200 Suicide and the Media MADELYN S. GOULD Division of Child and Adolescent Psychiatry and Division of Epidemiology, Columbia University and New York State Psychiatric Institute, New York, New York 11024, USA ABSTRACT: Evidence continues to amass on the significant impact of media coverage on suicide. The research literature on the impact of news reports of nonfictional suicides as well as fictional suicide stories is reviewed in or- der to determine the nature and scope of the influence of the mass media on suicide. The current review, building upon earlier reviews, is limited to English language publications or English translations of articles and/or abstracts. The interactive factors that may moderate the impact of media stories are also reviewed. Such interactive factors include characteristics of the stories (agent), individuals’ attributes (host), and social context of the stories (environment). Recommendations are presented for the report- ing of suicide stories, which may minimize the risk of imitative suicides. The media’s positive role in educating the public about risks for suicide and shaping attitudes about suicide is emphasized. In summary, the ex- istence of suicide contagion no longer needs to be questioned. We should refocus our research efforts on identifying which particular story compo- nents promote contagion under which circumstances and which compo- nents are useful for preventive programming. KEYWORDS: Behavioral contagion; Imitative suicide; Media coverage of suicide; Prevention of suicide INTRODUCTION The media affords the opportunity for indirect transmission of suicide con- tagion, the process by which one suicide becomes a compelling model for successive suicides. 1,2 This means of influence is potentially more far reach- ing than direct person-to-person propagation. Suicide contagion can be viewed within the larger context of behavioral contagion, which has been de- scribed as the situation in which the same behavior spreads quickly and spon- taneously through a group. 3 Behavioral contagion has also been conjectured to influence the transmission of conduct disorder, drug abuse, and teenage Address for correspondence: Madelyn S. Gould, Ph.D., M.P.H., Division of Child and Adoles- cent Psychiatry, Columbia University/New York State Psychiatric Institute, 1051 Riverside Drive, Unit 72, New York, NY 11024. Voice: 212-543-5329; fax: 212-543-5966. gouldm@child.cpmc.columbia.edu