302

Suicide and Life-Threatening Behavior 33(3) Fall 2003

2003 The American Association of Suicidology

Suicidal Ideation and Attempts

in Norwegian Police
ANNE MARIE BERG, MA, ERLEND HEM, MD, BJRN LAU, PHD,
MITCHELL LOEB, MSC, AND IVIND EKEBERG, MD

Studies on suicide among police show inconsistent results, thereby contributing to considerable speculation regarding why police officers commit suicide.
The present paper is the first nationwide study on suicidal ideation and attempts
among police. 3,272 Norwegian police completed Paykels Suicidal Feelings in the
General Population questionnaire. Lifetime prevalence of specific questionnaire
items ranged from 24% for the feeling that life was not worth living, 6.4% for
having seriously considered suicide, and 0.7% for attempted suicide. Independent
predictors of serious suicidal ideation were marital status, subjective health complaints, reality weakness, anxiety, and depression. Serious suicidal ideation was
mainly attributed to personal and family problems.

Suicide in police has been described as an epidemic (Loo, 2001; Violanti, 1996). It has
been claimed that the suicide rate of law enforcement personnel is between two and three
times that of the general population (Mohandie & Hatcher, 1999; Slovenko, 1999). Recently, we published the first systematic review of suicide in police in which strict
methodological inclusion criteria were applied to original studies. The review concluded that an elevated suicide rate in police

ANNE MARIE BERG is with the National

Police Academy in Oslo, Norway. ERLEND HEM,
BJRN LAU, and IVIND EKEBERG are with the
Department of Behavioral Sciences in Medicine,
Faculty of Medicine at the University of Oslo.
MITCHELL LOEB is with SINTEF Unimed, Health
Services Research in Oslo.
Funding for this project was provided by
the Norwegian Department of Justice and the
Norwegian Foundation for Health and Rehabilitation.
Address correspondence to Anne Marie Berg,
The National Police Academy, P.O. Box 5027
Majorstua, NO-0301 Oslo, Norway; E-mail:
anne.m.berg@politihs.no

has not been documented (Hem, Berg, &

Ekeberg, 2001). A particular problem of
previous research has been methodological
flaws.
There has been considerable speculation regarding why police officers commit
suicide, and numerous theories have been
proposed (Violanti, 1996). It is argued that
policing is one of the most dangerous, stressful, and health-threatening occupations, with
high levels of stress, alcoholism, divorce, suicide, and so forth associated with this profession (Hill & Clawson, 1988). However, the
suggestions have been highly speculative, and
there has been a call for studies examining
causal factors of police suicide (Loo, 1986).
Police officers are prone to sudden and unexpected situations, violence, and the potential
death of both others and themselves. This
threat may have psychological consequences,
such as posttraumatic stress disorder or burnout, which are often assumed to contribute
to suicidal behavior (Schmidtke, Fricke, &
Lester, 1999). Shift work, the publics antipolice sentiments, and access to firearms are
also mentioned as potential explanations.

BERG ET AL.
Earlier studies among police have mainly focused on suicide. The motivation for research on suicidal ideation and attempts is
that attempted suicide is both one of the
strongest predictors of completed suicide and
an important indicator of extreme emotional
distress and psychological suffering. Moreover, identification of both the risk of suicide,
and prevention of suicide based on risk factors, have proven to be difficult. Thus it has
been proposed that risk factors for morbidity
preceding suicide, especially depressive mood,
suicidal ideation, and attempted suicide should
be studied. It is hoped that a better understanding of the pathways that lead to suicide
as well as the early identification and treatment of suicidal ideation may reduce rates of
both attempted and completed suicide (Hintikka, Viinamaki, Tanskanen, Kontula, & Koskela, 1998). To our knowledge, only one previous paper has studied suicidal ideation
among police (Lennings, 1995). This was a
small pilot study from Queensland, Australia,
investigating suicidal ideation among a group
of students and police officers (N = 118).
Only 30 of the participants were police officers. Suicidal ideation was measured on the
Suicide Ideation Scale (total scores can range
from 10 to 50). In this study, the mean suicidal ideation score was 12.4 in both groups.
There are few national surveys of the
prevalence of suicidal ideation; however, Weissman et al. (1999) recently reported data from
nine countries. The rates of suicide ideation
varied widely by country, while the rates of
suicide attempts were more consistent across
most countries. In the U.S. National Comorbidity Survey, the lifetime prevalence of suicidal ideation was 13.5%, suicidal planning
3.9%, and suicidal attempt 4.6% (Kessler,
Borges, & Walters, 1999). The lack of uniform methodology makes comparisons difficult. Prevalence rates in different studies vary
widely due to the different settings, populations, age groups, definitions of suicidal
ideation, assessment instruments, and retrospective timeframe for presence of suicidal
ideation (Burless & De Leo, 2001). Unfortunately, there is no nationwide data of suicidal
ideation and suicide attempts in the general

