Why People Engage in Parasuicide: A Cross‐Cultural Study of Intentions

Abstract

Information obtained at interview from 1,646 parasuicide patients in 14 regions in 13 European countries participating in the WHO/EURO Multicentre Study on Suicidal Behaviour was used to study self-reported intentions involved in parasuicide. Comparisons were made across cultures, genders, and age groups. Although some statistically significant differences were found, the effect sizes were very small. The main finding from this study is thus that parasuicide patients in different countries tend to indicate that similar types of intentions are involved in their acts of parasuicide, and that the intentions do not vary greatly with gender or age. The hypothesis that rates of suicide and parasuicide vary between regions with the frequency with which suicidal intention is indicated by the patients was also tested, but was supported only for women and in relation to national suicide rates. The findings from this study are likely to be generalizable to other settings and have implications for clinical practice.HEIDI HJELMELAND is with the

Suicide‐related behavior after psychiatric hospital discharge: implications for risk assessment and management

“…Thus, reliance on stated intent alone would reduce the proportion of SRB classified as suicide attempts from 80% to 63%. The latter figure is consistent with the results of the WHO study, which suggests that 64% of SRB involved suicide attempts (Hjelmeland, 1996;Hjelmeland et al, 2002). Additional research suggests that only a small subgroup of patients repeatedly engage in SRB (Kessel & McCulloch, 1966), and this group manifests less intent to die than those with less frequent SRB (Hjelmeland, 1996).…”

The factorial structure of the Suicide Intent Scale: a comparative study in clinical samples from 11 European regions

“…A close inspection of the SIS items of the 'objective part' suggests that the meaning of some of the items is somehow ambiguous if the heterogeneity of motives or intentions of the non-fatal suicidal act is accounted for (Hjelmeland et al, 2002a;Hjelmeland et al, 2002b;Chopin et al, 2004;Hjelmeland and Hawton, 2004;Antretter et al, 2006;Conner et al, 2007). For example, in SIS item 4 ('Action to gain help after the attempt') the most severe item score indicates that a patient did not contact or notify a helper after the non-fatal suicidal act.…”

“…Second, other studies examined the relationships between the SIS and several variables associated with non-fatal suicidal behavior (e.g. clinical and sociodemographic characteristics) (Casey, 1989;Nielsen et al, 1993;Suominen et al, 1997;Hjelmeland et al, 2000;Blenkiron et al, 2000;Hjelmeland et al, 2002a;Hjelmeland et al, 2002b;Milnes et al, 2002;Haw et al, 2003;Astruc et al, 2004;Chopin et al, 2004;Hawton et al, 2004;Sudhir Kumar et al, 2006;Conner et al, 2007). Third, topics related to the clinical usefulness of the SIS for the treatment of patients with nonfatal suicidal behavior were discussed (Keeley et al, 2002;Baca-Garcia et al, 2004;Bergen and Hawton, 2007).…”

How adolescents who cut themselves differ from those who take overdoses

“…This list of motives was an adapted version of that developed by Bancroft and colleagues [1] and used in several other studies, e.g. [18,27]. We have previously reported motives for self-harm acts as reported by adolescents who cut themselves and those taking overdoses [38] but included them in the present study for completeness.…”

“…In the UK the term 'deliberate self-harm' (DSH) has been used to encompass all acts of intentional self-poisoning and selfinjury [20,35], whereas in North America researchers often divide such behaviour into 'attempted suicide', where death is at least part of the intended outcome, and 'nonsuicidal self-injury', where death is definitely not the intended outcome [40]. The rationale for the approach used in the UK is because, first, the motivation for an act of selfpoisoning or self-injury is often mixed, both suicidal and non-suicidal intentions being involved in many acts [1,27], secondly, suicidal intent is a dimensional rather than a unitary phenomenon [16], and thirdly, motives or intentions underlying some acts of self-poisoning and self-injury may be unclear. While pressure from user groups has lead some organisations and researchers to change the term 'deliberate self-harm' to 'self-harm' [22], we prefer to retain the full term 'deliberate self-harm' in order to indicate intentionality and thus distinguish the behaviour from accidental self-harm.…”