Prevalence of and risk factors for suicide attempt versus suicide gestures: Analysis of the National Comorbidity Survey

Department of Psychology, Harvard University, Cambridge, MA 02138, USA.
Journal of Abnormal Psychology (Impact Factor: 4.86). 09/2006; 115(3):616-23. DOI: 10.1037/0021-843X.115.3.616
Source: PubMed


Definitions and classification schemes for suicide attempts vary widely among studies, introducing conceptual, methodological, and clinical problems. We tested the importance of the intent to die criterion by comparing self-injurers with intent to die, suicide attempters, and those who self-injured not to die but to communicate with others, suicide gesturers, using data from the National Comorbidity Survey (n = 5,877). Suicide attempters (prevalence = 2.7%) differed from suicide gesturers (prevalence = 1.9%) and were characterized by male gender, fewer years of education, residence in the southern and western United States; psychiatric diagnoses including depressive, impulsive, and aggressive symptoms; comorbidity; and history of multiple physical and sexual assaults. It is possible and useful to distinguish between self-injurers on the basis of intent to die.

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Available from: Matthew K Nock, May 20, 2014
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    • "Further detail about this limitation is provided in the Discussion section. Suicide attempts (46.5%) occurred at a rate higher than estimated for the general U.S. population, which has a selfreported lifetime suicide rate of approximately 4.6% (Nock & Kessler, 2006). Table 2 explores the predictor variables of interest by lifetime suicide attempt. "
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    • "While it is hard to understand, these behaviors and thoughts help people stay alive and manage their feelings and relationships. Current studies suggest that more than half (52.9%) reported they use the behavior to " stop bad feelings " and not to die (Nock & Kessler, 2006). Further studies have shown that suicidal individuals who self-injure typically make suicide attempts during periods of time when they are not using self-injury to manage (Gratz, 2006). "
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    • "Demographic and clinical differences between NSB and suicide gestures (SG) have been investigated in literature. SG in general has been found to be more common between women (Nock 2006). In another study patients who attempted suicide were more likely to be older in age and to be diagnosed with bipolar disorder and/or narcisistic personality disorder. "
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    ABSTRACT: BACKGROUND: Nonfatal suicidal behaviours (NSB), including suicide ideation, suicide plan and suicide attempt, constitute a serious problem for public healthcare services. Suicide gesture (SG) which refers to self-injurious behaviour with no intent to die, differs from NSB in a variety of important ways. The aim of this study was to investigate demographic and clinical characteristics of NSB and SG to examine whether self-injurers with intent to die differ significantly from self injurers without such intent. METHODS: All admissions for NSB and SG to the Psychiatric Inpatient Unit of University / General Hospital Santa Maria della Misericordia, Perugia, Umbria, Italy, from January 2015 to June 2015 were included in a medical record review. Basic descriptive statistics and distributional properties of all variables were first examined. Bivariate analyses were performed using Chi-square tests for group comparisons and t-test for independent samples used when appropriated. RESULTS: The study sample included 38 patients. Of these 23 had committed NSB (13.1 %), 15 had commetted SG (8.5%). Number of married NSB was significantly higher than the number of married SG (p=0.08). We found a significant difference between NSB and SG related to the item of impulse control that was poorer in SG than NSB (p=0.010). BPRS items of hostility (p=0.082), suspiciousness (p=0.042) and excitement (p=0.02) were found to be significantly higher in SG than NSB. Borderline personality disorder (p=0.032) and Passive-Aggressive personality disorder (p=0,082) diagnosed by the means of the SCID-II, were more represented in SG than NSB (p=0.044). Schizoid personality disorder was significantly related to NSB (p=0.042). No others significant differences were found. CONCLUSIONS: NSB and SG are different for many psychopathological characteristics. These results confirm the importance of classifying individuals on the basis of the intent to die. Additional research is needed to understand and elucidate psychopatological and clinical characteristics of the different categories of self-injurers to find risk factors specific to suicide attempts.
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