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Communication

Psychological Autopsy: A Powerful Tool in Forensic Investigations

1
Interdisciplinary Department of Medicine, Section of Legal Medicine, University of Bari Aldo Moro, 70124 Bari, Italy
2
Department of Education, Psychology and Communication, University of Bari Aldo Moro, 70121 Bari, Italy
3
Department of Primary Care, Local Health Service (ASP), 85100 Potenza, Italy
4
Psychiatric Diagnosis and Treatment Service of Policoro (SPDC), Local Health Service (ASM), 75025 Matera, Italy
*
Author to whom correspondence should be addressed.
Forensic Sci. 2024, 4(4), 635-646; https://doi.org/10.3390/forensicsci4040044
Submission received: 9 July 2024 / Revised: 23 November 2024 / Accepted: 27 November 2024 / Published: 2 December 2024

Abstract

:
Background: A psychological autopsy is a post-mortem investigative tool used to carry out a retrospective reconstruction of a missing subject’s life. The method includes gathering information from all the potentially involved parties, which may indicate the relevant elements directly or indirectly to trace the victim’s experience and identify personality traits, lifestyle, and interpersonal relationships. Discussion: Psychological autopsies are mainly performed during criminal investigations to identify the cause of death and the specific circumstances (natural, accidental, suicidal, or homicidal death). In addition, from an epidemiological point of view, this method aims to collect the relevant information about an individual’s behavior, circumstances, and reasons for their death to identify common risk factors to prevent new suicides. Although less frequently, this tool can also serve other purposes, such as the legal validity estimation of pre-death actions. Moreover, it may be used to assess whether mistakes have been made in treating people undergoing medical or psychological treatment. Conclusions: Currently, this methodology still has a limited diffusion on the Italian and European scenes due to the lack of standardized guidelines and substantial relevant scientific literature. It is the main factor affecting the tool’s reliability, validity, and systematic application in forensic investigations.

1. Introduction

The loss of life due to violent circumstances evokes widespread public concern, eliciting collective feelings of dismay and insecurity within society [1]. It triggers intense emotional crises, particularly among the victim’s relatives and close associates, as well as within the institutions and environments where the incident occurred. The impact is worsened when criminal acts by third parties cause the loss of life.
Injuries have different causes, including road traffic crashes, falls, drowning, burns, poisoning, and acts of violence. In particular, 4,400,000 deaths per year derive from injuries. Among them, unintentional injuries account for approximately 3,160,000 fatalities, while violence-related injuries result in around 1,250,000 deaths. Road traffic crashes are responsible for approximately one in three of these deaths, suicides for one in six, homicides for one in ten, and war conflict for one in sixty-one. Among individuals aged 5–29 years old, the three most common causes of mortality are injury-related and arise from road traffic injuries, homicide, and suicide. Drowning ranks as the sixth leading cause of death for children aged 5–14 years old. Additionally, falls contribute to over 684,000 deaths each year, representing a growing yet under-recognized public health concern [2]. Therefore, it is crucial to shed light on the possible criminogenic context leading to a violent death under examination by using the multidisciplinary potentials of the forensic sciences. Scientific techniques and methodologies are used to supplement the traditional legal investigations and determine whether a legally relevant crime or act has occurred [3].
Like the advancements in other scientific fields, the progress in technology and science has continually aimed to enhance the investigative techniques and strategies within the legal realm to achieve the highest levels of validity and reliability. In this context, one emerging investigative tool is the psychological autopsy, a method centered on retrospectively reconstructing the life of an individual who has gone missing or died violently (either via suicide or homicide).
The psychological autopsy (PA) is a technique that involves reviewing the psychosocial aspects of a deceased’s life in the attempt to reconstruct his/her psychological state leading up to and at the time of their death. Therefore, this tool aims to collect information from all the potentially relevant sources to review the victim’s lifetime, identifying their personality traits, lifestyle, and interpersonal relationships. This process can elucidate the intentions behind the death, provide insights into the timing and the victim’s involvement in the event’s dynamics, and suggest underlying motivations [4].
Currently, no standardized guidelines exist for conducting a psychological autopsy, at least in Italy. However, some recommendations are available, although they have not garnered universal consensus, indicating a need for further methodological study and extensive research in this specific scientific field. To the best of our knowledge, only a few countries have incorporated psychological autopsies into their legal frameworks as an investigative tool. Notably, Cuba has pioneered in this area, as the Ministry of Public Health has developed and adopted the MAPI (Modelo de Autopsia Psicologica Integrado) protocol [5,6].
This communication aims to shed light on the current state of the art regarding the application of the psychological autopsy, to identify its methodological limitations, and to understand how it may be implemented in the legal field.

2. Materials and Methods

A comprehensive literature search was conducted using the following primary scientific research databases: PubMed, Scopus, Google Scholar, and the Web of Science. The search strategy focused on identifying the relevant studies and authoritative contributions related to the application of a psychological autopsy in forensic, medico-legal, and criminal contexts, as well as its standardization. The following keywords were used alone or combined in different ways: Psychological Autopsy, Medico-Legal Investigation, Criminal Investigation, Forensic Psychiatry, Standardization, Legal Framework, Forensic Evidence Collection, Death Investigation, and Forensic Assessment Tools. From the articles retrieved, we selected those pertinent to the topic, and relevant data were extracted. This process ensured that the collected information was directly instrumental to implementing a psychological autopsy in the abovementioned fields, thus contributing to a comprehensive and well-supported analysis of the subject matter.

