Differences in Guilt, Shame, Self-Anger, and Suicide Cognitions Based on Recent Suicide Ideation and Lifetime Suicide Attempt History

Abstract

Suicide risk factors such as hopelessness and psychiatric disorders can predict suicide ideation (SI) but cannot distinguish between those with SI and those who attempt suicide (SA). The fluid vulnerability theory of suicide posits that a person's activation of the suicidal mode is predicated on one's predisposition, triggers, and baseline/acute risks. This study compared guilt, shame, self-anger, and suicidal beliefs based on recent SI and lifetime SA. In a total of 2222 primary care patients in this cross-sectional, observational study reported no recent SI or lifetime SA (SI−SA−), 161 reported recent SI only (SI−SA+), 145 reported lifetime SA only (SI+SA−), and 56 reported both recent SI and lifetime SA (SI+SA+). Kruskal-Wallis test showed that the four risk factors were the highest for SI+SA+, followed by SI+SA−, then SI−SA+, and lastly SI−SA−. The study shows that risk factors may be worse in those with recent SI than those with SA history.

The effects of low familial support and depressive symptomatology on suicide attempt among adolescents: A sex‐based assessment

“…Finally, due to data limitations, negative emotions were restricted to depressive symptomatology. But there are many other negative emotions—self‐anger, guilt, and shame (Szeto et al., 2023)—that may impact the relationship between low familial support and suicide attempt. Studies focusing on the effects of these alternative emotional states are welcomed.…”

A Suicide-Specific Diagnosis – The Case Against

“…The second example reflects an over-exclusive frame, as if other symptoms and behaviors associated with near-term suicide risk, but not identified as Criterion B categories, simply do not apply as indicators of near-term risk or criteria indicative of a suicidal crisis. Examples of these near-term risk factors are: (a) recent discharge from inpatient psychiatric hospitalization (Knesper et al, 2010); (b) sleep problems (Berman, 2018; Liu et al, 2020), more broadly defined than simply that of “global insomnia” that is listed in the SCS as a manifestation of hyperarousal; (c) negative emotions and self-evaluations such as shame, embarrassment, moral injury, or humiliation that arise in relation to the perception of having done something dishonorable, immoral, or improper (Szeto et al, 2023), but do not necessarily occur in “rapid spikes” or ruminations, as suggested by the SCS; and (d) a negative or mixed reaction to the patient by the clinician-interviewer, in the context of other criteria (Motto & Bostrom, 1990).…”