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Trautman, E. C. (1961) The suicidal fit: A psychobiologic study on Puerto Rican immigrants. Archives of General Psychiatry, 5, 98-105.

Most studies on suicidal behaviors have findings from a psychologic, sociologic and a cultural point of view, and present statistics that could explain why people commit suicide. However, Trautman’s concern is not why people attempt to commit suicide, but rather what goes through their minds, what lead them to the act and what overpowers the instinct of self-preservation and the fear of death.

Method:
This study only focuses on one type of diagnosis category of suicide; patients who acted out under a severe emotional excitement and distress. Another requirement for this study was that all patients examined had attempted suicide in the same manner, with almost identical motivations and were from the same socioeconomic position. Out of the 131 patients who were admitted to the Lincoln Hospital in New York after attempting suicide between 1957 and 1958, 38 American born patients were excluded from the study for the sake of uniformity. The remaining 93 Puerto Rican patients were then interviewed multiple times, and a psychiatric examination was done as well. Family members and close friends were also interviewed to obtain more information of their day-to-day behavior.

Results:
76 out of the 93 patients were female. The consumption of cleaning chemicals, an overdose of sleeping pills or other toxic substances were the tactics used for the act of committing suicide of all cases. 58 of the females showed effects of ingesting poison such as deep coma, drowsiness, semiconscious state, stomach and vomit symptoms. A report of symptoms and effects on male were not reported in this study. 62% of the women indicated that the cause of the suicide act was a fight with their spouse/lover, 14% (majority were under 19 of age) argument with their mothers and 12% dealt with depression due to financial issues, homesickness, and others similar problems. Among 14 males, 11 reported the act to be caused by a fight with their spouse/lover or family member, 2 were due to loosing their jobs and 1 was because of a foreclosure of his home.
All patients showed a consistent trend of an instinctive urge to escape from overwhelming pain and find refuge in oblivion, also known as emotional death. The interviews confirmed that all patients had limited concept of death, meaning that their reason of consuming toxic substances was not because their objective was to die, but because they wanted to get rid of the pain and get away from their issues. Studies show that all patients were glad they survived and expressed regret of such act. The majority also showed optimism to improve their current situation and make changes in their lives, while others remained hopeless. None of these cases were severe enough to be transferred to a psychiatric ward. According to this study, these patterns (suicidal fit) were mostly found among young women from the ages of 15 to 26 (with a peak at 18-20). Due to the low number of cases from males, there was not a define conclusion. Though, they do indicate a peak between the ages of 27 and 29.

Discussion:
Trautman defines the suicidal patterns shown on the results of this study as a suicidal fit, an intense impulse of escape without a conscious motivation of death. The suicidal fit however do not happen out of nowhere; there are phases that lead to suicide behaviors:
1) Basic emotional disturbance- emotional distress or depression caused by a variety of situations arising.
2) Suicidal atmosphere- the start of suicidal thoughts, but not the decision to act.
3) Antisuicidal barrier- the instinct of rational thinking and the fear of death.
4) Precipitating cause- the antisuicidal barrier breaks down.

Another study in 1958 uncovers that the majority of women examined after suicide behaviors were in menstrual conditions during the time of the act, suggesting the possibility of them never attempting suicide if they were not in their menstrual cycle. Thus, Trautman concludes that the menstrual cycle may have played a role in these cases of suicidal fit as well. He also discusses that since these cases of suicidal fit never had a the initial goal of death, another possible reason behind the act of a suicidal fit could have been to create guilt feelings in others, or a desperate way for longing for love and sympathy from family and loved ones.