3. The Evolution of the Methodology

Both in suicide and criminal cases, different approaches to the psychological autopsy have been outlined in the literature, with the common characteristic of using interviews as a central tool. These interviews have typically consisted of a structured set of points and questions to be asked, aiming at exploring all the ambits of interest related to the deceased person. Generally, for each point, it is recommended to start with an open-ended question, followed by a more specific and closed question (semi-structured interview format), to increase the interviewee’s trust and ease. Moreover, the setting and demeanor of the interviewer are crucial in establishing an atmosphere of trust and collaboration that can guarantee reliable results, preserving the psychological integrity of the interviewee [7].
Several interview models have been suggested to boost the reliability of the obtained information and meet the criteria for admissibility in court. Nonetheless, these models are not a standardized protocol, and each method can be prone to interpretation and conduction bias.
The first authors to deal with the psychological autopsy were Shneidman and Farberow in 1961, who defined it as “a retroactive reconstruction of the life of a person that can individuate aspects revealing the intentions behind the death, supply clues to the type of death, the level (if any) of participation in the dynamics and explain the reasons why the death occurred at that given moment” [4].
In particular, Shneidman’s approach involved the administration of an interview—described as a “mixture of conversation, interview, emotional support, general questions, and a good deal of listening”—consisting of 16 criteria characterizing the victim’s lifestyle, life stressor events, any psychiatric disease, and any other previous suicide attempts.
Unlike Shneidman’s criteria, Rosenberg and the working group on the determination and reporting of suicide (1988) proposed a more scientific view of the interview to increase its reliability in Law Courts. This working group drew up 22 criteria and ambits of interest to assess during the interview (OCDS: Operational Criteria for the Determination of Suicide) [8].
Similarly, Litman (1989) referred to the psychological autopsy as a tool for retrospectively analyzing the personality traits and socio-relational conditions of individuals during their lifetime to gain an understanding of the circumstances surrounding their death [9].
Subsequently, Jobes (1991) et al. defined the Empirical Criteria for the Determination of Suicide, consisting of 16 items mainly aimed at going into greater depth regarding the criteria of self-infliction and intention, which have been demonstrated to have the strongest correlation with the suicide event [10].
In 1995, Gelles proposed a guide widely adopted in Chile [11]. It consisted of a semi-structured interview subdivided into 24 assessment areas, including the intentional and lethal nature of the suicide behavior, as well as the relational, social, and working activities of the victim.
To ensure the proper utilization of this investigative tool, García-Pérez (1998) advocated for integrating forensic psychologists into the working groups at crime scenes [12]. This integration was deemed essential due to the critical role of interdisciplinary activities in solving criminal cases. By viewing it from this standpoint, the psychological autopsy had the potential to act as a form of evidence in the legal domain. Moreover, García-Pérez developed the Model of Integrated Psychological Autopsy (MAPI), a method widely used in Latin America consisting of a semi-structured interview with yes/no answers subdivided into 60 areas [13]. There was also a version including a battery of questions specifically created for the investigations of death via suicide.
To make more scientific use of the tool, Canter and Alison (1999) [14] proposed the following points: (1) collecting elements that offer alternative explanations justifying the equivocal death; (2) indicating the proofs that support or deny each explanation; (3) making a complete summing up of the evidence and the way it links to the criteria required for its admissibility as proof; (4) indicating an assessment of the available evidence and the procedures that determined its validity and accuracy; and (5) clearly stating how the evidence is used to reach the conclusions about each alternative explanation.
In 2003, Werlang and Botega proposed another interesting model in the investigational field, that is, the Semi-Structured Interview for Psychological Autopsy (SSIPA), which contained 69 items subdivided into four areas: precipitating factors and stressors, motivation, lethal method, and the intentionality of the act [15]. It was an attempt to produce an algorithm allowing an interpretation of a “more standardized interview”.
Lastly, the Psychological Autopsy Methodology Checklist (PAMC) was created to address the fundamental aspects of the case-control research methodology and the distinctive methodologies employed in psychological autopsy studies. It incorporates the established elements outlined in a validated checklist for studies utilizing case-control designs and associated methods, as developed by Downs and Black (1998) [16], covering aspects like external and internal validity. Several items from their report have been adjusted for use in the PAMC. Additionally, specific PAMC items were formulated to account for the specialized aspects of case-control psychological autopsy research, informed by the authors’ collective experience and two reviews on the methodology of case-control psychological autopsy research conducted by Conner et al. (2011, 2012) [17,18]. Furthermore, 35 reports included in a meta-analysis of case-control psychological autopsy research on mood and substance use disorders (Conner et al., 2017) [19] were utilized to refine the PAMC and establish its inter-rater reliability [20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53]. The PAMC was developed based on five steps: the drafting of items, revision of items, training of raters, second revision, and inter-rater reliability. It is a valid method to carry out a psychological autopsy, given the inter-rater reliability demonstrated by the scale. On the other hand, the PAMC still has some limits, such as not examining other clinical elements of studies like their timeliness. In addition, the PAMC was produced to foster a “quantitative” analysis of the characteristics featured by the psychological autopsy but lacks any indications about qualitative elements.
Among the mentioned protocols, only those provided by Rosenberg et al. [8], Jobes et al. [10], and Werlang and Botega [15] illustrate a systematic structure since they explain the items to explore in the interviews either by attaching the checklist for the psychological autopsy performance in the case of structured interviews or describing step by step the procedure directly in the text in the case of semi-structured interviews. Table 1, Table 2 and Table 3 provide a graphical illustration of these methodologies to highlight the strengths and weaknesses.

