Autopsy, Psychological

The psychological autopsy is a procedure for investigating a person's death by reconstructing what the person thought, felt, and did preceding his or her death. This reconstruction is based upon information gathered from personal documents, police reports, medical and coroner's records, and face-to-face interviews with families, friends, and others who had contact with the person before the death.

The first psychological autopsy study was most likely Gregory Zilboorg's investigation of ninety-three consecutive suicides by police officers in New York City between 1934 and 1940. In 1958 the chief medical examiner of the Los Angeles Coroners Office asked a team of professionals from the Los Angeles Suicide Prevention Center to help in his investigations of equivocal cases where a cause of death was not immediately clear. From these investigations, the psychiatrist Edwin Shneidman coined the phrase "psychological autopsy" to describe the procedure he and his team of researchers developed during those investigations. The method involved talking in a tactful and systematic manner to key persons—a spouse, lover, parent, grown child, friend, colleague, physician, supervisor, and coworker—who knew the deceased. Their practice of investigating equivocal deaths in Los Angeles continued for almost thirty years and allowed for more accurate classification of equivocal deaths as well as contributing to experts' understanding of suicide.

In the 1970s and 1980s, researchers using the psychological autopsy method investigated risk factors for suicide. Psychological autopsies have confirmed that the vast majority of suicide victims could be diagnosed as having had a mental disorder, usually depression, manic depression, or alcohol or drug problems. Other studies focused upon the availability of firearms in the home of suicide completers, traumatic events in person's lives, and other psychological and social factors.

There are two major trends in the use of psychological autopsies: research investigation and clinical and legal use. Research investigations generally involve many people who died by suicide and comparing the results with another group, for example, accident victims, in order to see if some factors are important in discriminating between suicides and other deaths. Clinical and legal use of psychological autopsies involves investigations of a single death in order to clarify why or how a person died. These often involve descriptive interpretations of the death and may include information to help family and friends better understand why a tragic death occurred. They also may lead to suggesting means of preventing suicides, for example by suggesting improvements in hospital treatment or suicide prevention in jails.

Psychological autopsies have been conducted for literary interpretation of the deaths of famous people. Of note is Shneidman's analysis eighty-eight years later of the death of Malcolm Melville in 1867, the son of Moby Dick author Herman Melville. They also have been used in legal cases to settle estate questions concerning the nature of death; for example, the death of the billionaire Howard Hughes. Psychological autopsies have been used in criminal investigations of blame, including one case where a mother was found guilty of numerous abusive behaviors toward a child who had committed suicide.

There is no consensus on the exact procedure for conducting a psychological autopsy. However, psychological autopsy studies for research purposes often use complex methods to ensure that the information is reliable and valid. All psychological autopsies are based upon possibly biased recollections. Nevertheless, the psychological autopsy constitutes one of the main investigative tools for understanding suicide and the circumstances surrounding death.

See also: Autopsy; Suicide Influences and Factors: Alcohol and Drug Use, Mental Illness

Bibliography

Friedman, P. "Suicide among Police: A Study of 93 Suicides among New York City Policemen, 1934–1940." In Edwin S. Shneidman ed., Essays in Self-Destruction. New York: Science House, 1967.

Jabobs, D., and M. E. Klein. "The Expanding Role of Psychological Autopsies." In Antoon A. Leenaars ed.,Suicidology: Essays in Honor of Edwin S. Shneidman. Northvale, NJ: Aronson, 1993.

Litman, Robert, T. Curphey, and Edwin Shneidman. "Investigations of Equivocal Suicides." Journal of the American Medical Association 184, no. 12 (1963):924–929.

Shneidman, Edwin S. "Some Psychological Reflections on the Death of Malcom Melville." Suicide and Life-Threatening Behavior 6, no. 4 (1976):231–242.

BRIAN L. MISHARA