Effects of media stories of hope and recovery on suicidal ideation and help-seeking attitudes and intentions: systematic review and meta-analysis
Summary: Background: There is strong evidence that suicides increase after media stories about suicides by celebrities, particularly those that highlight the suicide method (the Werther effect). Much less is known about the Papageno effect—the protective effects of media stories of hope and recover...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-02-01
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| Series: | The Lancet Public Health |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468266721002747 |
| _version_ | 1819291664692281344 |
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| author | Thomas Niederkrotenthaler, PhD Benedikt Till, DSc Stefanie Kirchner, MPH Mark Sinyor, MD Marlies Braun, MPhil Jane Pirkis, ProfPhD Ulrich S Tran, DSc Martin Voracek, ProfPhD Florian Arendt, PhD Maria Ftanou, PhD Reka Kovacs, MSc Kylie King, PhD Marisa Schlichthorst, PhD Steven Stack, ProfPhD Matthew J Spittal, ProfPhD |
| author_facet | Thomas Niederkrotenthaler, PhD Benedikt Till, DSc Stefanie Kirchner, MPH Mark Sinyor, MD Marlies Braun, MPhil Jane Pirkis, ProfPhD Ulrich S Tran, DSc Martin Voracek, ProfPhD Florian Arendt, PhD Maria Ftanou, PhD Reka Kovacs, MSc Kylie King, PhD Marisa Schlichthorst, PhD Steven Stack, ProfPhD Matthew J Spittal, ProfPhD |
| author_sort | Thomas Niederkrotenthaler, PhD |
| collection | DOAJ |
| description | Summary: Background: There is strong evidence that suicides increase after media stories about suicides by celebrities, particularly those that highlight the suicide method (the Werther effect). Much less is known about the Papageno effect—the protective effects of media stories of hope and recovery from suicidal crises. A synthesis of the retrievable evidence is lacking. We aim to summarise findings from randomised controlled trials about the effects of stories of hope and recovery on individuals with some degree of vulnerability to suicide. Methods: For this systematic review and individual participant data meta-analysis, we searched PubMed (including MEDLINE), Scopus, Embase, PsycInfo, Web of Science, and Google Scholar published from inception to Sept 6, 2021, without language restrictions. We included trials that reported suicidal ideation (the primary outcome) or help-seeking attitudes or intentions (the secondary outcome) and tested a media narrative of hope and recovery. Studies were excluded if they did not feature a clearly positive story of hope and recovery, or had a control group exposed to suicide-related stimulus material. We contacted the lead or senior authors of all original studies to obtain participant-level data for this study. The primary analysis was restricted to individuals with some vulnerability to suicide. Risk of bias was assessed using the Cochrane risk-of-bias tool for randomised trials. The study is registered with PROSPERO, number CRD42020221341. Findings: Our search yielded 7347 records. 3920 records were screened by title and abstract, and 25 full-text records assessed for eligibility. There were eight eligible studies with 2350 participants for which individual participant data were sought. For suicidal ideation, six studies met the inclusion criteria for the primary analysis. Follow-up responses were available for 569 (90%) of 633 participants who were randomised with high vulnerability (345 [55%] allocated to the intervention group and 288 [45%] to the control group). The pooled standardised mean difference (SMD) indicated a small reduction in suicidal ideation of –0·22 (95% CI –0·39 to –0·04, p=0·017; six studies) in the intervention group. For help-seeking attitudes and intentions, four studies met the inclusion criteria and follow-up data were available for 362 (86%) of 420 participants (247 [59%] allocated to the intervention group and 173 [41%] to the control group). The pooled SMD showed no evidence of a difference between the groups (SMD=0·14, 95% CI –0·15 to 0·43, p=0·35; four studies). Low levels of cross-study heterogeneity effects were observed for both analyses (I2=5% [suicidal ideation] and I2=36% [help-seeking attitudes and intentions]). We found no evidence of publication bias. Interpretation: Media narratives of hope and recovery from suicidal crises appear to have a beneficial effect on suicidal ideation in individuals with some vulnerability, but there is insufficient evidence regarding help-seeking attitudes and intentions. These findings provide new evidence about narratives for suicide prevention. Funding: None. |
| first_indexed | 2024-12-24T03:42:14Z |
| format | Article |
| id | doaj.art-94c51b288e354a328c6bc169db5b7d1b |
| institution | Directory Open Access Journal |
| issn | 2468-2667 |
| language | English |
| last_indexed | 2024-12-24T03:42:14Z |
| publishDate | 2022-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Public Health |
| spelling | doaj.art-94c51b288e354a328c6bc169db5b7d1b2022-12-21T17:16:52ZengElsevierThe Lancet Public Health2468-26672022-02-0172e156e168Effects of media stories of hope and recovery on suicidal ideation and help-seeking attitudes and intentions: systematic review and meta-analysisThomas Niederkrotenthaler, PhD0Benedikt Till, DSc1Stefanie Kirchner, MPH2Mark Sinyor, MD3Marlies Braun, MPhil4Jane Pirkis, ProfPhD5Ulrich S Tran, DSc6Martin Voracek, ProfPhD7Florian Arendt, PhD8Maria Ftanou, PhD9Reka Kovacs, MSc10Kylie King, PhD11Marisa Schlichthorst, PhD12Steven Stack, ProfPhD13Matthew J Spittal, ProfPhD14Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria; Wiener Werkstaette for Suicide Research, Vienna, Austria; Correspondence to: Dr Thomas Niederkrotenthaler, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna A-1090, AustriaUnit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria; Wiener Werkstaette for Suicide Research, Vienna, AustriaUnit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria; Wiener Werkstaette for Suicide Research, Vienna, AustriaDepartment