4. Potential Fields of Application

Historically, despite its demonstrated utility in various areas, the psychological autopsy has predominantly been used in epidemiological studies focused on suicide [54,55,56], with clearly defined objectives such as assessing the risk profile [57,58], characterizing the childhood and adolescent suicide population [35,59,60,61] as well as that of the elderly population [62,63], differentiating the suicide population by using the method employed [64,65] and the risk factors associated with suicidal behavior, such as the presence of mental disorders [52,64,66,67], particular personality traits [68], adverse events in life [69,70], or unfavorable psychosocial factors [71,72,73,74]. Based on the obtained results, the psychological autopsy has been demonstrated to be a valuable predictive tool in the scientific disciplines exploring mental health, such as psychiatry and psychology, helping to establish a risk profile for suicide and define specific prevention policies for the categories at risk [58,75,76]. Psychiatric diseases, substance abuse, psychological disorders, genetics, family and social-cultural situations, trauma, or loss experiences are all factors influencing the likelihood of suicide [77,78], with drug abuse and mental illness frequently coexisting [79]. Other potential risk factors involve having a family history of suicide, having previously attempted suicide [80], having a readily available means to end one’s life, or having traumatic brain damage [81]. Based on the obtained information about the suicide risk factors in specifically selected populations, the psychological autopsy can be used as a systematic preventive intervention tool in social contexts with high rates of suicide or suicidal behavior (such as prisons, military barracks, etc.).
The psychological autopsy serves a practical purpose, for example, in discriminating between genuine suicide and suspected criminal interventions by third parties [82] in cases of suspicious or equivocal death, i.e., when the manner of death (such as suicide, accident, or otherwise) is uncertain or not immediately evident [83].
Thus, while its initial application was within clinical settings, its capacity to analyze the psychological processes of the deceased individual and the circumstances surrounding their death revealed its value as a forensic tool. In this way, similarly to other ancillary branches such as forensic genetics, forensic toxicology, and forensic radiology, the psychological autopsy provides a useful tool to gather information for investigations.
The psychological autopsy application in the criminal field becomes even more functional when the historical and circumstantial data are unclear. Such scenarios are relatively common, for example, when the information provided by relatives is conflicting or insufficient to reconstruct a clear sequence of events. In other words, although a psychological autopsy does not offer conclusive evidence, it provides admissible clues in legal contexts [3]. This tool is not a replacement for forensic and medical-legal investigations. Instead, it has to be considered a complementary tool to be adopted by experts in the field appointed by the judicial authority to find additional evidence through a validated method [84].
The progressive application of this investigation method, not only in cases of suicide but also above all in cases of suspicious deaths, has gradually been shown to have a dual relevance because, on the one hand, it contributes to the work of the police forces and legal operators, helping to clarify the causes and circumstances of the death (whether natural, accidental, suicidal, or homicidal), and, on the other hand, it has resulted in a valuable tool for victim profiling.
In certain criminal cases in the United States, psychological autopsies have been used to assess the potential influence of external factors on a victim’s suicide. A notable example is Jackson v. State [85], where the psychological autopsy was employed to explore the role of an abusive relationship in the victim’s death. Additionally, in U.S. v. St. Jean [86], the prosecution used a psychological autopsy to evaluate whether the suspected homicide victim might have been a likely candidate for suicide.
It is important to emphasize that the role of the psychological autopsy in criminal investigations is still limited and only occasionally used, mainly due to the reservations about this tool’s usability in forensic contexts. Moreover, collaboration with the police is limited to the later phases of the investigation when the crime scene and medico-legal investigations have already been made [87,88].
In evaluating the admissibility of the psychological autopsies within criminalistic legal proceedings, the application of the Daubert standard presents significant challenges. The Daubert criteria, which require expert testimony to be grounded in scientifically valid methods and procedures, set a high bar for evidence acceptance in court [89]. These criteria include the testability of the methodology, peer review and publication, known error rates, general acceptance within the relevant scientific community, and the existence of standards governing the application of the techniques used.
The psychological autopsy consideration under the Daubert standard raises several issues that complicate its admissibility. Firstly, the testability of the psychological autopsy is inherently limited, as the method relies on retrospective interviews with third parties and the analysis of historical documents rather than on repeatable experiments. Peer review and publication represent another area of concern. Although there is a body of literature discussing psychological autopsies, the extent to which these studies are accepted and disseminated varies. The method has been subject to scrutiny and debate, particularly regarding its interpretative nature, which can undermine the perceived scientific reliability of the findings. The error rate estimation for psychological autopsies is particularly problematic due to the qualitative nature of the data involved. General acceptance within the scientific community is also not unequivocal for psychological autopsies. While the technique is recognized in certain fields, such as forensic psychiatry and legal medicine, its interpretative nature and lack of standardization have prevented it from achieving universal acceptance across the broader scientific community. Lastly, the relevance and reliability of psychological autopsies are contingent upon the quality of the information gathered and the competence of the expert conducting the analysis. The method’s reliance on third-party interviews introduces potential biases, including recall bias, which can significantly affect the accuracy and reliability of the findings [89,90,91]. In summary, the psychological autopsy may provide valuable insights in specific forensic settings, but its application in court is limited if it is subject to the strict requirements of the Daubert standard.
While there is still hesitation regarding its use in criminal cases, testimony based on psychological autopsies has been more readily accepted in civil cases [92]. In particular, in the civil field, this tool could be functional to establish the subject’s competency and mental status when drawing up a final will. This approach is particularly applicable in cases involving the validity of legal documents, such as wills or contracts, where understanding an individual’s mental state at the time of execution is crucial. In other words, a retrospective assessment of the psychological and emotional condition of the deceased through a psychological autopsy can provide insight into their decision-making abilities and overall legal competence during critical moments.
Moreover, the psychological autopsy, which originated as a support for the medico-legal diagnosis of suicides, has now evolved into a tool that can be useful in many other areas apart from the forensic field. Over time, it has become a significant asset in fields like forensic psychology, psychiatry, and criminology [93]. Therefore, its multifaceted role, centered on analyzing and interpreting the psychological findings, allows a comprehensive examination of the deceased person, providing reliable information serving to reconstruct the criminal dynamics or the level of participation that the victim may have had in the fatal event [13,94]. Within this context, the victim’s personal documents, property, professional or artistic productions, living areas during life, relationships, and interactions in the social field, all of which are typical elements determining the fatal event, take on a particular relevance [3].

5. Discussion and Conclusions

As it has emerged up to this point, a few critical issues hinder the systematic adoption of the psychological autopsy method.
One drawback of psychological autopsy is its inherently retrospective nature, as data are collected after the individual’s death. Since the direct questioning of the subject is impossible, the process relies solely on the information provided by the acquaintances and family members of the deceased (i.e., any person who had a relatively close relationship or contact with the defunct), without any clear definition of the sources from which data should best be collected [95,96,97].
Cultural considerations are important: even though a universally applicable tool could be beneficial for conducting psychological autopsies in legal contexts, the protocols should be tailored to factors like the deceased’s language, nationality, and cultural background [17].
Numerous efforts have been undertaken to standardize the procedures for conducting psychological autopsies, aiming to minimize the variables that could introduce bias in various ways. However, despite its significance, the application of this investigative method has received limited attention. Certainly, there is not enough scientific literature assessing its efficacy and contribution in comparison to the traditional methods. In addition, the studies available about the application of the psychological autopsy show extreme methodological non-homogeneity since there are differences in terms of the structural aspects of the analytical tool (interview), number and professional skills of the examiners involved, quality and quantity of data to record, information sources to be identified, timing, and place where the investigation should be made [67]. Furthermore, these studies are primarily case-control studies, where the primary bias is due to the difference between the deceased cases and live controls. It has been suggested to use control subjects having the same age, gender, and medical conditions as the studied cases to gain more reliable information [71].
The present literature review demonstrates an extreme methodological inhomogeneity and the lack of a systematic application of the psychological autopsy. The available studies are mainly focused on the tool application in the clinical contexts of the mental health field [98,99] to identify the risk factors associated with suicide [73,98], individual differences in terms of gender and ethnic origin [100], in such cases as during the COVID-19 pandemic [99], and with suicide in the elderly population [63,101,102,103].
The need for a single standardized model is clearly shown in this article, serving to individuate the specific areas of use and to define the possible applications in the forensic context, especially in cases of investigations related to suspicious deaths. Commonly, there emerges the absence of “single governance” or precise and well-defined coordination of legal investigations and expert opinion reports, which should be performed by the Magistrate or designated delegates. These are needed to allow the experts and consultants sufficient time to carry out all the activities involved in a psychological autopsy, which inevitably takes time and involves many resources.
A standardized methodology would guarantee not only a more solid scientific basis for the psychological autopsy, but also a greater satisfaction of the Daubert criteria, which would make it more admissible as proof in the legal field [89]. As many authors have pointed out, this would result in the procedure becoming a regular practice in the forensic field [83,104,105,106].
To promote the systematic adoption of psychological autopsies, establishing a framework for standardized guidelines is essential. Although no methodological approach has been so far promoted as a standard, some procedural key points seem to be consistently accounted for.
Thus, a potential recommendable framework should ensure that the interviewers receive comprehensive foundational training that covers the essential skills and knowledge areas relevant to the practice. Additionally, ethical principles, such as cultural sensitivity, should be emphasized to ensure that the interviews are appropriately adapted to the needs of the individuals being interviewed. This approach would help make the interviewee feel more at ease and more likely to provide as much information as possible. Moreover, the guidelines for conducting interviews should be designed with flexibility, allowing for adjustments that respect the unique characteristics of each case.
It is crucial to establish standardized guidelines for the timing of interviews in psychological autopsies. Conducting interviews too soon after the subject’s death may lead to cognitive biases due to heightened emotional responses, while delaying them for too long increases the risk of important details being omitted or forgotten. To enhance the validity and reliability of psychological autopsies as a practical tool, evidence-based studies should inform the optimal timing for these interviews, ensuring a balanced approach that minimizes emotional bias and preserves accuracy.
Furthermore, the involvement of a multidisciplinary team is crucial. This team should not only include a forensic pathologist but also other professionals, such as a forensic psychiatrist, to ensure a holistic approach. Such collaboration should begin at the earliest stages of the investigation, including at the crime scene, to gather the most comprehensive evidence possible.

