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Distinguishing prisoners who think about suicide from those who attempt suicide

Published online by Cambridge University Press:  18 November 2019

Louis Favril  and
Rory C. O'Connor
Louis Favril*
Affiliation:
Institute for International Research on Criminal Policy (IRCP), Faculty of Law and Criminology, Ghent University, Belgium
Rory C. O'Connor
Affiliation:
Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, UK
*
Author for correspondence: Louis Favril, E-mail: louis.favril@ugent.be
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Abstract

Background

Many people who consider suicide do not translate these intentions into action. Although prisoners constitute a particularly high-risk group for suicide, little is known about the factors that distinguish those who think about suicide from those who attempt suicide.

Methods

Participants were 1326 adult offenders (1203 men) randomly selected from 15 Belgian prisons, representing 14% of the national prison population. Multivariate regression analysis compared prisoners who attempted suicide (n = 277) with those who thought about suicide but never made an attempt (n = 312) on a range of established risk factors.

Results

Among the 589 participants reporting a lifetime history of suicidal ideation (44% of the total sample), almost half (47%) had made a suicide attempt. Relative to those who only thought about suicide, participants who attempted suicide were more likely to be violent offenders (aOR 2.33, 95% CI 1.49–3.62) and have a history of non-suicidal self-injury (aOR 3.19, 95% CI 2.09–4.86). The presence of self-reported mental disorder diagnosis (aOR = 2.84, 95% CI 1.91–4.24) and illicit substance abuse (aOR = 2.01, 95% CI 1.24–3.28) also independently differentiated prisoners who attempted v. considered suicide.

Conclusion

This study provides preliminary evidence that behavioural and mental health factors are implicated in the transition from thoughts to acts of suicide in prisoners. Prospective studies are warranted to explore whether these risk factors predict progression from ideation to action over time.

Keywords

Ideation-to-actionoffenderself-harmsuicidal processsuicidal behaviour
Type
Original Articles
Information
Psychological Medicine , Volume 51 , Issue 2 , January 2021 , pp. 228 - 235
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Copyright
Copyright © Cambridge University Press 2019

