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Why Suicide? The Analysis of Motives for Self-Harm

Published online by Cambridge University Press:  19 June 2017

Mohammed J. Abbas ,
Mostafa A. Mohanna ,
Tarig A. Diab ,
Millicent Chikoore  and
Michael Wang
Mohammed J. Abbas*
Affiliation:
Leicestershire Partnership NHS Trust
Mostafa A. Mohanna
Affiliation:
Lincolnshire Partnership NHS Foundation Trust
Tarig A. Diab
Affiliation:
Somerset Partnership NHS Foundation Trust
Millicent Chikoore
Affiliation:
Latrobe Regional Hospital, Victoria, Australia
Michael Wang
Affiliation:
Clinical Psychology Unit, University of Leicester, Centre for Medicine
*
Correspondence to Dr Mohammed Abbas, Consultant Psychiatrist, Bradgate Mental Health Unit, Glenfield Hospital, Groby Road, Leicester LE3 9EJ. E-mail: mohdgum@hotmail.com
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Abstract

Background: There is a gap in understanding the meaning and motives behind suicidal behaviour. Using the Ideal Type methodology, Jean Baechler systematically examined the internal logic of suicidal and self-harming behaviours. He developed a typology of eleven typical meanings/motives: Flight, Grief, Self-punishment, Vengeance, Crime, Blackmail, Appeal, Sacrifice, Transfiguration, Ordeal and Game. Aims: To develop and validate a standardized instrument to measure the motives/meanings of suicidal and self-harming behaviours, using Baechler's typology. Method: We developed a self-fill Likert questionnaire (Ideal Typical Meaning Questionnaire, ITMQ) covering ten of Baechler's eleven types. The questionnaire was completed by 147 patients within four weeks of attempting suicide or self-harm. The Death Attitude Profile-Revised (DAP-R) questionnaire was used to examine the concurrent validity of the Flight and the Transfiguration types and to explore the association between suicidal/self-harming motives and views about death. Results: The final 25-item ITMQ has an eight-factor structure (Appeal/Blackmail, Ordeal/Game, Vengeance, Self-punishment, Sacrifice, Flight, Grief and Transfiguration) supporting Baechler's theory. The types have adequate reliability. Correlations with the DAP-R gave some support for the concurrent validity of the Flight and Transfiguration types. Conclusions: The ITMQ is a measure of suicidal and self-harming motives/meanings based on a sound conceptual framework and could significantly contribute to the understanding of suicidal and self-harming behaviour in research and clinical settings.

Keywords

suicideself-harmtypes of suicidemeaning of suicidemeaning of self-harmmotives
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 46 , Issue 2 , March 2018 , pp. 209 - 225
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2017 