303
population in Norway. Studies have been conducted among adolescents, medical students,
and physicians (Hem, Grnvold, Aasland, &
Ekeberg, 2000; Tyssen, Vaglum, Grnvold, &
Ekeberg, 2001; Wichstrm & Rossow, 2002).
The aims of the present study are to
investigate: (1) the prevalence of suicidal ideation and suicide attempts in a nationwide
study of Norwegian police, (2) predictors of
serious suicidal ideation, and (3) the factors
to which police attribute their serious suicidal ideation.

TERMINOLOGY

There is no consistent terminology in

the area of suicidal problems, leading to a
somewhat bewildering situation (Renberg,
2001). In this study, the terms suicidal ideation
and suicidal attempts are used. Suicidal ideation is described by the first four questions
in Paykels Suicidal Feelings in the General
Population questionnaire (see the discussion
under Methods), while a suicidal attempt is
described in the last question in this questionnaire (Paykel, Myers, Lindenthal, & Tanner, 1974).
This study includes not only police officers, but also middle managers and managers in the police force. Hence, the term police
is used to describe the general sample.

METHODS

Participants
On a worldwide basis, police in Norway are well educated. Until 1992, a person
had to undertake 2 years of training to become a Norwegian police officer. After 1992
the training expanded to 3 years of unpaid
full-time study at The National Police Academy, which is governed by The Department
of Justice. The police in this study are all
members of the largest police organization
in NorwayThe Norwegian Police Union.
Approximately 95% of all police officers are
members of this organization.

304

SUICIDAL IDEATION IN NORWEGIAN POLICE

In December 2000 a questionnaire was

distributed by the organization, presumably
to all the 6,398 members who were trained
police officers. The questionnaire included 396
questions on background information, physical and mental health, working condition, job
dissatisfaction, burnout, coping, personality,
and suicidal ideation. It was an anonymous
questionnaire, and it was distributed once.
Several reminders were distributed through
trade union representatives, and the internal
data system within the police force (G-mail).
At the same time it became clear that many
members had not received the questionnaire.
It is unclear whether this was due to chance
or systematic mistakes. Thus, the final response rate was 51%, which represents a total of 3,272 persons who completed and returned the questionnaire (see Table 1).
Due to the problems in distributing
the questionnaire, the project manager distributed 680 letters to randomly selected police in November 2001. The letters included
two questions: first, Did you receive the
questionnaire?, and second, If you received
it, did you answer it?. The responses were
yes and no. A total of 475 persons responded
TABLE 1
Description of Sample

Gender
Women
Men
Age (years)
2029
3039
4049
5059
6069
Civil status
Single
Married/cohabitant
Separated/divorced
Widow(er)
Occupational level
Manager
Middle manager
Officer