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References

Batterham, PJ, Calear, AL, Christensen, H, Carragher, N and Sunderland, M (2018) Independent effects of mental disorders on suicidal behavior in the community. Suicide and Life-Threatening Behavior 48, 512–521.CrossRefGoogle Scholar
Binswanger, IA, Merrill, JO, Krueger, PM, White, MC, Booth, RE and Elmore, JG (2010) Gender differences in chronic medical, psychiatric, and substance-dependence disorders among jail inmates. American Journal of Public Health 100, 476–482.CrossRefGoogle ScholarPubMed
Boren, EA, Folk, JB, Loya, JM, Tangney, JP, Barboza, SE and Wilson, JS (2018) The suicidal inmate: a comparison of inmates who attempt versus complete suicide. Suicide and Life-Threatening Behavior 48, 570–579.CrossRefGoogle ScholarPubMed
Borges, G, Nock, MK, Abad, JMH, Hwang, I, Sampson, NA, Alonso, J, Andrade, LH, Angermeyer, MC, Beautrais, A, Bromet, E, Bruffaerts, R, de Girolamo, G, Florescu, S, Gureje, O, Hu, CY, Karam, EG, Kovess-Masfety, V, Lee, S, Levinson, D, Medina-Mora, ME, Ormel, J, Posada-Villa, J, Sagar, R, Tomov, T, Uda, H, Williams, DR and Kessler, RC (2010) Twelve-month prevalence of and risk factors for suicide attempts in the World Health Organization World Mental Health Surveys. Journal of Clinical Psychiatry 71, 1617–1628.CrossRefGoogle ScholarPubMed
Brown, G, Hoffman, R, Neufeld, E and Mrozewski, T (2017) Suicide Risk Assessment Instruments: a Review of Current Literature. Ottawa: Correctional Service of Canada.Google Scholar
Cerel, J, Maple, M, Venne, J, Brown, M, Moore, M and Flaherty, C (2017) Suicide exposure in the population: perceptions of impact and closeness. Suicide and Life-Threatening Behavior 47, 696–708.CrossRefGoogle ScholarPubMed
Cha, CB, Franz, PJ, Guzmán, EM, Glenn, CR, Kleiman, EM and Nock, MK (2018) Suicide among youth – epidemiology, (potential) etiology, and treatment. Journal of Child Psychology and Psychiatry 59, 460–482.CrossRefGoogle Scholar
Dhingra, K, Boduszek, D and O'Connor, RC (2015) Differentiating suicide attempters from suicide ideators using the Integrated Motivational-Volitional model of suicidal behaviour. Journal of Affective Disorders 186, 211–218.CrossRefGoogle ScholarPubMed
Favril, L (2019) Non-suicidal self-injury and co-occurring suicide attempt in male prisoners. Psychiatry Research 276, 196–202.CrossRefGoogle ScholarPubMed
Favril, L and Dirkzwager, A (2019) De psychische gezondheid van gedetineerden in België en Nederland: een systematisch overzicht. Tijdschrift voor Criminologie 61, 5–33.CrossRefGoogle Scholar
Favril, L, Vander Laenen, F, Vandeviver, C and Audenaert, K (2017) Suicidal ideation while incarcerated: prevalence and correlates in a large sample of male prisoners in Flanders, Belgium. International Journal of Law and Psychiatry 55, 19–28.10.1016/j.ijlp.2017.10.005CrossRefGoogle Scholar
Favril, L, Wittouck, C, Audenaert, K and Vander Laenen, F (2019) A 17-year national study of prison suicides in Belgium. Crisis 40, 42–53.CrossRefGoogle ScholarPubMed
Fazel, S, Cartwright, J, Norman-Nott, A and Hawton, K (2008) Suicide in prisoners: a systematic review of risk factors. Journal of Clinical Psychiatry 69, 1721–1731.CrossRefGoogle ScholarPubMed
Fazel, S, Hayes, AJ, Bartellas, K, Clerici, M and Trestman, R (2016) Mental health of prisoners: prevalence, adverse outcomes, and interventions. Lancet Psychiatry 3, 871–881.CrossRefGoogle ScholarPubMed
Fazel, S, Ramesh, T and Hawton, K (2017) Suicide in prisons: an international study of prevalence and contributory factors. Lancet Psychiatry 4, 946–952.CrossRefGoogle Scholar
Franklin, JC, Ribeiro, JD, Fox, KR, Bentley, KH, Kleiman, EM, Huang, X, Musacchio, KM, Jaroszewski, AC, Chang, BP and Nock, MK (2017) Risk factors for suicidal thoughts and behaviors: a meta-analysis of 50 years of research. Psychological Bulletin 143, 187–232.10.1037/bul0000084CrossRefGoogle ScholarPubMed
