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Why Parasuicides Repeat Despite Problem Resolution

Published online by Cambridge University Press:  02 January 2018

Isaac Sakinofsky ,
Robin S. Roberts  and
Patricia James
Isaac Sakinofsky*
Affiliation:
Department of Psychiatry, University of Toronto and St Michael's Hospital
Robin S. Roberts
Affiliation:
Department of Clinical Epidemiology and Biostatistics, McMaster University
Patricia James
Affiliation:
Department of Clinical Epidemiology and Biostatistics, McMaster University
*
∗St Michael's Hospital, 30 Bond Street, Toronto, Canada, M5B 1W8
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Abstract

To discover why parasuicides who resolved their difficulties repeated self-harm within three-month follow-up at the same rate as those who had not resolved problems, a group of 30 repeaters was compared with 156 non-repeaters. The repeaters had a history of more frequent episodes, beginning younger. Their problems were more severe, the acts of self-harm potentially less lethal. They experienced greater feelings of externally directed hostility, powerlessness, and ‘normlessness'. A constellation of nine variables correctly predicted 81.5% of the repeaters and 77.5% of the non-repeaters. At follow-up the non-repeaters had improved on several parameters but the repeaters were essentially unchanged. The resolvers among the subgroup of repeaters were more like repeaters in the overall sample than the resolvers, which may explain why some parasuicides repeat in spite of resolving their problems.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 156 , Issue 3 , March 1990 , pp. 399 - 405
Copyright
Copyright © Royal College of Psychiatrists, 1990 

