Homicide Studies

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Estimates of Homicide-Suicides Among the Elderly, 1968 to 1975

F. Stephen Bridges
Homicide Studies 2013 17: 224 originally published online 25 March 2013
DOI: 10.1177/1088767913483130

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research-article2013
HSX17210.1177/1088767913483130Homicide StudiesBridges

Article
Homicide Studies
17(2) 224­–236
Estimates of Homicide- © 2013 SAGE Publications
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DOI: 10.1177/1088767913483130
1968 to 1975 hs.sagepub.com

F. Stephen Bridges1

Abstract
This article describes homicide-suicide among those aged 65 years and older in
the United States using archival data from 1968 to 1975. Comparisons were made
between 184 homicide-suicides and 400 randomly selected victims of all other types
of homicide. The findings indicate that homicide-suicides occurred predominantly
in the family unit, especially involving female spouses, and among White victims and
offenders. Handguns and other firearms were the weapon of choice in homicide-
suicides.

Keywords
homicide, suicide, homicide-suicide(s), murder followed by suicide

Homicide-suicide is defined as an incident or event whereby a person commits a

homicide that is then followed by the person’s suicide. Homicide-suicide is a rare but
serious form of interpersonal violence. It involves the death of the suspect, but also the
death of one or more victims, frequently spouses and/or family members (Barraclough
& Harris, 2002; Brock, 2002). Liem (2010) provides a description of four generally
discussed types of homicide-suicides: (a) intimate partner, (b) child homicide-suicides,
(C) familicide-suicides, and (d) extrafamilial homicide-suicides. Extrafamilial homicide-
suicides include school and workplace homicides characterized by the killing of a
number of classmates/fellow workers, friends, and acquaintances in school or work
settings.

1The University of West Florida, Pensacola, FL, USA

Corresponding Author:
F. Stephen Bridges, Professor of Community Health Education, Division of Health, Leisure & Exercise
Science, The University of West Florida, Bldg 72/rm 258, 11,000 University Parkway, Pensacola, FL
32514, USA.
Email: fbridges@uwf.edu

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Bridges 225

Homicide-suicides have received much less attention in research and theory in

comparison to homicides or suicides. One reason is that there is no national count of
homicide-suicides (although Marzuk, Tardiff, & Hirsch, 1992, estimated between
1,000 and 1,500 homicide-suicides per year). Better empirically based counts, although
not national, are found in the National Violent Death Reporting System (NVDRS) data
(http://wisqars.cdc.gov:8080/nvdrs/nvdrsDisplay.jsp). For 16 states from 2005 through
2009, the Web-based Injury Statistics Query and Reporting System (WISQARS) file
recorded information on 901 homicide-suicides (http://www.cdc.gov/injury/wisqars/
fatal_injury_reports.html).
According to the seminal article by Marzuk et al. (1992), a short time span between
the suicide and homicide is needed to suggest a causal connection. For the present
study no data were available for the time interval between the death of a homicide
victim and that of a suicide suspect. The study by Marzuk et al. (1992) required that
the suicide should follow the murder within 1 week to distinguish homicides that are
linked to the suicide from violent events in which individuals with a history of vio-
lence commit suicide for other reasons. In a review of the homicide-suicide literature,
Riedel (2010) found that nearly all studies conducted since the Marzuk et al. publica-
tion followed the 1-week requirement.
There is a paucity of earlier studies in which the numbers of elderly homicide vic-
tims and suicide suspects are reported (Berman, 1996; Bourget, Gagné& Whitehurst,
2010; Brown &Barraclough, 1999; Malphurs& Cohen, 2005; West, 1965). Of these,
most were considered to be “mercy killings” and the result of suicide pacts or altruistic
homicide-suicides among older and ailing spouses. However, things may be changing
with regard to elderly violence given reports in Florida where rates seem to be increas-
ing (Bourget, Gagné, & Whitehurst, 2010; Cohen, 1995; Cohen, Llorente, & Eisdorfer,
1998; Malphurs, Eisdorfer, & Cohen, 2001). What makes the problem of elderly vio-
lence an emerging public issue in the United States is the projected large increase in
the elderly population. One major source of the increase is the first of the baby boom-
ers (born between 1945 and 1965) turning 65 in 2011 (Brookings Institute Metropolitan
Policy Program, 2010; Frey, 2007). This is on top of the increase produced by the
World War II generation (born between 1936 and 1945) becoming part of the 65 years
and older group. According to Frey (2007), there is expected to be a 15% increase in
the over 65 population from 2000 to 2010 and an over a 35% increase in the decade
that follows (i.e., 2010 to 2020). The projections are that the elderly population
increase will finally start to decline in the decade 2020 to 2030.
Despite the projected large increase in the elderly population, the state of knowl-
edge and policies pertaining to elder abuse, neglect, and exploitation are sadly lacking.
There are no comprehensive national data, definitions of elder abuse vary, and state
statistics vary as there is no uniform reporting system (National Research Council,
2003). Compared to the child abuse movement that prompted extensive investigation
and publicity, elder abuse has received relatively little attention in the medical and
legal areas (Shields, Hunsaker, & Hunsaker, 2004).
There are four interrelated problems with the knowledge base on homicide-sui-
cides. More recent studies have addressed some of the methodological shortcomings