Georgiades, K, Boylan, K, Duncan, L, Wang, L, Colman, I, Rhodes, AE, Bennett, K, Comeau, J, Manion, I and Boyle, MH (2019) Prevalence and correlates of youth suicidal ideation and attempts: evidence from the 2014 Ontario Child Health Study. Canadian Journal of Psychiatry 64, 265–274.CrossRefGoogle ScholarPubMed
Glenn, CR, Kleiman, EM, Cha, CB, Deming, CA, Franklin, JC and Nock, MK (2018) Understanding suicide risk within the Research Domain Criteria (RDoC) framework: a meta-analytic review. Depression and Anxiety 35, 65–88.10.1002/da.22686CrossRefGoogle ScholarPubMed
Gould, C, McGeorge, T and Slade, K (2018) Suicide screening tools for use in adult offenders: a systematic review. Archives of Suicide Research 22, 345–364.CrossRefGoogle ScholarPubMed
Hales, H, Edmondson, A, Davison, S, Maughan, B and Taylor, PJ (2015) The impact of contact with suicide-related behavior in prison on young offenders. Crisis 36, 21–30.CrossRefGoogle ScholarPubMed
Hawton, K, Linsell, L, Adeniji, T, Sariaslan, A and Fazel, S (2014) Self-harm in prisons in England and Wales: an epidemiological study of prevalence, risk factors, clustering, and subsequent suicide. Lancet 383, 1147–1154.CrossRefGoogle ScholarPubMed
Humber, N, Webb, R, Piper, M, Appleby, L and Shaw, J (2013) A national case-control study of risk factors among prisoners in England and Wales. Social Psychiatry and Psychiatric Epidemiology 48, 1177–1185.CrossRefGoogle ScholarPubMed
Jenkins, R, Bhugra, D, Meltzer, H, Singleton, N, Bebbington, P, Brugha, T, Coid, J, Farrell, M, Lewis, G and Paton, J (2005) Psychiatric and social aspects of suicidal behaviour in prisons. Psychological Medicine 35, 257–269.CrossRefGoogle ScholarPubMed
Joiner, TE, Ribeiro, JD and Silva, C (2012) Nonsuicidal self-injury, suicidal behavior, and their co-occurrence as viewed through the lens of the Interpersonal Theory of Suicide. Current Directions in Psychological Science 21, 342–347.CrossRefGoogle Scholar
Kiekens, G, Hasking, P, Boyes, M, Claes, L, Mortier, P, Auerbach, RP, Cuijpers, P, Demyttenaere, K, Green, JG, Kessler, RC, Myin-Germeys, I, Nock, MK and Bruffaerts, R (2018) The associations between non-suicidal self-injury and first onset suicidal thoughts and behaviors. Journal of Affective Disorders 239, 171–179.CrossRefGoogle ScholarPubMed
Kim, SM, Baek, JH, Han, DH, Lee, YS and Yurgelun-Todd, DA (2015) Psychosocial-environmental risk factors for suicide attempts in adolescents with suicidal ideation: findings from a sample of 73,238 adolescents. Suicide and Life-Threatening Behavior 45, 477–487.CrossRefGoogle ScholarPubMed
Klonsky, ED and May, AM (2014) Differentiating suicide attempters from suicide ideators: a critical frontier for suicidology research. Suicide and Life-Threatening Behavior 44, 1–5.CrossRefGoogle ScholarPubMed
Klonsky, ED and May, AM (2015) The three-step theory (3ST): a new theory of suicide rooted in the ‘ideation-to-action’ framework. International Journal of Cognitive Therapy 8, 114–129.CrossRefGoogle Scholar
Klonsky, ED, May, AM and Glenn, CR (2013) The relationship between nonsuicidal self-injury and attempted suicide: converging evidence from four samples. Journal of Abnormal Psychology 122, 231–237.CrossRefGoogle ScholarPubMed
Klonsky, ED, May, AM and Saffer, BY (2016) Suicide, suicide attempts, and suicidal ideation. Annual Review of Clinical Psychology 12, 307–330.CrossRefGoogle ScholarPubMed
Klonsky, ED, Qiu, TY and Saffer, BY (2017) Recent advances in differentiating suicide attempters from suicide ideators. Current Opinion in Psychiatry 30, 15–20.CrossRefGoogle ScholarPubMed
Klonsky, ED, Saffer, BY and Bryan, CJ (2018) Ideation-to-action theories of suicide: a conceptual and empirical update. Current Opinion in Psychology 22, 38–43.10.1016/j.copsyc.2017.07.020CrossRefGoogle ScholarPubMed