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References

Andover, M. S., Morris, B. W., Wren, A. and Bruzzese, M. E. (2012). The co-occurrence of non-suicidal self-injury and attempted suicide among adolescents: distinguishing risk factors and psychosocial correlates. Child and Adolescent Psychiatry and Mental Health, 6, 11. doi: 10.1186/1753-2000-6-11 Google Scholar
Baechler, J. (1979). Suicides. Basic Books.Google Scholar
Bancroft, J., Skrimshire, A. M. and Simkin, S. (1976). The reasons people give for taking overdoses. British Journal of Psychiatry, 128, 538–548.CrossRefGoogle ScholarPubMed
Baumeister, R. F. (1990). Suicide as escape from self. Psychological Review, 97, 90–113.CrossRefGoogle Scholar
Beck, A. T., Brown, G., Berchick, R. J., Stewart, B. L. and Steer, R. A. (1990). Relationship between hopelessness and ultimate suicide: a replication with psychiatric outpatients. American Journal of Psychiatry, 147, 190–195.Google ScholarPubMed
Beck, A. T., Steer, R. A., Kovacs, M. and Garrison, B. (1985). Hopelessness and eventual suicide: a 10-year prospective study of patients hospitalized with suicidal ideation. American Journal of Psychiatry, 142, 559–563.Google Scholar
Chapman, A. L. and Dixon-Gordon, K. L. (2007). Emotional antecedents and consequences of deliberate self-harm and suicide attempts. Suicide and Life-Threatening Behavior, 37, 543–552. doi: 10.1521/suli.2007.37.5.543 CrossRefGoogle ScholarPubMed
Clark, L. A. and Watson, D. (1995). Constructing validity: basic issues in objective scale development. Psychological Assessment, 7, 309–319.Google Scholar
Comrey, A. L. (1988). Factor-analytic methods of scale development in personality and clinical psychology. Journal of Consulting and Clinical Psychology, 56, 754–761.CrossRefGoogle ScholarPubMed
Costello, A. B. and Osborne, J. (2005). Best practices in exploratory factor analysis: four recommendations for getting the most from your analysis. Practical Assessment Research and Evaluation, 10, 1–9.Google Scholar
Dulit, R. A., Fyer, M. R., Leon, A. C., Brodsky, B. S. and Frances, A. J. (1994). Clinical correlates of self-mutilation in borderline personality disorder. American Journal of Psychiatry, 151, 1305–1311.Google Scholar
Floyd, F. J. and Widaman, K. F. (1995). Factor analysis in the development and refinement of clinical assessment instruments. Psychological Assessment, 7, 286–299.Google Scholar
Goldstein, R. B., Black, D. W., Nasrallah, A. and Winokur, G. (1991). The prediction of suicide. Sensitivity, specificity, and predictive value of a multivariate model applied to suicide among 1906 patients with affective disorders. Archives of General Psychiatry, 48, 418–422.Google Scholar
Gould, M. S., Greenberg, T., Velting, D. M. and Shaffer, D. (2003). Youth suicide risk and preventive interventions: a review of the past 10 years. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 386–405. doi: 10.1097/01.chi.0000046821.95464.cf Google Scholar
Guerry, J. D. and Prinstein, M. J. (2010). Longitudinal prediction of adolescent non-suicidal self-injury: examination of a cognitive vulnerability-stress model. Journal of Clinical Child and Adolescent Psychology, 39, 77–89. doi: 10.1080/15374410903401195 Google Scholar
Hjelmeland, H., Hawton, K., Nordvik, H., Bille-Brahe, U., De Leo, D., Fekete, S. et al. (2002). Why people engage in parasuicide: a cross-cultural study of intentions. Suicide and Life-Threatening Behavior, 32, 380–393.Google Scholar
Holden, R., Kerr, P., Mendonca, J. and Velamoor, V. (1998). Are some motives more linked to suicide proneness than others? Journal of Clinical Psychology, 54, 569–576.Google Scholar
Holden, R. R. and DeLisle, M. M. (2006). Factor structure of the Reasons for Attempting Suicide Questionnaire (RASQ) with suicide attempters. Journal of Psychopathology and Behavioral Assessment, 28, 1–8. doi: 10.1007/s10862-006-4532-3 Google Scholar
Holden, R. R. and McLeod, L. D. (2000). The structure of the Reasons for Attempting Suicide Questionnaire (RASQ) in a non-clinical adult population. Personality and Individual Differences, 29, 621–628.Google Scholar
Jacobson, C. M. and Batejan, K. (2014). Comprehensive theoretical models of non-suicidal self-injury. In Nock, M. (ed), The Oxford Handbook of Suicide and Self-Injury (pp. 308–322). New York: Oxford University Press.Google Scholar
Johns, D. and Holden, R. R. (1997). Differentiating suicidal motivations and manifestations in a non-clinical population. Canadian Journal of Behavioural Science, 29, 266–274.CrossRefGoogle Scholar
Joiner, T. E. (2005). Why People Die by Suicide. Cambridge, MA: Harvard University Press.Google Scholar
Joiner, T. E. and Rudd, M. D. (2000). Suicide Science: Expanding the Boundaries. Boston; London: Kluwer Academic.Google Scholar
Klonsky, E. D. and May, A. M. (2015). The Three-Step Theory (3ST): a new theory of suicide rooted in the ‘ideation-to-action’ framework. International Journal of Cognitive Therapy, 8, 114–129. doi: 10.1521/ijct.2015.8.2.114 Google Scholar
Klonsky, E. D., May, A. M. and Saffer, B. Y. (2016). Suicide, suicide attempts, and suicidal ideation. Annual Review of Clinical Psychology, 12, 307–330. doi: 10.1146/annurev-clinpsy-021815-093204 CrossRefGoogle ScholarPubMed
Kovacs, M., Beck, A. T. and Weissman, A. (1975). The use of suicidal motives in the psychotherapy of attempted suicides. American Journal of Psychotherapy, 29, 363–368.Google Scholar
Lester, D. (1983). Why People Kill Themselves: A 1980s Summary of Research Findings on Suicidal Behavior (2nd edition). Springfield: C. C. Thomas.Google Scholar