Frequency

Percent

501
2,692

15.7
84.3

509
1,175
1,047
430
9

16.1
37.1
33.0
13.6
0.3

342
2,715
164
11

10.6
84.0
5.1
0.3

96
1,034
2,128

2.9
31.7
65.3

to the letter, which was a response rate of

70%. The results showed that 26% never received the questionnaire. Based on this figure, the true response rate would be 51/74
100 = 69%. Since this is an indirect measure,
we will not be too conclusive about this figure; however, we are sure that the true response rate is closer to 69% than to 51%. Of
those who originally received the questionnaire there is reason to believe that approximately two-thirds have answered the questionnaire.
Of the police who responded to the
questionnaire, 16% were female, which is
an accurate reflection of the distribution of
women in the police force (17.9%, information collected from The Department of Justice). A total of 79 persons did not answer the
question about gender, 51 persons did not
answer the question regarding civil status,
and 14 persons did not answer the question
about position; these individuals were excluded from the analyses. The age of participants ranged from 20 to 66 years of age, with
a mean age of 38.9 years (SD = 8.7); the
mean age of men was 39.7 (SD = 7.0), and for
women 34.0 years (SD = 8.7) (p < .001). The
mean age of all members of the Norwegian
Police Union is 40.2; with males and females
having a mean age of 41 and 35 years, respectively. The sample in this study is about 1
year younger than the whole population according to the mean age. Officers are overrepresented in the study in proportion to the
general police population (65.3% vs. 56.1%),
while managers are underrepresented (2.9%
vs. 9.6%).
Suicidal Behavior
The prevalence of suicidal ideation and
attempts was assessed by a modified questionnaire, originally introduced by Paykel et al.
(1974). Paykels Suicidal Feelings in the General Population questionnaire contains five
questions:
1. Have you ever felt that life was not
worth living?
2. Have you ever wished you were dead

BERG ET AL.
(for instance, that you could get to
sleep and not wake up)?
3. Have you ever thought of taking
your life, even if you would not really do it? [These three questions
had the four following response categories: often, sometimes, hardly ever,
never. Before the statistical analyses,
the responses were dichotomized into
never (0) and any frequency (1), according to Paykels original work.]
4. Have you ever reached the point
where you seriously considered taking your life, or perhaps made plans
how you would go about doing it?
[This question contained six response possibilities: never, once, 23
times, 45 times, 69 times, and at
least 10 times.]
5. Have you ever made an attempt to
take your life? [This question had four
response possibilities: never, once,
twice, and three times or more. Responses to the last two questions were
dichotomized into never (0) and any
frequency (1) prior to statistical analyses.]
Questions four and five contained an additional subquestion: To what extent do you
think the following factors influenced you to
consider taking your life? with the following response categories: personal problems,
family problems, social problems, problems
connected with police profession, and other
problems. The responses could be indicated
as: not at all, a little, somewhat, quite a lot,
and very much. In the multivariate analyses,
ever seriously considered taking your life
was used as the dependent variable. The questionnaire has been applied in several other
studies, including Norway (Hem et al., 2000;
Tyssen et al., 2001) and Sweden (Renberg,
2001).
Somatic Health Complaints
The subjective experience of health
was assessed by a 10-item version of the Subjective Health Complaint (SHC) question-

305
naire, previously referred to as the Ursin
Health Inventory (UHI). This questionnaire
consists of questions examining the occurrence, extroversion, and duration of pain in
the neck, back, feet, arms and shoulders; pain
in the chest; migraine and headache; digestive problems; and vertigo for the last 30 days
(Eriksen, Ihlebk, & Ursin, 1999; Ursin, Endresen, & Ursin, 1988). The items are scored
on a 4-point rating scale ranging from no
complaints (0) to serious complaints (3). In the
present study, the SHC sum score was transformed to a dichotomous variable. Consistent with a previous study (Aasland, Olff, Falkum, Schweder, & Ursin, 1997), those who
had a response of 2 or 3 on at least one of
the ten items were scored as cases. According to this procedure, 40.7% (women: 46.2%;
men: 39.7%) were considered a case.
Anxiety and depression
The Hospital Anxiety and Depression
Scale (HADS; Zigmond & Snaith, 1983) includes 14 questions, divided into two subscales: an anxiety subscale and a depression
subscale. Each subscale contains seven items,
and is scored on a 4-point scale. HADS has
been found to perform well in assessing the
prevalence and symptom severity of anxiety
disorders and depression in both somatic,
psychiatric, and primary care patients, as well
as in the general population (Bjelland, Dahl,
Haug, & Neckelmann, 2002). As indicated in
Table 2, female police had higher mean scores
on the anxiety subscale, but lower scores on
the depression subscale.
Personality
The personality inventory used in this
study was the Basic Character Inventory (BCI),
which is based on an original questionnaire
constructed by Lazare, Klerman, and Armor
(1966) and modified by Torgersen (1980).
This instrument contains 36 items that measure four different dimensions of personality:
neuroticism, extroversion, control/compulsiveness, and reality weakness. BCI is based
on the big three personality dimensions