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References

Adam, K. S., Valentine, J., Scarr, G., et al (1983) Follow-up of attempted suicide in Christchurch. Australian and New Zealand Journal of Psychiatry, 17, 18–25.Google Scholar
Alderson, M. R. (1985) National trends in self-poisoning in women. Lancet, i, 974–975.CrossRefGoogle Scholar
American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM–III). Washington, DC: APA.Google Scholar
Asberg, M., Nordstrom, P. & Traskman-Bendz, L. (1986) Biological factors in suicide. In Suicide (ed. Roy, A.). Baltimore: Williams and Wilkins.Google ScholarPubMed
Bancroft, J. & Marsack, P. (1977) The repetitiveness of self-poisoning and self-injury. British Journal of Psychiatry, 131, 394–399.CrossRefGoogle ScholarPubMed
Bancroft, J., Skrimshire, A., Carson, J., et al (1977) People who deliberately poison or injure themselves: their problems and their contacts with helping agencies. Psychological Medicine, 7, 289–303.Google Scholar
Bancroft, J., Hawton, K., Simkin, S., et al (1979) The reasons people give for taking overdoses: a further inquiry. British Journal of Medical Psychology, 52, 323–365.Google Scholar
Barnes, R. A. (1986) The recurrent self-harm patient. Suicide and Life-Threatening Behavior, 16, 399–408.Google Scholar
Barraclough, B. (1987) Suicide: Clinical and Epidemiological Studies. London: Groom Helm.Google Scholar
Beck, A. T., Ward, C. H., Mendelsohn, M., et al (1961) An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571.Google Scholar
Beck, A. T., Schuyler, D. & Herman, I. (1974) Development of suicidal intent scales. In The Prediction of Suicide (eds Beck, A. T., Resnik, H. L. & Lettieri, D. J.). Bowie, Maryland: Charles Press.Google Scholar
Beck, A. T., Steer, R. A., Kovacs, M., et al (1985) Hopelessness and eventual suicide: a 10-year prospective study of patients hospitalized with suicidal ideation. American Journal of Psychiatry, 142, 559–563.Google ScholarPubMed
Bille-Brahe, U. & Juel-Nielsen, N. (1986) Trends in attempted suicide in Denmark, 1976–1980. Suicide and Life-Threatening Behavior, 16, 46–55.CrossRefGoogle ScholarPubMed
Chowdhury, N., Hicks, R. C. & Kreitman, N. (1973) Evaluation of an after-care service for parasuicide (“attempted suicide”) patients. Social Psychiatry, 8, 67–81.CrossRefGoogle Scholar
Dahlgren, K. G. (1977) Attempted suicides - 35 years afterward. Suicide and Life-Threatening Behavior, 7, 75–79.CrossRefGoogle ScholarPubMed
Dean, D. G. (1961) Alienation: its meaning and measurement. American Sociological Review, 26, 753–757.Google Scholar
Diekstra, R. F. W. (1982) Epidemiology of attempted suicide in the EEC. Bibliotheca Psychiatrica, 162, 1–16.Google ScholarPubMed
Diekstra, R. F. W. (1985) Suicide and suicide attempts in the European Economic Community: an analysis of trends, with special emphasis upon trends among the young. Suicide and Life-Threatening Behavior, 15, 27–42.CrossRefGoogle ScholarPubMed
Dyer, J. A. T. & Kreitman, N. (1984) Hopelessness, depression, and suicidal intent in parasuicides. British Journal of Psychiatry, 144, 127–133.CrossRefGoogle Scholar
D'Zurilla, T. J. & Goldfried, M. R. (1971) Problem solving and behavior modification. Journal of Abnormal Psychology, 78, 107–126.CrossRefGoogle ScholarPubMed
Eastwood, M. R., Henderson, A. S. & Montgomery, I. M. (1972) Personality and parasuicide: methodological problems. Medical Journal of Australia, i, 170–175.CrossRefGoogle Scholar
Farberow, N. L. & Shneidman, E. S. (1961) The Cry for Help. New York: McGraw-Hill.Google Scholar
Farmer, R. (1980) The differences between those who repeat and those who do not. In The Suicide Syndrome (eds Farmer, R. & Hirch, S. R.). London: Croom Helm.Google Scholar
Farmer, R. (1987) Hostility and deliberate self-poisoning: the role of depression. British Journal of Psychiatry, 150, 609–614.Google Scholar
Farmer, R. & Creed, F. (1986) Hostility and deliberate self-poisoning. British Journal of Medical Psychology, 59, 311–316.Google Scholar
Foulds, G. A., Caine, T. M. & Creasy, M. A. (1960) Aspects of extra- and intro-punitive expression in mental illness. Journal of Mental Science, 106, 599–610.CrossRefGoogle ScholarPubMed
Gibbons, J. S., Butler, J., Urwin, P., et al (1978) Evaluation of a social work service for self-poisoning patients. British Journal of Psychiatry, 133, 111–118.Google Scholar
Goldberg, J. O. & Sakinofsky, I. (1988) Intropunitiveness and suicide: prediction of interview response. British Journal of Psychiatry, 153, 801–804.CrossRefGoogle ScholarPubMed
Goldberg, S. C., Schulz, S. C., Schulz, P. M., et al (1986) Borderline and schizotypal personality disorders treated with low-dose thio-thixene vs placebo. Archives of General Psychiatry, 43, 680–686.CrossRefGoogle ScholarPubMed
Goldney, R. D. (1982) Locus of control in young women who have attempted suicide. Journal of Nervous and Mental Disease, 170, 198–201.Google Scholar
Hawton, K., Bancroft, J., Catalan, J., et al (1981) Domiciliary and out-patient treatment of self-poisoning patients by medical and non-medical staff. Psychological Medicine, 11, 169–177.CrossRefGoogle ScholarPubMed
Hawton, K. & Catalan, J. (1987) Attempted Suicide: A Practical Guide to its Management. Oxford: Oxford University Press.Google Scholar
Hawton, K., McKeown, S., Day, A., et al (1987) Evaluation of outpatient counselling compared with general practitioner care following overdoses. Psychological Medicine, 17, 751–761.Google Scholar
