Violence victimization and perpetration in relation to fearlessness about death in suicidal psychiatric inpatients

Abstract

Purpose The interpersonal theory of suicide proposes that fearlessness about death, one aspect of the capability for suicide, may explain men’s greater risk for death by suicide. The purpose of this paper is to examine whether violence perpetration and victimization would mediate the relation of gender with fearlessness about death in suicidal psychiatric inpatients. Design/methodology/approach The current study used a cross-sectional survey design in a sample of 196 psychiatric inpatients admitted for suicide risk. Findings Men endorsed greater fearlessness about death compared to women. The relation of gender with fearlessness about death was partially mediated by violence perpetration, but not victimization. Violence perpetration may play a more central role in the development of fearlessness about death, the capability for suicide, and the transition from suicide ideation to action compared to violence victimization. Research limitations/implications The current study was cross-sectional and not able to definitively answer questions about the development of the capability for suicide. Future research must examine how fearlessness about death evolves over time. Practical implications Suicide risk assessment should include history of violence perpetration, as this may better identify those who may be at greater risk for suicide due to greater fearlessness about death. Originality/value The current study adds to the growing literature that aims to understand variables that explain the transition from suicide ideation to action.

What Differentiates Prisoners Who Attempt Suicide from Those Who Experience Suicidal Ideation? A Nationally Representative Study

“…Our findings align with this assumption, as factors that most clearly distinguished attempters from ideators all include features associated with increased exposure to such painful and provocative events. For example, studies indicate that attempters can be differentiated from ideators on the basis of perpetrating interpersonal violence (Gunn, Lester, & McSwain, 2011;Rooney, Hill, Oosterhoff, & Kaplow, 2019;Stack, 2014). Theoretically, these findings suggest that enacting physical violence on others may build one's capability for suicide through increased pain tolerance and fearlessness about death (Bryan & Cukrowicz, 2011;Granato, Boone, Kuhlman, & Smith, 2018).…”

“…For example, studies indicate that attempters can be differentiated from ideators on the basis of perpetrating interpersonal violence (Gunn, Lester, & McSwain, 2011;Rooney, Hill, Oosterhoff, & Kaplow, 2019;Stack, 2014). Theoretically, these findings suggest that enacting physical violence on others may build one's capability for suicide through increased pain tolerance and fearlessness about death (Bryan & Cukrowicz, 2011;Granato, Boone, Kuhlman, & Smith, 2018). Similarly, victimization of sexual and physical violence inherently represents exposure to a particularly painful and provocative event.…”

What differentiates prisoners who attempt suicide from those who experience suicidal ideation? A nationally representative study

“…For example, studies indicate that attempters can be differentiated from ideators on the basis of perpetrating interpersonal violence (Gunn, Lester, & McSwain, 2011;Rooney et al, 2019;Stack, 2014). Theoretically, these findings suggest that enacting physical violence on others may build one's capability for suicide through increased pain tolerance and fearlessness about death (Bryan & Cukrowicz, 2011;Granato et al, 2018). Similarly, victimization of sexual and physical violence inherently represents exposure to a particularly painful and provocative event.…”