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226 Homicide Studies 17(2)

(Liem, Postulart, & Nieuwbeerta, 2009; Logan et al., 2008; Stack, 1997). While the
preceding focused on all types of homicide-suicides and compared them to both homi-
cides and suicides, two studies have researched intimate partner homicide-suicides,
the most frequent type, but have compared their results only to homicides (Dawson,
2005; Lund & Smorodinsky, 2001).
Second, homicide-suicides fall between the typical boundaries of two disciplines,
public health and criminology, and have been studied independently (Liem, 2010;
Riedel, 2008). As Stack (1997, p. 435) indicated, “Research on homicide has tended to
neglect suicide and the research on suicide has neglected homicide.” Falling between
the boundaries of areas of inquiry has left the topic of homicide-suicide with no
national data, serious methodological shortcomings, and finally the absence of a theo-
retical approach that explains homicide-suicides.
Third, Liem (2010) reviewed theories of strain, the stream analogy for lethal vio-
lence, psychodynamic theories, social integration theories, and psycho-evolutionary
theories. Liem (2010 p. 159) concluded: “Each of these theories alone, however, is
unable to provide a full understanding of the homicide-suicide phenomenon.” It seems
unlikely that theories reviewed by Liem can explain the homicide-suicides of this
highly diverse group. Other than involving males and imputed mental illness, what do
“going postal” workplace homicides have in common with intimate partner homicide-
suicides? What is particularly problematic about including both workplace and school
shootings is the apparently random selection of victims (Newman, Fox, Harding,
Mehta, & Roth, 2004).
A fourth problem is that much of the research has relied on small samples. Prior to
the emergence of the NVDRS, most of the research on homicide-suicides had to rely
on data extracted from medical examiner case records, and each homicide and suicide
had to be linked together manually. This has meant that many studies of homicide-
suicides are limited to local data sites, primarily cities or counties, without comparison
groups, with very small samples, and a heavy emphasis on description. To avoid the
latter limitations, some studies used newspapers to help corroborate homicide-suicides
or supplemented their analysis with data obtained from the newspapers (Malphurs &
Cohen, 2002; Riedel, 2010).
Given this state of affairs, research on elderly homicide-suicides has been sparse
and historical studies of elderly homicide-suicides have been rarer. The present study
addresses this issue by analyzing a nationwide data base of homicide-suicides using
data from 1968 to 1975. Finding a contemporary comparison was difficult. Cohen
et al. (1998) used a data set of 171 homicide-suicides from seven Florida counties
from 1988 to 1994. However, reporting of characteristics and comparison with homi-
cides and suicides was highly descriptive and broken into two geographical regions
that mean little to a general audience. Malphurs et al. (2001) compared older married
male perpetrators who committed suicides with those who committed homicide-sui-
cides, which limits comparisons because the data set used in the current study focuses
only on victims. Malphurs and Cohen (2005) completed a statewide case control study
of 20 spousal homicide-suicides of Floridians aged 55 years and older and compared
the results to suicides rather than homicides which, in addition to the small numbers,

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Bridges 227

limited the comparisons with homicides. From 1992 to 2007, researchers using data
from coroners’ files identified 27 cases of homicide committed by an older spouse or
family member aged 65 years or older in Quebec, Canada (Bourget et al. (2010).The
findings from the current article are compared to Lund and Smorodinsky’s (2001)
research comparing intimate partner homicides and intimate partner homicide-suicides
in California.

