title: Psychological processes and repeat suicidal behavior: a four-year prospective study.
abstract: OBJECTIVE
  Although suicidal behavior is a major public health concern, understanding of individually sensitive suicide risk mechanisms is limited. In this study, the authors investigated, for the first time, the utility of defeat and entrapment in predicting repeat suicidal behavior in a sample of suicide attempters.
  
  
  METHODS
  Seventy patients hospitalized after a suicide attempt completed a range of clinical and psychological measures (depression, hopelessness, suicidal ideation, defeat, and entrapment) while in hospital. Four years later, a nationally linked database was used to determine who had been hospitalized again after a suicide attempt.
  
  
  RESULTS
  Over 4 years, 24.6% of linked participants were readmitted to hospital after a suicidal attempt. In univariate logistic regression analyses, defeat and entrapment as well as depression, hopelessness, past suicide attempts, and suicidal ideation all predicted suicidal behavior over this interval. However, in the multivariate analysis, entrapment and past frequency of suicide attempts were the only significant predictors of suicidal behavior.
  
  
  CONCLUSIONS
  This longitudinal study supports the utility of a new theoretical model in the prediction of suicidal behavior. Individually sensitive suicide risk processes like entrapment could usefully be targeted in treatment interventions to reduce the risk of repeat suicidal behavior in those who have been previously hospitalized after a suicide attempt.
authors.affiliation: Suicidal Behavior Research Laboratory, Institute of Health and Wellbeing, College of Medical, Veterinary & Life Sciences, University of Glasgow.
authors.forename: Rory C
authors.initials: RC
authors.lastname: O'Connor
authors.forename: Roger
authors.initials: R
authors.lastname: Smyth
authors.forename: Eamonn
authors.initials: E
authors.lastname: Ferguson
authors.forename: Caoimhe
authors.initials: C
authors.lastname: Ryan
authors.forename: J Mark G
authors.initials: JM
authors.lastname: Williams
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003469:Culture; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D065026:Hope; D006801:Humans; D007389:Internal-External Control; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D009042:Motivation; D010359:Patient Readmission / Q000706:statistics & numerical data; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D012606:Scotland; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000523:psychology*; D055815:Young Adult