DOCSLIB.ORG

The Suicide Epidemic in Japan and Strategies of Depression Screening for Its Prevention Mutsuhiro Nakao a & Takeaki Takeuchi A,B

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
The Suicide Epidemic in Japan and Strategies of Depression Screening for Its Prevention Mutsuhiro Nakao a & Takeaki Takeuchi A,B Perspectives The suicide epidemic in Japan and strategies of depression screening for its prevention Mutsuhiro Nakao a & Takeaki Takeuchi a,b Introduction fication of highcrisk persons to prevent Simple screening methods suicide) and postcintervention (social Suicide is among the most tragic outcc to detect depression support for bereaved family and friends). comes of all mental disorders. WHO They also published two guidelines for The most commonly used standard for estimates that, worldwide, there are managing depression: one for healthccare the diagnosis of major depressive disc approximately one million deaths from order (MDD) is a structured interview suicide each year, and 20 times this numc professionals and one for public servants. The guidelines recommend a screening by a specialist, such as a psychiatrist, ber of people attempt suicide. Although according to the DSMcIVcTR criteria. the Japanese population leads the world test for depression in the workplace and the community, using a method based Essential MDD symptoms are depresc in longevity, it has a high rate of suicide sive mood and a loss of interest lasting at that is globally ranked ninth. From 1995 on the full criteria of the Statistical man-- ual of mental disorders, 4th edition, text least two weeks; diagnosis also requires to 2004, the incidence of reported suicc three additional concurrent symptoms cides rose dramatically from 17.5 to 25.1 revision (DSMcIVcTR), including eight or nine items for assessment. A simpler (e.g. appetite loss, fatigue and insomnia). per 100 000. Some studies have reported With the possible exceptions of psychiac method is required to promote screening that this increase is closely related to trists and psychological specialists, diagc for depression nationwide. Fulfilment the economic depression that occurred nosing depression is not an easy task: of the national goal within the next five in Japan over the same period. While a interviews are somewhat complex and years will require identification of target reduction in suicide rates may depend are time consuming. Although some relic groups and extensive intervention for on an economic recovery, public health able questionnaires exist and are used in highcrisk persons in these groups. practitioners must try to help potentially clinical screening, such as the Profile of suicidal individuals, regardless of outside Mood States, the Selfcrating Depression influences such as the economy. Identification of target Scale and the Center for Epidemiologic Depression plays an important role groups Studies–Depression questionnaire, the in the etiology of suicide. Over 60% length of such questionnaires (consistc Depression is one of the most rapidly c of the individuals who commit suicide ing of more than 10 questions) can be spreading mental disorders in Western were identified as depressive. Reducing burdensome and they can be expensive countries and in Japan. According to the the number of suicide attempts requires, (US$ 7.00 per person for a professional National Survey in Japan, the number therefore, an initial identification of evaluation in Japan). It is important, of individuals diagnosed with depresc people with potential depression. When therefore, to find screening methods sion increased from 83.1 to 340.0 per the University of Iowa’s psychiatric dec that are less costly in terms of both time partment hosted clinics on the National 100 000 during the period 1984–98. and money. Depression Screening Day in the USA Although depression is generally more Previous studies have examined the in 1996, 65% of the 927 participants common in women than in men, the possibility of reducing the number of required further evaluation, of whom most dramatic increase has involved questions in depression screening quesc 83% subsequently received treatment for middlecaged men (40–60 years); this tionnaires. American researchers found depression.1 Efforts made in the USA tendency also applies to the percentage that using two items (“depressed mood” indicate that tactics instituted to identify of the population who commit suicide. and “no feeling of pleasure”) from the depression can work well to reduce suicc In Japan, most middlecaged men funcc Primary