Author Contributions

Conceptualization, S.S. and I.G.; methodology, S.S. and I.G.; software, M.B., M.G.V., A.N.C. and R.R.; validation, S.S. and I.G.; formal analysis, A.M. and V.P.; investigation, S.S., M.B., M.G.V., A.N.C. and R.R.; data curation, S.S. and M.B.; writing—original draft preparation, S.S., M.B., M.G.V., A.N.C. and R.R.; writing—review and editing, S.S. and I.G.; supervision, S.S. and I.G.; project administration, S.S. and I.G. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

Not applicable.

Informed Consent Statement

Not applicable.

Data Availability Statement

Data are contained within the article.

Conflicts of Interest

The authors declare no conflicts of interest.

References

  1. Ceretti, A.; Cornelli, R. Oltre la Paura: Affrontare IL Tema Della Sicurezza in Modo Democratico; Feltrinelli Editore: Milan, Italy, 2018. [Google Scholar]
  2. World Health Organization Injuries and Violence. Available online: https://www.who.int/news-room/fact-sheets/detail/injuries-and-violence (accessed on 28 August 2024).
  3. Ceballos-Espinoza, F. Aplicación forense de la autopsia psicológica en muertes de alta complejidad. Anu. Psicol. Juríd. 2015, 25, 65–74. [Google Scholar] [CrossRef]
  4. Farberow, N.L.; Edwin, S.S. The Cry for Help; The Blaksiston Division/McGraw-Hill Book Co., Inc.: New York, NY, USA, 1961. [Google Scholar]
  5. Posa, F.; Leone, J.; Rondinelli, V.; Sclavi, F.; Posa, M. Psychological Autopsy Structured on Individual Cases: Methodological Considerations for A New Protocol. Med. Res. Arch. 2023, 11, 3. [Google Scholar] [CrossRef]
  6. Bonicatto, B.; García Perèz, T.; Lopez, R.R.; Angeli, F. L’ Autopsia Psicologica. L’indagine Nei Casi DI Morte Violenta O Dubbia; Franco Angeli: Milan, Italy, 2006. [Google Scholar]
  7. Robins, E.; Murphy, G.E.; Wilkinson, R.H.; Gassner, S.; Kayes, J. Some Clinical Considerations in the Prevention of Suicide Based on a Study of 134 Successful Suicides. Am. J. Public Health 1959, 49, 888–899. [Google Scholar] [CrossRef] [PubMed]
  8. Rosenberg, M.L.; Davidson, L.E.; Smith, J.C.; Berman, A.L.; Buzbee, H.; Gantner, G.; Gay, G.A.; Moore-Lewis, B.; Mills, D.H.; Murray, D. Operational criteria for the determination of suicide. J. Forensic Sci. 1988, 33, 1445–1456. [Google Scholar] [CrossRef]
  9. Litman, R.E. 500 psychological autopsies. J. Forensic Sci. 1989, 34, 638–646. [Google Scholar] [CrossRef]
  10. Jobes, D.A.; Casey, J.O.; Berman, A.L.; Wright, D.G. Empirical criteria for the determination of suicide manner of death. J. Forensic Sci. 1991, 36, 244–256. [Google Scholar] [CrossRef]
  11. Gelles, M.G. Psychological autopsy: An investigative aid. In Police Psychology Into the 21st Century; Series in Applied Psychology; Lawrence Erlbaum Associates, Inc.: Hillsdale, NJ, USA, 1995; pp. 337–355. ISBN 0-8058-1344-6. [Google Scholar]
  12. García Pérez, T. La Autopsia Psicológica En El Homicidio. Rev. Med. Leg. De Costa Rica 1998, 15, 1–2. [Google Scholar]
  13. Pérez, T.G. Pericia en Autopsia Psicológica; Ediciones La Rocca: Buenos Aires, Argentina, 2007. [Google Scholar]
  14. Canter, D.; Alison, L. Profiling in Policy and Practice, 1st ed.; Routledge: Oxfordshire, UK, 1999; ISBN 978-1-315-24594-2. [Google Scholar]
  15. Werlang, B.G.; Botega, N.J. A semi-structured interview for psychological autopsy in suicide cases. Rev. Bras. Psiquiatr. 2003, 25, 212–219. [Google Scholar] [CrossRef]
  16. Downs, S.H.; Black, N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J. Epidemiol. Community Health 1998, 52, 377–384. [Google Scholar] [CrossRef]
  17. Conner, K.R.; Beautrais, A.L.; Brent, D.A.; Conwell, Y.; Phillips, M.R.; Schneider, B. The Next Generation of Psychological Autopsy Studies: Part I. Interview Content. Suicide Life Threat. Behav. 2011, 41, 594–613. [Google Scholar] [CrossRef]
  18. Conner, K.R.; Beautrais, A.L.; Brent, D.A.; Conwell, Y.; Phillips, M.R.; Schneider, B. The Next Generation of Psychological Autopsy Studies: Part 2. Interview Procedures. Suicide Life Threat. Behav. 2012, 42, 86–103. [Google Scholar] [CrossRef]
  19. Conner, K.R.; Bridge, J.A.; Davidson, D.J.; Pilcher, C.; Brent, D.A. Metaanalysis of Mood and Substance Use Disorders in Proximal Risk for Suicide Deaths. Suicide Life Threat. Behav. 2019, 49, 278–292. [Google Scholar] [CrossRef] [PubMed]
  20. Almasi, K.; Belso, N.; Kapur, N.; Webb, R.; Cooper, J.; Hadley, S.; Kerfoot, M.; Dunn, G.; Sotonyi, P.; Rihmer, Z.; et al. Risk factors for suicide in Hungary: A case-control study. BMC Psychiatr. 2009, 9, 45. [Google Scholar] [CrossRef] [PubMed]
  21. Appleby, L.; Cooper, J.; Amos, T.; Faragher, B. Psychological autopsy study of suicides by people aged under 35. Br. J. Psychiatr. 1999, 175, 168–174. [Google Scholar] [CrossRef]
  22. Beautrais, A.L. Suicides and serious suicide attempts: Two populations or one? Psychol. Med. 2001, 31, 837–845. [Google Scholar] [CrossRef]
  23. Brent, D.A.; Baugher, M.; Bridge, J.; Chen, T.; Chiappetta, L. Age- and Sex-Related Risk Factors for Adolescent Suicide. J. Am. Acad. Child Adolesc. Psychiatr. 1999, 38, 1497–1505. [Google Scholar] [CrossRef]
  24. Brent, D.A.; Perper, J.A.; Moritz, G.; Allman, C.; Friend, A.; Roth, C.; Schweers, J.; Balach, L.; Baugher, M. Psychiatric Risk Factors for Adolescent Suicide: A Case-Control Study. J. Am. Acad. Child Adolesc. Psychiatr. 1993, 32, 521–529. [Google Scholar] [CrossRef]
