The differences between suicide ideators and suicide attempters: Simple, complicated, or complex?

Xieyining Huang; Jessica D. Ribeiro; Joseph C. Franklin

doi:10.1037/ccp0000498

Epidemiological Trends in Attempted Suicide in Adolescents and Young Adults Between 1996 and 2004

Crisis ◽

10.1027/0227-5910.30.3.115 ◽

2009 ◽

Vol 30 (3) ◽

pp. 115-119 ◽

Cited By ~ 10

Author(s):

Stephanie De Munck ◽

Gwendolyn Portzky ◽

Kees Van Heeringen

Keyword(s):

Young Adults ◽

Attempted Suicide ◽

Suicide Attempts ◽

Epidemiological Studies ◽

Adolescents And Young Adults ◽

University Hospital ◽

International Studies ◽

Suicide Attempters ◽

Increased Risk ◽

Epidemiological Trends

Background: Notwithstanding the epidemiological studies indicating an increased risk of attempted suicide among adolescents and young adults, there is a scarcity of international studies that examine long-term epidemiological trends in rates and characteristics of this vulnerable group. Aims: This article describes the results of a 9-year monitoring study of suicide attempts in adolescents and young adults referred to the Accident and Emergency Department of the Gent University Hospital (Belgium). Methods: Between January 1996 and December 2004, trends, sociodemographic, and methodrelated characteristics of suicide attempts were assessed by a psychiatrist on data sheets. Results: Attempted suicide rates declined from 1996 to 2001 and then rose until 2004, but did not exceed previous rates. During the 9 years of monitoring, there was a preponderance of female suicide attempters, except for 1997. Rates of attempts and of fatal suicide were negatively correlated. Significantly more males than females deliberately injured themselves. Younger attempters, especially females, significantly more often poisoned themselves with analgesics. In nearly one in five attempts, alcohol was used in combination with other methods, and alcohol intake was more commonly observed in older suicide attempters. Nearly half of the adolescents were identified as repeaters. Conclusions: The results of this study warrant further monitoring of trends and characteristics of young suicide attempters.

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Self-Report vs. Computerized Measures of Impulsivity as a Correlate of Suicidal Behavior

Crisis ◽

10.1027//0227-5910.22.1.27 ◽

2001 ◽

Vol 22 (1) ◽

pp. 27-31 ◽

Cited By ~ 47

Author(s):

Netta Horesh

Keyword(s):

Suicidal Behavior ◽

Attention Deficit Disorder ◽

Impulse Control ◽

Performance Test ◽

Adolescent Suicide ◽

Continuous Performance Test ◽

Self Report ◽

Suicide Attempters ◽

Computerized Measures ◽

Adolescent Suicide Attempters

Objectives: To compare the use of a self-report form of impulsivity versus a computerized test of impulsivity in the assessment of suicidal adolescent psychiatric inpatients. Methods: Sixty consecutive admissions to an adolescent in patient unit were examined. The severity of suicidal behavior was measured with the Childhood Suicide Potential Scale (CSPS), and impulse control was measured with the self report Plutchik Impulse Control Scale (ICS) and with the Test of Variables of Attention (TOVA), a continuous performance test (CPT). The TOVA is used to diagnose adolescents with attention deficit disorder. Results: There was a significant but low correlation between the two measures of impulsivity. Only the TOVA commission and omission errors differentiated between adolescent suicide attempters and nonattempters. Conclusions: Computerized measures of impulsivity may be a useful way to measure impulsivity in adolescent suicide attempters. Impulsivity appears to play a small role only in nondepressed suicidal adolescents, especially boys.

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

Crisis ◽

10.1027/0227-5910/a000041 ◽

2010 ◽

Vol 31 (6) ◽

pp. 303-310 ◽

Cited By ~ 9

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.

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Validity of Proxy-Based Reports of Impulsivity and Aggression in Chinese Research on Suicidal Behavior

Crisis ◽

10.1027/0227-5910/a000019 ◽

2010 ◽

Vol 31 (3) ◽

pp. 137-142 ◽

Cited By ~ 17

Author(s):

Jing An ◽

Michael R. Phillips ◽

Kenneth R. Conner

Keyword(s):

Risk Factors ◽

Suicidal Behavior ◽

Rural China ◽

Suicide Attempters ◽

Barratt Impulsiveness Scale ◽

Single Location ◽

Aggression Questionnaire ◽

Community Controls

Background: In studies about the risk factors for suicidal behavior, the assessment of impulsiveness and aggression often depend on information from proxy informants. Aims: To assess the validity of proxy informants’ reports on impulsiveness and aggression in China. Methods: Modified Chinese versions of the Barratt Impulsiveness Scale (BIS-CV) and the Buss-Perry Aggression Questionnaire (AQ-CV) were administered to 131 suicide attempters treated at a hospital in rural China, to coresident relatives about the attempters, to 131 matched community controls, and to coresident relatives about the controls. Results: BIS-CV and AQ-CV total scores and subscale scores were all significantly higher for suicide attempters than for matched controls. Proxy informants considered subjects slightly more impulsive and aggressive than the subjects reported themselves. Subject-proxy concordance for total BIS-CV and AQ-CV scores were excellent for both attempters and controls (ICCs = 0.76–0.83). Concordance for the three BIS-CV subscales was 0.74–0.81 for attempters and 0.74–0.83 for controls. Concordance for the five AQ-CV subscales was 0.66–0.85 for attempters and 0.56–0.82 for controls. Limitations: Results are based on respondents from a single location in rural China. Conclusions: The results support the validity of the BIS-CV and AQ-CV and of research on suicidal behavior in China that uses proxy-based reports of impulsiveness and aggression.