Care Evaluation of Mental Disc cide rates at the national level. tion as the family breadwinner and may orders questionnaire resulted in 96% In 2000, the Japanese Government be too busy with work to visit a clinic, sensitivity and 57% specificity for MDD declared its goal to reduce the annual even when they feel mental distress. detection.2 European researchers found incidence of suicide by 30% until 2010. Because it is mandatory for all workers in that two items (“depressive mood” and The National Committee published Japan to undergo health checkcups every “not active”) from the WHOc5 Wellbeing proposals for suicide prevention in year at the expense of their employers, Index were sufficient to screen for cde 2002, emphasizing the importance of targeting middlecaged men in the workc pression.3 Although these studies were precintervention (assessment of factors place is a good strategy for identifying limited, in that they examined only parc affecting suicide), intervention (identic potentially depressive persons. ticipants who visited clinics in the USA a Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi, Tokyo 173-8605, Japan. Correspondence to this author (email: [email protected]). b Harvard Graduate School of Public Health, Boston, MA 02115, USA. Ref. No. 06-031476 492 Bulletin of the World Health Organization | June 2006, 84 (6) Perspectives Mutsuhiro Nakao & Takeaki Takeuchi Depression screening for suicide prevention in Japan or Europe, they provide practical possic number of somatic symptoms for dec these annual health checkcups: the total bilities for depression screening in Japan. tecting MDD.4 More specifically, lower annual cost borne by Japanese industry Results from our recent studies indicc back pain and dizziness at baseline were for the checkcups is estimated to be cate that including one or two screening independent risk factors of major depresc several billion dollars. The addition of questions in annual medical checkcups sion in the year following the checkcup.5 one or two questions would not increase can be an effective way to screen for Studies in clinical settings have also expenditure except for copying costs, MDD in Japanese workers. Items selected found that the number of somatic sympc and the answers could offer a very pracc for inclusion are not necessarily limited toms can predict the severity of major tical way for finding depressive persons 6 to psychological discomfort; any comc depression and suicidal ideation. among workers. Once a person is idenc mon somatic symptom can also be usec This screening plan may be limited tified as suffering from depression, the ful. For example, our study concerning because of possible overcdiagnosis. When treatment is covered by health insurance. annual health checkcups involved using one or two questions with high sensitivc While compulsory annual health checkc DSMcIVcTR interviews with 991 male ity are selected, they simply elicit core ups may be specific to Japan, elements of requirement symptoms for diagnosis. A workers, 24 (2.4%) of whom were diagc the approach may be useful for settings 4 definite diagnosis of depression requires nosed with MDD. Based on our previc in other countries. more symptoms, which may result in ous studies and Western studies involvc A systematic reduction of the incc ing primary care patients, the following situations of unsatisfied falsecpositives cidence of suicide in Japan will first 12 common major somatic symptoms (individuals who were initially diagc require finding potentially depressive were simultaneously assessed: fatigue, nosed as positive but were subsequently persons because most individuals who headache, insomnia, back pain, abdomic found to be without the disorder). This nal pain, joint or limb pain, dizziness, screening plan, however, is proposed as commit suicide are depressive. In Japan, chest pain, constipation, palpitation, a first and convenient test to identify government healthccare policy recogc nausea, and shortness of breath. Somatic real depression. High sensitivity is much nizes mental health as a topcpriority symptoms were defined as positive when more important than low specificity, issue, and in 2005 the Ministry of experienced one or more times a week. so as not to leave a depressive person Health, Labour and Welfare organized Surprisingly, no cases of MDD were idenc undetected, and marginal tests could the Strategic Research Group on Managc tified among the 665 (67.1%) subjects improve specificity during the successive ing Suicide Related to Depression. The