Challenges in Assessing Intent to Die: Can Suicide Attempters Be Trusted?

2007 ◽  
Vol 55 (1) ◽  
pp. 57-70 ◽  
Author(s):  
Stacey Freedenthal
Keyword(s):  
Risk Assessment ◽  
Suicide Attempt ◽  
Circumstantial Evidence ◽  
Accurate Assessment ◽  
Secondary Gain ◽  
Suicide Attempters ◽  
Suicidal Intent ◽  
Suicide Intent ◽  
Suicide Note

Assessing a person's intent to die in a suicide attempt is crucial for risk assessment and research, yet suicidal intent is notoriously difficult to measure. People who intended to die when they hurt themselves may deny it, and others may feign intent for secondary gain. Additionally, ambivalence, memory gaps, impulsivity, and fluidity of intent can hinder accurate assessment of intent. Circumstantial evidence, such as a suicide note, may illuminate true intentions but also has substantial limitations. This article summarizes disparate challenges to the measurement of suicidal intent; describes strengths and weaknesses of circumstantial indicators; reviews evidence from studies using the Suicide Intent Scale to show that subjective and circumstantial indicators do not strongly correlate with each other; and concludes with a call to place more trust in individuals whose disclosures of suicidal intent are questionable, even if the possibility for manipulation exists.

Factor Structure of Beck's Suicide Intent Scales

1977 ◽  
Vol 40 (1) ◽  
pp. 295-302 ◽  
Author(s):  
Richard D. Wetzel
Keyword(s):  
Suicide Attempt ◽  
Factor Structure ◽  
General Factor ◽  
Factor Scores ◽  
Suicide Attempters ◽  
Suicidal Intent ◽  
Suicide Intent

Data obtained from 48 suicide attempters and 56 suicide threateners on three of Beck's suicide intent scales were factor analyzed. The scale, attempt suicide intent, yielded four orthogonal factors reflecting seriousness of intent, lethality of the act, precautions against interference and failure to initiate rescue after the attempt. The current scale of suicidal intent yielded four factors, bur one, the still suicidal factor, accounted for 44% of the variance. The suicide ideators scale yielded a general factor, called specificity of planning, accounting for more than half the variation. Factor scores were computed and correlated with diagnostic groupings. Character disordered subjects were more likely to report both more serious intent at time of suicide attempt and at interview than other attempters.

Reassessment of Suicide Attempters at Home, Shortly After Discharge from Hospital

Crisis ◽  
2010 ◽  
Vol 31 (6) ◽  
pp. 303-310 ◽  
Author(s):  
Bas Verwey ◽  
Jeroen A. van Waarde ◽  
Molla A. Bozdağ ◽  
Iris van Rooij ◽  
Edwin de Beurs ◽  
...  
Keyword(s):  
Suicide Attempt ◽  
General Hospital ◽  
Hospital Environment ◽  
Initial Assessment ◽  
Suicide Attempters ◽  
Systematic Assessment ◽  
Suicide Intent ◽  
Initial Hospital ◽  
Discharge From Hospital ◽  
At Home

Background: Assessment of suicide attempters in a general hospital may be influenced by the condition of the patient and the unfavorable circumstances of the hospital environment. Aims: To determine whether the results of a reassessment at home shortly after discharge from hospital differ from the initial assessment in the hospital. Methods: In this prospective study, systematic assessment of 52 suicide attempters in a general hospital was compared with reassessment at home, shortly after discharge. Results: Reassessments at home concerning suicide intent, motives for suicide attempt, and dimensions of psychopathology did not differ significantly from the initial hospital assessment. However, patients’ motives for the suicide attempt had changed to being less impulsive and more suicidal, worrying was significantly higher, and self-esteem was significantly lower. A third of the patients had forgotten their aftercare arrangements and most patients who initially felt no need for additional help had changed their mind at reassessment. Conclusions: Results from this group of suicide attempters suggest that a brief reassessment at home shortly after discharge from hospital should be considered.

