Suicide plan prevalence, recurrence, and longitudinal association with nonfatal suicide attempt

Abstract

Background Each year, millions of people develop suicide plans. These plans are assumed to indicate imminent suicide risk, yet this has rarely been tested. The present study seeks to address two questions: (1) how prevalent are specific thoughts of suicide plans among individuals with a history of suicidal thoughts and behaviors and (2) do suicide plans confer risk of future suicide attempts in the short term? Methods Secondary data analysis was performed on a longitudinal dataset (N = 1021). Prevalence and frequencies of suicide planning features (i.e., method, time, place) at baseline and 3, 14, and 28 days post‐baseline were calculated. Logistic regressions were conducted to assess whether suicide plans confer risk of suicide attempts across a 28‐day follow‐up period. Results Suicide planning more commonly involved thoughts of method than place and/or time. High variability in suicide planning was evident and thoughts of suicide plans frequently recurred. Contrary to assumptions, suicide plans displayed weak associations with nonfatal suicide attempt across the 28‐day follow‐up period. Conclusions Suicide plans appear heterogeneous in nature. They do not appear to play a strong role in predicting nonfatal suicide attempts. Re‐evaluation of the central role that suicide plans occupy within clinical risk assessments may be warranted.

Specificity, frequency, and intent: Multiple characteristics of adolescents' suicide plan correlate with their history of suicidal behavior

“…This is consistent with implementation intention findings that individuals who engage in goal-focused planning more frequently are more likely to achieve their goals (Chapman & Armitage, 2010;Harkin et al, 2016;Hayes et al, 2021). Our results also echo findings that past-week frequency of thinking about an SP predicted suicide attempts made within 28 days (Linthicum & Ribeiro, 2022). The Interpersonal Theory of Suicide offers a possible explanation for our findings.…”

“…Within suicide risk assessment frameworks, detailed SPs can indicate heightened risk (Veterans Affairs & Department of Defense, 2019). These recommendations are also supported by preliminary findings that detailed SPs can serve as a short-term predicter of suicide attempts (Linthicum & Ribeiro, 2022). This is consistent with implementation intention findings that specifying more details of an implementation intention can increase goal-directed behavior (Dombrowski et al, 2016;Wiedemann et al, 2011).…”

“…While some results point to an association between SP history and SB during adolescence (Nock et al, 2013(Nock et al, , 2018Voss et al, 2019) and adulthood (Chaudhury et al, 2016;T. E. Joiner et al, 2003;Naifeh et al, 2020), other studies suggest mere history (i.e., presence or absence) of SP is a weak predictor of future SB (Linthicum & Ribeiro, 2022;Prinstein et al, 2008). A reason for these findings may be that SB is characterized by at least two phenotypes (Bernanke et al, 2017).…”

“…Second, we know very little about how SPs are experienced among adolescents. Among adults, we do know that not all suicidal individuals think about a specific method, place, and time when generating an SP, but having an SP with all three details specified predicts suicide attempt in ways that SP history alone cannot (Linthicum & Ribeiro, 2022). Formal assessment of SP characteristics among adolescents may thereby shed further light on whether and how to engage adolescents prior to SB.…”

Suicide Ideation, Plans, and Attempts Among Military Veterans vs Nonveterans With Disability

“…Thus, additional studies that explore factors before suicide attempt are critically needed to develop more intervention points to prevent an attempt. The NSDUH asked generally about a suicide plan, yet studies of suicide planning suggest various aspects to explore within this domain, such as the difference between identifying a specific method vs identifying a time and place . Thus, the current study builds on this literature base but also helps identify future areas of inquiry.…”