who exhibited no somatic symptoms. screening process. strategy proposed here could promote MDD prevalence was positively associc understanding of the need to screen for ated (P<0.001) with the total number of Depression screening as depression in the working population, somatic symptoms, and an area of 0.92 an approach to suicide with less dependence on psychological appeared under the receiver operator specialists. O characteristic (ROC) curve, indicating prevention the sensitivity and specificity of the total Financially, employers cover the cost of Competing interests: none declared. References 1. Greenfield SF, Reizes JM, Muenz LR, Kopans B, Kozloff RC, Jacobs DG. 4. Nakao M, Yano E. Reporting of somatic symptoms as a screening marker for Treatment
Load more

Recommended publications
  • Suicide: a Unique Epidemic in Japan a High GDP, a Literacy Rate of 99
    Suicide: A Unique Epidemic in Japan Magdalena Wilson College of Arts and Science, Vanderbilt University Japan, a country with a long life expectancy, strong economy and stable political system seems like an unlikely place to encounter a deadly global epidemic. Yet, the unique history and culture of Japan, including its religion, media, and economy, create a setting in which rates of suicide are reaching unprecedented levels. The culture of Japan combined with the peculiar nature of suicide, which allows it to evade clear classification as a disease, creates an intriguing public health challenge for Japan in tackling this epidemic. A high GDP, a literacy rate of 99 percent, a performing a form of seppuku more appropriate for healthy life expectancy of 72-78 years, and a health times of peace, junshi or “suicide to follow one‟s lord budget of 1660 international dollars per capita (World to the grave,” (59) as an outlet for expressing their Health Organization 2005) are not the features valor and dedication to their lord. Seppuku emerged typically associated with a country suffering from one yet again in a slightly different form in the 17th of the worst outbreaks of a deadly global epidemic. century Japanese legal system as a somewhat more Then again, nothing is really typical about the suicide dignified alternative to the death penalty. Throughout epidemic in Japan. In general, suicide is a growing the next two hundred years, seppuku remained central public health problem globally, with international to Japanese society in its various forms until Japan suicide rates increasing 60 percent in the last 45 years began to modernize during the Meiji period in the late (World Health Organization 2009).
    [Show full text]
  • Sunshine and Suicides in Japan: Revisiting the Relevance of Economic Determinants of Suicide*
    DE GRUYTER DOI 10.1515/cj-2013-0006 Contemporary Japan 2013; 25(2): 105–126 Ulrike Schaede Sunshine and Suicides in Japan: revisiting the relevance of economic determinants of suicide* Abstract: This paper investigates how exposure to sunshine affects the suicide rate in Japan, especially in relation to economic variables. Using prefecture- based data on socioeconomic variables for the years 1993–2009, the paper con- firms existing research in finding a significant correlation between suicides and unemployment, for both men and women. The interaction between sunshine and unemployment is also significant, and further analysis reveals that unem- ployment is not an important factor for suicide in high-sunshine prefectures, whereas in low-sunshine areas the effect of unemployment on the suicide rate rises. The divorce rate is highly significant and positive for men, but significant and negative for women, suggesting that many Japanese women consider divorce liberating. Current suicide research in Japan with its strong emphasis on economic variables may benefit from an inclusion of measures of general well-being. Keywords: suicide, divorce, socioeconomic factors, sunshine, SAD Ulrike Schaede: University of California, San Diego, e-mail: [email protected] 日照と自殺の関係：日本における自殺に関する経済的要因の再考察 ウリケ・シェーデ 本稿は日照がいかに日本における自殺率、特に経済変数との関係性を調査す るものである。1993年から2009年（都道府県統計）の社会経済変数基礎デー タで調べたところ、先行研究の結果も明らかしたように、男女とも対象とし た自殺と失業に関する有意な相関関係が確認された。また日照と失業との間 * I am indebted to Brian Main at the University of Edinburgh for valuable support. Nicholas Sramek provided excellent research assistance, and an anonymous journal reviewer offered helpful feedback. The contribution by Kuniaki Nemoto to an earlier project is gratefully acknowledged, as are comments from participants at the UC San Diego “Japan Lunch” work- shop series. All remaining errors are mine.
