurrent interpersonal problems.


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SUICIDE A N D A G E 49H ealthy expression of affect should be en-couraged. Where the stress is marital andwhere it is apparent that the patient loves andpraises his spouse but feels unworthy andmisunderstood th e partners might be broughtinto the therapy. This is a typical note fromthis sample, written by a 28-year-old woman:Dear M o m :I've tried very hard to hide it, but I'm still as muchin love with Bill as always. I don't know how he feelsabout me, but my life is in his hands now. H e knowsI can't go on without him and if you read this itmeans he didn't care enough to stop me. I'm sorryto have failed you this way, but I love Bill so much,I'm not quite sane, let alone intelligent without him.It's better for the babies that I just check out thisw ay than for me to keep on being so unhappyaround them. There's a letter somewhere in my greysuitcase for Tim when he is 16.

A ll my love forever,M a ryIndividuals from ages 40 to 49 who com-mitted suicide left a communication of thevanquished. They seemed unequal to the de-mands of life an d were tired or bored an dwanted a way out. They entered the period of

the change of life already stating they ha dreached the end and couldn't go on. Thisgroup looked beyond life to the deity and pe-titioned fo r forgiveness. A combination ofindividual and group psychotherapy wouldpossibly be most effective in these cases. Theaim here might be a more accurate assess-m ent of the self. It is likely that m any of thesepeople have spent their earlier years attempt-ing to achieve above their potential or operat-in g below it. The result is a defeatist feelingand/or guilty thoughts of a wasted life. Ineither case the future is viewed with pessi-mism. Closing the gap between self-ideal an dself would be an immediate goal of the ther-apy. The special interest of this age group inthe deity should be explored. In some cases,and especially in crisis therapy, importantpsychological support may be gained from thereligious convictions of these people. A n ex-ample of a note from this age group w as writ-ten by a 43-year-old man.Please God forgive me, never again after this isover will I hurt anyone. I love my wife and chil-dren too much to continue on not knowing when I'lldo something again to hurt them . . . My back will

soon give m e real trouble an d then I'll be worthless toeveryoneSomething is wrong with m e inside an dI've tried to find out just what that something is asfar back as I can remember. I'm lost. If I continue asI have in the past m y family will not have a chance.Now they can.I'll pay for all when my maker sees me. I cannotcontinue to hurt people here on earth and I will not.I'm not weak. I must die.

BillP.S. God try to forgive me. I believe in God andalways havea person no good like myself shouldleave this earth.With the 50-59-year-old suicides, an inter-esting finding was presented. Even thoughresponding to a need to write a final com-

munication, they less frequently than anyother group gave a reason fo r their suicide.This group's use of the note to give instruc-tions and to convey information an d unemo-tional messages may indicate a plausible ex-planation. Expression of affect was found sig-nificantly less than in other notes. Possiblythese people have arrived at the conclusionthat others would not care or understand theirfeelings. They may have decided it is betternot to permit themselves emotional involve-m ent. A nother reason could be that these arethe individuals who are beginning to experi-ence failing health and other "more rational"reasons for suicide. They have given their acta great deal of thought and within their per-sonal logic have concluded death fo r them-selves. Until more is known about this group,they will present a difficult problem fo r pre-vention. Depth therapy seems less likely tosucceed here than with the previous groups.These individuals wo uld probably be reluctantto accept involvement in a therapeutic rela-tionship. When the therapist does treat suchpatients, he may find active environmentalmanipulation much more his role than usual.If one relates significant world events to thelifetime of these suicides, it is not too diffi-cult to imagine from whence they learned tobe realists. These were the Americans whom et World War I as teenagers, the Depres-sion during the most productive years of theirlives, World War II as they approached mid-dle age, and then saw their children called forthe Korean conflict. Certainly treatmentwould need to consider the effect of suchevents on the individual. A n example of a


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50 A L L E N R. D A R B O N N Enote from this age group w as written by aSO-year-old woman:To Whom It May Concern,I, M ary Smith, being of sound mind, do this day,make m y last will as followsI bequeath my rings,Diamond and Black Opal to my daughter-in-law,Doris Jones and any other of my personal belong-ings she might wish. What money I have in my sav-ings account and my checking account goes to mydear father, as he won't have me to help him.To m y husban d, Ed Smith, I leave my furniture andcar.I w ould like to be buried as close to the gra ve ofJohn Jones as possible.

