Problem resolution and repetition of parasuicide

Article Abstract:

Parasuicide refers to deliberate attempts to harm oneself. Often the attempts are superficial and repetitious. These people have difficulty coping with their psychosocial situations, usually as a result of deficiency in social skills. They tend to see self-harm as the only option when presented with a problem, and they generally have poor insight regarding the inappropriateness of this response. To study the relationship between resolution of problems and subsequent behavior and psychological changes, 228 persons who attempted suicide in response to psychosocial problems were interviewed. Information was gathered regarding demographics, circumstances leading to and method of the suicide attempt, resultant medical condition, potential to have eventually succeeded if not treated, duration of difficulties, number of previous attempts, age at first attempt, and clinical diagnosis. Various psychological symptoms were assessed as well. Patients were re-interviewed three months later and they were separated into two groups: resolvers (60.4 percent; those for whom severity of problem decreased by at least 50 percent) and nonresolvers (39.6 percent). The main finding was that resolution of problems did not affect repetition rate. This is despite improved social and psychological well-being on the scales used. It appeared that nonresolvers suffered more chronic, low-grade stress as opposed to resolvers, who seemed to be presented with severe, chronic stressors. Shared characteristics of resolvers and nonresolvers to help explain why problem resolution does not reduce incidence or repetition are discussed, although specific variables are elaborated in another article in the March 1990 issue of The British Journal of Psychiatry, by the same researchers. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Life skills

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Why parasuicides repeat despite problem resolution

Article Abstract:

If parasuicide (repetitive attempted suicide) involves people who are experiencing psychosocial difficulties, as has been shown to be the case, then the incidence of repeat attempts on one's life should decrease if the psychosocial precipitants are resolved. This turns out not to be the case. There is no significant difference in repeat rate for those who resolve versus those who do not resolve their major psychosocial difficulties. Using a sample of 187 patients admitted after a suicide attempt and followed-up for three months, clinical and psychosocial factors were identified that could distinguish repeaters from those who do not. It was found that on measures of powerlessness and externally directed hostility, resolvers who repeated a suicide attempt did not improve more on these measures than nonresolvers, even though resolvers as a group did. Therefore, resolvers who repeat are similar in some ways to nonresolvers, despite improvement in psychosocial conditions. Predictive factors for repeaters were perceptions of problems as more severe, a sense of social disconnection, poor frustration tolerance, older age, being male, a greater sense of powerlessness, being younger at first attempt, and using less lethal acts of suicidal behavior. This last factor suggests that death was not the real goal. It is hypothesized that there may be physiological components of this repetitive behavior as well. (Consumer Summary produced by Reliance Medical Information, Inc.)

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