Larney, S, Topp, L, Indig, D, O'Driscoll, C and Greenberg, D (2012) A cross-sectional survey of prevalence and correlates of suicidal ideation and suicide attempts among prisoners in New South Wales, Australia. BMC Public Health 12, 14.CrossRefGoogle ScholarPubMed
Mars, B, Heron, J, Klonsky, ED, Moran, P, O'Connor, RC, Tilling, K, Wilkinson, P and Gunnell, D (2019 a) What distinguishes adolescents with suicidal thoughts from those who have attempted suicide? A population-based birth cohort study. Journal of Child Psychology and Psychiatry 60, 91–99.CrossRefGoogle ScholarPubMed
Mars, B, Heron, J, Klonsky, ED, Moran, P, O'Connor, RC, Tilling, K, Wilkinson, P and Gunnell, D (2019 b) Predictors of future suicide attempt among adolescents with suicidal thoughts or non-suicidal self-harm: a population-based birth cohort study. Lancet Psychiatry 6, 327–337.CrossRefGoogle ScholarPubMed
Marzano, L, Hawton, K, Rivlin, A, Smith, EN, Piper, M and Fazel, S (2016) Prevention of suicidal behavior in prisons. Crisis 37, 323–334.10.1027/0227-5910/a000394CrossRefGoogle ScholarPubMed
May, AM and Klonsky, ED (2016) What distinguishes suicide attempters from suicide ideators? A meta-analysis of potential factors. Clinical Psychology 23, 5–20.Google Scholar
May, AM and Victor, SE (2018) From ideation to action: recent advances in understanding suicide capability. Current Opinion in Psychology 22, 1–6.CrossRefGoogle ScholarPubMed
McMahon, K, Hoertel, N, Olfson, M, Wall, M, Wang, S and Blanco, C (2018) Childhood maltreatment and impulsivity as predictors of interpersonal violence, self-injury and suicide attempts: a national study. Psychiatry Research 269, 386–393.CrossRefGoogle ScholarPubMed
McManus, S, Gunnell, D, Cooper, C, Bebbington, PE, Howard, LM, Brugha, T, Jenkins, R, Hassiotis, A, Weich, S and Appleby, L (2019) Prevalence of non-suicidal self-harm and service contact in England, 2000–14: repeated cross-sectional surveys of the general population. Lancet Psychiatry 6, 573–581.CrossRefGoogle ScholarPubMed
Millner, AJ, Lee, MD and Nock, MK (2015) Single-item measurement of suicidal behaviors: validity and consequences of misclassification. PLoS ONE 10, e0141606.CrossRefGoogle ScholarPubMed
Millner, AJ, Ursano, RJ, Hwang, I, King, A, Naifeh, JA, Sampson, NA, Zaslavsky, AM, Stein, MB, Kessler, RC and Nock, MK (2019) Prior mental disorders and lifetime suicidal behaviors among US Army soldiers in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). Suicide and Life-Threatening Behavior 49, 3–22.CrossRefGoogle Scholar
Miranda, R, Ortin, A, Scott, M and Shaffer, D (2014) Characteristics of suicidal ideation that predict the transition to future suicide attempts in adolescents. Journal of Child Psychology and Psychiatry 55, 1288–1296.CrossRefGoogle ScholarPubMed
Naghavi, M (2019) Global, regional, and national burden of suicide mortality 1990 to 2016: systematic analysis for the Global Burden of Disease Study 2016. BMJ 364, l94.CrossRefGoogle ScholarPubMed
Nock, MK, Borges, G, Bromet, EJ, Alonso, J, Angermeyer, M, Beautrais, A, Bruffaerts, R, Chiu, WT, de Girolamo, G, Gluzman, S, de Graaf, R, Gureje, O, Haro, JM, Huang, Y, Karam, E, Kessler, RC, Lepine, JP, Levinson, D, Medina-Mora, ME, Ono, Y, Posada-Villa, J and Williams, D (2008) Cross-national prevalence and risk factors for suicidal ideation, plans and attempts. British Journal of Psychiatry 192, 98–105.CrossRefGoogle ScholarPubMed
Nock, MK, Hwang, I, Sampson, NA and Kessler, RC (2010) Mental disorders, comorbidity and suicidal behavior: results from the National Comorbidity Survey Replication. Molecular Psychiatry 15, 868–876.CrossRefGoogle ScholarPubMed
Nock, MK, Kessler, RC and Franklin, JC (2016) Risk factors for suicide ideation differ from those for the transition to suicide attempt: the importance of creativity, rigor, and urgency in suicide research. Clinical Psychology 23, 31–34.Google Scholar
