PSYCHOLOGICAL AUTOPSY

Physical Health:

Recent visit to physician? MD name?

Any experience with chronic pain?

Any concerns or diagnoses (recent or past) re: chronic, fatal, or disabling disease?

Any significant reduction in physical capabilities? If so, what, and how was the deceased adjusting?

Family Background:

How supportive or close were the nuclear and extended families?

Was there a history of significant abuse (physical, sexual, emotional, etc.) Or a perception of abuse on the part of the decedent?

Any substance use or abuse in the family of origin?

Use of Substances:

History of substance abuse? If so, what was the degree of substance abuse at time of death?

Any recent attempts to discontinue substance abuse?

Did the pattern of substance abuse include poly-substance abuse?

Had the deceased ever experienced an “accidental overdose?” On...

Lifestyle Issues:

Did deceased routinely take risks considered unusual by most people?

Any self-destructive behaviors (such as self-mutilation, routine substance abuse, drinking/driving, etc.) Were crisis situations “created” on an unusually frequent basis?

HX Medical/Psychiatric Treatment:

Any past suicide attempts, or ever talked of suicide as a solution to problems or in response to interpersonal conflict?

On any psychiatric medications for anxiety, depression, or psychosis at any point?

Ever hospitalized in a psychiatric setting? Where?

Had decedent seen a therapist or psychiatrist in recent past? Was he/she in therapy at the time of death? With whom?

Had decedent ever expressed concerns about "going crazy" or of losing cognitive functioning?

Existence of Psychopathology:

Had the deceased --

Appeared depressed, sad, tearful, or moody recently? Recently appeared to have recovered from a depression?

Appeared anxious, or complained recently of anxiety or panic attacks? Demonstrated perfectionistic tendencies?

Experienced problems with insomnia? (initial, mid-sleep, or terminal)

Problems with appetite? (either lack of or excessive appetite)

Shown a lack of interest or joy in life? (to include sex, sports, usual interests, personal hygiene)

Had a lower than usual energy level? Demonstrated slowed or preoccupied thinking?

Demonstrated constricted thinking or “tunnel vision?” Discussed feelings of guilt or appeared agitated?

Shown a tendency to behave in an impulsive manner? Appeared confused, disoriented, or psychotic?

Expressed feelings of hopelessness, helplessness, or worthlessness?

Talked specifically about suicide, or life not being worth living?

Quality of Social Adaptation:

To what degree was the decedent able to create and maintain close personal relationships?

Able to express feeling as needed (esp. grief and anger), or did they have a pattern of holding, then “blowing”?

Had decedent talked recently about feeling unsupported, uncared for, not important?

To what degree was decedent successful in relationships? (work, social, personal, etc.)

Precipitants to the Death: Had the deceased–

Experienced a significant loss or series of losses (relationships, job, finances, prestige, self-concept, family member moving, anything of importance to the person)?

Had a significant (or perceived significant) disruption of a primary relationship?

Any legal troubles or difficulties with police?

Experienced an event which was traumatic, or perceived to be traumatic?

Had an significant life changes? (negative as well as positive, ie. marriage, birth of child, promotion, etc.)

Experienced the completed suicide or suicidal behavior of a family member or loved one?

Made preparations for death? (include updating wills, insurance policies, etc.) Deviated from usual routing just prior to death?

Is this the anniversary of an important death, or important loss for deceased?