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Psychological Autopsy

By Lanny Berman, Ph.D., ABPP, Executive Director, American Association of Suicidology

Developed in 1968 by AAS’s founding president, Dr. Edwin Shneidman, and refined over the years since, the psychological autopsy has become a best practice postmortem procedure to reconstruct the near- and long-term causes of an individual’s death by suicide or to ascertain the most likely manner of death where that manner of death is equivocal and left undetermined by a medical examiner or coroner.  The psychological autopsy, furthermore, helps promote understandings to the often-asked “why?” question raised by survivors regarding the suicide of their loved one, is used in case-control research studies to better ascertain risk factors for suicide, and helps to answer questions of causation in both individual cases (e.g. where negligence may be alleged) of suicide and interconnections between cases (as in clusters of suicides), hence lessons learned to inform prevention efforts.

While not a perfect investigative tool, the psychological autopsy, when conducted by a trained behavioral health investigator, pieces together knowledgeable observer’s recollections about the decedent, notably about events in the decedent’s life that helped shape character and typical patterns of coping and vulnerability to being suicidal, with a focus on the last days of life and observations that help to explain that the death was (or was not) a suicide and explanations for the determined manner of death to have occurred when and how it did. Perhaps the most notable psychological autopsies were those of the actress Marilyn Monroe and Deputy White House Counsel Vincent Foster, Jr.

The American Association of Suicidology (AAS) has conducted a number of psychological autopsies of clusters of youth suicides and of individuals who died on railroad rights-of-way; this latter study was conducted under contract from the Federal Railroad administration and was designed to establish a causal understanding of these deaths in order to recommend and pilot test one or more prevention initiatives.

Starting in the fall of 2011, AAS will be offering training programs leading to a certification as a psychological autopsy investigator. For more information about this certification program, go to www.suicidology.org.

Reference

Cavanagh, J.T.O., Carson, A.J., Sharpe, M., & Lawrie, S.M. (2003). Psychological autopsy studies of suicide: A systematic review. Psychological Medicine, 33, 395-405.

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