306

SUICIDAL IDEATION IN NORWEGIAN POLICE

TABLE 2
Descriptive Statistics for Independent Variables and t-Statistics for Gender Differences
All

Job Satisfaction Scale (JSS)

Emotional exhaustion (MBI)
Depersonalization (MBI)
Personal accomplishment (MBI)
Anxiety subscale (HADS)
Depression subscale (HADS)
Subjective Health Complaint (SHC)
Neuroticism (BCI)
Extroversion (BCI)
Control/compulsiveness (BCI)
Reality weakness (BCI)

Women

Men

SD

SD

SD

t-statistics
p

44.27
2.23
2.24
2.43
1.54
1.42
0.41
0.28
0.58
0.48
0.14

9.25
0.69
0.75
0.41
0.42
0.41
0.49
0.23
0.27
0.24
0.17

43.54
2.14
2.12
2.48
1.59
1.34
0.46
0.39
0.66
0.49
0.15

8.83
0.64
0.68
0.42
0.42
0.36
0.50
0.25
0.25
0.25
0.19

44.38
2.25
2.26
2.42
1.53
1.44
0.40
0.26
0.57
0.48
0.13

9.33
0.70
0.76
0.41
0.42
0.42
0.49
0.23
0.27
0.24
0.17

.60
.002**
.000***
.003**
.001**
.000***
.008**
.000***
.000***
.328
.018*

Note. *p < 0.05, **p < 0.01, ***p < 0.001.

(neuroticism, extroversion, and control/compulsiveness), with an additional fourth dimension (reality weakness). The neuroticism
factor closely resembles the classic neuroticism scales, the extroversion scale measures
extroversion/introversion, the control/compulsiveness dimension assesses the degree of
compulsiveness, and reality weakness measures
chronic illusions, paranoid traits, and problems with identity-insecurity and relations
traits that are associated with severe personality disorders (Torgersen & Alns, 1989).
Each dimension is based on nine questions
with a dichotomous response (0 = not apply,
1 = apply), allowing each dimension a range
of scores between 0 (low) and 1 (high). Female
police had higher mean scores on neuroticism, extroversion, and reality weakness. No
significant gender differences were found on
the control/compulsiveness dimension (see Table 2 for details).
Job Dissatisfaction
The Job Satisfaction Scale ( JSS) consists of ten questions examining various aspects of working conditions and stressors (responsibility, variation, collaboration, salary,
working hours, etc.) (Warr, Cook, & Wall,
1979). All items are scored on a scale from

1 (extremely satisfied) to 7 (extremely dissatisfied) and summed to provide an overall score

ranging from 10 (high satisfaction) to 70 (low
satisfaction). There were no differences in score
between males and females (see Table 2).
Burnout
Burnout was measured with a 22-item
version of the Maslach Burnout Inventory
(MBI). MBI has been shown to provide reliable data and valid findings and is generally
considered the gold standard measure for
burnout (Maslach, Schaufeli, & Leiter, 2001).
The inventory contains questions regarding
three factors that specify burnout: emotional
exhaustion, depersonalization (cynicism), and
personal accomplishment. The items are scored
on a 5-point scale. Male police were found to
have higher mean scores on the dimensions
of emotional exhaustion and depersonalization, while female police scored higher on
personal accomplishment.
Statistics
The 2 test was used to examine group
differences, and the t-test was used to test
differences on continuous data. Simultaneous
effects were analyzed through logistic regres-

BERG ET AL.

307

sion models. The level of significance was set

at 0.05.

subjective health complaints, the personality

trait of reality weakness, anxiety and depression, and personal accomplishment remained
significant. The other variables that were significant in the bivariate analyses became nonsignificant in the adjusted model because of
high intercorrelations, especially for anxiety
and depression. That the burnout component of personal accomplishment and the
civil status category became significant predictors in the adjusted model implicates that
these variables were statistically repressed in
the bivariate model. However, we were not
able to identify single variables responsible
for these effects.
In another analysis, all independent
variables were entered in a logistic regression
analysis to predict suicidal attempt. Despite
a low number (n = 22), and hence, wide confidence intervals, the model showed four significant independent predictors: being female
(OR = 3.27, 95% CI = 1.198.95), separated/
divorced civil status (OR = 6.43, 95% CI =
2.0220.51), anxiety (OR = 4.15, 95% CI =
1.0915.82), and the burnout dimension personal accomplishment (OR = 0.23, 95% CI =
0.090.59).
As can be seen in Figure 1, female
police related their serious suicidal ideation

