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Fowler, J.C. Hilsenroth, M.J. Groat, M. Biel, S. Biedermann, C. Ackerman, S. (2012). Risk Factors for Medically Serious Suicide Attempts: Evidence for a Psychodynamic Formulation of Suicidal Crisis. J. Amer. Psychoanal. Assn., 60(3):555-576.

(2012). Journal of the American Psychoanalytic Association, 60(3):555-576

Research Section

Risk Factors for Medically Serious Suicide Attempts: Evidence for a Psychodynamic Formulation of Suicidal Crisis

J. Christopher Fowler, Mark J. Hilsenroth, Michael Groat, Spencer Biel, Christina Biedermann and Steven Ackerman

This study explored a psychodynamic model for suicide risk by examining risk factors for medically serious suicide attempts, including assessments of affect flooding, negative self-schema / fragmentation, and impaired reality testing, closely approximating Maltsberger's psychodynamic formulation of suicide crisis. Baseline risk factors including age, gender, psychiatric symptoms, high-risk behaviors, and the Implicit Risk for Suicide Index (IRSI) were used to detect medically serious suicide attempts monitored for up to a year after the assessment. Twenty-five psychiatric inpatients who made life-threatening suicide attempts after assessment were compared to 25 inpatients and 25 psychotherapy outpatients who made no suicide attempts during follow-up. Statistical analysis revealed that a history of at least one suicide attempt and elevated IRSI scores accounted for 60 percent of the variance in detecting medically serious suicide attempts. Elevated IRSI accurately identified suicide attempt status above and beyond past suicide attempts and other empirically validated risk factors. Results are discussed in light of psychodynamic formulations of suicide risk.

[This is a summary excerpt from the full text of the journal article. The full text of the document is available to journal subscribers on the publisher's website here.]

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