When the solution is part of the problem: problem solving in elderly suicide attempters.
OBJECTIVE
Depression, loss, and physical illness are associated with suicide in the elderly. However, the nature of individual vulnerability remains poorly understood. Poor problem solving has been suggested as a risk factor for suicide in younger adults. Unresolved problems may create an accumulation of stressors. Thus, those with perceived deficits in problem-solving ability may be predisposed to suicidal behavior. To test this hypothesis, we investigated whether elderly suicide attempters perceived their problem solving as deficient.


METHODS
Sixty-four individuals aged 60 and older participated in the study including depressed suicide attempters, depressed non-attempters, and non-depressed controls. The social problem solving inventory-revised: short-version was used to measure participants' perceived social problem solving, assessing both adaptive problem-solving dimensions (positive problem orientation and rational problem solving) and dysfunctional dimensions (negative problem orientation, impulsivity/carelessness, and avoidance).


RESULTS
Depressed elderly who had attempted suicide perceived their overall problem solving as deficient, compared to non-suicidal depressed and non-depressed elderly. Suicide attempters perceived their problems more negatively and approached them in a more impulsive manner. On rational problem solving and avoidant style sub-scales, suicide attempters did not differ from non-suicidal depressed. However, both depressed groups reported lower rational problem solving and higher avoidance compared to non-depressed controls.


CONCLUSIONS
A perception of life problems as threatening and unsolvable and an impulsive approach to problem solving appear to predispose vulnerable elderly to suicide attempts.
Gibbs
Lawrence M
LM
Western Psychiatric Institute and Clinic, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Dombrovski
Alexandre Y
AY
Morse
Jennifer
J
Siegle
Greg J
GJ
Houck
Patricia R
PR
Szanto
Katalin
K
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D008875:Middle Aged; D011340:Problem Solving; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012649:Self Concept; D012940:Social Problems; D013406:Suicide, Attempted / Q000517:prevention & control / Q000523:psychology*