    [Show full text]
  • Special Article 1
    Special Article 1 By Rene Duignan Author Rene Duignan Introduction week nights and weekends for two years. People laughed at the tiny In a war on suicide, who is the enemy? scale of our project but gave us an interview anyway. After a year doing 96 interviews and a year editing 100 hours of footage the Despite having one of the highest living standards and the longest movie was almost complete, but I collapsed from exhaustion. I life expectancy in the world, Japan has tragically lost over 450,000 remember the peace I felt while in a hospital bed on a drip. I used lives to suicide in the last 15 years. Attempted suicides could be 10 this precious time to make the final movie edits in my head as I knew times that figure, according to the World Health Organization. From each scene by heart. 1995 to 2009, a decline in suicide was achieved in most OECD I am not naive enough to believe that with this uncomfortable topic countries but the rate increased by 40% in Japan (Chart). In the we could ever make it onto Japanese TV, so we work at the international context, Japan’s suicide rate is double that of the United grassroots level. We made DVDs and have started to do screenings, States, three times that of Thailand, six times higher than Greece and and the audience reactions have been incredible. One audience 12 times larger than the Philippines. member told me that the movie was like an answer to his prayers. I felt compelled to make a documentary on how Japan could Many people have shared personal stories of suicide loss with me reduce suicide but many people warned me this was a foolish idea, after seeing the movie.
    [Show full text]
  • How Is Suicide Different in Japan?
    Maison Franco-Japonaise Séminaires de recherche Mardi 26 février 2008 How is Suicide Different in Japan? by Joe Chen, Yun Jeong Choi, and Yasuyuki Sawada Université de Tokyo Presented by Yasuyuki Sawada 1 Aims of Our Study A rash of suicides, starting from the late 1990’s, has become a major issue in Japan. Aims of our research project, “Studies on Suicide (SOS),” are to: z Summarize evidence on suicides in Japan through international comparisons z Uncover determinants of high suicide rates in Japan z Identify effective policy instruments 2 Outline of Presentation 1. Facts on Suicide in Japan 2. Sociological and Economic Theories on Suicides 3. Possible Determinants of Suicides: Empirical Investigations I using Cross-Country Data 4. Possible Determinants of Suicides: Empirical Investigations II using Micro Data from the joint Lifelink and University of Tokyo Survey 5. Policies 3 1. Facts on Suicide in Japan z Suicide is a serious problem in current-day Japan. ¾ Jinshinjiko, (train) accidents involving human bodies, is part of the daily life of Tokyo residents. In many Tokyo metro stations, barriers on the platforms have been constructed recently to stop suicide jumps into trains. ¾ The growing use of the internet to learn about effective suicide methods or even to form a suicide group. ¾ High-profile suicides are reported in the media: The 1968 Nobel Prize in Literature Laureate Yasunari Kawabata (1899-1972), Yukio Mishima (1925-1970), 62 years old Toshikatsu Matsuoka, the sitting Minister of Agriculture, Forestry and Fisheries of Japan and a successively 6 times elected member of the House of Representatives, hanged himself on 28 May 2007, hours before he was to face questioning in the Diet over a series of scandals in his political career.
    [Show full text]
  • Newspaper Reporting and the Emergence of Charcoal Burning Suicide in Taiwan: a Mixed Methods Approach
    Chen, Y-Y., Tsai, C-W., Biddle, L. A., Niederkrotenthaler, T., Chang Wu, K. C., & Gunnell, D. (2016). Newspaper reporting and the emergence of charcoal burning suicide in Taiwan: A mixed methods approach. Journal of Affective Disorders, 193, 355-361. https://doi.org/10.1016/j.jad.2015.12.041 Peer reviewed version Link to published version (if available): 10.1016/j.jad.2015.12.041 Link to publication record in Explore Bristol Research PDF-document University of Bristol - Explore Bristol Research General rights This document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Full terms of use are available: http://www.bristol.ac.uk/red/research-policy/pure/user-guides/ebr-terms/ Title: Newspaper reporting and the emergence of charcoal burning suicide in Taiwan: A mixed methods approach Authors: Ying-Yeh Chen1,2 M.D., Sc.D., Chi-Wei Tsai2 M.S., Lucy Biddle3 PhD, Thomas Niederkrotenthaler4, M.D., PhD, Kevin Chien-Chang Wu5,6*, M.D., LL.M., Ph.D. David Gunnell3 M.D., Ph.D. 1 Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan 2 Institute of Public Health and Department of Public Health, National Yang-Ming University, Taipei, Taiwan 3 School of Social and Community Medicine, University of Bristol, Bristol, UK 4 Suicide Research Unit, Center for Public Health, Medical University of Vienna, Vienna, Austria 5 Department and Graduate Institute of Medical Education and Bioethics, National Taiwan University College of Medicine, School of Medicine, Taipei, Taiwan 6 Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan Corresponding author: Kevin Chien-Chang Wu No.1 Changde Street, Zhongzheng Dist., Taipei City 10048, Taiwan Tel: 886-2-23123456 # 66788, 88575 Fax: 886-2-2382-5646; 886-2-2393-5254 E-mail: [email protected] 1 Abstract Background: It has been suggested that extensive media reporting of charcoal burning suicide was a key factor in the rapid spread of this novel method in many East Asia countries.