RESULTS

As can be seen in Table 3, 24% of the

police had, on one or more occasions, felt
that life was not worth living; 6.4% had seriously considered suicide; and 0.7% had attempted suicide. Compared to men, significantly more female police had once or more
felt that life was not worth living (2 = 5.6;
p < .02), wished you were dead (2 = 7.2; p <
.01), and made a suicide attempt (2 = 10.6;
p = .001). There were no gender differences
in thoughts of taking my life and seriously
considered taking my life. Furthermore, there
were no gender differences in suicidal ideation during the previous year.
As can be seen from Table 4, serious suicidal ideation was bivariately associated with
separated/divorced marital status, age above
40 years, job dissatisfaction, subjective health
complaints, three personality traits, anxiety, depression, and burnout. All independent variables were entered in a logistic regression
analysis to predict serious suicidal ideation.
In this adjusted model, only marital status,

TABLE 3
Prevalence of Suicidal Ideation and Attempts in Norwegian Police
Total respondents
All

Women Men

Felt life was not worth living

3,142

493

2,649

Wished you were dead

2,795

437

2,358

Thought of taking your life

3,075

484

2,591

Seriously considered taking

your life
Attempted suicide

3,046

483

2,563

3,057

482

2,575

Ever N (%)
All

Women Men

755
(24.0)
489
(17.5)
694
(22.6)
194
(6.4)
22
(0.7)

Note. Gender differences are marked with an asterisk (*).

*p < 0.05, **p < 0.01.

139*
(28.2)
96**
(22.0)
118
(24.4)
38
(7.9)
9**
(1.9)

616*
(23.3)
393**
(16.7)
576
(22.2)
156
(6.1)
13**
(0.5)

Last year N (%)

All
279
(8.9)
198
(7.1)
230
(7.5)
52
(1.7)
2
(0.1)

Women Men
44
(8.9)
31
(7.1)
40
(8.3)
4
(0.8)
0
()

235
(8.9)
167
(7.1)
190
(7.3)
48
(1.9)
2
(0.1)

308

SUICIDAL IDEATION IN NORWEGIAN POLICE

TABLE 4
Predictors of Serious Suicidal Ideation in Norwegian Police
Crude (bivariate)
OR
Gender
Men
Women
Age
2029
3039
4049
5059
Civil status1
Married/cohabitant
Single
Separated/divorced
Occupational level
Officer
Manager
Middle manager
Job Satisfaction Scale (JSS)+
Emotional exhaustion (MBI)+
Depersonalization (MBI)+
Personal accomplishment (MBI)+
Anxiety (HADS)+
Depression (HADS)+
Subjective Health Complaint (SHC)
Vulnerability (BCI)+
Intensity (BCI)+
Control (BCI)+
Reality weakness (BCI)+

95% CI

Adjusted model (n = 2,751)

(multivariate)
OR

95% CI

1.31

0.91

1.89

1.08

0.69

1.69

1.42
1.77*
1.82*

0.87
1.09
1.04

2.32
2.88
3.20

1.24
1.57
1.81

0.71
0.85
0.86

2.16
2.90
3.80

1.47
2.76**

0.96
1.72

2.26
4.43

2.08*
2.46**

1.24
1.43

3.50
4.25

0.80
0.84
1.87***
3.06***
1.93***
0.95
4.02***
4.34***
2.57***
2.57***
.83
1.40*
3.88***

