Suicide Among Gifted Children and Adolescents- Second Edition

This topic is so important that it has drawn considerable attention from professionals who work on behalf of students with gifts and talents. A great deal has been published claiming that either gifted students are more susceptible to suicidal behavior or they have qualities that naturally protect them from this behavior. Although reasonable logic exists on both sides of the argument, neither side has brought any data to back up their assertions. Therefore, those articles will generally not be included in this book.

As noted in Chapter 2, typically the first step in studying suicide among subgroups begins with establishing the total numbers and prevalence rates. Perhaps surprisingly in the year 2017, the actual numbers and prevalence rates of suicide among students with gifts and talents are unknown. This is due in part because of the lack of a consensus definition of a gifted population (Cross, 1996a, 1996b; Delisle, 1986). Without knowing exactly who they are, we cannot be accurate in our estimates of prevalence rates. Even if there was greater consensus on a definition, the CDC (2015c) does not maintain detailed statistics of suicide deaths to indicate demographics such as giftedness.

Making this determination even more difficult is the fact that, due to our commitment to local control, school districts often have differing definitions of giftedness. Consequently, if a student with gifts and talents happens to die via suicide in a school district that does not use the same definition as his or her previous school, then that information has little chance of becoming known. Each of the examples noted above has nuances that make following giftedness as a demographic variable almost impossible. Even with profound impediments to knowing absolute numbers and prevalence rates, like their nongifted peers, it is quite likely that gifted students are completing suicide and the incidence of suicidal behavior among both groups has followed the basic pattern wherein rates have recently increased (Cross, 1996a, 1996b). Consequently, it is judicious to assume that the rates of suicidal behavior of gifted and nongifted same-aged students are quite similar unless empirically proven otherwise. Although we cannot know whether the incidence of suicide among students with gifts and talents is different from that of their peers in the general population, we can, however, describe the few studies that offer clues into this murky phenomenon.

Several large-scale studies have explored the relationship between IQ and suicidal behaviors, with mixed results. In some studies, researchers have found that, as IQ increases, so does suicidal ideation, although only by a small amount. Other researchers have found the opposite relationship, with low IQ associated with greater risk of suicidal behavior. When examining the relationship between achievement and suicidal ideation, we see similar conflicting findings, with some studies identifying high levels of achievement as an apparent risk factor and others finding it protective (see Cross & Cross, 2017b, for a review). In our review of this research, we have concluded that, in studies designed specifically to explore intelligence or achievement and suicidal ideation, the findings appear more positive for students with gifts and talents. When studies utilize existing data, sometimes from disparate sources, the findings suggest a suicide risk is associated with advanced intellect, but these findings should be interpreted with caution.

In the few studies comparing suicidal ideation between gifted and nongifted samples, there are not significant differences in ideation scores (Baker, 1995; Cassady & Cross, 2006; Cross, Cassady, & Miller, 2006; Metha & McWhirter, 1997). In Tracy’s studies with colleagues, rates of suicidal ideation in the gifted sample were similar to the norm group on Reynolds’s (1987) Adult Suicide Ideation Questionnaire. Exploring the data further, however, they found that the factor structure of suicidal ideation was different in the gifted sample from the norm (Cassady & Cross, 2006). Whereas Reynolds found three factors in his norm sample of adolescents—(a) wishes and plans, (b) focus on responses and aspects of others, and (c) morbid ideation—they found four factors. The gifted student sample factors were (a) wishes and plans, (b) morbid fixation, (c) social isolation, and (d) social impact. A positive outcome of this study is the possibility that exists for tailoring interventions to work with this unique ideation pattern, focusing on adolescents with specific risk orientations. For example, students who strongly indicate they have wishes or plans for suicide should be observed closely and any potentially lethal objects (i.e., guns, knives, drugs) should be kept away from them. Interventions for those who indicate they are socially isolated can focus on developing social skills and improving self-esteem.

In most cases, gifted students have been identified for their advanced cognitive abilities. If suicide attempts begin with suicide ideation, and gifted persons have the ability or inclination to think about suicide in a different way from their nongifted peers, it is important to further explore their ideation. Typical intervention methods used for nongifted adolescents may be ineffective or inappropriate for suicidal students who are gifted (Cross, 2008). Stillion, McDowell, and May (1984) found that adolescent females who scored higher on IQ tests were less likely to agree with the reasons for suicide than those with lower IQ scores. This suggests a connection between cognitive abilities and the belief that suicide is a viable solution. Although how gifted individuals think about suicide requires further exploration, at this time we need to realize that students with gifts and talents engage in suicidal ideation differently than their nongifted peers, if not at different rates. This may have important ramifications for counseling approaches and foci.

