AAS Suicide Research & Data Analysis 2 — Questions and Answers
Question 1: Which data source does the CDC use as the primary national surveillance system for tracking suicide mortality in the United States?
- National Violent Death Reporting System (NVDRS) (Correct answer)
- Uniform Crime Reporting (UCR) Program
- National Health Interview Survey (NHIS)
- Behavioral Risk Factor Surveillance System (BRFSS)
Correct answer: National Violent Death Reporting System (NVDRS)
The NVDRS collects detailed, incident-level data on violent deaths including suicides from state vital statistics, medical examiner/coroner reports, and law enforcement records.
Question 2: What statistical concept refers to the ratio of observed suicide deaths to expected deaths based on population rates, used to compare subgroup risk?
- Standardized Mortality Ratio (SMR) (Correct answer)
- Relative Risk Reduction (RRR)
- Number Needed to Treat (NNT)
- Attributable Risk Fraction (ARF)
Correct answer: Standardized Mortality Ratio (SMR)
The SMR compares observed deaths in a specific group to what would be expected if general population rates applied, making it useful for quantifying excess suicide risk.
Question 3: In psychological autopsy studies, information is typically gathered from which primary source?
- Retrospective interviews with family members and close associates (Correct answer)
- Medical examiner toxicology reports only
- Emergency department records
- Self-report questionnaires completed before death
Correct answer: Retrospective interviews with family members and close associates
Psychological autopsies reconstruct the decedent's mental state and life circumstances through structured interviews with informants who knew the individual.
Question 4: Which methodological limitation is most associated with cross-sectional surveys measuring suicidal ideation?
- Inability to establish temporal sequence between risk factors and ideation (Correct answer)
- Lack of generalizability to clinical populations
- Overestimation of ideation prevalence due to biological markers
- Inability to measure demographic variables
Correct answer: Inability to establish temporal sequence between risk factors and ideation
Cross-sectional designs capture a single point in time, making it impossible to determine whether identified risk factors preceded or followed suicidal ideation.
Question 5: What does 'attempt-to-completion ratio' measure in suicide epidemiology?
- The number of nonfatal attempts relative to each suicide death in a population (Correct answer)
- The proportion of attempters who later die by suicide
- The time elapsed between first attempt and eventual death
- The accuracy of clinician predictions about lethality
Correct answer: The number of nonfatal attempts relative to each suicide death in a population
The attempt-to-completion ratio estimates how many nonfatal attempts occur for every suicide death, typically cited as approximately 25:1 in the general population.
Question 6: Which type of study design provides the highest level of evidence for evaluating suicide prevention interventions?
- Randomized controlled trial (RCT) (Correct answer)
- Case-control study
- Ecological study
- Case series report
Correct answer: Randomized controlled trial (RCT)
RCTs randomly assign participants to intervention or control conditions, minimizing confounding and providing the strongest causal evidence for intervention effectiveness.
Question 7: The Joiner Interpersonal Theory of Suicide proposes that which combination is necessary—but not sufficient alone—for serious suicidal behavior?
- Thwarted belongingness and perceived burdensomeness together (Correct answer)
- Hopelessness and impulsivity together
- Depression and substance use together
- Access to means and recent loss together
Correct answer: Thwarted belongingness and perceived burdensomeness together
Joiner's theory posits that thwarted belongingness and perceived burdensomeness create the desire for suicide, which must be coupled with acquired capability to result in lethal attempts.
AAS Suicide Research & Data Analysis 2
Which data source does the CDC use as the primary national surveillance system for tracking suicide mortality in the United States?