Method
In a nationwide homicide research project that covered the period 1968 through 1978,
Riedel and Zahn (1994) analyzed the FBI’s Supplementary Homicide Reports (SHR).1
Unfortunately, because of changes in the SHR in 1976, there were no data collected
for homicide-suicide after 1975. Riedel and Zahn’s data files were subsequently filed
with the Inter-University Consortium for Political and Social Research (ICPSR) at the
University of Michigan. These ICPSR files were downloaded and data on homicide-
suicides were separated from all other types of homicide from 1968 through 1975
(Bridges & Lester, 2011). Between 1968 and 1975, there were 2,215 homicide-suicide
events out of 123,467 homicides among persons of all ages.
The research question in this study asks: “What factors distinguish elderly homi-
cide victims in homicide-suicides from older victims of all other types of homicide?”
Variables examined include sociodemographic characteristics of the victims such as
age, race, and gender, the type of weapon used (i.e., cause of death), and the circum-
stances surrounding the deaths. The original data consisted of 6,703 elderly homicides
and 184 elderly homicide-suicides, defined as aged 65 years and over. However, to
avoid any statistical problem created by having such a large number of homicides to
compare with such a small number of homicide-suicides, a random sample of 400
homicides was selected and merged with the file of 184 homicide-suicides.
With older data from the SHR, there is little evidence of reliability from other stud-
ies. While there may be omissions or other forms of error, it could be argued that
homicide-suicide events are so rare that they appear in the data as a result of curiosity
of law enforcement. Of course, with a dead offender, the offense is easily cleared. To
determine some measure of the accuracy of the data, the literature was searched for
research to compare datasets with a different origin such as police departmental
records or medical examiner records.
Block (1987) used a dataset created from police departmental records and reported
on homicides in Chicago for the 1965 to 1981 time period. Subsequently, Stack
(1997) used these data for analysis of 16,245 homicides (all ages) in Chicago from
1965 to 1990. Stack (1997) reported a total of 265 homicide-suicides of all ages in
Chicago between 1965 and 1990. Of these 265 homicide-suicides there were eight
victims who were 65 years of age and older. This is in exact agreement with the
number of Chicago victims aged 65 years and older who were extracted from the
dataset used here.
Berman (1979) used data from police department death investigation reports and/or
medical examiner files for all certified suicides for the years 1974 and 1975. He

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228 Homicide Studies 17(2)

reported a total of 972 completed suicides for three cities—Washington, DC,

Philadelphia, and Baltimore—during the 2-year study period. Of these nearly 1,000
completed suicides, Berman determined which of those met his criteria of “dyadic
deaths” (i.e., homicide-suicides). He identified 15 cases of homicide-suicide in the
three cities. The dataset used here includes 13 cases of homicide-suicide for the same
cities. With that kind of agreement, limited though it may be, it seems logical to have
some confidence in the estimated number of elderly homicides and homicide-suicides
from 1968 to 1975 used in the present study.

Results
One of the major problems in this historic study was finding another study for com-
paring characteristics of elderly homicides to those of elderly homicide-suicides.
One California study was found which compared characteristics of victims and per-
petrators of intimate partner homicide and intimate partner homicide followed by
suicide2 (Lund & Smorodinsky, 2001). Bridges and Lester (2011) reported that of all
the circumstances surrounding the deaths of victims (of all ages) in a homicide-sui-
cide, the most common circumstance was “spouse killing spouse.” In their study, the
circumstance “spouse killing spouse” accounted for 56% of homicide-suicides.
However, this same circumstance only accounted for 11% of all homicides including
homicide-suicides.

Age
The mean ages of the 400 homicide and 184 victims of homicide-suicide were 72.9
and 72.8 years, respectively; the SD for homicide victims was 6.6 years and for
homicide-suicide victims it was 6.1 years (MS = 72.92 vs. 72.80; t582 = .197, two-
tailed p = .844).
Lund and Smorodinsky (2001) provided a detailed breakdown by age for victims of
intimate partner homicide and homicide followed by suicide. There were a total of
only 11 victims of intimate partner homicide and intimate partner homicide followed
by suicide among those aged 70 years and older in their California study. Only one
(9.1%) of these was a victim in an intimate partner homicide, whereas 10 (90.9%) of
these were victims in an intimate partner homicide followed by suicide. In contrast,
the present study reports that for those aged 70 years and older 244 were victims of
homicide and 119 were victims of homicide-suicides.

