Q & A: Public Health Research Sheds Light on Important Factor in Suicide Prevention

Dr. Robert Cramer
Monday, October 28, 2019

New research co-led by UNC Charlotte public health associate professor Robert Cramer is providing insights into important factors related to suicidal thoughts and behaviors. Cramer and colleagues used data from a cross-national study of suicide among young adults aged 18–34 from the United States and United Kingdom. The study offers particular insight into entrapment, an emerging factor associated with suicide-related diagnosis, intervention and prevention. The project was conducted with partners Dr. Susan Rasmussen from the University of Strathclyde (Glasgow, Scotland) and Dr. Ray Tucker from Louisiana State University. UNC Charlotte communications spoke with Dr. Cramer to learn more about the new research. 

What were you able to learn from this study? 

Among the important findings is that our study shows the best way to capture or assess feelings of entrapment using an existing self-report measure, the Entrapment or “E-Scale”. This is critically important because assessment of two types of entrapment can have differing influences on suicide and other areas of health and well-being.

We also learned that feelings of internal entrapment, or the sense one cannot escape negative self-perceptions, is important in understanding suicide among U.K. young adults. On the contrary, external entrapment, or the sense of inability to evade social and circumstantial situations, is important for understanding suicide in U.S. young adults. In essence, it's the difference between being trapped by self-deprecating thoughts (U.K.) versus interpersonal circumstances (e.g., job loss, financial strain - U.S.). 

What is the value of making these types of comparisons across countries? 

We tend to think of suicide prevention efforts as “one-size-fits-all”, when this is not the case.  Collaborative efforts like this project help to establish the basic science for development of tailored suicide prevention programs within the unique context of particular countries.    

Do scholars have a sense for why these differences in feelings of entrapment exist?

Not yet! However, this is the exact focus of our next set of studies. We are in the planning stages of a multi-method set of studies that will include interviews of persons with lived suicide experience in order to understand how and why entrapment develops.  We will also conduct short-term prospective assessment of entrapment to try to gain further insight into how entrapment may differentially influence suicidal thinking across countries.  

We also think studying entrapment has wider-ranging implications. A sense of entrapment is something we all may experience, but understanding why it has negative impacts on some and not others is an important next step.  We also want to understand the variety of health-related impacts of entrapment in additional areas such as interpersonal violence.