  25. Chan, S.S.M.; Chiu, H.F.K.; Chen, E.Y.H.; Chan, W.S.C.; Wong, P.W.C.; Chan, C.L.W.; Law, Y.W.; Yip, P.S.F. Population-Attributable Risk of Suicide Conferred by Axis I Psychiatric Diagnoses in a Hong Kong Chinese Population. Psychiatr. Serv. 2009, 60, 1135–1138. [Google Scholar] [CrossRef]
  26. Chen, E.Y.H.; Chan, W.S.C.; Wong, P.W.C.; Chan, S.S.M.; Chan, C.L.W.; Law, Y.W.; Beh, P.S.L.; Chan, K.K.; Cheng, J.W.Y.; Liu, K.Y.; et al. Suicide in Hong Kong: A case-control psychological autopsy study. Psychol. Med. 2006, 36, 815–825. [Google Scholar] [CrossRef]
  27. Cheng, A.T.A. Mental Illness and Suicide: A Case-Control Study in East Taiwan. Arch. Gen. Psychiatr. 1995, 52, 594. [Google Scholar] [CrossRef]
  28. Cheng, A.T.A.; Chen, T.H.H.; Chen, C.-C.; Jenkins, R. Psychosocial and psychiatric risk factors for suicide: Case-control psychological autopsy study. Br. J. Psychiatr. 2000, 177, 360–365. [Google Scholar] [CrossRef] [PubMed]
  29. Chiu, H.F.K.; Yip, P.S.F.; Chi, I.; Chan, S.; Tsoh, J.; Kwan, C.W.; Li, S.F.; Conwell, Y.; Caine, E. Elderly suicide in Hong Kong—A case-controlled psychological autopsy study. Acta Psychiatr. Scand. 2004, 109, 299–305. [Google Scholar] [CrossRef]
  30. Conner, K.R.; Beautrais, A.L.; Conwell, Y. Moderators of the Relationship Between Alcohol Dependence and Suicide and Medically Serious Suicide Attempts: Analyses of Canterbury Suicide Project Data. Alcohol Clin. Exp. Res. 2003, 27, 1156–1161. [Google Scholar] [CrossRef] [PubMed]
  31. Conwell, Y.; Duberstein, P.R.; Hirsch, J.K.; Conner, K.R.; Eberly, S.; Caine, E.D. Health status and suicide in the second half of life. Int. J. Geriatr. Psychiatr. 2010, 25, 371–379. [Google Scholar] [CrossRef]
  32. De Leo, D.; Draper, B.M.; Snowdon, J.; Kõlves, K. Contacts with health professionals before suicide: Missed opportunities for prevention? Compr. Psychiatr. 2013, 54, 1117–1123. [Google Scholar] [CrossRef]
  33. De Leo, D.; Draper, B.M.; Snowdon, J.; Kõlves, K. Suicides in older adults: A case–control psychological autopsy study in Australia. J. Psychiatr. Res. 2013, 47, 980–988. [Google Scholar] [CrossRef] [PubMed]
  34. Foster, T.; Gillespie, K.; McLelland, R.; Patterson, C. Risk factors for suicide independent of DSM–III–R Axis I disorder: Case–control psychological autopsy study in Northern Ireland. Br. J. Psychiatr. 1999, 175, 175–179. [Google Scholar] [CrossRef]
  35. Freuchen, A.; Kjelsberg, E.; Lundervold, A.J.; Grøholt, B. Differences between children and adolescents who commit suicide and their peers: A psychological autopsy of suicide victims compared to accident victims and a community sample. Child Adolesc. Psychiatr. Ment. Health 2012, 6, 1. [Google Scholar] [CrossRef]
  36. Harwood, D.; Hawton, K.; Hope, T.; Jacoby, R. Psychiatric disorder and personality factors associated with suicide in older people: A descriptive and case-control study. Int. J. Geriatr. Psychiatr. 2001, 16, 155–165. [Google Scholar] [CrossRef]
  37. Khan, M.M.; Mahmud, S.; Karim, M.S.; Zaman, M.; Prince, M. Case–control study of suicide in Karachi, Pakistan. Br. J. Psychiatr. 2008, 193, 402–405. [Google Scholar] [CrossRef]
  38. Kim, C.D.; Lesage, A.; Seguin, M.; Chawky, N.; Vanier, C.; Lipp, O.; Turecki, G. Patterns of co-morbidity in male suicide completers. Psychol. Med. 2003, 33, 1299–1309. [Google Scholar] [CrossRef] [PubMed]
  39. Kolves, K.; Sisask, M.; Anion, L.; Samm, A.; Värnik, A. Factors predicting suicide among Russians in Estonia in comparison with Estonians: Case-control study. Croat. Med. J. 2006, 47, 869–877. [Google Scholar]
  40. Manoranjitham, S.D.; Rajkumar, A.P.; Thangadurai, P.; Prasad, J.; Jayakaran, R.; Jacob, K.S. Risk factors for suicide in rural south India. Br. J. Psychiatr. 2010, 196, 26–30. [Google Scholar] [CrossRef] [PubMed]
  41. Page, A.; Morrell, S.; Hobbs, C.; Carter, G.; Dudley, M.; Duflou, J.; Taylor, R. Suicide in young adults: Psychiatric and socio-economic factors from a case–control study. BMC Psychiatr. 2014, 14, 68. [Google Scholar] [CrossRef]
  42. Palacio, C.; García, J.; Diago, J.; Zapata, C.; Lopez, G.; Ortiz, J.; Lopez, M. Identification of Suicide Risk Factors in Medellín, Colombia: A Case-Control Study of Psychological Autopsy in a Developing Country. Arch. Suicide Res. 2007, 11, 297–308. [Google Scholar] [CrossRef]
  43. Préville, M.; Hébert, R.; Boyer, R.; Bravo, G.; Seguin, M. Physical health and mental disorder in elderly suicide: A case-control study. Aging Ment. Health 2005, 9, 576–584. [Google Scholar] [CrossRef] [PubMed]
  44. Renaud, J.; Berlim, M.T.; McGirr, A.; Tousignant, M.; Turecki, G. Current psychiatric morbidity, aggression/impulsivity, and personality dimensions in child and adolescent suicide: A case-control study. J. Affect. Disord. 2008, 105, 221–228. [Google Scholar] [CrossRef]
  45. Schneider, B.; Wetterling, T.; Sargk, D.; Schneider, F.; Schnabel, A.; Maurer, K.; Fritze, J. Axis I disorders and personality disorders as risk factors for suicide. Eur. Arch. Psychiatr. Clin. Neurosci. 2006, 256, 17–27. [Google Scholar] [CrossRef]
  46. Shaffer, D. Psychiatric Diagnosis in Child and Adolescent Suicide. Arch. Gen. Psychiatr. 1996, 53, 339. [Google Scholar] [CrossRef]
