title: Examining the Impact of Suicide Attempt Function and Perceived Effectiveness in Predicting Reattempt for Emergency Medicine Patients.
abstract: While previous studies have examined motivational aspects of self-directed violence, few studies have included specific motivations in predictive models for future suicide attempts. The current study utilized a sample of 160 individuals treated in an acute emergency setting following a suicide attempt who completed an interview battery that included an assessment of functional aspects of the index suicide attempt. A follow-up interview was conducted at 6 months to ascertain subsequent suicide attempts. The functional domains of suicide attempts were labeled as reduction-of-distress, communication, perceived better alternative to living, and self-loathing. Above and beyond other known risk factors, including history and highest lethality of previous self-injury, suicide attempts that served a communication function (OR = 0.18, p = .02, CI = 0.04, 0.73) and higher ratings of clinical dysfunction (OR = 3.41, p = .05, CI = 1.02, 11.36) were associated with a significant reduction in likelihood to engage in a suicide attempt during the 6-month follow-up window. Including the perceived effectiveness of the index suicide attempt in getting one's needs met strengthened the overall model predicting a suicide attempt in the follow-up window and was an independent risk factor above and beyond other variables in the model OR = 1.75, p = .04, CI = 1.02, 3.01). Assessment of functional aspects of suicide attempt is feasible and may improve formulation of risk in a population where typical risk factors for suicide are ubiquitous.
authors.affiliation: University of Louisville. Electronic address: stephen.oconnor@louisville.edu.
authors.forename: Stephen S
authors.initials: SS
authors.lastname: O'Connor
authors.affiliation: University of Washington.
authors.forename: Katherine Anne
authors.initials: KA
authors.lastname: Comtois
authors.affiliation: University of Washington.
authors.forename: David C
authors.initials: DC
authors.lastname: Atkins
authors.affiliation: University of Washington.
authors.forename: Amanda H
authors.initials: AH
authors.lastname: Kerbrat
mesh_terms: D000328:Adult; D001294:Attitude to Health; D004635:Emergency Medicine; D005260:Female; D006801:Humans; D008297:Male; D010349:Patient Compliance / Q000706:statistics & numerical data; D011369:Professional-Patient Relations; D012307:Risk Factors; D016728:Self-Injurious Behavior; D013406:Suicide, Attempted / Q000517:prevention & control* / Q000523:psychology*
keywords: assessment; emergency medicine; function; longitudinal; suicide attempt