Characteristics of Suicidal Behavior in a Turkish Sample

Crisis ◽  
2009 ◽  
Vol 30 (2) ◽  
pp. 90-93 ◽  
Author(s):  
Osman Ozdel ◽  
Gulfizar Varma ◽  
Figen C. Atesci ◽  
Nalan K. Oguzhanoglu ◽  
Filiz Karadag ◽  
...  
Keyword(s):  
Suicide Attempt ◽  
Suicidal Behavior ◽  
Clinical Characteristics ◽  
Religious Orientation ◽  
Educational Status ◽  
Suicide Attempters ◽  
Suicide Intent ◽  
Suicidal Intention ◽  
The Family ◽  
Dsm Iv

Background: Suicidal behavior is one of the most important problems in psychiatric clinics. Several sociodemographic and clinical characteristics may have different effects on suicidal behavior. Aims: To examine the sociodemographic and clinical characteristics of a sample of 144 suicide attempters admitted to a Turkish emergency clinic for a suicide attempt. Methods: All subjects were interviewed by a consultant psychiatrist. For all individuals, data on DSM-IV psychiatric diagnoses, sociodemographic data, Beck’s Hopelessness Scale (BHS), Becks’s Suicidal Ideation Scale (SIS), and Beck’s Suicidal Intention Scale (BSIS) were collected. Results: The majority of suicide attempters were females characterized by low educational status and low religious orientation. Drug overdose was the most common method of suicide attempt and conflict within the family was the most fre uent psychological stress factor. Three- uarters of attempters (74.6%) met DSM-IV criteria for at least one psychiatric diagnosis. Of these, 28.5% met criteria for major depressive disorder. Suicide attempters with depression tended to be immigrant, urban dwellers with high scores on the suicide intent scale. Conclusions: In the present study, the findings are useful in showing the risk factors related to suicidal behavior.

scholarly journals Prevalence of depression among people who attempt suicide

2017 ◽  
Vol 5 (9) ◽  
pp. 4108
Author(s):  
Ramanujam G ◽  
Abdul Rahuman ◽  
R. Mahalakshmi
Keyword(s):  
Major Depressive Disorder ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Recent Past ◽  
Major Depressive ◽  
Suicide Attempters ◽  
Suicidal Intent ◽  
Suicide Intent ◽  
Prevalence Of Depression ◽  
Icd 10

Background: This is a study aimed at assessing the prevalence of major depressive disorder among persons who attempted suicide.Methods: The study involved 30 persons above 18years of age of both sexes who has attempted suicide in the recent past. An informed consent was obtained from all of them. The prevalence of depression among those suicide attempters was studied based on major ICD- 10 depression inventory. Also, intent rating based on Beck’s suicide intent scale was done to assess the severity of suicide attempt. Questionnaire was given and the details were collected.Results: The prevalence of depression is estimated to be 20%. Regarding the suicidal intent, 13 cases (43.33%) showed high intent for suicide.Conclusions: Prevalence of depression is common among people who attempt suicide. Early diagnosis and intervention will reduce suicide attempts.

Explaining Suicide: The Views of Survivors of Serious Suicide Attempts

1996 ◽  
Vol 168 (6) ◽  
pp. 780-786 ◽  
Author(s):  
Ian O'Donnell ◽  
Richard Farmer ◽  
José Catalán
Keyword(s):  
Suicide Attempt ◽  
Mental State ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Psychiatric Treatment ◽  
Psychiatric Morbidity ◽  
Preventive Strategies ◽  
Suicidal Intent ◽  
Suicide Intent ◽  
High Level

BackgroundThere is a dearth of information on the motivational aspects of serious suicide attempts, in particular those which involve violent methods. Clarification of the reasons which lie behind such acts may suggest appropriate preventive strategies.MethodInterviews were carried out with 20 individuals who had attempted suicide by jumping in front of a railway train. Demographic and psychiatric data were collected for each case and the Suicidal Intent Scale was administered.ResultsIn most cases the act had been impulsive and was characterised by an extremely high level of suicidal intent. The majority were receiving psychiatric treatment at the time of their suicide attempt. In some cases, survival and the aftermath of the attempt appeared to have a beneficial effect on mental state.ConclusionsWhile high levels of psychiatric morbidity and high suicidal intent were common, impulsivity and improved mental state indicate that there are similarities between high and low suicide intent survivors.

scholarly journals Risk Assessment on Suicide Death and Attempt among Chinese Rural Youths Aged 15–34 Years