  47. Shafii, M.; Steltz-Lenarsky, J.; Derrick, A.M.; Beckner, C.; Whittinghill, J.R. Comorbidity of mental disorders in the post-mortem diagnosis of completed suicide in children and adolescents. J. Affect. Disord. 1988, 15, 227–233. [Google Scholar] [CrossRef]
  48. Tong, Y.; Phillips, M.R. Cohort-specific risk of suicide for different mental disorders in China. Br. J. Psychiatr. 2010, 196, 467–473. [Google Scholar] [CrossRef] [PubMed]
  49. Vijayakumar, L.; Rajkumar, S. Are risk factors for suicide universal? A case-control study in India. Acta Psychiatr. Scand. 1999, 99, 407–411. [Google Scholar] [CrossRef]
  50. Waern, M. Alcohol dependence and misuse in elderly suicides. Alcohol Alcohol 2003, 38, 249–254. [Google Scholar] [CrossRef] [PubMed]
  51. Wærn, M.; Runeson, B.S.; Allebeck, P.; Beskow, J.; Rubenowitz, E.; Skoog, I.; Wilhelmsson, K. Mental Disorder in Elderly Suicides: A Case-Control Study. Am. J. Psychiatr. 2002, 159, 450–455. [Google Scholar] [CrossRef]
  52. Zhang, J.; Xiao, S.; Zhou, L. Mental Disorders and Suicide Among Young Rural Chinese: A Case-Control Psychological Autopsy Study. Am. J. Psychiatr. 2010, 167, 773–781. [Google Scholar] [CrossRef]
  53. Zonda, T. One-Hundred Cases of Suicide in Budapest. Crisis 2006, 27, 125–129. [Google Scholar] [CrossRef]
  54. Jacobs, D.; Klein-Benheim, M. The psychological autopsy: A useful tool for determining proximate causation in suicide cases. Bull. Am. Acad. Psychiatr. Law 1995, 23, 165–182. [Google Scholar]
  55. Scott, C.L.; Swartz, E.; Warburton, K. The Psychological Autopsy: Solving the Mysteries of Death. Psychiatr. Clin. N. Am. 2006, 29, 805–822. [Google Scholar] [CrossRef]
  56. Knoll, J.L.; Hatters-Friedman, S. The Homicide–Suicide Phenomenon: Findings of Psychological Autopsies. J. Forensic Sci. 2015, 60, 1253–1257. [Google Scholar] [CrossRef] [PubMed]
  57. Phillips, M.R.; Yang, G.; Zhang, Y.; Wang, L.; Ji, H.; Zhou, M. Risk factors for suicide in China: A national case-control psychological autopsy study. Lancet 2002, 360, 1728–1736. [Google Scholar] [CrossRef]
  58. de Arco, J.N.; Huici, T. El Uso de La Autopsia Psicològica Forense En El Proceso Penal. Identidad Jurídica 2005, 1, 235–242. [Google Scholar]
  59. Shafii, M.; Carrigan, S.; Whittinghill, J.R. Psychological autopsy of completed suicide in children and adolescents. Am. J. Psychiatr. 1985, 142, 1061–1064. [Google Scholar] [CrossRef] [PubMed]
  60. Kwon, H.; Kim, R.; Bhang, S.-Y.; Hong, H.J.; Kweon, Y.S. A Methodological Review of Psychological Autopsy for Adolescents. J. Korean Acad. Child Adolesc. Psychiatr. 2014, 25, 121–127. [Google Scholar] [CrossRef]
  61. Zalsman, G.; Siman Tov, Y.; Tsuriel, D. EPA-0860–Quantitative and qualitative psychological autopsy of 70 high school students: Tragic vs. regressive narratives. Eur. Psychiatr. 2014, 29, 1. [Google Scholar] [CrossRef]
  62. Aadamali, N.; Anand, M. Psychological Autopsy Study of Suicides among Elderly. J. Indian Acad. Forensic Med. 2014, 36, 156–159. [Google Scholar]
  63. Torresani, S.; Toffol, E.; Scocco, P.; Fanolla, A. Suicide in elderly South Tyroleans in various residential settings at the time of death: A psychological autopsy study. Psychogeriatrics 2014, 14, 101–109. [Google Scholar] [CrossRef]
  64. Berman, A.L.; Sundararaman, R.; Price, A.; Au, J.S. Suicide on Railroad Rights-of-Way: A Psychological Autopsy Study. Suicide Life Threat. Behav. 2014, 44, 710–722. [Google Scholar] [CrossRef]
  65. Sun, S.-H.; Jia, C.-X. Completed Suicide with Violent and Non-Violent Methods in Rural Shandong, China: A Psychological Autopsy Study. PLoS ONE 2014, 9, e104333. [Google Scholar] [CrossRef]
  66. McGirr, A.; Renaud, J.; Seguin, M.; Alda, M.; Benkelfat, C.; Lesage, A.; Turecki, G. An examination of DSM-IV depressive symptoms and risk for suicide completion in major depressive disorder: A psychological autopsy study. J. Affect. Disord. 2007, 97, 203–209. [Google Scholar] [CrossRef]
  67. Pacchioni, F.; Bosia, M.; Moretti, G.; Barbieri, C.; Bellumore, S.; Travaini, G. Mind the past: A systematic review on psychological autopsy. Behav. Sci. Law 2023, 41, 343–372. [Google Scholar] [CrossRef]
  68. Draper, B.; Kõlves, K.; De Leo, D.; Snowdon, J. A Controlled Study of Suicide in Middle-Aged and Older People: Personality Traits, Age, and Psychiatric Disorders. Suicide Life Threat. Behav. 2014, 44, 130–138. [Google Scholar] [CrossRef] [PubMed]
  69. Castañeda, G.; Eduardo, I. Análisis conductual forense en un caso de delito financiero. Cuad. Contab. 2008, 9, 465–486. [Google Scholar]
  70. Foster, T. Adverse Life Events Proximal to Adult Suicide: A Synthesis of Findings from Psychological Autopsy Studies. Arch. Suicide Res. 2011, 15, 1–15. [Google Scholar] [CrossRef] [PubMed]
  71. Hawton, K.; Malmberg, A.; Simkin, S. Suicide in doctors. J. Psychosom. Res. 2004, 57, 1–4. [Google Scholar] [CrossRef]
  72. Schneider, B.; Grebner, K.; Schnabel, A.; Hampel, H.; Georgi, K.; Seidler, A. Impact of employment status and work-related factors on risk of completed suicide. Psychiatr. Res. 2011, 190, 265–270. [Google Scholar] [CrossRef]