    [Show full text]
  • Epidemic of Charcoal Burning Suicide in Japan Eiji Yoshioka, Sharon J
    The British Journal of Psychiatry (2014) 204, 274–282. doi: 10.1192/bjp.bp.113.135392 Epidemic of charcoal burning suicide in Japan Eiji Yoshioka, Sharon J. B. Hanley, Yasuyuki Kawanishi and Yasuaki Saijo Background Results The charcoal burning suicide epidemics in both Hong Kong In males and females aged 15–24 and 25–44 years, the and Taiwan have been well documented. However, little is charcoal burning epidemic led to a substantial increase in known about the situation in Japan. overall suicides, without a decrease in other methods. In all other age groups, no such trend was observed. Aims To examine the impact of charcoal burning suicide on the Conclusions overall and other method-specific suicide rates between In young Japanese, the charcoal burning method may have 1998 and 2007 in Japan. appealed to individuals who might not have chosen other highly or relatively lethal methods, and consequently led to Method an increase in overall suicides. Using data obtained from the Vital Statistics of Japan, negative binomial regression analyses were performed to Declaration of interest investigate the impact of the charcoal burning method. None. Suicide is an important global healthcare issue, and suicide rates also important.13,14 Compared with the number of population vary according to region, gender, age, time, ethnic origin and, to studies conducted on the impact on overall suicide rates when a a certain extent, practices of death registration.1 In Japan, the specific method is restricted, little attention has been paid to the annual number of suicides rose sharply to 30 000 in 1998, and impact of newly emerging methods on overall suicide rates.7 Thus, has remained high to the present day.2 In 2012, suicide was the the rapid emergence of burning charcoal indoors as a source of seventh major cause of death in Japan.
    [Show full text]
  • Depression and Suicide
    Depression and Suicide JMAJ 44(8): 359–363, 2001 Yoshitomo TAKAHASHI Chief, Department of Suicidology, Tokyo Institute of Psychiatry Abstract: Among the various mental disorders which tend to be closely related to suicide, depression is a particularly important risk factor. Many patients suffering from depression commit suicide never having had access to psychiatric care or proper treatment. Although depressed mood, psychomotor retardation, anxiety, and autonomic symptoms may occur in depression, patients suffering from depres- sion often visit a primary care physician rather than a psychiatrist, complaining of various somatic symptoms. Therefore, the role of the primary care physician, not only that of the psychiatrist, is critical in preventing such patients from committing suicide. In this regard, the present report outlines means of assessing suicide risk in depressed patients. Since early diagnosis and implementation of intensive treat- ment for depression provide a good chance of preventing suicide, every physician should know how to assess the risk of suicide. Key words: Depression; Suicide; Risk factors; Accident-proneness Introduction This report focuses on assessment of the risk of suicide in depressed patients. Since early According to statistics published by the diagnosis and implementation of intensive treat- National Police Agency, 31,957 individuals com- ment provide a good chance of suicide preven- mitted suicide in Japan in 2000, a rate of 25.2 tion, it is important that every physician be well per 100,000 population.1) Among the causes of informed as to how to assess the risk of suicide. suicide, physical illness was the most common, accounting for 34.9% of all suicides.
