Psychological processes and repeat suicidal behavior: A four-year prospective study.

Abstract

Objective: Although suicidal behavior is a major public health concern, understanding of individually sensitive suicide risk mechanisms is limited. In this study, the authors investigated, for the first time, the utility of defeat and entrapment in predicting repeat suicidal behavior in a sample of suicide attempters. Method: Seventy patients hospitalized after a suicide attempt completed a range of clinical and psychological measures (depression, hopelessness, suicidal ideation, defeat, and entrapment) while in hospital. Four years later, a nationally linked database was used to determine who had been hospitalized again after a suicide attempt. Results: Over 4 years, 24.6% of linked participants were readmitted to hospital after a suicidal attempt. In univariate logistic regression analyses, defeat and entrapment as well as depression, hopelessness, past suicide attempts, and suicidal ideation all predicted suicidal behavior over this interval. However, in the multivariate analysis, entrapment and past frequency of suicide attempts were the only significant predictors of suicidal behavior. Conclusions: This longitudinal study supports the utility of a new theoretical model in the prediction of suicidal behavior. Individually sensitive suicide risk processes like entrapment could usefully be targeted in treatment interventions to reduce the risk of repeat suicidal behavior in those who have been previously hospitalized after a suicide attempt.

Explaining the income and suicidality relationship: income rank is more strongly associated with suicidal thoughts and attempts than income

“…According to Gilbert and colleagues, this involuntary subordination and resulting negative affect could potentially lead to suicidal thoughts and actions [39]. Such an explanation is consistent with the Integrated Motivational-Volitional (IMV) Model of suicidal behaviour which maps out the process from defeat and entrapment to suicidal thoughts and behaviours [4,27].…”

“…Consequently, if an individual perceives no escape or rescue from the situation, suicidal ideation emerges. More recently, defeat and entrapment have been shown to be important factors in understanding suicidal thoughts and actions [25] and self-harm [26] cross-sectionally and over time [27,28].…”

Smartphone-Based Safety Planning and Self-Monitoring for Suicidal Patients: A Conceptual Basis for the CASPAR (Continuous Assessment for Suicide Prevention and Research) Study

“…The volitional phase factors govern the transition from suicidal thinking to suicidal behaviour and include access to the means of suicide, the personal capacity for carrying out suicide and impulsivity [1,43] There is growing evidence in supports of the IMV model with several studies having yielded support for the central tenets of the model. Higher levels of defeat are associated with suicide ideation [47] and entrapment, defined as blocked attempts to escape from high stress or defeating circumstances, was found to be the most important modifiable predictor of repeat suicidal behaviour four years after a previous attempt [48]. Other studies have demonstrated that volitional phase factors are key to the emergence of suicidal behaviour, like impulsivity [49] and access to means [50,51].…”

Personal and Collective Resilience Building- A Suicide Prevention Program for Schools Using Positive Psychology. Consultancy Project for an Irish Secondary School

“…They experienced tunnel vision and could not see or comprehend any other solution to solve their problems [14].…”