2021 ◽  
Vol 18 (24) ◽  
pp. 13362
Author(s):  
Long Sun ◽  
Jie Zhang ◽  
Dorian A. Lamis ◽  
Yifan Wang
Keyword(s):  
Risk Assessment ◽  
Suicide Attempt ◽  
Suicide Risk ◽  
Roc Curves ◽  
Assessment Tools ◽  
Assessment Model ◽  
Suicide Risk Assessment ◽  
Suicide Attempters ◽  
Suicide Death ◽  
Community Residents

Background: Although many suicide risk assessment tools are available in the world, their validity is not adequately assessed. In this study, we aimed to develop and evaluate a suicide risk assessment model among Chinese rural youths aged 15–34 years. Method: Subjects were 373 suicide deaths and 507 suicide attempters aged 15–34 years in three Chinese provinces (Shandong, Liaoning, and Hunan). Information about the community residents was also collected as the control groups. Social-demographic, social and psychological variables were examined for the suicides, suicide attempters, and community residents. Logistic regressions based on subjects from Shandong and Liaoning provinces were conducted to establish the suicide risk assessment models. Receiver operating characteristic (ROC) curves were drawn, and area under the ROC curves (AUC) were calculated to show how well the models separated the group being tested into those with and without suicide attempt or suicide. Results: The assessment model for suicide death included education years (OR = 0.773, p < 0.001), agricultural worker (OR = 2.091, p < 0.05), physical health (OR = 0.445, p < 0.05), family suicide history (OR = 6.858, p < 0.001), negative life events (OR = 1.340, p < 0.001), hopelessness (OR = 1.171, p < 0.001), impulsivity (OR = 1.151, p < 0.001), and mental disorder (OR = 8.384, p < 0.001). All these factors were also supported in the assessment model for suicide attempt, with an extension of very poor economic status (OR = 1.941, p < 0.01) and social interaction (OR = 0.855, p < 0.001). The AUC was 0.950 and 0.857 for the sample used to establish the assessment models of suicide death and attempt, respectively. The AUC was 0.967 and 0.942 for the sample used to verify the established assessment models of suicide death and attempt, respectively. Conclusions: Compared with some other assessment tools, the models for suicide death and attempt in the current study performed well among Chinese rural youths aged 15–34 years. A reliable suicide risk assessment approach, which includes multiple risk factors, should be evaluated in various cultures and populations.

Depressed Multiple-Suicide­Attempters – A High-Risk Phenotype

Crisis ◽  
2017 ◽  
Vol 38 (6) ◽  
pp. 367-375 ◽  
Author(s):  
Leo Sher ◽  
Michael F. Grunebaum ◽  
Ainsley K. Burke ◽  
Sadia Chaudhury ◽  
J. John Mann ◽  
...  
Keyword(s):  
Family History ◽  
Suicide Attempt ◽  
Suicide Attempts ◽  
Borderline Personality ◽  
Cross Sectional ◽  
Suicide Attempters ◽  
Depressed Patients ◽  
Suicide Intent ◽  
History Of ◽  
Cross Sectional Design

Abstract. Background: There is compelling evidence that suicide attempts are among the strongest predictors of suicide and future suicide attempts. Aim: This study aimed to examine psychopathology in multiple-suicide attempters. Method: We compared the demographic and clinical features of three groups: depressed patients without a history of suicide attempts (non-attempters), depressed patients with a history of one to three suicide attempts (attempters), and depressed patients with a history of four or more suicide attempts (multiple attempters). Results: We found that attempters and multiple attempters had higher levels of depression, hopelessness, aggression, hostility, and impulsivity and were more likely to have borderline personality disorder and family history of major depression or alcohol use disorder compared with non-attempters, but did not differ between each other on these measures. Multiple attempters had greater suicidal ideation at study entry and were more likely to have family history of suicide attempt compared with attempters. Importantly, multiple attempters had greater suicide intent at the time of the most medically serious suicide attempt and more serious medical consequences during their most medically serious suicide attempt compared with attempters. Limitations: The cross-sectional design of the study. Conclusion: Our data suggest that multiple-suicide attempters require careful evaluation as their behavior can have serious medical consequences.

scholarly journals Higher Suicide Intent in Patients Attempting Suicide With Violent Methods Versus Self-Poisoning

