Socio Cultural Perspective on Rising Suicide Rate for South Koreans

Rising Suicide Rates for South Korea |

Public Health Issues

A Socio-cultural Perspective on Rising Suicide Rate for South Koreans

Suicide is an overarching social concern that affects all age groups. In recent years, there has been growing concern regarding the increasing rates of suicidal tendencies among adolescents. The Korea National Statistical Office reported that suicide numbers for ages 10 -- 29 years in South Korea (1,255) comprised 22.2% of the total number of suicides (5,663) for the year 2002, thus representing a higher percentage of total suicide victims, compared with those in other age groups (Centers for Disease Control and Prevention, 2007). In addition, suicide was the 10th leading cause of death in the adult population in 1992 and the seventh leading cause of death in 2002, but was the fourth leading cause of death in 2005 in the Korean population. More importantly, suicide was one of the three most prevalent causes of death in teenagers and was the first leading cause of death in 2005 for South Koreans in their twenties. In response to these concerns, there has been a growing research interest in the risk factors and predictors of young peoples' suicidal behaviors. An increasing number of studies have examined the extent to which social, family, personal, and environmental factors contribute to suicide risks in young people. Most studies which examined the associations between measures of social disadvantage and suicide or suicide attempts have reported an increased risk of suicidal behavior among individuals from socially disadvantaged backgrounds characterized by low socioeconomic status (SES), limited educational achievement, low income, and poverty. Considerable research has focused on the extent to which exposure to adverse, dysfunctional or abusive family and/or childhood circumstances is associated with an increased risk of suicidal behavior in Korean youth. The National Youth Persons with suicidal tendencies are categorized into three groups: those with suicidal ideation, those who attempted suicide, and those who have completed suicide (Linehan, 1986). In the YRBS survey, 16.9% of participants (21.8% of girls and 12.0% of boys) reported seriously considering suicide in the past 12 months (Centers for Disease Control and Prevention, 2007). The prevalence of suicidal ideation was higher than the rate of suicide attempt (Centers for Disease Control and Prevention, 2007), and suicidal ideation may be the earliest recognition of suicidal tendencies (Keane, Dick, Bechtold, & Manson, 1996).

South Korea's suicide rate has increased rapidly in the past 2 decades. The rate of completed suicide in 1982 was 6.8 per 100,000 people per year, but it rose to 19.1 by 2002. In particular, over the past 10 years the rate has raised an average of one percent annually. During this decade Korean society has become an increasingly integrated member of the globalized economy. What appears to have taken place in this process of globalization is an evolution from traditional and collective moral values to a Western, individualistic, and materialistic culture. With this cultural change, Korean society has faced an increasing incidence of social problems, such as drug abuse, crime, divorce, and unemployment. Thus, South Korean society can be characterized as moving toward a state that Durkheim (1897) called anomic, a pathological social condition that weakens the bonds between the individual and society. Individuals who are confronted with anomie may commit a wide range of destructive acts, including suicide. The most alarming connections recently found to be in regards to suicide are the numbers of suicides because of plastic surgery as well as suicide pacts. In recent studies found just this year, many women have committed suicide because they were found to be unhappy with results after undergoing plastic surgery. Along with this, suicide pacts are made online by teenagers who vow to take their lives together.

This paper attempts to define the situation in South Korea in regards to suicide rates. This is not only a rampant problem within the youth, but also among the elderly and the middle-aged. There are socio-economic factors which are influencing these rates, as well as some significant psychological findings. The early recognition of suicidal tendencies as well as their varying causes is explored. Recommendations are then given to suit the situation of the South Korean environment which may be promulgating this suicide.

Lester and Yang (1998) operationalized social integration / regulation by using the marriage and birth rates of societies (marriages and births increase social integration / regulation) and divorce rates (divorces decrease social integration/regulation). In regression analyses to predict suicide rates in 21 nations, they found that 22 of the regression coefficients for divorce rates were positive vs. 7 negative, 9 of the regression coefficients for marriage rates were positive vs. 20 negative, and 12 of the regression coefficients for births rates were positive vs. 17 negative. Thus, divorce and marriage rates were consistently associated with suicide rates in the manner predicted by Johnson (1965). The present study was designed to explore these associations for the suicide rate of South Korea.

During the year 1970, a garment worker, set himself on fire at Chongghye-Chun, the country's largest textile and garment wholesale district, to protest the subhuman working conditions in the sweatshops and the government's lack of enforcement of even the most rudimentary rights of workers (Cho, 2003). This is the story of the first suicide protest which struck Korea's culture at a large.

"Do not let my death be in vain" was the only decipherable words coming from his mouth after a burning ritual of suicide (Cho, 2003). Those were the same last words said to his mother and friends while on his deathbed. Chun died in a hospital about 9 hours later, surrounded by his mother and friends (Cho, 2003). Chun's suicide was apparently a form of protest. This unusual use of suicide as protest -- I use the term "suicide protest" to indicate it being a form of protest by means of suicide -- has occurred more often than one would expect in modern societies throughout the world. In South Korea alone, a total of 107 protesters, including Chun, died by suicide protest from 1970 to 2004.

Suicide protest was not limited to Korea. According to a study, about one-half of all 133 incidents of "suicide by burning," reported in The Times of London or the New York Times from 1790 to 1971, were "political suicide"; all of these political suicides have occurred since 1963 (Crosby, Rhee, and Holland, 1991). What made so many people commit this highly unusual form of suicide? What did they want to achieve from their suicide protest? Notwithstanding the unexpected and counterintuitive surge of suicide protest in the second half of the twentieth century across countries, these incidents were rarely subject to systematic scholarly study. When studied, much of the emphasis was placed on the act of suicide rather than the motive for protest (Wood, 1980). Suicide protests were rarely analyzed from a perspective of social movement and collective action.

