A Typology of Parasuicide

Abstract

Parasuicide is not a single syndrome. Subtypes at present recognized are based largely on clinically derived stereotypes. When considering a series of patients, the clinician is unable to handle more than a few attributes at a time. This paper describes the application of three very different clustering algorithms to a material of 350 treated parasuicide patients. Mathematically, three types emerge. Clinically, two of these are interpretable and make sense. The types established are: I (n = 107) a group not characterized by any of the variables we examined; this group is a puzzle, mainly because the reasons for the parasuicidal act are not clear. II (n = 132) a depressed, alienated group with high life-endangerment. III (n = III) a group whose act was highly operant: they felt alienated and were angry with others. These groups did not differ significantly on demographic variables. The usefulness of this typology, particularly for management, after-care and prevention, has now to be assessed.

Suicide and self-inflicted injuries

“…The use of a gun, for instance, may be easily interpreted as a suicide attempt while, in fact, the intention of the actor was self mutilation, for whatever reason [Bancroft et al, 19761. The literature indicates that suicide and SII are related to stressful situations, personal stress and despair, and feelings of inadequacy, anomie and social disintegration [Morgan et al, 1975;Henderson et al, 1977;Henderson &Lance, 19791. The literature contains a variety of viewpoints on the gradations of self destructive behavior. In the least ambiguous sense, suicide includes all self destructive acts motivated by the intention to die.…”

Classification of Attempted Suicide: A Review of Empirical Studies, 1963–1993

“…Henderson and Lance (1979) distinguished six subgroups, of which five could be clinically interpreted. This study included a further examination of the same data in which a three-group classification was found by Henderson et al (1977). Compared to the earlier study, their statistical techniques were improved, which made it possible to consider different types of variables simultaneously and to specify the optimum number of subgroups into which a population may be divided.…”

Interventions to reduce repetition of deliberate self-harm

“…Unfortunately attempts to define a typology of D SH have not been particularly successful. A number of studies have used cluster analysis in an attempt to de® ne such sub-types (Engstrom et al, 1996;Henderson et al, 1977;Paykell & Rassaby, 1978). There appears to be little concordance in the results of these cluster analyses and the utility of any of these systems of classi® cation has not been tested.…”