0.32
0.61
1.38
2.20
1.42
0.71
2.89
3.09
1.91
1.91
.62
1.05
2.70

2.00
1.16
2.54
4.27
2.63
1.27
5.60
6.10
3.47
3.47
1.11
1.86
5.56

0.73
0.67
0.94
1.41
1.10
0.67*
1.77**
2.08***
1.59**
1.31
1.08
1.01
2.07**

0.27
0.44
0.66
0.93
0.77
0.48
1.20
1.38
1.13
0.91
0.78
0.74
1.38

1.99
1.02
1.33
2.16
1.58
0.93
2.62
3.12
2.25
1.86
1.50
1.39
3.12

Note. 1Widow(er) was omitted from the analyses due to the low number.
+
These scores were transformed into z-scores and dichotomized at the 50th percentile.
*p < 0.05, **p < 0.01, ***p < 0.001.

mainly to personal problems (82.9%), followed by family problems (63.9%), social

problems (31.3%), and work problems (6.7%).
Male police related serious suicidal ideation
to personal problems (52.4%) and family problems (47.5%), and considered work problems
to be of significantly higher importance than
females. More female police considered personal and social problems as important impacting factors on serious suicidal ideation;
however, female police on average presented 2.2 attributions, compared to 1.7 among
male police.

DISCUSSION

The results in this study show a low

prevalence of serious suicidal ideation and
attempts among police. When compared to
Norwegian physicians, the findings show that
physicians have about 50% more serious suicidal ideation (10.4%) and attempts (1.6%)
than police (Hem et al., 2000). There were
significantly more women who reported having ever attempted suicide, although there
were no gender differences in serious suicidal
ideation during the previous year.

BERG ET AL.

309

Note. Gender differences marked with an asterisk (*)

*p < .05
Figure 1. Impacting factors on serious suicidal ideation in Norwegian police (n = 194).

Comparisons with other studies of suicidal behavior are difficult, because most general population studies have developed their
own questions to measure suicidality (Burless & De Leo, 2001). Moreover, Paykels
classic work was based on interviews, while
the present study is a postal survey. A relevant comparison with the present study is a
study in a general population in Sweden,
comparing results from Paykels questionnaire between 1986 and 1996. The lifetime
prevalence of serious suicidal ideation was
10.4% and 13.1%, respectively (Renberg,
2001). Among Norwegian medical students
and physicians, the corresponding figures
were 8.4% and 10.4%, respectively (Hem et
al., 2000; Tyssen et al., 2001). All these figures from comparable studies are higher than
in the present police sample (6.4%).
The clinical significance of fleeting
thoughts that life is not worth living is still
not sufficiently explored. Therefore, we em-

phasize the question about serious suicidal

ideation, because this is a very important
clinical point in the questionnaire (i.e., expression of some kind of suicidal planning),
and the relatively large number of respondents is necessary to employ multivariate analytic techniques.
Predictors of Serious Suicidal Ideation
Predictors of suicidal ideation are not
quite the same as predictors of suicide; however, data suggest that suicidal ideation is the
best predictor of suicidal acts (Ahrens, Linden, Zaske, & Berzewski, 2000). Further, suicidal attempts and suicide are two overlapping phenomena with a very similar pattern
of risk factors (Beautrais, 2001). Some of the
present results represent expected predictors,
such as marital status, anxiety, and depression. These findings have been replicated in

310
a large number of studies, both for suicidal
ideation, suicide attempts, and suicide.
We found job dissatisfaction to predict
suicidal ideation bivariately, although this was
not the case in the model that controlled for
other factors (see Table 4). That job dissatisfaction became nonsignificant in the multivariate model was mainly due to its association with anxiety and depression. This
implies that low job dissatisfaction increases
the risk of suicidal ideation through an increased level of anxiety and depression. In
other words, those who are dissatisfied with
their job in the police without being depressed or anxious do not have an elevated
risk of suicidal ideation.
In accordance with the findings in the
study of Norwegian physicians (Hem et al.,
2000), subjective health complaints were found
to be a predictor of suicidal ideation. The
current literature addressing the issue of an
association between subjective health complaints and suicidal ideation remains limited
(Nakao, Yamanaka, & Kuboki, 2002). In a recent study from a psychosomatic clinic in
Japan, suicidal ideation was statistically and
independently associated with 15 major somatic symptoms (Nakao et al., 2002). Our results are in accordance with this study, showing a relationship between suicidal ideation
and subjective health complaints, when controlled for well-known predictors like anxiety
and depression. This indicates that for some
persons, suicidal ideation occurs without an
accompanying subjective experience of anxiety or depression, but is associated with somatic complaints. Our findings show that the
subjective health condition is of importance;
alternatively, it demonstrates that this condition is all part of a general distress syndrome.
Consequently, somatic complaints should be
taken seriously in the police population, also
with respect to potential suicidality.
In the present sample, the personality factor of reality weakness was a significant
predictor in the multivariate model. This personality factor was also important in an earlier study among Norwegian physicians, where
it was found to predict the transition from
suicidal thoughts to plans (Tyssen, Hem, Vag-