Hawton, K. & Fagg, J. (1988) Suicide and other causes of death following attempted suicide. British Journal of Psychiatry, 152, 359–366.CrossRefGoogle ScholarPubMed
Hirsch, S. R., Walsh, C. & Draper, R. (1983) The concept and efficacy of the treatment of parasuicide. British Journal of Clinical Pharmacology, 15, 189S–194S.Google Scholar
Kennedy, P., Kreitman, N. & Ovenstone, I. M. K. (1974) The prevalence of suicide and parasuicide (“attempted suicide”) in Edinburgh. British Journal of Psychiatry, 124, 36–41.Google Scholar
Kessel, N. (1966) The respectability of self-poisoning and the fashion of survival. Journal of Psychosomatic Research, 10, 29–36.CrossRefGoogle ScholarPubMed
Kleinbaum, D. G., Kupper, L. L. & Muller, K. E. (1988) Applied Regression Analysis and Other Multivariate Methods. Boston: PWS-Kent Publishing Co.Google Scholar
Kreitman, N. (1977) Parasuicide. London: John Wiley & Sons.Google Scholar
Kreitman, N. & Casey, P. (1988) Repetition of parasuicide: an epidemiological and clinical study. British Journal of Psychiatry, 153, 792–800.Google Scholar
Kreitman, N., Smith, P. & Tan, E. (1970) Attempted suicide as language: an empirical study. British Journal of Psychiatry, 116, 465–473.Google Scholar
Lefcourt, H. M. (1976) Locus of Control: Current Trends in Theory and Research. New York: John Wiley & Sons.Google Scholar
Linehan, M. M., Chiles, J. A., Egan, K. J., et al (1986) Presenting problems of parasuicides versus suicide ideators and nonsuicidal psychiatric patients. Journal of Consulting and Clinical Psychology, 54, 880–881.Google Scholar
McAleer, J. J. A., Murphy, G. J. J., Taylor, R. H., et al (1986) Trends in the severity of self-poisoning. Journal of the Royal Society of Medicine, 79, 74–75.CrossRefGoogle ScholarPubMed
McLeavey, B. C., Daly, R. J., Murray, C. M., et al (1987) Interpersonal problem-solving deficits in self-poisoning patients. Suicide and Life-Threatening Behavior, 17, 33–49.Google Scholar
Melges, F. T. & Weisz, A. E. (1971) The personal future and suicidal ideation. Journal of Nervous and Mental Disease, 170, 198–201.Google Scholar
Mitchell, I. & Lawson, A. A. H. (1974) Social and environmental aspects of self-poisoning. Scottish Medical Journal, 19, 13–19.CrossRefGoogle ScholarPubMed
Morgan, H. G., Barton, J., Pottle, S., et al (1976) Deliberate self-harm: a follow-up study of 279 patients. British Journal of Psychiatry, 128, 361–368.Google Scholar
Neuringer, C. (1964) Rigid thinking in suicidal individuals. Journal of Consulting Psychology, 28, 54–58.Google Scholar
Newson-Smith, J. G. B. & Hirsch, S. R. (1980) Psychiatric symptoms in self-poisoning patients. In The Suicide Syndrome (eds Farmer, R. & Hirsch, S. R.). London: Croom Helm.Google Scholar
O'Brien, G., Holton, A. R., Hurren, K., et al (1987) Deliberate self-harm - correlates of suicidal intent and severity of depression. Acta Psychiatrica Scandinavica, 75, 474–477.Google Scholar
Patsiokas, A. T., Clum, G. A. & Luscomb, R. L. (1979) Cognitive characteristics of suicide attempters. Journal of Consulting and Clinical Psychology, 47, 478–484.Google Scholar
Philip, A. E. (1970) Traits, attitudes and symptoms in a group of attempted suicides. British Journal of Psychiatry, 116, 475–482.Google Scholar
Rosenberg, M. (1965) Society and the Adolescent Self-image. New Jersey: Princeton University Press.Google Scholar
Rotter, J. (1966) Generalized expectancies for internal versus external control of reinforcement. Psychological Monographs, 80, 1–28.Google Scholar
Roy, A., Adinoff, B. & Linnoila, M. (1988) Acting out hostility in normal volunteers: negative correlation with levels of 5HIAA in cerebrospinal fluid. Psychiatry Research, 24, 187–194.Google Scholar
Roy, A. & Linnoila, M. (1988) Suicidal behavior, impulsiveness and serotonin. Acta Psychiatrica Scandinavica, 78, 529–535.Google Scholar
Shneidman, E. S. (1963) Orientations toward death: a vital aspect of the study of lives. In The Study of Lives (ed. White, R. W.). New York: Atherton Press.Google Scholar
Siani, R., Garzotto, N., Zimmerman Tansella, C., et al (1979) Predictive scales for parasuicide repetition. Further results. Acta Psychiatrica Scandinavica, 59, 17–23.Google Scholar
Stengel, E. & Cook, N. (1958) Attempted Suicide. London: Oxford University Press.Google Scholar
Vinoda, K. S. (1966) Personality characteristics of attempted suicides. British Journal of Psychiatry, 112, 1143–1150.Google Scholar
Weissman, M. M. (1975) The assessment of social adjustment. Archives of General Psychiatry, 32, 357–365.Google Scholar
Weissman, M. M., Fox, K. & Klerman, G. L. (1973) Hostility and depression associated with suicide attempts. American Journal of Psychiatry, 130, 450–455.Google Scholar
Weissman, M. M. & Paykel, E. S. (1974) The Depressed Woman: A Study of Social Relationships. Chicago: University of Chicago Press.Google Scholar
Whitehead, P. C., Johnson, F. G. & Ferrence, R. (1973) Measuring the incidence of self-injury: some methodological and design considerations. American Journal of Orthopsychiatry, 43, 142–148.CrossRefGoogle ScholarPubMed
Williams, J. M. G. (1986) Differences in reasons for taking overdoses in high and low hopelessness groups. British Journal of Medical Psychology, 59, 269–277.CrossRefGoogle ScholarPubMed
Worden, J. W. & Sterling-Smith, R. S. (1973) Lethality patterns in multiple suicide attempts. Life-Threatening Behavior, 3, 95–104.Google Scholar
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