Race
In a cross-tabulation, 171 (94.0%) and 11 (6.0%) of the victims of elderly homicide-
suicide were White and Black, respectively3 (Table 1). Thus, homicide-suicide was
least likely when victims were Black and most likely when victims were White (χ2 =
46.1, one degrees of freedom, p < .0001).

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Bridges 229

Table 1. Race of Victims of Homicide and Homicide Followed by Suicide.

Racea Homicide Homicide-suicide

White 266 (68.0%) 171 (94.0%)
Black 125 (32.0%) 11 (6.0%)
Total 391 (100%) 182 (100%)

Note. aRace was missing data for 11 victims. χ2 = 46.1, one degree of freedom, p < .0001

Table 2. Gender of Victims of Homicide and Homicide Followed by Suicide.

Gender Homicide Homicide-suicide

Females 110 (27.5%) 149 (81.0%)
Males 290 (72.5%) 35 (19.0%)
Total 400 (100%) 184 (100%)

Note. χ2 = 146.037, one degree of freedom, p < .0001

Gender
Table 2 shows that elderly females accounted for 149 (81.0%) homicide-suicide vic-
tims while elderly males accounted for just 35 (19.0%) of the victims of intimate
partner homicide-suicide victims (χ2 = 146.037, one degree of freedom, p < .0001). In
stark contrast, elderly female victims accounted for 110 (27.5%) of intimate partner
homicides while elderly male victims accounted for 290 (72.5%) of intimate partner
homicides (Table 2).

Weapon
Handguns and other firearms, collectively known as guns, were used by perpetrators in
148 (81.8%) of elderly homicide-suicides and cutting instruments, blunt objects, and
other (weapons) were used in 33 (18.2%) of the elderly homicide-suicides (χ2 = 82.9,
1 df, p < .0001; Table 3)4 Roughly speaking, for homicide-suicides 8 out of every 10 per-
petrators used a gun, while less than 2 out of every 10 perpetrators used another type of
weapon to kill an elderly victim. These findings are similar to the findings reported by
Lund and Smorodinsky (2001) albeit for victims of all ages. They reported victims were
killed with guns in 87.8% of intimate partner homicides followed by suicide.

Victim Offender Relationship

Approximately 122 (72%) of elderly homicide-suicides involve a spouse killing a
spouse (Table 4). Children killing their elderly parents accounted for 17 (10.0%) of the
homicide-suicides. Family conflicts accounted for 11 (6.5%) of the elderly homicide-
suicides and other arguments accounted for 14 (8.2%). The percentages of character-
istics of elderly victims, that is, child kills parent, family conflicts, other arguments,

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230 Homicide Studies 17(2)

Table 3. Cause of Death Characteristics of Elderly Victims of Homicide and Homicide

Followed by Suicide.

Cause of deatha Homicide Homicide-suicide

Handguns 110 (29.1%) 114 (63.0%)
Other firearms 44 (11.6%) 34 (18.8%)
Cutting instruments 80 (21.2%) 16 (8.8%)
Blunt objects 56 (14.8%) 10 (5.5%)
Other 88 (23.3%) 7 (3.9%)
Total 378 (100%) 181 (100%)

Note. aCause of death was missing data for 25 victims. χ2 = 86.5, one degree of freedom, p < .0001

Table 4. Cause of Death Characteristics of Victims of Homicide and Homicide Followed by

Suicide.

Victim circumstancesa Homicide Homicide-suicide

Spouse kills spouse 22 (6.6%) 122 (71.8%)
Child kills parent 17 (5.1%) 17 (10.0%)
Family conflicts 15 (4.5%) 11 (6.5%)
Other arguments 59 (17.6%) 14 (8.2%)
Other 222 (66.3%) 6 (3.5%)
Total 335 (100%) 170 (100%)

Note. Percentage totals not 100% are due to rounding. aVictim Circumstances were missing data for
79 victims, that is, 65 for victims of homicide and 14 for homicide-suicide. χ2 = 278.2, four degrees of
freedom, p < .0001

and other, were equal to or proportionately more often homicides than homicide-
suicides (χ2 = 278.2, 4 df, p < .0001). By comparison, Lund and Smorodinsky (2001)
reported that legal spouses and those cohabitating were the victims in 57 (77%) of
intimate partner homicide followed by suicide; whereas, those dating and former
spouses were victims in 17 (23%) of intimate partner homicide followed by suicide.
Other types of intimate partner relationships (i.e., dating and former spouses) were
proportionately more often an intimate partner homicide than an intimate partner
homicide followed by suicide.