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A Pilot Study of Mobile Telephone Message Interventions with Suicide Attempters in China

Crisis ◽

10.1027/0227-5910/a000017 ◽

2010 ◽

Vol 31 (2) ◽

pp. 109-112 ◽

Cited By ~ 35

Author(s):

Hui Chen ◽

Brian L. Mishara ◽

Xiao Xian Liu

Keyword(s):

Pilot Study ◽

Effective Means ◽

Text Message ◽

Text Messages ◽

Mobile Telephone ◽

Future Research ◽

Quick Method ◽

Suicide Attempters ◽

To Receive

Background: In China, where follow-up with hospitalized attempters is generally lacking, there is a great need for inexpensive and effective means of maintaining contact and decreasing recidivism. Aims: Our objective was to test whether mobile telephone message contacts after discharge would be feasible and acceptable to suicide attempters in China. Methods: Fifteen participants were recruited from suicide attempters seen in the Emergency Department in Wuhan, China, to participate in a pilot study to receive mobile telephone messages after discharge. All participants have access to a mobile telephone, and there is no charge for the user to receive text messages. Results: Most participants (12) considered the text message contacts an acceptable and useful form of help and would like to continue to receive them for a longer period of time. Conclusions: This suggests that, as a low-cost and quick method of intervention in areas where more intensive follow-up is not practical or available, telephone messages contacts are accessible, feasible, and acceptable to suicide attempters. We hope that this will inspire future research on regular and long-term message interventions to prevent recidivism in suicide attempters.

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Suicidal Behavior and Non-Suicidal Self-Injury in Emergency Departments Underestimated by Administrative Claims Data

Crisis ◽

10.1027/0227-5910/a000499 ◽

2018 ◽

Vol 39 (5) ◽

pp. 318-325 ◽

Cited By ~ 8

Author(s):

Barbara Stanley ◽

Glenn W. Currier ◽

Megan Chesin ◽

Sadia Chaudhury ◽

Shari Jager-Hyman ◽

...

Keyword(s):

Emergency Departments ◽

Suicide Attempts ◽

The United States ◽

Administrative Claims ◽

Suicide Attempters ◽

Self Injury ◽

Axis I ◽

Ed Visits ◽

External Causes ◽

Severe Psychopathology

Abstract. Background: External causes of injury codes (E-codes) are used in administrative and claims databases for billing and often employed to estimate the number of self-injury visits to emergency departments (EDs). Aims: This study assessed the accuracy of E-codes using standardized, independently administered research assessments at the time of ED visits. Method: We recruited 254 patients at three psychiatric emergency departments in the United States between 2007 and 2011, who completed research assessments after presenting for suicide-related concerns and were classified as suicide attempters (50.4%, n = 128), nonsuicidal self-injurers (11.8%, n = 30), psychiatric controls (29.9%, n = 76), or interrupted suicide attempters (7.8%, n = 20). These classifications were compared with their E-code classifications. Results: Of the participants, 21.7% (55/254) received an E-code. In all, 36.7% of research-classified suicide attempters and 26.7% of research-classified nonsuicidal self-injurers received self-inflicted injury E-codes. Those who did not receive an E-code but should have based on the research assessments had more severe psychopathology, more Axis I diagnoses, more suicide attempts, and greater suicidal ideation. Limitations: The sample came from three large academic medical centers and these findings may not be generalizable to all EDs. Conclusion: The frequency of ED visits for self-inflicted injury is much greater than current figures indicate and should be increased threefold.

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Suicide Attempters, Suicide Ideators, and Non-Ideators

Crisis ◽

10.1027/0227-5910/a000554 ◽

2019 ◽

Vol 40 (4) ◽

pp. 294-297 ◽

Cited By ~ 2

Author(s):

Tobias Teismann ◽

Laura Paashaus ◽

Paula Siegmann ◽

Peter Nyhuis ◽

Marcus Wolter ◽

...

Keyword(s):

Mental Health ◽

Social Support ◽

Protective Factors ◽

Suicide Ideation ◽

Suicide Attempts ◽

Self Esteem ◽

Positive Mental Health ◽

Cross Sectional ◽

Reasons For Living ◽

Suicide Attempters

Abstract. Background: Suicide ideation is a prerequisite for suicide attempts. However, the majority of ideators will never act on their thoughts. It is therefore crucial to understand factors that differentiate those who consider suicide from those who make suicide attempts. Aim: Our aim was to investigate the role of protective factors in differentiating non-ideators, suicide ideators, and suicide attempters. Method: Inpatients without suicide ideation ( n = 32) were compared with inpatients with current suicide ideation ( n = 37) and with inpatients with current suicide ideation and a lifetime history of suicide attempts ( n = 26) regarding positive mental health, self-esteem, trust in higher guidance, social support, and reasons for living. Results: Non-ideators reported more positive mental health, social support, reasons for living, and self-esteem than suicide ideators and suicide attempters did. No group differences were found regarding trust in higher guidance. Suicide ideators and suicide attempters did not differ regarding any of the study variables. Limitations: Results stem from a cross-sectional study of suicide attempts; thus, neither directionality nor generalizability to fatal suicide attempts can be determined. Conclusion: Various protective factors are best characterized to distinguish ideators from nonsuicidal inpatients. However, the same variables seem to offer no information about the difference between ideators and attempters.

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