Consequently, they were seen as being issues with more psychiatric bearing than that of collective action. Suicide protest was suggested by some as resulting from psychological disorders (Scully and Hutcherson, 1983). Others viewed it as an outlet for expressing inflammatory emotions or as a path to a divine state or means for self-glorincation after death (Ashton, 1980). Yet others attempted to classify personality types that might be prone to committing self-immolation (Crosby et al., 1991). As Park (1994) aptly summarized, this "psychopathological account of suicide stresses unconscious or irrational elements in individual

psyches, maintaining that suicides are caused by some impulsive 'psychodynamics' stemming ultimately from 'depression.'." Recent studies show that the psychopathological interpretation of these incidents of self-immolation is not quite empirically supported (Park, 1994; Biggs, 2005). For example, Singh and his associates (Singh et al., 1998) investigated 22 survivors of self-immolation in India and found only one incident of psychopathological symptoms. Likewise,

Biggs (2005), after examining a total of 533 incidents of self-immolation between 1963 and 2002, reports little incidents of self-immolation resulting from psychological disturbances such as the pursuit of vanity or escape from personal failings. He concludes that the "suicidal tendencies almost never lead to self-immolation. . . . Self-immolation is rarely explained by suicidal tendencies" (qtd. Biggs, 2005). Park (1994) criticizes the psychopathological approach as neglecting the actor's beliefs and values, and more importantly, "the significance of their suicides as political acts."

Selective preventive interventions have been developed for a subgroup of people who exhibit higher level of risk for suicide. Such interventions are known to be cost-effective and efficient (Jones et al., 1992). The findings of the present study have demonstrated the need for developing selective preventive interventions for girls who exhibit high levels of anger. This is seen in those women who were unhappy with their plastic surgery and had committed suicide as well. According to the most recent case this year of a suicide due to plastic surgery, a Korean source states that: "At approximately 9.20pm on October 18, 41-year-old Ms. A was discovered, hanged, in the living room of her apartment in the Bok-gu area of Gwangju by her older sister's husband, who alerted police." (qtd.). It was later found that the woman was recently divorced and had psychological issues which she tried to address through plastic surgery. Interventions for these women and adolescence should be taken. Such interventions should reflect the unique features of anger expression among girls and teach them how to express anger in acceptable ways. These would focus on problem-solving and communication skills. Considering that girls reported low levels of school satisfaction, which is a significant risk factor for suicidal ideation, it is important to provide appropriate school-based services for girls. Also, in regards to those women who commit suicide due to plastic surgery, interventions must be taken on hand before they undergo the process. A screening of patients who request for plastic surgery must be done to identify the emotional status as well as their reasons for plastic surgery. The present has several limitations. The first is the self-report bias.

Several difficulties are inherent in the assessment of suicidal ideation. It has been found that studies indicate that the anger measurement could have been underreported by boys, who may not have taken the survey as seriously as one would hope. The second is that all participants were from one city in South Korea. Thus recruiting adolescents from different areas, including rural regions on a random basis could increase the generalizability of the findings. Despite these limitations, results of this study have significant clinical implications. This anger is reflected upon the adolescents found to make suicide pacts online. Along with the story of suicide protest discussed above, many findings believe that suicides and suicide letters are misinterpreted. Usually, the adolescent who commits the act is found channeling unhealthy anger towards one thing, therefore leads his or her own kind of suicide protest to whatever cause he or she believes is triggering the anger. Adolescents experiencing high levels of anger are more likely than adolescents with lower levels of anger to report suicidal ideation. Interestingly, the girls who were above the threshold point of anger score manifested a steep increase in suicidal ideation. Based on these literature reviews, it is recommended that suicide prevention programs focusing on anger management be offered to adolescents who exhibit early signs of anger problems and suicidal tendencies.

Suicide rates among Korean adolescents have recently increased, and there is increasing public concern regarding the issue of youth suicide in South Korea. We found that in these adolescents, their families showed higher levels of family-related problems such as intra-familial sexual abuse, psychotic disorders, depression, epilepsy, chronic illness, alcoholism, and family histories of suicidal behavior, compared to the families of those study participants who did not attempt suicide. These intra-familial dysfunctions relate to the pressure the media may be putting on adolescence to be perfect, thus resulting to plastic surgery. Not only did families in which adolescent suicide attempts occur have more dysfunctional family dynamics, adolescents who attempted suicide expressed significantly higher levels of psychosomatic symptoms, frustration, and depression than those who did not attempt suicide. The adolescent who attempted suicide showed a significantly lower level of life satisfaction and less effective coping strategies than those adolescents who did not. This coincides with the popular trend of plastic surgery in Korea, where women feel unsatisfied with how they look, and turn to artificial ways to be able to control one aspect of their lives. Based on the findings, there is a regression analysis which can be used, five predictors appeared to be significant in the following order: coping strategies; parental child-rearing pattern; depression; parent-child relationship; and psychosomatic symptoms. In other words, the odds ratio for the risk of attempted suicide was highest in adolescents who used less effective coping strategies. Adolescents who were subjected to a dysfunctional parental child-rearing pattern as well as those with a higher level of depression, a poor parent-child relationship, and/or a higher level of psychosomatic symptoms had the second, third, fourth, and fifth greatest increased risk of attempted suicide, respectively. It is therefore concluded that Korean adolescents who are exposed to these risk factors have less effective personal coping strategies and more readily engage in suicidal behavior.