PTSD From a Suicide Attempt: Phenomenological and Diagnostic Considerations

Abstract

Objective: A suicide attempt is at least somewhat life-threatening by definition and is, for some, traumatic. Thus, it is possible that some individuals may develop posttraumatic stress disorder (PTSD) from a suicide attempt. Method: In this article, we consider whether one’s suicide attempt could fulfill Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for a PTSD Criterion A event and contribute to the development of attendant PTSD symptoms (e.g., flashbacks, avoidance, shame/guilt, nightmares); discuss theoretical models of PTSD as they relate to suicide attempts; reflect on factors that might influence rates of suicide attempt–related PTSD; highlight methodological limitations that have hampered our understanding of suicide attempt–related PTSD; and posit areas for future scientific and clinical inquiry. Results: Strikingly, the degree to which a suicide attempt leads to PTSD is unknown. Conclusions: We conclude with a call for research to systematically assess for suicide attempts alongside other potentially traumatic experiences (e.g., combat exposure, rape) that are included in standardized PTSD assessments.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. Incidentally, theoretical models of suicide suggest that, in the weeks and days leading up to this attempt, this individual might miscalculate his impending attempt as actually in his children’s best interest (see Joiner, 2005). However, these perceptions are often recalibrated following a nonfatal attempt; in this regard, the attempt might be subsequently perceived as morally injurious.

2. It would be prudent to follow up with and assess these individuals for at least one month following their suicide attempt, in line with DSM-5 diagnostic criteria for PTSD (APA, 2013).

Additional information

Funding

This work was supported in part by the Military Suicide Research Consortium (MSRC), an effort supported by the Office of the Assistant Secretary of Defense for Health Affairs, under award W81XWH-16-2-0003. Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the MSRC or the Department of Defense.