SUICIDAL IDEATION IN NORWEGIAN POLICE

lum, Grnvold, & Ekeberg, 2002). Reality
weakness might represent a risk factor for
suicidal behavior because it is related to severe personality disorders. Consequently, reality weakness is an important personality trait
to be considered in further studies of suicidality. The personality factors of neuroticism
and control/compulsiveness were found to be
significant predictors of suicidal ideation in
the bivariate analyses, but not in the adjusted
model. Neuroticism dropped out because of
its association with anxiety and depression,
while no single variable was responsible for
control/compulsiveness not being a significant contributor in the adjusted model. A
vulnerable police officer appears to have more
suicidal ideation because he or she is more
often depressed and anxious.
We found that the burnout components of emotional exhaustion and depersonalization (cynicism) predicted suicidal ideation in the bivariate analyses, but failed to
do so in the adjusted model. This was partly
due to their correlations with depression and
anxiety. Some of the discussion about burnout has focused on issues of discriminant
validity. Is burnout truly a distinctly different
phenomenon from depression? The present
view is that burnout is a problem that is
specific to the work context, which contrasts
with depression, which tends to pervade every domain of a persons life (Maslach et al.,
2001). Although burnout and depression are
considered distinct constructs, our results indicate that the burnout components of emotional exhaustion and depersonalization only
predict suicidal ideation through depression
and anxiety. The finding that personal accomplishment was a significant predictor in
the multivariate analyses both for serious suicidal ideation and suicidal attempt could not
be explained by any single variables. This is a
surprising finding, and may represent an artifact. However, this remains to be investigated
more thoroughly in future studies.
There are some gender differences in
the pattern of factors that led to suicidal ideation in the police population. Both female
and male police consider personal problems
as the most important factor in suicidal ide-

BERG ET AL.
ation, being 82.9% and 52.4% of respondents,
respectively. When personal and, partially,
family problems can be reasonably coped
with, other kinds of stress may be better tolerated. On the other hand, when problems at
home become too overwhelming, the risk of
suicide may increase. Compared with females, male police more often attributed suicidal ideation to work problems. In addition,
female police had a higher number of attributions. With respect to gender differences,
similar attribution was made by physicians, although female physicians are more like male
police (Hem et al., 2000).
Strengths and Limitations
The strength of the study is that it is a
nationwide study, and represents all occupational levels in the police force. In addition,
the large number of respondents makes multivariate analysis feasible. It remains unclear,
however, whether the respondents provided
honest answers in the questionnaire, which
includes personal questions on suicidal ideation and attempts (Renberg, 2001). It is recognized that respondents tend toward more
socially desirable responses in interviews than
with self-administered questionnaires (Oka-

311
moto et al., 2002). Hence, since suicidal behavior clearly is a socially undesirable topic,
anonymous questionnaires may reduce response bias. Another limitation of the study
is the cross-sectional design, and therefore
risk estimates cannot be drawn. There remains a lack of longitudinal prospective studies in this field. Moreover, the formulation of
suicidal attempt has been criticized, since it
may be interpreted in different ways (Meehan, Lamb, Saltzman, & OCarroll, 1992).

CONCLUSIONS

This is the first large-scale study of

suicide in police, and it shows that they have
a low prevalence of suicidal ideation and
suicide attempts. Serious suicidal ideation
was predicted by marital status, subjective
health complaints, reality weakness, anxiety
and depression, and was mainly attributed to
personal and family problems. Compared to
males, female police had a higher number of
factors to which they attributed suicidal ideation, identifying personal problems as a greater influence. Compared to females, however,
male police attributed suicidal ideation and
attempts more often to work problems.

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Manuscript Received: July 16, 2002
Revision Accepted: February 28, 2003