An Empirical Study of the Psychodynamics of Suicide

Abstract

This paper presents results from an empirical study of four key psychodynamic concepts (self-directed aggression, object loss, ego functioning disturbance, pathological object relations) of suicidal behavior. The sample consists of hospitalized psychiatric patients following a suicide attempt (attempters: n = 52) and demographically similar hospitalized psychiatric patients with no history of suicidal behavior (controls: n = 47). The study was designed to ascertain whether attempters differed from matched psychiatric control patients on the four psychodynamic constructs hypothesized to be associated with suicide. It was predicted that attempters would manifest higher levels of depression and self-targeted anger, a more significant history of loss, less adaptive defenses, and more primitive object representations. Results strongly supported an object-relational view of suicidal behavior. In addition, support for the loss hypothesis was found in the identification of one specific constellation of losses. Namely, attempters were significantly more likely to report a history of childhood loss combined with a recent loss in adulthood than were their nonattempter counterparts. Limited support was provided for the other two hypotheses in differentiating suicidal from nonsuicidal severely ill psychiatric patients. This unexpected finding is examined and suggestions are made for the refinement and greater specification of psychodynamic theories regarding the etiology of suicidal behavior, with the aim of differentiating individuals prone to such action from those with similar psychopathology and dynamic issues who do not actually attempt suicide. Limitations of the study are discussed and implications of the findings for the theory and treatment of suicidal behavior are offered.

Suicide-nearness assessed with PORT, the Percept-genetic Object-Relation Test: A replication and a reliability study

“…Titelman, 2006). Kaslow et al (1998) and Leichsenring (2004) have documented the object-relations dynamics of suicidality in empirical research that is comparable to this study. The obliteration of intimate relatedness from consciousness in the lack-of-attachment phenomena brings into focus aggression as a dimension of suicidality.…”

Suicide Among Patients with Schizophrenia: A Consideration of Risk and Protective Factors

“…The connection betweeti aggression towards oneself (suicide) and aggression towards others (violence) has been proposed by psychodynamic theorists (5,77,78). Subsequently, aggression was considered a distinguishing factor between those who did and did not commit suicide (79), with serotonergic dysregulation appearing to mediate this process (80).…”

Adolescent Avoidance and Risk Behavior

“…Research supports the role of dynamic and developmental factors in understanding suicidal patients [5,11,26]. Exploring the transfer and processing of counter…”

“…Empirical studies that aimed at testing the object-relational view of suicidal behavior concluded that object-loss (i.e. a more significant history of past and recent losses) could better explain suicidal behavior than self-targeted anger, maladaptive defenses or primitive object representations [25,26].…”