Hostname: page-component-848d4c4894-m9kch Total loading time: 0 Render date: 2024-05-12T18:13:03.926Z Has data issue: false hasContentIssue false
  • English
  • Français

Motivations for attempting suicide in mid- and late-life

Published online by Cambridge University Press:  20 June 2018

Maria Alessi Open the ORCID record for Maria Alessi [Opens in a new window] ,
Katalin Szanto  and
Alexandre Dombrovski
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.
Get access Rights & Permissions [Opens in a new window]

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.

Keywords

suicidepersonality disordersgender differences
Type
Original Research Article
Information
International Psychogeriatrics , Volume 31 , Issue 1: Issue Theme: Parkinson's Disease , January 2019 , pp. 109 - 121
Copyright
Copyright © International Psychogeriatric Association 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bancroft, J. H., Skrimshire, A. M. and Simkin, S. (1976). The reasons people give for taking overdoses. The British Journal of Psychiatry: The Journal of Mental Science, 128, 538–548.Google Scholar
Bancroft, J., Hawton, K., Simkin, S., Kingston, B., Cumming, C. and Whitwell, D. (1979). The reasons people give for taking overdoses: a further inquiry. British Journal of Medical Psychology, 52, 353–365. https://doi.org/10.1111/j.2044-8341.1979.tb02536.xGoogle Scholar
Beck, A. T., Beck, R. and Kovacs, M. (1975). Classification of suicidal behaviors: I. Quantifying intent and medical lethality. The American Journal of Psychiatry, 132, 285–287. https://doi.org/10.1176/ajp.132.3.285Google Scholar
Beck, A. T., Schuyler, D. and Herman, I. (1974). Development of suicidal intent scales. In Beck, A. T., Resnik, H. L. and Lettieri, D. J. (eds.), The Prediction of Suicide (p. xii, 249). Oxford, England: Charles Press Publishers.Google Scholar
Bilsker, D. and White, J. (2011). The silent epidemic of male suicide. BMJ, 53, 529–534.Google Scholar
Brodsky, B. S., Groves, S. A., Oquendo, M. A., Mann, J. J. and Stanley, B. (2006). Interpersonal precipitants and suicide attempts in borderline personality disorder. Suicide and Life-Threatening Behavior, 36, 313–322. https://doi.org/10.1521/suli.2006.36.3.313Google Scholar
Bryan, C. J., Rudd, M. D. and Wertenberger, E. (2013). Reasons for suicide attempts in a clinical sample of active duty soldiers. Journal of Affective Disorders, 144, 148–152. https://doi.org/10.1016/j.jad.2012.06.030Google Scholar
Canetto, S. S. (1997). Gender and suicidal behavior: theories and evidence. In Maris, R. W., Silverman, M. M. and Canetto, S. S. (eds.), Review of Suicidology, 1997 (pp. 138–167). New York, NY: Guilford Press.Google Scholar
CDC. (2015). Fatal Injury Reports. Retrieved February 23, 2017, from https://www.cdc.gov/injury/wisqars/fatal_injury_reports.htmlGoogle Scholar
Cohen, S., Mermelstein, R., Kamarck, T. and Hoberman, H. M. (1985). Measuring the functional components of social support. In Sarason, I. G. and Sarason, B. R. (eds.), Social Support: Theory, Research and Applications (pp. 73–94). The Netherlands: Springer. https://doi.org/10.1007/978-94-009-5115-0_5Google Scholar
Costa and McCrae. (1989). Neo PI/FFI Manual Supplement. Odessa, FL: Psychological Assessment Resources.Google Scholar
De Leo, D. et al. (2001). Attempted and completed suicide in older subjects: results from the WHO/EURO multicentre study of suicidal behaviour. International Journal of Geriatric Psychiatry, 16, 300–310.Google Scholar
Digman, J. (1990). Personality structure: emergence of the five-factor model. Annual Review of Psychology, 41, 417–440. https://doi.org/10.1146/annurev.ps.41.020190.002221Google Scholar
Freedenthal, S. (2007). Challenges in assessing intent to die: can suicide attempters be trusted? OMEGA-Journal of Death and Dying, 55, 57–70.Google Scholar
Hjelmeland, H. et al. (2002). Why people engage in parasuicide: a cross-cultural study of intentions. Suicide and Life-Threatening Behavior, 32, 380–393. https://doi.org/10.1521/suli.32.4.380.22336Google Scholar
Hjelmeland, H. and Knizek, B. L. (1999). Conceptual confusion about intentions and motives of nonfatal suicidal behavior: a discussion of terms employed in the literature of suicidology. Archives of Suicide Research, 5, 277–283. https://doi.org/10.1023/A:1009685700347Google Scholar
Holden, R. R., Kerr, P. S., Mendonca, J. D. and Velamoor, V. R. (1998). Are some motives more linked to suicide proneness than others? Journal of Clinical Psychology, 54, 569–576. https://doi.org/10.1002/(SICI)1097-4679(199808)54:5<569::AID-JCLP2>3.0.CO;2-G3.0.CO;2-G>Google Scholar
Holden, R. R. and McLeod, L. D. (2000). The structure of the Reasons for Attempting Suicide Questionnaire (RASQ) in a nonclinical adult population. Personality and Individual Differences, 29, 621–628.Google Scholar