Logistic Regression
Table 5 depicts the results of the logistic regression analysis used to determine the
probability that a homicide would result in a homicide-suicide and to assess the effect
of each variable in the model. The Hosmer–Lemeshow test was not significant (p =
0.153) indicating an acceptable model fit. Groups of dummy variables were used in a
logistic regression to represent the categorical variables like cause of death and victim/
offender relationships.

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Bridges 231

Table 5. Binary Logistic Regression: Elderly Homicide and Homicide-Suicide Victims.

Standard Degrees of
Variable β- error Wald freedom Significance Odds ratio
Age .042 .028 2.191 1 .139 1.043
White race 1.471 .455 10.440 1 .001 4.355
Male –2.318 .385 36.228 1 .000 0.098
Handguns 2.071 .626 10.936 1 .001 7.931
Firearms 2.344 .723 10.494 1 .001 10.420
Cutting instrument .789 .697 1.282 1 .258 2.201
Blunt object –.198 .807 .061 1 .806 .820
Spouse 4.524 .538 70.822 1 .000 92.235
Parricide 3.458 .622 30.892 1 .000 31.760
Family conflicts 3.036 .697 18.972 1 .000 20.818
Other arguments 2.780 .600 21.458 1 .000 16.120

For the present statistical analysis, homicide-suicides were coded “1” and all other
homicides were coded as “0.” Victim age was entered as a continuous variable. Males
were coded “1” and females “0.” Victim race was coded “0” for Black and “1” for
White. Weapons were coded into dummy variables for handguns, other firearms, cut-
ting instruments, blunt instruments, and other weapons (the reference category).
Similarly, victim/offender relationships were coded into dummy variables for spouses,
parricide, family conflicts, other arguments, and other (the reference category).
As the binary logistic regression in Table 5 indicates, the age of victims was not
significant. The race of the homicide victim was significantly related to the odds of
homicide-suicide. Deaths in which the victim is an elderly White person are 4.355
times more likely to be a homicide-suicide. The gender of homicide victims was sig-
nificantly related to the odds of homicide-suicides. Homicides in which a male is the
elderly victim decreased the odds for homicide-suicide 0.098 times.
Weapons like handguns and other firearms were significantly related to the odds
of elderly homicide-suicide; however, cutting instruments and blunt objects were not.
The odds of a homicide-suicide increased 7.931 and 10.420 times for homicides
involving a handgun and other firearms respectively (Table 5). Homicides in which
an elderly spouse is the victim increased the odds for a homicide-suicide 92.235
times compared to homicides involving other circumstances. Parricides were 31.76
times more likely to be homicide-suicides compared to those involving other circum-
stances. Incidents involving family conflicts were 20.818 times more likely to be
homicide-suicides and those involving other arguments were 16.12 times more likely
to be homicide-suicides compared to incidents involving other circumstances.

Discussion
Elderly homicide and elderly homicide followed by suicide have different characteris-
tics and perhaps distinct causes. More research is needed to identify and clarify

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232 Homicide Studies 17(2)

