Microanalysis of adolescent suicide attempters and ideators during the acute suicidal episode.
OBJECTIVE
To compare psychological and event-related contingencies that characterize and differentiate adolescent suicidal ideation and attempts.


METHODS
Thirty-five ideators and 32 attempters (aged 12 to 17 years) consecutively referred to the suicide disorders clinic were evaluated with a semistructured interview about current and past emotional, cognitive, and behavioral states.


RESULTS
Before the precipitant stressor (baseline), attempters reported significantly more hopelessness than ideators (odds ratio [OR] = 4.2, p < .05). During the suicidal episode, attempters, relative to ideators, spent more time ideating (OR = 4.3, p < .05), were more likely to isolate themselves (OR = 5.8, p < .01), and were less likely to tell anyone what they were thinking (OR = 4.5, p < .05). In contrast, ideators reported significantly more residual anger after the episode than did attempters (OR = 4.0, p < .05). All the episodes of ideation and attempts were preceded by a stress event. No differences were found between the groups on Beck Depression inventory scores.


CONCLUSIONS
Preexisting hopelessness, a tendency toward isolation, not talking about ideation, and longer length of time ideating during suicidal episodes discriminated suicide attempters from suicide ideators. Knowledge of these factors may be helpful in preventive and treatment efforts with suicidal adolescents.
Negron
R
R
Disruptive Behaviors Disorders Clinic, East Ridge Health Systems, Martinsburg, WV 25401, USA.
Piacentini
J
J
Graae
F
F
Davies
M
M
Shaffer
D
D
D000296:Adolescent Psychiatry / Q000379:methods*; D000342:Affective Symptoms; D002648:Child; D005191:Family Characteristics; D005260:Female; D005544:Forecasting; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012934:Social Isolation; D013406:Suicide, Attempted / Q000523:psychology*