Assessing and Treating Different Suicidal States in a Danish Outpatient Sample

Abstract

The studies presented compare two methodologies for categorizing suicidal patients based on clinical data. Discussion follows regarding implications for risk assessment and treatment. In these studies, 52 outpatient subjects were placed into different groups based on coding their “suicidal motivation” (Study 1) and their “internal struggle” ratings (Study 2) using data collected at intake. Self-report ratings of 6 Suicide Status Form (SSF) Core Constructs (Psychological Pain, Stress, Agitation, Hopelessness, Self-Hate, and Overall Risk of Suicide) recorded both at intake and at completion of treatment were then compared to determine differences in Core Construct ratings among groups at different time points. In Study 1, overall differences among motivation groups (Life-motivated, Ambivalent, and Death-motivated) were significant for ratings at treatment completion of Overall Risk of Suicide, Self-Hate, and Psychological Pain. In Study 2, overall differences among groups (Wish to live, Ambivalent, and Wish to die) were significant for ratings at intake of Overall Risk of Suicide. At completion of treatment, overall differences among groups were significant for ratings of Overall Risk of Suicide, Hopelessness, and Self-Hate. In addition, significant interactions were found between test time and group for Overall Risk of Suicide and Self-Hate. Results suggest that categorizing suicidal patients by motivation and by the nature of their internal struggle could be beneficial to differential risk assessment with implications for clinical treatment.

Keywords:

• internal struggle
• motivation
• suicide
• typology

Notes

Note. Groups presented in this table were derived by subtracting the total number of Reasons For Dying responses from the total number of Reasons For Living responses for each subject.

^a Significant difference from one other group within the same Suicide Status Form (SSF) Core Construct.

*Overall model significant at p < .05.

Note. Groups presented in this table were derived by calculating a Suicide Index Score (subtracting the converted Wish to Die score from the converted Wish to Live score) for each subject.

^a Significant difference from one other group within the same Suicide Status Form (SSF) Core Construct.

*Overall model significant at p < .05.

**Overall model significant at p < .001.