Crisis ◽  
2021 ◽  
pp. 1-8
Author(s):  
Per Sverre Persett ◽  
Øivind Ekeberg ◽  
Dag Jacobsen ◽  
Mari Asphjell Bjornaas ◽  
Hilde Myhren
Keyword(s):  
Suicidal Ideation ◽  
Suicide Attempt ◽  
Hospital Stay ◽  
Statistical Power ◽  
Suicide Ideation ◽  
Suicidal Intent ◽  
Suicide Intent ◽  
Follow Up Studies

Abstract. Background: Suicidal intent for patients attempting suicide using violent methods (VMs) is assumed to be higher than for those using self-poisoning (SP), which may explain the higher mortality observed in follow-up studies. However, this has not been studied prospectively. Aims: We aimed to compare patients attempting suicide using VMs with those using SP regarding suicidal intent, suicidal ideation, depression, and hopelessness during hospital stay and after 1 year. Methods: Patients hospitalized after suicide attempt by VMs ( n = 80) or SP ( n = 81) completed the Beck scales for Suicide Intent, Suicide Ideation, Depression Inventory, and Hopelessness on admission and at the 12-month follow-up. Results: On admission, those using VMs had higher suicidal intent than those using SP ( M = 16.2 vs. 13.3, p < .001), but lower depression scores ( M = 22.2 vs. 26.8, p < .05). No significant differences were found in suicidal ideation ( M = 20.1 vs. 23.1) or hopelessness ( M = 10.1 vs. 11.9). At 12-month follow-up, depression scores decreased significantly for both groups, while hopelessness decreased only for the SP group. Limitations: The statistical power achieved was lower than intended. Conclusion: The higher levels of suicidal intent, but lower levels of depression, may indicate more impulsivity among people attempting suicide using VMs. Suicidal ideation was relatively stable.

Gender Differences in Suicidal Intent and Choice of Method Among Suicide Attempters

Crisis ◽  
2008 ◽  
Vol 29 (4) ◽  
pp. 209-212 ◽  
Author(s):  
Merete Nordentoft ◽  
Jacob Branner
Keyword(s):  
Gender Differences ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Suicidal Intent ◽  
Suicide Intent ◽  
Suicidal Intention ◽  
National Patient ◽  
Prevention Center ◽  
Suicide Prevention Center

The objective was to examine gender differences in choice of method and suicidal intent among persons referred to a suicide prevention center. A total of 351 consecutive patients who had attempted suicide were interviewed using the European Parasuicide Study Interview Schedule I (EPSIS I) while participating in a 2-week inpatient treatment program. They were invited to a 1-year follow-up interview, and followed in the National Patient Register. Compared to women, men who had attempted suicide were older, had better self-esteem, fewer depressive symptoms, and higher total suicidal intention scores, but they were not more likely to use violent methods. Neither use of violent method nor dangerousness of the attempt was associated with suicidal intention. Although men had higher suicide intent scores than women, there were no significant gender differences in the number of repeat suicide attempts during a 1-year follow-up period. Suicidal intent was not related to dangerousness of suicide method.

Psychological, Structural, Social and Economic Determinants of Suicide Attempt: Risk Assessment and Decision Making Strategies

2021 ◽  
pp. 003022282110034
Author(s):  
Azam Farmani ◽  
Mojtaba Rahimianbougar ◽  
Yousef Mohammadi ◽  
Hossein Faramarzi ◽  
Siamak Khodarahimi ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Suicide Attempt ◽  
Suicide Attempts ◽  
Psychological Services ◽  
Cross Sectional ◽  
Economic Determinants ◽  
History Of ◽  
Cross Sectional Design ◽  
High Level ◽  
Risk Assessment And Management

The aim of this research was to conduct a risk assessment and management of psychological, structural, social and economic determinants (PSSED) in a suicide attempt. The sample consisted of 353 individuals who had a recorded history of suicidal attempt; and 20 professional individuals by purposive sampling method within a descriptive cross-sectional design. Worksheets for RAM and AHP were used for data collection in this study. The rate of suicide attempt was 7.21 per 100,000 population in this study. Analysis showed that depression and mental disorders; personality disorders; family problems; socio-cultural and economic problems; lack of awareness; and low level of education have a high level of risk for suicide attempts. Psychiatric and psychological services; awareness and knowledge of life skills; medical services to dysfunctional families; development of community-based planning for PSSED of suicide; and employment and entrepreneurship services may lower suicide attempt risk.

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