Psychological autopsy

Definition: Set of postmortem investigative procedures carried out to gain a better understanding of the psychological circumstances that may have contributed to a suicide.

Significance: Psychological autopsies allow researchers and investigators to gather information on suicidal behavior that cannot be obtained through the use of other methodologies. In addition to helping investigators determine the modes of death in cases of suicide, psychological autopsies can shed light on the reasons people commit suicide.

Edwin S. Shneidman, one of the founders of the field of suicidology, coined the term “psychological autopsy” to describe the procedure he developed with his colleagues at the Los Angeles County Medical Examiner’s Office to assist medical examiners and coroners in clarifying equivocal deaths (deaths the causes of which are unknown). The psychological autopsy entails the analysis of medical autopsy and police reports, personal documents left behind by the deceased, and interviews with those who knew the deceased. Since the late twentieth century, the psychological autopsy has gained widespread usage in suicidology, and research studies of psychological autopsies have been conducted in several countries, including Sweden, Finland, Scotland, Taiwan, New Zealand, and Great Britain. The psychological autopsy has also become a widely used forensic investigatory tool.

Psychological Autopsies and Forensic Investigations

Psychologists conducting psychological autopsies compile information retrospectively about the behaviors, psychological states, and motives of deceased persons. For a death to be considered a potential suicide, evidence surrounding the death must show that the wound suffered could have been self-inflicted. Psychologists and law-enforcement officials must also determine that the deceased understood the consequences of the actions that led to the person’s death (also called lethal intent).

During forensic investigations of possible suicides, the physical evidence should corroborate the findings of the psychological autopsies. For example, when it occurs, cadaveric spasm (instant rigor mortis) can help establish whether a death was homicide or a suicide. The presence of a weapon (such as a gun, knife, or razor blade) tightly clutched in the hand of the deceased as the result of cadaveric spasm strongly indicates suicide. The absence of cadaveric spasm, however, does not preclude suicide, as this phenomenon does not occur in every case. For reasons such as this, the careful consideration of both physical evidence and findings from psychological autopsies is critical to successful forensic investigations into possible suicides.

Elements of a Psychological Autopsy

A psychological autopsy includes semistructured interviews with relatives, friends, and other persons connected to the deceased. Another central component is a review of the medical and psychiatric histories of the deceased. In analyzing the information gathered, the psychologist attempts to understand the final days and hours of the dead person’s life. In doing so, the psychologist may rely on examination of the death scene as well as examination of such materials as the deceased’s journals and suicide notes, books and music owned by the deceased, and the deceased’s school, military, and employment records.

Many psychologists also gather information about the deceased person’s family history of death and mental illness, familiarity with death methods, stress reaction patterns, involvement with alcohol or drugs, habits and routines, and relationship history when conducting a psychological autopsy. Of particular interest in this search for information is anything that indicates that the deceased person experienced any major life disruptions, such as the loss of a job or a loved one, in the days and hours leading up to the death.

Limitations of Psychological Autopsies

Despite the obvious utility of the psychological autopsy, much has been written about the limitations of this technique. Critics have noted, for example, that because the deceased are not available for questioning, psychologists must rely on interviews with those who knew them, and any of these people may contaminate the process by providing “biased” recollections.

The most commonly cited limitation or weakness of psychological autopsies is the lack of any standardized procedures for conducting them. Although psychologists have developed a guide with twenty-six categories to assist investigators in conducting psychological autopsies, not all of the categories are applicable to every case or are considered by every psychologist conducting a psychological autopsy. Despite these limitations, the psychological autopsy has proven to be an invaluable investigative tool, and findings from studies on psychological autopsies have led to innumerable advances in suicide prevention and the treatment of persons with suicidal tendencies.

Bibliography

Cohen, Ronald J., Mark Swerdlik, and Edward D. Sturman. Psychological Testing and Assessment: An Introduction to Tests and Measurement. 8th ed. New York: McGraw-Hill, 2012.

Eliopulos, Louis N. Death Investigator’s Handbook. Expanded ed. Boulder, Colo.: Paladin Press, 2003.

Joiner, Thomas. Why People Die by Suicide. Cambridge, Mass.: Harvard University Press, 2006.

Maris, Ronald W., Berman, Alan L., and Morton M. Silverman. Comprehensive Textbook of Suicidology. New York: Guilford Press, 2000.

Shneidman, Edwin S. Autopsy of a Suicidal Mind. New York: Oxford University Press, 2004.

Shneidman, Edwin S. Lives and Deaths: Selections from the Works of Edwin S. Shneidman. Edited by Antoon A. Leenaars. Philadelphia: Brunner/Mazel, 1999.