    [Show full text]
  • Resources for At-Risk Veterans and the Practicing Bar: the Suicide Epidemic
    RESOURCES FOR AT-RISK VETERANS AND THE PRACTICING BAR: THE SUICIDE EPIDEMIC CLE Credit: 1.0 Sponsor: KBA Military Law Committee and KYLAP Wednesday, June 12, 2019 11:50 a.m. – 12:50 p.m. Carroll-Ford Galt House Hotel Louisville, Kentucky A NOTE CONCERNING THE PROGRAM MATERIALS The materials included in this Kentucky Bar Association Continuing Legal Education handbook are intended to provide current and accurate information about the subject matter covered. No representation or warranty is made concerning the application of the legal or other principles discussed by the instructors to any specific fact situation, nor is any prediction made concerning how any particular judge or jury will interpret or apply such principles. The proper interpretation or application of the principles discussed is a matter for the considered judgement pf the induvial legal practitioner. The faculty and staff of this Kentucky Bar Association CLE program disclaim liability therefore. Attorneys using these materials, or information otherwise conveyed during the program in dealing with a specific legal matter have a duty to research the original and current sources of authority. Printed by: Evolution Creative Solutions 7107 Shona Drive Cincinnati, Ohio 45237 Kentucky Bar Association TABLE OF CONTENTS The Presenters ................................................................................................................. i Untreated Depression and the Risk of Suicide Among Lawyers and Veterans Who are Lawyers ...........................................................
    [Show full text]
  • Police Suicide Prevention
    QPR: Police Suicide Prevention A 5-year veteran uniformed police officer, in acute distress about his wife divorcing him, hints to his shift supervisor, “Forget that transfer I asked for; I’ve decided to work things out permanently.” The shift supervisor takes him aside and asks, “What’s the matter? Is something going on in your personal life?” After this inquiry, the officer announces that his wife is leaving him, describes his sense of devastation, and laments his inability to reverse her decision. The supervisor says, “I’m worried about you and concerned for your safety. Have you had any thoughts about killing yourself?” The officer nods. “Then I want you to see a professional immediately -- strictly confidential. I’ll make arrangements. Chaplain or psychologist?” “Psychologist,” the officer replies, accepting help. Then he asks, “Do I have to give up my badge and gun?” “No,” replies the supervisor. “But for your safety you have to promise me you will not kill yourself until you’ve gotten some help. Are you willing to do that?” “Okay,” the officer sighs. “Okay, okay… How soon can I see the psychologist?” “Today. I will take you myself,” replies the supervisor. Suicide is a tragedy that impacts tens of thousands of people each year: family members, friends and colleagues. Suicide also has an impact on those in law enforcement, whether as direct observers of a death by suicide, as survivors of a family member or friend’s suicide, or as a person struggling with his or her own personal thoughts of self-destruction. The fact is we expect a lot of law enforcement personnel and they, in turn, expect a lot of themselves.
    [Show full text]
  • Geographies of Suicide and the Representation of Self-Sacrifice in Japanese Popular Culture and Media
    Megan Rose O'Kane 40082809 Geographies of Suicide and the Representation of Self-Sacrifice in Japanese Popular Culture and Media 27/04/16 Word Count: 13,142 1 This dissertation has been submitted towards the degree of BSc Honours in Geography at Queen's University Belfast. I certify that all material in this dissertation is my own, except where explicitly identified. 2 Abstract Japan's suicide rate is the highest in the developed world. Despite being a nation famous for its economic prosperity, Japan has a multitude of issues relating to social development. Patrick Smith (1997) writes about 'the samurai who carries a briefcase', a visual metaphor which effectively conveys the cultural schizophrenia plaguing the mentalities of modern Japanese society. The convergence of deep- rooted traditional Japanese philosophies with the modern capitalist mindset has resulted in a very unique and convoluted moral code among the contemporary Japanese population. Unlike Western society, suicide carries no social stigma and at times is even celebrated; a mindset inherited from generations of honourable self- sacrifice instilled by the samurai code. This research paper explores two famous pieces of Japanese popular media, and assesses the ways in which representations of suicide are produced and consumed. By focussing on the identification of geographies of suicide, spatially and temporally specific Japanese social maladies, and the sensationalisation of suicide in the media, this paper provides a comprehensive insight into the social realities reflected in these fictional works. 3 Acknowledgements I could not have completed my dissertation without the emotional support from my family and friends. I would like to single out my mother for all her proof-reading and constant support, I cannot thank her enough.
