Research in Child Abuse and Neglect: Filicide-Suicide: Common factors in parents who kill their children and themselves (2005)

Part of our ongoing survey on what the child abuse and neglect literature says about perpetrators. The relevant findings are highlighted in bold.

http://www.jaapl.org/cgi/content/full/33/4/496

Am Acad Psychiatry Law 33:4:496-504 (2005)

Filicide-Suicide: Common Factors in Parents Who Kill Their Children and Themselves

Susan Hatters Friedman, MD, Debra R. Hrouda, MSSA, Carol E. Holden, PhD, Stephen G. Noffsinger, MD and Phillip J. Resnick, MD

Dr. Hatters Friedman was a Fellow (now Senior Instructor) in Forensic Psychiatry, Ms. Hrouda is Doctoral Candidate, and Dr. Resnick is Professor of Psychiatry and Director of Forensic Psychiatry, University Hospitals of Cleveland, Department of Psychiatry; and Case Western Reserve University, Cleveland, OH. Dr. Holden is Director of Evaluation Services, Michigan Center for Forensic Psychiatry; University of Michigan, Ann Arbor, MI. Dr. Noffsinger is Associate Professor of Psychiatry, Northcoast Behavioral Healthcare Systems and Case Western Reserve University, Cleveland, OH. Address correspondence to: Susan Hatters Friedman, MD, University Hospitals of Cleveland, Department of Psychiatry, Hanna Pavilion, 11100 Euclid Avenue, Cleveland, OH 44106.

Abstract
The purpose of this phenomenological study was to identify commonly occurring factors in filicide-suicide offenders, to describe this phenomenon better, and ultimately to enhance prevention of child murder. Thirty families’ files from a county coroner’s office were reviewed for commonly occurring factors in cases of filicide-suicide. Parental motives for filicide-suicide included altruistic and acutely psychotic motives. Twice as many fathers as mothers committed filicide-suicide during the study period, and older children were more often victims than infants. Records indicated that parents frequently showed evidence of depression or psychosis and had prior mental health care. The data support the hypothesis that traditional risk factors for violence appear different from commonly occurring factors in filicide-suicide. This descriptive study represents a step toward understanding filicide-suicide risk.

Methods
To investigate phenomenologically the commonly occurring factors in parents who kill their children and then themselves, a retrospective review of records in coroners’ cases of filicide-suicide was conducted. Institutional Review Board approval was obtained from Case Western Reserve University/University Hospitals of Cleveland. Subsequently, the office of the Cuyahoga County Coroner (the county encompassing the Cleveland, Ohio, metropolitan area) granted access to their complete files of parents who committed "homicide abated by suicide." Records encompassed 1958 through 2002. Inclusion criteria for the study were parents who killed their biological children (under age 18) and committed suicide within 24 hours. Files of stepparents who killed a stepchild and then themselves were not included in the analysis because of the potential of identifying different risk factors.
Data sources available for all subjects included the coroner’s official reports; various police reports including interviews with relatives, neighbors, and employers; autopsy results; and toxicology results. In addition, some files included pertinent hospital records, newspaper clippings about the incident, and if applicable, the suicide note. The data sources were searched for approximately 50 factors (comprising eight subgroups of factors) identified through a review of the literature. The factors included demographics, legal history, substance use history, offense characteristics, illness characteristics, family’s characteristics, offender’s characteristics, and offender’s medical history. In addition, based on the classification of filicide motives established by Resnick, a consensus of the authors regarding motive was reached in each case. (If there was not sufficient information about the offender’s mental state around the time of the crime, the motive was labeled as inconclusive.) These results were then analyzed for commonly occurring factors in families in which filicide-suicide occurred, and especially for commonly occurring factors in the parent who killed the child. Familicides were also evaluated as a distinct subgroup.
Data were examined with descriptive statistics (means ± standard deviations for continuous variables and percentages for categorical variables). Statistics were computed for the sample as a whole, for fathers, and for mothers. When appropriate and when sample size permitted, means were compared using t tests, and categorical distributions were compared by using the chi square test. Because of the small sample size and the exploratory nature of the study, statistical tests of significance were frequently unfeasible.

Results
Data from the Cuyahoga County coroner shows an average of 3,200 coroner cases per year, of which approximately five percent are reported as homicides. Thirty cases of filicide-suicide were identified, resulting in a sample comprised of 10 (33%) mothers and 20 (67%) fathers who had committed filicide-suicide over the time period. In most cases, data were not available for all 50 variables.