  73. Pompili, M.; Innamorati, M.; Di Vittorio, C.; Baratta, S.; Masotti, V.; Badaracco, A.; Wong, P.; Lester, D.; Yip, P.; Girardi, P.; et al. Unemployment as a Risk Factor for Completed Suicide: A Psychological Autopsy Study. Arch. Suicide Res. 2014, 18, 181–192. [Google Scholar] [CrossRef]
  74. Sablone, S.; Spagnolo, L.; Macorano, E.; Ciavarella, M.C.; Pascale, N.; Strisciullo, G.; Introna, F.; Di Fazio, A. “Freedom and Dignity Are Worth More than Life”: The Dramatic Suicide of an Anti-Vax Man. Healthcare 2022, 10, 2141. [Google Scholar] [CrossRef]
  75. Di Vella, G.; Grattagliano, I.; Curti, S. Multiple stab wounds: Understanding the manner of death through the psychological autopsy. Clin. Ter. 2017, 168, 233–239. [Google Scholar] [CrossRef]
  76. Sablone, S.; Groicher, M.; Patrizia Fanco, T.; Risola, R.; M Violante, G.; Bellino, M.; Lagona, V.; Grattagliano, I. Work-related stress amongst legal medical doctors: The need for systematic psychological support. An Italian perspective. Forensic Sci. Res. 2023, 8, 116–122. [Google Scholar] [CrossRef] [PubMed]
  77. Zalsman, G.; Hawton, K.; Wasserman, D.; Van Heeringen, K.; Arensman, E.; Sarchiapone, M.; Carli, V.; Höschl, C.; Barzilay, R.; Balazs, J.; et al. Suicide prevention strategies revisited: 10-year systematic review. Lancet Psychiatr. 2016, 3, 646–659. [Google Scholar] [CrossRef]
  78. Hawton, K.; Saunders, K.E.; O’Connor, R.C. Self-harm and suicide in adolescents. Lancet 2012, 379, 2373–2382. [Google Scholar] [CrossRef] [PubMed]
  79. Vijayakumar, L.; Kumar, M.S.; Vijayakumar, V. Substance use and suicide. Curr. Opin. Psychiatr. 2011, 24, 197–202. [Google Scholar] [CrossRef] [PubMed]
  80. Chang, B.; Gitlin, D.; Patel, R. The depressed patient and suicidal patient in the emergency department: Evidence-based management and treatment strategies. Emerg. Med. Pract. 2011, 13, 1–23; quiz 23–24. [Google Scholar]
  81. Simpson, G.; Tate, R. Suicidality in people surviving a traumatic brain injury: Prevalence, risk factors and implications for clinical management. Brain Inj. 2007, 21, 1335–1351. [Google Scholar] [CrossRef]
  82. Seminario Sobre la Diligencia de Inspección Ocular, Identificación Y Levantamiento Del Cádaver; García Valdés, C. (Ed.) Colección Cursos/Centro de Estudios Judiciales, Ministerio de Justicia: Madrid, Spain, 1991; ISBN 978-84-7787-225-2. [Google Scholar]
  83. Knoll, J.L. The Psychological Autopsy, Part I: Applications and Methods. J. Psychiatr. Pract. 2008, 14, 393–397. [Google Scholar] [CrossRef]
  84. Caulkins, C.G. The Psychological Autopsy: What, Who, and Why. Forensic Ment. Health Pract. 2019, 2, 1–10. [Google Scholar]
  85. Supreme Court of Florida. Jackson v. State; Supreme Court of Florida: Tallahassee, FL, USA, 1989. [Google Scholar]
  86. United States Court of Appeals for the Armed Forces. U.S. v. St. Jean; United States Court of Appeals for the Armed Forces: Washington, DC, USA, 1996. [Google Scholar]
  87. Fargnoli, A.L. Manuale Di Psicologia Investigativa; Giuffré: Milan, Italy, 2005. [Google Scholar]
  88. De Leo, G.; Patrizi, P. Lo Psicologo Criminologo; Giuffré: Milan, Italy, 2006. [Google Scholar]
  89. Snider, J.E.; Hane, S.; Berman, A.L. Standardizing the Psychological Autopsy: Addressing the Daubert Standard. Suicide Life Threat. Behav. 2006, 36, 511–518. [Google Scholar] [CrossRef]
  90. Haque, M.A. Psychological Autopsy: A Lead to the Truth Untold. Indian J. Forensic Med. Toxicol. 2022, 16, 274–277. [Google Scholar] [CrossRef]
  91. Majid, A.; Suhaff, A.A.; Khan, A.W. Psychological Autopsy: Reconstructing the Mystery of Suicide. Ind. J. Priv. Psychiatr. 2017, 11, 24–25. [Google Scholar] [CrossRef]
  92. Ogloff, J.R.P.; Otto, R. Psychological Autopsy: Clinical and Legal Perspectives. St Louis Univ. Law J. 1993, 37, 607–646. [Google Scholar]
  93. Jiménez Rojas, I.A. La Autopsia Psicológica Como Instrumento de Investigación. In Revista Colombiana de Psiquiatría; Asociación Colombiana de Psiquiatría: Bogotá, Colombia, 2001. [Google Scholar]
  94. Sablone, S.; Margari, A.; Introna, F.; Catanesi, R.; Mandarelli, G. Denial of pregnancy and neonaticide: A historical overview and case report. J. Forensic Sci. 2023, 68, 688–695. [Google Scholar] [CrossRef] [PubMed]
  95. Poythress, N.; Otto, R.K.; Darkes, J.; Starr, L. APA’s expert panel in the Congressional review of the USS Iowa incident. Am. Psychol. 1993, 48, 8–15. [Google Scholar] [CrossRef] [PubMed]
  96. Vicent, T.; Rodrigo, I. Autopsia psicológica. Evaluación crítica y su aplicabilidad en el ámbito forense. Anu. Psicol. Jurídica 2007, 17, 111–130. [Google Scholar]
  97. Gómez, J.J.C. Tratado de Psiquiatría Legal Y Forense, 4th ed.; LA LEY: Buenos Aires, Argentina, 2010. [Google Scholar]
  98. Giupponi, G.; Pycha, R.; Innamorati, M.; Lamis, D.A.; Schmidt, E.; Conca, A.; Kapfhammer, H.P.; Lester, D.; Girardi, P.; Pompili, M. The association between suicide and the utilization of mental health services in South Tirol, Italy: A psychological autopsy study. Int. J. Soc. Psychiatr. 2014, 60, 30–39. [Google Scholar] [CrossRef] [PubMed]
  99. Innamorati, M.; Pompili, M.; Masotti, V.; Pearsonéi, F.; Lester, D.; Tatarelli, R.; Girardi, P.; Amore, M. Completed Versus Attempted Suicide in Psychiatric Patients: A Psychological Autopsy Study. J. Psychiatr. Pract. 2008, 14, 216–224. [Google Scholar] [CrossRef]
