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Motivations for attempting suicide in mid- and late-life

Published online by Cambridge University Press:  20 June 2018

Maria Alessi*
Affiliation:
Western Psychiatric Institute & Clinic, The University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
Katalin Szanto
Affiliation:
Western Psychiatric Institute & Clinic, The University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
Alexandre Dombrovski
Affiliation:
Western Psychiatric Institute & Clinic, The University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
*
Correspondence should be addressed to: Maria Alessi, Western Psychiatric Institute & Clinic, the University of Pittsburgh Medical Center, 100 N. Bellefield Ave, Pittsburgh 100 N. Bellefield Ave., Room 740, Pittsburgh, PA 15213, USA. Phone: +1-412-683-7358. Email: maria.grace.alessi@gmail.com.

Abstract

Objectives:

To understand pathways to suicide by investigating the association between personality and suicidal motivations in mid- and late-life attempts.

Design:

In a two-study approach, we measured different components of suicidal motivations using an existing self-report investigating reasons for suicide and a semi-qualitative assessment of motivational states preceding attempts.

Setting:

Inpatient and outpatient psychiatric services in Pittsburgh, PA.

Participants:

Study 1 (n = 50, mean age at attempt = 60.4) was a smaller sample of suicide attempters included in Study 2 (n = 69, mean age at attempt = 60.9). Non-psychiatric healthy controls (n = 50, mean age = 67.1) were used as benchmarks for dispositional measures.

Measurements:

Motives for suicide were measured by the Reasons for Attempting Suicide Questionnaire (RASQ). Participants' written descriptions of the thoughts and feelings preceding their attempt captured motivational states. Measures of personality for both studies included assessments of impulsivity, five-factor model, interpersonal dysfunction, and borderline traits.

Results:

In study 1, escape/self-punishment motives on the RASQ were associated with multiple attempts and borderline pathology, while interpersonal motives were less frequently endorsed and associated with poorly planned attempts. In study 2, experiences of defeat (i.e. powerlessness, poor coping to threats to autonomy/status) were more frequently endorsed by men and associated with disagreeableness.

Conclusions:

Study 1 revealed that attempters high in dysfunctional psychopathology were more likely to report self-oriented escape motives for suicide, while study 2 identified a putative pathway to suicide in men involving antagonism and the experience of defeat.

Type
Original Research Article
Copyright
Copyright © International Psychogeriatric Association 2018 

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