specific risk and protective factors in this population. Due to the complexity of these
events a mixture of intervention approaches may be needed, including those preven-
tion strategies that identify persons at risk for impulsive violent acts and persons at risk
for planning another’s death and/or their own.
Homicide-suicide was least likely when elderly victims were Black and most likely
when elderly victims were White. The same results for intimate partner homicide fol-
lowed by suicide were reported by Lund and Smorodinsky’s (2001) once Hispanics
and other victims were omitted from the data prior to analysis. Victims in their study
were various ages to include those 70 years and older.
For comparison with Lund and Smorodinsky (2001), the numbers of handguns and
other firearms were pooled and relabeled “guns.” Similarly, the data for cutting instru-
ments, blunt objects, and other were pooled and relabeled “other weapons.” Upon
reanalysis homicide-suicide was most likely when the modus operandus or cause of
death was a gun, that is, handguns and other firearms, and least likely due to the use of
other weapons, for example, cutting instruments and blunt objects. These findings
support those reported by Lund and Smorodinsky’s (2001) for intimate partner homi-
cide followed by suicide. Other studies have concluded that homicide-suicides are a
White man’s crime (Riedel, 2010). In general, the results of the present study and oth-
ers support the view that homicide-suicides are for the most part the result of intimate
partner violence, especially involving spouses. In addition, there is general agreement
in the research literature on the use of handguns and other firearms as the weapon of
choice in homicide-suicides (Bridges & Lester, 2011; Liem, 2010; Riedel, 2010).
Cohen (2000, p. 6) reported that “predisposing risk factors include advanced age
and a long-lived marriage where one or both members of the couple have real or per-
ceived multiple health problems, as well as depression and other psychiatric problems
in the perpetrator.Others reported risk factors for elderly homicide-suicides also
included caregiver stress, living arrangements, desperation, depression, and other psy-
chopathologies (Cohen, 2000; Cohen et al., 1998; Hiroeh, Appleby, Mortensen, &
Dunn, 2001; Paveza et. al., 1992; Stack, 2007).Still another Canadian study reported
that several homicide victims had pre-existing mental illnesses as well as their perpe-
trator caregivers who were mentally ill with depressive disorder and who later com-
mitted suicide (Bourget, 2010).
Milroy (1995b) reported that most cases of elderly homicide-suicides were not related
to violent relationships but to declining health and financial difficulties. Similarly,
Bourget et al. (2010) reported that elderly homicide in the context of spousal violence
accounted for only 15 percent of the elderly homicide followed by a suicide. This finding
for spousal violence in Quebec, Canada was not indicative of results reported for homi-
cide-suicidein the United States.(Cohen et al. 1998; Malphurs et al. 2001).
Lund and Smorodinsky (2001, p. 459) reported that “Routine screening of this
population to identify these problems may provide the opportunity for elderly couples
coping with chronic disease, disability, depression, or financial strain to benefit from
appropriate medical care and mental health services.” The American Medical
Association has recommended that physicians and other health care providers rou-
tinely screen for domestic violence and abuse. In addition, physicians could perform
lethality assessments and along with health care professionals perhaps refer batterers

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Bridges 233

to treatment programs (Lund & Smorodinsky, 2001). Identification of these services in

the community and a willingness to refer patients to them would be important.

Limitations
The present study is not without its limitations. Limited information was available by
gender for suspects (offenders) of homicide-suicide events, that is, three were female
and 15 were male with the gender being unknown for 166 out of the remaining 184
suspects. Likewise, extremely limited information was available on the gender of sus-
pects (offenders) involved in all other types of homicide, that is, 56 were female and
224 were male with the gender being unknown for 6,423 out of the remaining 6,703
victims. Although the historic data contains in-depth and rarely available information
on homicide victims involved in homicide-suicide events, the presence of additional
information on the suspect and offense characteristics would have improved the study
(Bridges & Tankersley, 2010). Older married persons may face a lower risk of suicide
than those widowed or divorced (Kposowa, 2000). Perhaps, some marriages involving
physical illness and caregiving may create such strain over time that the risk of homi-
cide-suicide increases regardless of the age of the couples (Bourget et al., 2010).
Homicide-suicide has been reported as a product of multiple ‘biopsychosocial and
environmental antecedents’ (Malphurs & Cohen, 2005). These researchers suggested
that “the additive and multiplicative relationships between these many factors remain to
be identified.” (Malphurs & Cohen, 2005, p 216) Homicide-suicide seems to be the
synergistic result of the interaction of these factors. In the future multidisciplinary
research may help to clarify the roles these factors play in homicide-suicide (Marzuk,
Tardiff, & Hirsch, 1992; Milroy, 1995).

Acknowledgment
The author acknowledges that the original collectors of the data, Drs. Marc Riedel and Margaret
Zahn, bear no responsibility for the present analyses and interpretations of the results. The Inter-
University Consortium for Political and Social Research provided the data online as submitted
by Riedel and Zahn (1994): Trends in American Homicide, 1968-1978: victim-level supple-
mentary homicide, ICPSR edition. Ann Arbor, MI. (http://www.icpsr.umich.edu/).

Author’s Note
Parts of these data were presented at the 2011 HRWG Annual Meeting held in New Orleans,
Louisiana from June 8 to 11, 2011.

Declaration of Conflicting Interests

The author declared no potential conflicts of interest with respect to the research, authorship,
and/or publication of this article.