  100. Pycha, R.; Pompili, M.; Innamorati, M.; Schwitzer, J.; Lester, D.; Sani, G.; Tatarelli, R.; Giupponi, G. Sex and ethnic differences among South Tirolean suicides: A psychological autopsy study. Eur. Psychiatr. 2009, 24, 47–56. [Google Scholar] [CrossRef]
  101. Aquila, I.; Sacco, M.A.; Ricci, C.; Gratteri, S.; Ricci, P. Quarantine of the COVID-19 pandemic in suicide: A psychological autopsy. Med. Leg. J. 2020, 88, 182–184. [Google Scholar] [CrossRef]
  102. Pompili, M.; Innamorati, M.; Masotti, V.; Personnè, F.; Lester, D.; Di Vittorio, C.; Tatarelli, R.; Girardi, P.; Amore, M. Suicide in the Elderly: A Psychological Autopsy Study in a North Italy Area (1994–2004). Am. J. Geriatr. Psychiatr. 2008, 16, 727–735. [Google Scholar] [CrossRef]
  103. Ventura, F.; Caputo, F.; Micera, C.; Molinelli, A. Elder abuse: A retrospective analysis of autopsy cases from the department of legal medicine in Genoa from 2006 to 2017. J. Elder Abus. Negl. 2020, 32, 388–398. [Google Scholar] [CrossRef]
  104. Bakst, S.S.; Braun, T.; Shohat, T. The postmortem proxy-based interview—Future directions. J. Psychiatr. Res. 2016, 75, 46–56. [Google Scholar] [CrossRef]
  105. Isometsä, E.T. Psychological autopsy studies—A review. Eur. Psychiatr. 2001, 16, 379–385. [Google Scholar] [CrossRef] [PubMed]
  106. Pouliot, L.; De Leo, D. Critical Issues in Psychological Autopsy Studies. Suicide Life Threat. Behav. 2006, 36, 491–510. [Google Scholar] [CrossRef] [PubMed]
Table 1. Psychological autopsy methodologies with structured interviews.
Table 1. Psychological autopsy methodologies with structured interviews.
NameAuthorCountryReference
OCDS (Operational Criteria for the Determination of Suicide)Rosenberg et al.USA[8]
ECDS
(Empirical Criteria for the Determination of Suicide manner of death)
Jobes et al.USA[10]
SSIPA
(Semi-Structured Interview for Psychological Autopsy)
Werlang and BotegaBrazil[12]
Table 2. Psychological autopsy methodologies with structured interviews.
Table 2. Psychological autopsy methodologies with structured interviews.
NameType of InterviewSubdivision in AreasNumber of ItemsAnswer to Items
OCDSStructuredNoTotal: 14
Among them:
3 for the explicit expression of suicidal intent;
11 for the implicit or indirect expression of suicidal intent
Y (yes);
N (no);
0 (no evidence);
- (respondent not asked)
ECDSStructured(1)
Forensic variables
(2)
Psychological variables
(3)
Recent behavior variables
(4)
Recent experience variables
(5)
Chronic behavior variables
(6)
Historic variables
Total:16
55 initial items (22 of them deriving from OCDS).
From the initial 55, 16 empirical criteria were selected after validation
PRES
(present)
ABSENT
(absent)
NOT INVEST
(not investigated)
NOT DETERM
(investigated but its presence can’t be determined)
SSIPASemi-structured, based on closed, open and/or echo-questions 1(1)
Precipitant and/or stressors
(2)
Motivation
(3)
Lethality
(4)
Intentionality
Precipitants and/or stressors: general question plus 2 items with dichotomic alternatives.
Motivation: general question plus 32 items with dichotomic alternatives.
Lethality: general question plus 5 items (3 of which with multiple-choice answers; 3 of 5 with specification of the death method).
Intentionality: general question plus 25 more items with dichotomic alternatives.
Open answers.
Dichotomic answer: yes or no.
Multiple-choice answers.
Specification of the death method.
1 Echo-questions: questions that repeat part of the answer of the interviewee, aiming to further elaborate it.
Table 3. Psychological autopsy methodologies with structured interviews.
Table 3. Psychological autopsy methodologies with structured interviews.
NameSubdivision of Items in SectionsCut-OffValidation of Accuracy
OCDSNoNot specifiedNo
ECDSSection A: self-infliction and intention (13 items)
Section B: self-infliction only (2 items)
Section C: intention only (1 item)
≥3 self-infliction score plus ≥ 3 intention score100% of suicides predicted
83% of accidents predicted
92% of cases correctly classified
SSIPANoNot specifiedValues lower than 80% were found in only 5% of the measurements.
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Sablone, S.; Bellino, M.; Cardinale, A.N.; Violante, M.G.; Risola, R.; Magno, A.; Pierro, V.; Grattagliano, I. Psychological Autopsy: A Powerful Tool in Forensic Investigations. Forensic Sci. 2024, 4, 635-646. https://doi.org/10.3390/forensicsci4040044

AMA Style

Sablone S, Bellino M, Cardinale AN, Violante MG, Risola R, Magno A, Pierro V, Grattagliano I. Psychological Autopsy: A Powerful Tool in Forensic Investigations. Forensic Sciences. 2024; 4(4):635-646. https://doi.org/10.3390/forensicsci4040044

Chicago/Turabian Style

Sablone, Sara, Mara Bellino, Andrea Nicola Cardinale, Maria Grazia Violante, Roberta Risola, Antonella Magno, Vincenzo Pierro, and Ignazio Grattagliano. 2024. "Psychological Autopsy: A Powerful Tool in Forensic Investigations" Forensic Sciences 4, no. 4: 635-646. https://doi.org/10.3390/forensicsci4040044

APA Style

Sablone, S., Bellino, M., Cardinale, A. N., Violante, M. G., Risola, R., Magno, A., Pierro, V., & Grattagliano, I. (2024). Psychological Autopsy: A Powerful Tool in Forensic Investigations. Forensic Sciences, 4(4), 635-646. https://doi.org/10.3390/forensicsci4040044

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