    [Show full text]
  • UNIVERSITY of CALIFORNIA, IRVINE Modernism's Suicidal Impulse: Psychic Contamination and the Crowd DISSERTATION Submitted in P
    UNIVERSITY OF CALIFORNIA, IRVINE Modernism’s Suicidal Impulse: Psychic Contamination and the Crowd DISSERTATION submitted in partial satisfaction of the requirements for the degree of DOCTOR OF PHILOSOPHY in English by Katherine Lynn Ryan Dissertation Committee: Professor Margot Norris, Chair Professor Laura O’Connor Professor Arlene R. Keizer 2014 © 2014 Katherine Lynn Ryan In loving memory of Martin Ryan ii TABLE OF CONTENTS Page ACKNOWLEDGEMENTS iv CURRICULUM VITAE v ABSTRACT OF THE DISSERTATION vi INTRODUCTION 1 CHAPTER 1: A “Fire That Purifies”: Psychic Contamination and Suicidal 26 Fantasy in Manhattan Transfer CHAPTER 2: “The pack may howl, but it shall never catch me”: Affective 72 Contagion, Suicidal Inoculation, and the Herd in Woolf CHAPTER 3: “Affected, or Infected, Forever”: Emmeline, Suicide, and 122 Atmospheric Affect in To the North CHAPTER 4: “I stood in the centre of eroticism and death”: Affective 162 Spillways and the Suicidal Logic of Desire in Nightwood BIBLIOGRAPHY 226 iii ACKNOWLEDGEMENTS First and foremost, I owe the success of this project to my dissertation committee. I would like to thank my dissertation chair Margot Norris, who believed in this project from the beginning and who aided me in countless ways throughout the dissertation process. I could not have asked for a kinder or more inspiring advisor. I would also like to thank Laura O’Connor for her invaluable advice throughout graduate school and especially for her guidance during this very hectic past year. Without her encouragement and support, this dissertation would not have been written. Arlene Keizer has also helped clarify and strengthen this project in innumerable ways, and I am very fortunate to have had the benefit of her dedication and expertise.
    [Show full text]
  • The Portrayal of Suicide in Postmodern Japanese Literature and Popular Culture Media
    University of Vermont ScholarWorks @ UVM UVM Honors College Senior Theses Undergraduate Theses 2014 The orP trayal of Suicide in Postmodern Japanese Literature and Popular Culture Media Pedro M. Teixeira Follow this and additional works at: https://scholarworks.uvm.edu/hcoltheses Recommended Citation Teixeira, Pedro M., "The orP trayal of Suicide in Postmodern Japanese Literature and Popular Culture Media" (2014). UVM Honors College Senior Theses. 15. https://scholarworks.uvm.edu/hcoltheses/15 This Honors College Thesis is brought to you for free and open access by the Undergraduate Theses at ScholarWorks @ UVM. It has been accepted for inclusion in UVM Honors College Senior Theses by an authorized administrator of ScholarWorks @ UVM. For more information, please contact [email protected]. THE PORTRAYAL OF SUICIDE IN POSTMODERN JAPANESE LITERATURE AND POPULAR CULTURE MEDIA Pedro Manço Teixeira Honors Thesis Final Draft, Spring 2014 Thesis Advisor: Kyle Keoni Ikeda INTRODUCTION Within Japanese society, suicide has been a recurring cultural and social concern explored extensively in various literary and artistic forms, and has evolved into a serious societal epidemic by the end of the 20 th century. This project investigates contemporary Japan’s suicide epidemic through an analysis of the portrayal of suicide in post-1970s Japanese literature, films, and popular culture media of manga 1 and anime 2, and in comparison to empirical data on suicide in Japan as presented in peer-reviewed psychology articles. In the analysis of these contemporary works, particular attention was given to their targeted demographic, the profiles of the suicide victims in the stories, the justifications for suicide, and the relevance of suicide to the plot of each work.
    [Show full text]