Nock, MK, Millner, AJ, Joiner, TE, Gutierrez, PM, Han, G, Hwang, I, King, A, Naifeh, JA, Sampson, NA, Zaslavsky, AM, Stein, MB, Ursano, RJ and Kessler, RC (2018) Risk factors for the transition from suicide ideation to suicide attempt: results from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). Journal of Abnormal Psychology 127, 139–149.CrossRefGoogle Scholar
O'Connor, RC and Nock, MK (2014) The psychology of suicidal behaviour. Lancet Psychiatry 1, 73–85.CrossRefGoogle ScholarPubMed
O'Connor, RC and Kirtley, OJ (2018) The integrated motivational-volitional model of suicidal behaviour. Philosophical Transactions of the Royal Society B 373, 20170268.CrossRefGoogle ScholarPubMed
O'Connor, RC and Portzky, G (2018) Looking to the future: a synthesis of new developments and challenges in suicide research and prevention. Frontiers in Psychology 9, 2139.CrossRefGoogle ScholarPubMed
O'Connor, RC, Rasmussen, S and Hawton, K (2012) Distinguishing adolescents who think about self-harm from those who engage in self-harm. British Journal of Psychiatry 200, 330–335.CrossRefGoogle ScholarPubMed
O'Donnell, O, House, A and Waterman, M (2015) The co-occurrence of aggression and self-harm: systematic literature review. Journal of Affective Disorders 175, 325–350.CrossRefGoogle ScholarPubMed
Rooney, EE, Hill, RM, Oosterhoff, B and Kaplow, JB (2019) Violent victimization and perpetration as distinct risk factors for adolescent suicide attempts. Children's Health Care 48, 410–427.CrossRefGoogle Scholar
Saffer, BY and Klonsky, ED (2018) Do neurocognitive abilities distinguish suicide attempters from suicide ideators? A systematic review of an emerging research area. Clinical Psychology 25, e12227.Google Scholar
Sánchez, FC, Fearn, N and Vaughn, MG (2018) Risk factors associated with near-lethal suicide attempts during incarceration among men in the Spanish prison system. International Journal of Offender Therapy and Comparative Criminology 62, 1452–1473.CrossRefGoogle ScholarPubMed
Sarchiapone, M, Carli, V, Di Giannantonio, M and Roy, A (2009) Risk factors for attempting suicide in prisoners. Suicide and Life-Threatening Behavior 39, 343–350.CrossRefGoogle ScholarPubMed
Stack, S (2014) Differentiating suicide ideators from attempters: violence – a research note. Suicide and Life-Threatening Behavior 44, 46–57.CrossRefGoogle ScholarPubMed
Stoliker, BE (2018) Attempted suicide: a multilevel examination of inmate characteristics and prison context. Criminal Justice and Behavior 45, 589–611.CrossRefGoogle Scholar
Swogger, MT, Van Orden, KA and Conner, KR (2014) The relationship of outwardly directed aggression to suicidal ideation and suicide attempts across two high-risk samples. Psychology of Violence 4, 184–195.CrossRefGoogle ScholarPubMed
Taliaferro, LA and Muehlenkamp, JJ (2014) Risk and protective factors that distinguish adolescents who attempt suicide from those who only consider suicide in the past year. Suicide and Life-Threatening Behavior 44, 6–22.CrossRefGoogle ScholarPubMed
Turecki, G and Brent, DA (2016) Suicide and suicidal behaviour. Lancet 387, 1227–1239.CrossRefGoogle ScholarPubMed
Turecki, G, Brent, DA, Gunnell, D, O'Connor, RC, Oquendo, MA, Pirkis, J and Stanley, BH (2019) Suicide and suicide risk. Nature Reviews Disease Primers 5, 74.CrossRefGoogle ScholarPubMed
Van Orden, KA, Witte, TK, Cukrowicz, KC, Braithwaite, SR, Selby, EA and Joiner, TE (2010) The interpersonal theory of suicide. Psychological Review 117, 575–600.CrossRefGoogle ScholarPubMed
Wetherall, K, Cleare, S, Eschle, S, Ferguson, E, O'Connor, DB, O'Carroll, RE and O'Connor, RC (2018) From ideation to action: differentiating between those who think about suicide and those who attempt suicide in a national study of young adults. Journal of Affective Disorders 241, 475–483.CrossRefGoogle Scholar