M ary Jane SmithThe age group 60 and over attempted toanswer the question "why" more than anyother age group. Their reasons m ore fre -quently than those of younger suicides citedillness, pain, and physical disability whichaccompanied their increasing years. They alsomost often told of loneliness an d isolation.Their frequently expressed affect of sorrowan d seeking forgiveness from specific personsseemed most often related to having causedtrouble to others. There is an absence of state-

ments of self-depreciation and guilt. Theyapparently retained good thoughts of them-selves, but sensed rejection by others. Thoughthese individuals ha d lived the longest, theirnotes indicated that they were no more tiredof life than any other age groups. This seemsto suggest that fo r individuals at this age, oncethe situation becomes critical, environmentaland milieu therapy combined with medicalpain relief would be most useful. Familytherapy may also be advantageous. This agegroup presents a special problem fo r preven-tion, if only for the reason that they con-tribute more than their share to suicide sta-tistics. Preventative programs should take intoconsideration the psychological side effects ofcompulsory retirement rules, th e importanceof educating adults to understand and meetthe needs of aging parents, and the need fo rgeneral medical staffs to be cognizant of psy-chological aspects of physical ailments amongthe old and the emotional counterparts ofphysical aging. This is the note of a 71-year-old man in this group:

John, I do not seem to be wanted living with youan d Betty so the best thing I can do is put myselfout of the way. When you brought up about th elarge telephone bill you had sure upset me. I hav enot been using your phone so I do not understandw hy you said that . . . S o goodbye to you al l andplease forgive me. I will never get any better at myag e so what is the use of trying to go on . . . justa lot of suffering an d expense. Say goodbye toMartha Smith for me and treat her right. Youknow we all have ou r faults when we get older. Sheha s been very nice to me for what she has done sinceM om died. I have ha d this heart trouble since 1948an d it sure is not going to get better. I do notwant to spend several months or years in a rest home.Good Bye. D adTwo categories of reasons fo r suicide were

relatively absent from the notes of all agegroups. These were reasons related to fi-nances and reasons indicating confusion orbizarre psychotic thoughts. Further investi-gation is necessary to determine the full mean-ing of this finding.The evidence presented supports the hy-pothesis that type of suicidal ideation, includ-ing conscious reason for the act, varies withage of the suicidal person. These results arein accord with the view that suicidal behavioris a symptom of various kinds of personalitydisorganization and not the result of a singlesuicidal personality syndrome. A ttention m ustbe paid to the effect of age variables uponsuch disorganization in order to enhance sci-entific understanding an d increase effectiveprevention of suicide.

R E F E R E N C E SF A E B E R O W , N. L., & SHNEIDMAN, E. S. Suicide anda g e . In E. S. Shneidman & N. L . Farberow (Eds.) ,

Clues to suicide. N ew Y ork: M cGraw-H ill , 19S7.S H N E I D M A N , E. S., & F A R B E R O W , N. L. A socio-psy-chological investigation of suicide. In H . P. David& J. C. Brengelmann (Eds.), Perspectives in per-sonality research. New Y ork: Springer, 1960.T U C K M A N , J., KLEINER, R. J., & L A V E I X , M . Emo-tional contents of suicide notes. American Journalo f Psychiatry, 19S9, 116, S9-63 .T U C K M A N , J., K L E I N E R , R. J., & L A V E L L , M . Credi-bility of suicide notes. American Journal of Psy-chiatry, 1960, 116, 1104-1106.W E L F A R E P L A N N I N G C O U N C I L . Guides for planning ofleisure time services. L os Angeles: Welfare Plan-ning Council, 1958.

(Received February 26, 1968)

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