Some characteristics of gifted adolescents are associated with an increased risk of suicide. Dixon and his colleagues (Dixon, Cross, Cook, & Scheckel, 1995) summarized the following characteristics that may put gifted adolescents at risk of suicide: unusual sensitivity and perfectionism (Delisle, 1986), isolation related to extreme introversion (Kaiser & Berndt, 1985), and overexcitabilities (heightened psychological or physiological sensitivities), as identified by Dabrowski (1964, 1972). According to Delisle (1986), there are four issues making gifted adolescents susceptible to suicide attempts: perfectionism, societal expectations to achieve, differential development of intellectual and social skills, and impotence to effect real-world change. These issues are plausible explanations for gifted students’ susceptibility, but we must keep in mind that there is not direct evidence that they actually have a role in the suicidal behavior of gifted students.

The connections between personality types and suicidal behavior are of interest to the gifted community for several reasons. Although there are no studies that clearly link giftedness to increased rates of suicide (Cross & Cross, 2017b), it is important that concerned adults remain vigilant, nonetheless. In a literature review, it was reported that half of gifted students express introverted tendencies (Sak, 2004). In a study of honors college students, we found nearly two thirds were significantly more introverted than the normative sample (Cross, Cross, Mammadov et al., 2017). Lester (2011) reviewed 43 studies including extraversion/introversion and suicidality, and reported that a majority (n = 23) found a positive association between introversion and suicidality. Street and Kromney (1994) have also implicated individuals with these personality characteristics who were involved in suicidal ideation or behavior. Not only does this indicate a potential higher risk among students with gifts and talents, it also suggests the possibility of other mental health concerns. Given that introversion is common among students who are gifted (Cross et al., 2002; Cross, Cross, Mammadov et al., 2017), there may be a high likelihood these students could experience more psychological distress and may, therefore, be candidates for depression and/or suicidal ideation screening. Combined, these studies suggest vigilance on our parts when we see high introversion among students with gifts and talents.

PSYCHOLOGICAL AUTOPSIES AMONG STUDENTS WITH GIFTS AND TALENTS WHO COMPLETED SUICIDE

Subsequent to the suicides at the Academy (see Chapter 1), three psychological autopsies were conducted. Psychological autopsy is a case study approach to research that was begun originally to determine equivocal deaths for insurance/legal purposes. This method draws its data from family, friends, and significant others; family doctors; school; and the home in terms of books, music, and so forth. Interviews, records, and observations are used to gather data. The approach attempts to paint as complete a picture of the life of the student as possible. It is slow and time consuming to conduct.

After the results of the three autopsies were published, Tracy was requested to conduct a fourth study of a gifted student who completed suicide in Vancouver. The results below represent the findings of the in-depth studies. Following this section is a comparison of the four psychological autopsies.

The following commonalities were found between three of the subjects studied and adolescent suicide in the general population (Cross et al., 1996):

The following were commonalities related to giftedness between the subjects studied (Cross et al., 1996):

c. experienced difficulty separating fact from fiction, especially overidentification with negative asocial or aggressive characters or themes in books and movies;

f. had difficulty with the role of emotions (e.g., one case devalued emotional experience, while two cases wanted to experience pain).

a. The subjects engaged in group theoretical discussions of suicide as a viable and honorable solution.

b. The subjects expressed behaviors consistent with Dabrowski’s Level II or Level III of Positive Disintegration.

c. The subjects attended residential school as a means of escape from their family or hometown. (p. 406)

In comparing the psychological autopsy of the three original intellectual gifted students who completed suicide with the fourth (Reed Ball), there were many similarities (Cross et al., 2002). Note that Reed’s mother has requested that we always use his name during our research writing in lieu of traditional terms such as “subject,” “client,” “deceased,” and the like. This is in an effort to enhance the cause of diminishing the stigma family members often feel after their loved one has completed suicide. The similarities found included (Cross et al., 2002):

1. All four subjects exhibited overexcitabilities. Their overexcitabilities were expressed in ways or levels beyond the norm even among their gifted peers. The four subjects had minimal prosocial outlets. All four subjects experienced difficulty separating facts from fiction, especially overidentification with negative asocial or aggressive characters or themes in books and movies. They experienced intense emotion, felt conflicted, and wanted to rid themselves of emotions.

2. Each of the young men expressed polarized, hierarchical, egocentric value systems.

3. They each engaged in group discussions of suicide as a viable and honorable solution.

4. Additionally, all four subjects expressed behaviors consistent with Dabrowski’s Level II and Level III of Positive Disintegration. (p. 252)

There were also other similarities between the fourth student and the original three (Cross et al., 2002):

Reed was a Caucasian male who manifested four emotional characteristics: depression, anger (represented more in suppressed rage and frustration than physical actions), mood swings and confusion about the future, while demonstrating poor impulse control (manifested more often in patterns of thought more than behavior). He experienced three relational commonalities with those in the general population who complete suicide: romantic relationship difficulties, self-esteem difficulties (either by exaggeration or self condemnation), and isolation from persons capable of disconfirming irrational logic. Reed shared warning signs in several categories: behavior problems, period of escalation of problems, constriction, withdrawal from friends, dichotomous thinking, talking about suicide, and erratic school performance. (p. 252)

Hyatt (2010) conducted a psychological autopsy of a highly gifted girl who died by suicide at age 18. “Amber” had experienced severe social isolation and her giftedness led to her being misunderstood by peers and adults. She mistrusted adults, including her parents, and exhibited significant self-oriented perfectionism. As in the four previous cases, Amber planned her suicide for several years, not hesitating to discuss it with her peers. She experienced similar emotional states and similar confusion about her future as the subjects in Tracy’s studies (Cross et al., 1996; Cross et al., 2002). Implications Hyatt drew from her study included the need for measures to be taken to reduce bullying, for counseling of students with perfectionistic beliefs, and for adults to be educated on the social and emotional needs of gifted students.