Funding
The author received no financial support for the research, authorship, and/or publication of this
article.

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234 Homicide Studies 17(2)

Notes
1. Riedel and Zahn (1994) obtained data from the Supplementary Homicide Reports taken
from FBI’s Uniform Crime Reporting Program Data for 1968 to 1978. The data were
organized into a standardized format in order to obtain consistency and comparability of
observations and variables over time. Their data set is available from the Inter-University
Consortium for Political and Social Research at the University of Michigan. More specifi-
cally, reformatted variables included information on the reporting agency, type of weapon
used, the circumstances of the incident, and the characteristics of the victim and suspect
(murderer). Data are available for the variables of population and city size and the victim’s
and the murderer’s age, race and sex. One of the circumstance indicators, OCIRCUM2,
is a variable indicating special circumstances relating to the homicide victim, but it was
used only for the years 1968 through 1975. The special circumstances of this variable were
described as follows: 0 = normal, 1 = murder by a juvenile, 2 = murder followed by suicide
and 9 = murder by an insane person. No “murder followed by suicide” data were available
for 1976 to 1978 (or later).
2. Lund and Smorodinsky (2001) defined intimate partner homicide as death at the hands of
an intimate partner without subsequent death of the perpetrator. Whereas, intimate partner
homicide followed by suicide was defined as death at the hands of an intimate partner with
subsequent perpetrator suicide within a day of the homicide incident.
3. Data for the race of decedents of homicide were missing for 11 victims; whereas, data for
the race of decedents of homicide-suicide were missing for 2 victims.
4. Cause of death data were missing for three decedents of homicide-suicide and 22 decedents
of homicide.

References
Barraclough, B., & Harris, E. C. (2002). Suicide preceded by murder: The epidemiology of
homicide-suicide in England and Wales 1988–92, Psychological Medicine, 32, 577-584.
Berman, A. L. (1996). Dyadic death: A typology. Suicide and Life-Threatening Behavior, 26,
342-350.
Berman, A. L. (1979). Dyadic death: Murder-suicide. Suicide and Life-Threatening Behavior,
9, 15-23.
Block, C. R. (1987). Homicide in Chicago: Aggregate and time series perspectives on victim,
offender and circumstance. Chicago, IL: Center for Urban Policy, Loyola University of
Chicago.
Bourget, D., Gagné, P., & Whitehurst, L. (2010). Domestic homicide and homicide-sui-
cide: The older offender. Journal of the American Academy of Psychiatry and Law,
38, 305-311.
Bridges, F. S., & Lester, D. (2011). Homicide-suicide in the United States, 1968-1975. Forensic
Science International, 206, 185-189.
Bridges, F. S., & Tankersley, W. B. (2010). Mean ages of homicide victims and victims of
homicide-suicide. Psychological Reports, 106, 163-169.
Brock, K. (2002). American Roulette: The untold story of murder-suicide in the United States.
Washington, DC: Violence Policy Center.
Brookings Institute Metropolitan Policy Program. (2010). State of metropolitan America: On
the front lines of demographic transition. Washington, DC: Author.
Brown, M., & Barraclough, B. (1999). Partners in life and death: The suicide pact in England
and Wales, 1988-1992. Psychological Medicine, 29, 1299-1306.