of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, CanadaUnit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria; Wiener Werkstaette for Suicide Research, Vienna, AustriaCentre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, AustraliaWiener Werkstaette for Suicide Research, Vienna, Austria; School of Psychology, Department of Cognition, Emotion, and Methods in Psychology, University of Vienna, Vienna, AustriaWiener Werkstaette for Suicide Research, Vienna, Austria; School of Psychology, Department of Cognition, Emotion, and Methods in Psychology, University of Vienna, Vienna, AustriaWiener Werkstaette for Suicide Research, Vienna, Austria; Department of Communication, University of Vienna, Vienna, AustriaCentre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, AustraliaWiener Werkstaette for Suicide Research, Vienna, Austria; School of Psychology, Department of Cognition, Emotion, and Methods in Psychology, University of Vienna, Vienna, AustriaTurner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, AustraliaCentre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, AustraliaDepartment of Criminology, Wayne State University, Detroit, MI, USA; Department of Psychiatry, Wayne State University, Detroit, MI, USACentre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, AustraliaSummary: Background: There is strong evidence that suicides increase after media stories about suicides by celebrities, particularly those that highlight the suicide method (the Werther effect). Much less is known about the Papageno effect—the protective effects of media stories of hope and recovery from suicidal crises. A synthesis of the retrievable evidence is lacking. We aim to summarise findings from randomised controlled trials about the effects of stories of hope and recovery on individuals with some degree of vulnerability to suicide. Methods: For this systematic review and individual participant data meta-analysis, we searched PubMed (including MEDLINE), Scopus, Embase, PsycInfo, Web of Science, and Google Scholar published from inception to Sept 6, 2021, without language restrictions. We included trials that reported suicidal ideation (the primary outcome) or help-seeking attitudes or intentions (the secondary outcome) and tested a media narrative of hope and recovery. Studies were excluded if they did not feature a clearly positive story of hope and recovery, or had a control group exposed to suicide-related stimulus material. We contacted the lead or senior authors of all original studies to obtain participant-level data for this study. The primary analysis was restricted to individuals with some vulnerability to suicide. Risk of bias was assessed using the Cochrane risk-of-bias tool for randomised trials. The study is registered with PROSPERO, number CRD42020221341. Findings: Our search yielded 7347 records. 3920 records were screened by title and abstract, and 25 full-text records assessed for eligibility. There were eight eligible studies with 2350 participants for which individual participant data were sought. For suicidal ideation, six studies met the inclusion criteria for the primary analysis. Follow-up responses were available for 569 (90%) of 633 participants who were randomised with high vulnerability (345 [55%] allocated to the intervention group and 288 [45%] to the control group). The pooled standardised mean difference (SMD) indicated a small reduction in suicidal ideation of –0·22 (95% CI –0·39 to –0·04, p=0·017; six studies) in the intervention group. For help-seeking attitudes and intentions, four studies met the inclusion criteria and follow-up data were available for 362 (86%) of 420 participants (247 [59%] allocated to the intervention group and 173 [41%] to the control group). The pooled SMD showed no evidence of a difference between the groups (SMD=0·14, 95% CI –0·15 to 0·43, p=0·35; four studies). Low levels of cross-study heterogeneity effects were observed for both analyses (I2=5% [suicidal ideation] and I2=36% [help-seeking attitudes and intentions]). We found no evidence of publication bias. Interpretation: Media narratives of hope and recovery from suicidal crises appear to have a beneficial effect on suicidal ideation in individuals with some vulnerability, but there is insufficient evidence regarding help-seeking attitudes and intentions. These findings provide new evidence about narratives for suicide prevention. Funding: None.http://www.sciencedirect.com/science/article/pii/S2468266721002747 |
| spellingShingle | Thomas Niederkrotenthaler, PhD Benedikt Till, DSc Stefanie Kirchner, MPH Mark Sinyor, MD Marlies Braun, MPhil Jane Pirkis, ProfPhD Ulrich S Tran, DSc Martin Voracek, ProfPhD Florian Arendt, PhD Maria Ftanou, PhD Reka Kovacs, MSc Kylie King, PhD Marisa Schlichthorst, PhD Steven Stack, ProfPhD Matthew J Spittal, ProfPhD Effects of media stories of hope and recovery on suicidal ideation and help-seeking attitudes and intentions: systematic review and meta-analysis The Lancet Public Health |
| title | Effects of media stories of hope and recovery on suicidal ideation and help-seeking attitudes and intentions: systematic review and meta-analysis |
| title_full | Effects of media stories of hope and recovery on suicidal ideation and help-seeking attitudes and intentions: systematic review and meta-analysis |
| title_fullStr | Effects of media stories of hope and recovery on suicidal ideation and help-seeking attitudes and intentions: systematic review and meta-analysis |
| title_full_unstemmed | Effects of media stories of hope and recovery on suicidal ideation and help-seeking attitudes and intentions: systematic review and meta-analysis |
| title_short | Effects of media stories of hope and recovery on suicidal ideation and help-seeking attitudes and intentions: systematic review and meta-analysis |
| title_sort | effects of media stories of hope and recovery on suicidal ideation and help seeking attitudes and intentions systematic review and meta analysis |
| url | http://www.sciencedirect.com/science/article/pii/S2468266721002747 |
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