Kjølseth, I., Ekeberg, Ø. and Steihaug, S. (2009). “Why do they become vulnerable when faced with the challenges of old age?” Elderly people who committed suicide, described by those who knew them. International Psychogeriatrics, 21, 903–912. https://doi.org/10.1017/S1041610209990342Google Scholar
Maltsberger, J. T. and Buie, D. H. (1974). Countertransference hate in the treatment of suicidal patients. Archives of General Psychiatry, 30, 625–633. doi:10.1001/archpsyc.1974.01760110049005Google Scholar
Maydeu-Olivares, A. and D'Zurilla, T. J. (1996). A factor-analytic study of the social problem-solving inventory: an integration of theory and data. Cognitive Therapy and Research, 20, 115–133. https://doi.org/10.1007/BF02228030Google Scholar
Mieczkowski, T. A., Sweeney, J. A., Haas, G. L., Junker, B. W., Brown, R. P. and Mann, J. J. (1993). Factor composition of the suicide intent scale. Suicide and Life-Threatening Behavior, 23, 37–45. https://doi.org/10.1111/j.1943-278X.1993.tb00277.xGoogle Scholar
Miller, M. D. et al. (1992). Rating chronic medical illness burden in geropsychiatric practice and research: application of the cumulative illness rating scale. Psychiatry Research, 41, 237–248. https://doi.org/10.1016/0165-1781(92)90005-NGoogle Scholar
Morey, L. C. (1991). Personality Assessment Inventory Professional Manual. Odessa, FL: Psychological Assessment Resources, Inc.Google Scholar
Morse, J. Q. and Pilkonis, P. A. (2007). Screening for personality disorders. Journal of Personality Disorders, 21, 179–198. https://doi.org/10.1521/pedi.2007.21.2.179Google Scholar
O'Carroll, P. W., Berman, A. L., Maris, R. W., Moscicki, E. K., Tanney, B. L. and Silverman, M. M. (1996). Beyond the tower of babel: a nomenclature for suicidology. Suicide and Life-Threatening Behavior, 26, 237–252. https://doi.org/10.1111/j.1943-278X.1996.tb00609.xGoogle Scholar
Patton, J. H., Stanford, M. S. and Barratt, E. S. (1995). Factor structure of the Baratt impulsiveness scale. Journal of Clinical Psychology, 51, 768–774.Google Scholar
Pincus, A. L., Cain, N. M. and Wright, A. G. C. (2014). Narcissistic grandiosity and narcissistic vulnerability in psychotherapy. Personality Disorders: Theory, Research, and Treatment, 5, 439–443. https://doi.org/10.1037/per0000031Google Scholar
Qin, P., Mortensen, P. B., Agerbo, E., Westergard-Nielsen, N. and Eriksson, T. O. R. (2000). Gender differences in risk factors for suicide in Denmark. The British Journal of Psychiatry, 177, 546–550.Google Scholar
Saulsman, L. M. and Page, A. C. (2004). The five-factor model and personality disorder empirical literature: a meta-analytic review. Clinical Psychology Review, 23, 1055–1085. https://doi.org/10.1016/j.cpr.2002.09.001Google Scholar
Schmidtke, A. et al. (1996). Attempted suicide in Europe: rates, trends and sociodemographic characteristics of suicide attempters during the period 1989–1992. Results of the WHO/EURO Multicentre Study on Parasuicide. Acta Psychiatrica Scandinavica, 93, 327–338. https://doi.org/10.1111/j.1600-0447.1996.tb10656.xGoogle Scholar
Schnyder, U., Valach, L., Bichsel, K. and Michel, K. (1999). Attempted suicide: do we understand the patients’ reasons? General Hospital Psychiatry, 21, 62–69.Google Scholar
Van Orden, K. A., Wiktorsson, S., Duberstein, P., Berg, A. I., Fässberg, M. M. and Waern, M. (2015). Reasons for attempted suicide in later life. The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry, 23, 536–544. https://doi.org/10.1016/j.jagp.2014.07.003Google Scholar
Whiteside, S. P. and Lynam, D. R. (2001). The five factor model and impulsivity: using a structural model of personality to understand impulsivity. Personality and Individual Differences, 30, 669–689.Google Scholar
Wiktorsson, S., Olsson, P. and Waern, M. (2016). Medically serious and non-serious suicide attempts in persons aged 70 and above. Geriatrics, 1, 23. doi:10.3390/geriatrics1030023Google Scholar
Williams, C. L., Davidson, J. A. and Montgomery, I. (1980). Impulsive suicidal behavior. Journal of Clinical Psychology, 36, 90–94.Google Scholar
Supplementary material: File

Alessi et al. supplementary material

Table S1

Download Alessi et al. supplementary material(File)
File 88 KB
Supplementary material: File

Alessi et al. supplementary material

Table S2

Download Alessi et al. supplementary material(File)
File 88.1 KB
Supplementary material: File

Alessi et al. supplementary material

Table S3

Download Alessi et al. supplementary material(File)
File 213.3 KB
Supplementary material: File

Alessi et al. supplementary material

Table S4

Download Alessi et al. supplementary material(File)
File 211.1 KB