Downloaded from hsx.sagepub.com by guest on December 3, 2014

Bridges 235

Cohen, D., Llorente, M., & Eisdorfer, C. (1998). Homicide-suicide in older persons. American
Journal of Psychiatry, 55, 390-396.
Cohen, D. (1995). Homicide-suicide in the aged: a growing public health problem. Journal of
Mental Health and Aging, 1, 83-85.
Cohen, D. (2000). Homicide-suicide in older persons. Psychiatry Times, 17, 49-52.
Dawson, M. (2005). Intimate femicide followed by suicide: Examining the role of premedita-
tion. Suicide and Life-Threatening Behavior, 35, 76-90.
Frey, W. H. (2007). Mapping the growth of older America: Seniors and boomers in the early
21st century. The Brookings Institute Metropolitan Policy Program, Washington, DC.
Hiroeh, U., Appleby, L., Mortensen, P. B., & Dunn, G. (2001) Death by homicide, suicide, and
other unnatural causes in people with mental illness: A population-based study. The Lancet,
358(9299), 2110-2112. doi:10.1016/S0140-6736(01)07216-6
Kposowa, A. J. (2000). Marital status and suicide in The National Longitudinal Mortality Study.
Journal of Epidemiology and Community Health, 54, 254-261.
Liem, M. (2010) Homicide followed by suicide: A review. Aggression and Violent Behavior,
15, 153-161.
Liem, M., Postulart, M., & Nieuwbeerta, P. (2009) Homicide-suicide in the Netherlands: An
epidemiology. Homicide Studies, 13, 99-123.
Logan, J., Hill, H. A., Black, M. L., Crosby, A. E., Karch, D. L., Barnes, J. D., & Lubell,
K. M. (2008). Characteristics of perpetrators in homicide-followed-by-suicide incidents:
National violent death reporting system—17 US states, 2003-2005. American Journal of
Epidemiology, 168(6), 1-9.
Lund, L. E., & Smorodinsky, S. (2001). Violent death among intimate partners: A comparison
of homicide and homicide followed by suicide in California. Suicide and Life-Threatening
Behavior, 31, 451-9.
Malphurs, J. E., & Cohen, D. (2002). A newspaper surveillance study of homicide-suicide in
the United States. American Journal of Forensic Medicine and Pathology, 23, 142-148.
Malphurs, J. E., & Cohen, D. (2005). A statewide case-control study of spousal homicide-
suicide in older persons. American Journal of Geriatric Psychiatry, 13, 211-217.
Malphurs, J. E., Eisdorfer, C., & Cohen, D. (2001). A comparison of antecedents of homicide-
suicide and suicide in older married men. American Journal of Geriatric Psychiatry, 9, 49-57.
Marzuk, P., Tardiff, K., & Hirsch, C. S. (1992). The epidemiology of murder-suicide. Journal
of the American Medical Association, 267, 3179-3183.
Milroy, C. M. (1995) The epidemiology of homicide-suicide (dyadic death). Forensic Science
International, 71, 117-122.
Milroy, C. M. (1995b). Reasons for homicide and suicide in episodes of dyadic death in
Yorkshire and Humberside. Medicine, Science, and the Law, 35, 213-217
National Research Council. (2003). Elder mistreatment: Abuse, neglect, and exploitation in an
aging America. In R. J. Bonnie, & Robert B. Wallace (Eds.). Washington, DC: National
Academy of Sciences.
Newman, K. S., Fox, C., Harding, D. J., Mehta, J., & Roth, W. (2004). Rampage: The social
roots of school shootings. New York, NY: Basic Books.
Paveza, G. J., Cohen, D., Eisdorfer, C., Freels, S., Semla, T., Ashford, J. W., & Levy, P.
(1992). Severe family violence and Alzheimer’s disease: prevalence and risk factors. The
Gerontologist, 32, 493-497.
Riedel, M. (2010). Homicide-Suicides in the United States: A review of the literature. Sociology
Compass, 4, 430-441.

Downloaded from hsx.sagepub.com by guest on December 3, 2014

236 Homicide Studies 17(2)

Riedel, M., & Zahn, M. (1994). Trends in American homicide, 1968-1978: Victim-level supple-
mentary homicide reports (Compiled by the Center for the Study of Crime, Delinquency,
and Corrections, Southern Illinois Univer). Carbondale. ICPSR ed. Ann Arbor, MI:
Inter-University Consortium for Political and Social Research [producer and distributor].
doi:10.3886/ICPSR08676 [Computer file]
Riedel, M. (2008). Homicide arrest clearances: A review of the literature. Sociology Compass,
2, 1145-1164.
Shields, L. B. E., Hunsaker, D. M., & Hunsaker, J. C., III. (2004). Abuse and neglect: A ten-
year review of mortality and morbidity in our elders in a large metropolitan area. Journal
of Forensic Sciences, 49, 122-127.
Stack, S. (1997). Homicide followed by suicide: An analysis of Chicago data. Criminology, 35,
435-453.
West, D. J. (1965). Murder followed by suicide. Cambridge, MA: Harvard University Press.

Author Biography
F. Stephen Bridges, professor, received his EdD in community health education from the
University of Alabama-Tuscaloosa. After this, Stephen completed postdoctoral training in com-
munity medicine at the University of Alabama–Tuscaloosa. His current research focuses on risk
and protective factors for disorders with low base rates in community populations, such as
homicide-suicides.

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