How do clinicians and suicide attempters understand suicide attempt impulsivity? A qualitative study

ABSTRACT

Inconsistencies in the definition of impulsive suicide attempts hamper research integration. To expand the currently limited data on how this construct is used in clinical practice, researchers interviewed eight suicide attempters to create timelines of their suicide process, then had seven experienced clinicians review these timelines. Thematic analysis of the patient and clinician data revealed three themes: “thinking out,” build-up, and unclear intentionality. The results imply that assessing build-up of agitation and exhaustion symptoms can contribute to understanding acuteness of suicide risk. In addition, uncertainty about one’s intentions during the attempt should not be equated to low intent to die.

Acknowledgments

We would like to acknowledge Ms. Jacinta Hawgood, who assisted with clinical supervision of the interviewing process, and Dr. Elisabeth Kendall who provided valuable suggestions regarding the structure of this manuscript.