title: Reasons for attempted suicide in later life.
abstract: OBJECTIVE
  Using the Interpersonal Theory of Suicide as a guiding framework, we investigated older adults' causal attributions for suicidal behavior. We hypothesized that older adults who attributed their suicidal behavior to thwarted belongingness or perceived burdensomeness would be more likely to use more immediately lethal means and to re-attempt suicide during the 12-month follow-up.
  
  
  METHODS
  Prospective cohort study in western Sweden.
  
  
  METHODS
  A total of 101 older adults who presented to medical emergency rooms for suicide attempts.
  
  
  METHODS
  Participants were asked why they attempted suicide.
  
  
  RESULTS
  Attributions included: a desire to escape (N = 29), reduced functioning and autonomy (N = 24), psychological problems, including depression (N = 24), somatic problems and physical pain (N = 16), perceived burdensomeness (N = 13), social problems that reflected either thwarted belongingness or family conflict (N = 13), and lack of meaning in life (N = 8); 41 participants provided more than one reason. No specific reason was given by 28 participants, 15 of whom reported not understanding or remembering why they attempted suicide and 13 reported simply wanting to die (or go to sleep and not wake up). As hypothesized, patients who attributed the attempt to thwarted belongingness were more likely to use more immediately lethal means for their index attempt and were more likely to re-attempt during follow-up. This was not the case for those reporting burdensomeness.
  
  
  CONCLUSIONS
  People who attribute suicide attempts to thwarted belongingness use more lethal methods and have a poorer prognosis. Replications across diverse cultural settings are needed to determine whether attributing suicide attempts to thwarted belongingness may warrant increased monitoring.
authors.affiliation: Department of Psychiatry, University of Rochester School of Medicine & Dentistry, Rochester, NY. Electronic address: kimberly_vanorden@urmc.rochester.edu.
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Van Orden
authors.affiliation: Department of Psychiatry & Neurochemistry, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Stefan
authors.initials: S
authors.lastname: Wiktorsson
authors.affiliation: Department of Psychiatry, University of Rochester School of Medicine & Dentistry, Rochester, NY; Department of Psychiatry and Family Medicine, University of Rochester School of Medicine & Dentistry, Rochester, NY.
authors.forename: Paul
authors.initials: P
authors.lastname: Duberstein
authors.affiliation: Department of Psychology, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Anne Ingeborg
authors.initials: AI
authors.lastname: Berg
authors.affiliation: Department of Psychiatry & Neurochemistry, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Madeleine Mellqvist
authors.initials: MM
authors.lastname: Fässberg
authors.affiliation: Department of Psychiatry & Neurochemistry, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Margda
authors.initials: M
authors.lastname: Waern
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015984:Causality; D003071:Cognition; D017281:Cost of Illness; D003863:Depression / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D007398:Interpersonal Relations; D008132:Loneliness; D008297:Male; D016743:Mental Competency; D009042:Motivation; D012944:Social Support; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data; D013548:Sweden / Q000453:epidemiology
keywords: Geriatrics; attempted suicide; perceived burden; social support; thwarted belongingness