Overexcitabilities similar to those seen in all of the psychological autopsies were observed in the gifted female subject of Peterson’s (2014) longitudinal case study, who had expressed suicidal ideation in her teen years. Peterson saw evidence that her subject’s giftedness served as a protective factor, particularly when she was able to analyze and problem solve in her own situation. Giftedness was also named as a protective factor by the gifted, gay subjects in Sedillo’s (2015) study, all of whom had experienced suicidal ideation. Extensive descriptions of other cases of gifted individuals who died by suicide or considered it seriously have been published, but not as peer-reviewed research (e.g., Johnson, 1994; Peterson, 1993; Scheiber, 2013).

A number of studies of suicidal behavior among gifted students have found evidence of perfectionism as a contributing factor (Hyatt, 2010; Peterson, 2014; Sedillo, 2015; Seiden, 1966). The three dimensions of Hewitt and Flett’s (1991) theory of perfectionism—self-oriented, other-oriented, and socially prescribed—have not been found to be equally influential in causing psychological distress. Whereas self- and other-oriented perfectionism have been associated with positive striving for excellence (Speirs Neumeister, 2015), high levels of socially prescribed perfectionism have been associated with more negative outcomes (Hewitt & Flett, 2004; Johnson, Panagioti, Bass, Ramsey, & Harrison, 2017; Stoeber & Otto, 2006). This tendency to believe that others have unrealistic expectations for one’s perfect behaviors correlates with a host of negative psychological outcomes (Stoeber & Otto, 2006). In a model relating suicidal behaviors and social disconnection, Hewitt, Flett, Sherry, and Caelian (2006) included socially prescribed perfectionism as a potential factor. The presence of perfectionism in several of the studies cited here suggests it may be a significant factor in suicidal behavior among students with gifts and talents and warrants special attention.

Although drawing conclusions from such a small research base is risky, especially when dealing with suicide, a few important lessons can be noted. The research that compares data from students with gifts and talents with that from the general population is quite valuable. This gives us a practical tie to tried-and-true suicidal factors. In other words, predicting suicidal behavior among gifted students can be aided by research on the general population. Students with gifts and talents are in many ways the same as their average peers, and what little research has compared their suicide ideation has found no statistically significant difference. This indicates that research from the general population can inform our explorations. Exceptional abilities, however, alter the lived experience for these students and, quite possibly, the way they think about that experience and the possibility of suicide, itself. Risk factors may differ when they are experienced in the context of exceptional abilities. A second lesson represents areas that seemingly are specific to students who are gifted. For example, the descriptions of overexcitabilities in all of the psychological autopsies are believed by many to be unique among students with gifts and talents. Using Dabrowski’s theory may afford suicidologists hints as to the more vulnerable among gifted students. It is critical that adults attend to the unique needs of this population, if we are to help them through difficult times.

KEY POINTS

images As a demographic group, students with gifts and talents are difficult to follow due to the differences in defining a gifted population.

images The rates of suicidal behavior of gifted and nongifted same-aged students are assumed to be quite similar unless empirically proven otherwise.

images Baker (1995) found that the incidence of depression and suicidal ideation was similar for both gifted and nongifted adolescents.

images When examining suicidal ideation among gifted adolescents, Cross et al. (2006) found that they did not exhibit heightened rates of suicidal ideation as compared to their nongifted peers.

images Certain characteristics, such as unusual sensitivity and perfectionism, isolation related to extreme introversion, and overexcitabilities, may put gifted adolescents at risk of suicide.

images Delisle (1986) defined four issues that make gifted adolescents susceptible to suicide attempts: perfectionism, societal expectations to achieve, differential development of intellectual and social skills, and impotence to effect real-world change.

images Due to the ability or inclination of gifted adolescents to think about suicide in a different way from their nongifted peers, typical intervention methods may be ineffective or inappropriate for suicidal gifted students (Cross, 2008).

images Cassady and Cross (2006) found that the factor structure of suicidal ideation in the gifted sample was different from the three-factor structure defined by Reynolds (1987) and included (a) wishes and plans, (b) morbid fixation, (c) social isolation, and (d) social impact. This should be taken into consideration when developing counseling approaches for students with gifts and talents.

images Highly introverted gifted students could experience more psychological distress, are more at-risk for suicidal ideation, and, therefore, require close attention.

images Psychological autopsy is a case study approach to research that attempts to paint as complete a picture of the life of the student who completed suicide as possible. It draws its data from the environment and people connected to the student, and is time consuming to conduct.

images Predicting suicidal behavior among students with gifts and talents can be aided by research on the general population.