A Review of “Suicidal Intent” Within the Existing Suicide Literature

Abstract

The results of a systematic literature review that investigated suicide intent are presented. Of the 44 relevant articles identified, 17 investigated the relationships between various suicide risk factors and suicide intent and 25 publications investigated the relationships between suicide intent and various suicide outcomes. Despite recent advancements in the definition and nomological validity of suicide intent, a high degree of variability in the empirical measurement and analysis of suicide intent was found. Such variability limits future research related to measuring suicidal risk and outcomes, reporting suicide intent, or the meaningful comparison of diagnostic approaches or treatments across multiple studies.

A cross-national study on gender differences in suicide intent

“…There are several measures to assess suicide intent, where Beck’s Suicide Intent Scale represents the most widely used one [47], however, the Feuerlein Scale [30], the five-point ordinal scale developed by Dorpat and Boswell [48] and other intent assessment instruments highlight the variability in the empirical measurement, nomenclature and analysis of suicide intent, and this lack of consistency and standardisation impedes future research related to the measurement of suicide risk and outcome [13]. Moreover, notwithstanding the clinical importance of assessing suicide intent, emergency department personnel often do not document suicide intent at all [49], despite national guidelines and policy initiatives recommending that psychosocial assessments (which include measuring suicide intent) must be undertaken after every self-harm presentation [50].…”

“…Suicide intent in this context is characterised as “an individual’s desire to bring about his or her own death” [13], which specifically excludes motives for attempting suicide. Studies exploring intent have found that the type of suicide intent at the time of a suicide attempt is associated with an elevated risk of completed suicide [14, 15], which is particularly prudent within the female population, where the association between the type of suicidal intent and completed suicide is markedly higher [15].…”

Adult mental health outcomes of adolescent depression: A systematic review

“…It is important to note that when measuring suicidal attempts, thoughts or completion, there is risk for reporting bias, as suicidal thoughts/attempts can be quite stigmatizing (Lehmann, Hilimire, Yang, Link, & DeVylder, 2016). It is often difficult to yield statistically significant results when measuring suicide as an outcome, as the sample size is often too small (Hasley et al, 2008). Given the known association between depression and suicidality (Bostwick & Pankratz, 2000;Nock et al, 2010), it appears likely that such methodological concerns may explain the lack of a consistent association between adolescent depression and suicidality among articles in this review.…”

A cognitive distortions and deficits model of suicide ideation

“…Suicide ideation is defined as “any self-reported thoughts of engaging in suicide-related behavior” (O’Carroll et al, 1996, p. 247), whereas a suicide attempt is a “potentially self-injurious behavior with a nonfatal outcome, for which there is evidence (either explicit or implicit) that the person intended at some (nonzero) level to kill himself/herself” (O’Carroll et al, 1996, p. 247). Suicidal thoughts and behaviour can vary by the degree of suicidal intent, that is, the “individual’s desire to bring about his or her own death” (Hasley et al, 2008, p. 577). Increasingly distorted cognitions have been associated with increased severity of suicidality, and may have utility for differentiating among non-ideators, ideators, and attempters (Beck, Steer, Kovacs, & Garrison, 1985).…”