Lester, D. (1992). Why People Kill Themselves: A 1990s Summary of Research Findings on Suicidal Behavior (3rd edition). Springfield, IL: C. C. Thomas.Google Scholar
Lester, D. (1997). Making Sense of Suicide: an In-Depth Look at Why People Kill Themselves. Philadelphia: Charles Press.Google Scholar
Lester, D. (2000a). Decades of suicide research: wherefrom and whereto. In Joiner, T. E. and Rudd, M. D. (eds), Suicide Science: Expanding the Boundaries (p. 15). Boston; London: Kluwer Academic.Google Scholar
Lester, D. (2000b). Why People Kill Themselves: A 2000 Summary of Research on Suicide (4th edition). Springfield, IL: C. C. Thomas.Google Scholar
Linehan, M. M. (1993). Cognitive-Behavioral Treatment of Borderline Personality Disorder. New York: Guilford Press.Google Scholar
Linehan, M. M. (2000). Behavioral treatments of suicidal behaviors: definitional obfuscation and treatment outcomes. In Maris, R. W., Cannetto, S. S., McIntosh, J. L. and Silverman, M. M. (eds), Review of Suicidology (pp. 84–111). New York, NY: Guilford Press.Google Scholar
Linehan, M. M., Comtois, K. A., Brown, M. Z., Heard, H. L. and Wagner, A. (2006). Suicide Attempt Self-Injury Interview (SASII): development, reliability, and validity of a scale to assess suicide attempts and intentional self-injury. Psychological Assessment, 18, 303–312. doi: 10.1037/1040-3590.18.3. 303 Google Scholar
Loughrey, G. and Kerr, A. (1989). Motivation in deliberate self-harm. Ulster Medical Journal, 58, 46–50.Google Scholar
Matthews, J. D. (2013). Cognitive Behavioral Therapy Approach for Suicidal Thinking and Behaviors in Depression. doi: 10.5772/52418 Google Scholar
May, A. M. and Klonsky, E. D. (2013). Assessing motivations for suicide attempts: development and psychometric properties of the inventory of motivations for suicide attempts. Suicide and Life-Threatening Behavior, 43, 532–546. doi: 10.1111/sltb.12037 CrossRefGoogle ScholarPubMed
Nixon, M. K., Cloutier, P. F. and Aggarwal, S. (2002). Affect regulation and addictive aspects of repetitive self-injury in hospitalized adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 1333–1341. doi: 10.1097/00004583-200211000-00015 Google Scholar
Nock, M. K., Joiner, T. E., Gordon, K. H., Lloyd-Richardson, E. and Prinstein, M. J. (2006). Non-suicidal self-injury among adolescents: diagnostic correlates and relation to suicide attempts. Psychiatry Research, 144, 65–72. doi: 10.1016/j.psychres.2006.05.010 Google Scholar
O'Carroll, P. W., Berman, A. L., Maris, R. W., Moscicki, E. K., Tanney, B. L. and Silverman, M. M. (1996). Beyond the Tower of Babel: a nomenclature for suicidology. Suicide and Life-Threatening Behavior, 26, 237–252.Google Scholar
O'Connor, R. C. (2011). Towards an integrated motivational-volitional model of suicidal behaviour. In O'Connor, R. C., Platt, S. and Gordon, J. (eds), International Handbook of Suicide Prevention: Research, Policy and Practice (pp. 181–198). Chichester: Wiley-Blackwell Google Scholar
Osuch, E. A., Noll, J. G. and Putnam, F. W. (1999). The motivations for self-injury in psychiatric in-patients. Psychiatry, 62, 334–346.CrossRefGoogle Scholar
Reynolds, F. M. T. and Berman, A. L. (1995). An empirical typology of suicide. Archives of Suicide Research, 1, 97–109. doi: 10.1080/13811119508258978 CrossRefGoogle Scholar
Rogers, J. R. (2001). Theoretical grounding: the ‘missing link’ in suicide research. Journal of Counseling and Development, 79, 16–25.Google Scholar
Schnyder, U., Valach, L., Bichsel, K. and Michel, K. (1999). Attempted suicide. Do we understand the patients’ reasons? General Hospital Psychiatry, 21, 62–69. doi: S0163834398000644 Google Scholar
Schütz, A. (1984). The Phenomenology of the Social World. Northwestern University Press.Google Scholar
Selby, E. A., Joiner, T. E. and Ribeiro, J. D. (2014). Comprehensive theories of suicidal behaviors. In Nock, M. (ed), The Oxford Handbook of Suicide and Self-Injury (pp. 286–307). New York: Oxford University Press.Google Scholar
Shneidman, E. S. (1985). Definition of Suicide. New York: NY: Wiley.Google Scholar
Smith, G. W. and Bloom, I. (1985). A study of the personal meaning of suicide in the context of Baechler's typology. Suicide and Life-Threatening Behavior, 15, 3–13.Google Scholar
Stanley, B., Winchel, R., Molcho, A., Simeon, D. and Stanley, M. (1992). Suicide and the self-harm continuum: phenomenological and biochemical evidence. International Review of Psychiatry, 4, 149–155. doi: doi:10.3109/09540269209066312 Google Scholar
Weber, M. (1949). On the Methodology of the Social Sciences (E. A. Shils and H. A. Finch, Trans.). Glencoe, IL: Free Press.Google Scholar
World Health Organization (WHO) (2014). Preventing Suicide: A Global Imperative.Google Scholar
Wichstrom, L. (2009). Predictors of non-suicidal self-injury versus attempted suicide: similar or different? Archives of Suicide Research, 13, 105–122. doi: 10.1080/13811110902834992 Google Scholar
Williams, J. M. G. (1997). Suicide and Attempted Suicide. London, UK: Penguin.Google Scholar
Williams, J. M. G. and Pollock, L. (2000). The psychology of suicidal behavior. In van Heeringen, K. H. K. (ed), The International Handbook of Suicide and Attempted Suicide (pp. 79–94). Chichester, UK: Wiley.CrossRefGoogle Scholar
Wong, P. T. P., Reker, G. T. and Gesser, G. (1994). The Death Attitude Profile-Revised (DAP-R): a multidimensional measure of attitudes toward death. In Neimeyer, R. A. (ed), Death Anxiety Handbook: Research, Instrumentation, and Application (pp. 121–148). London: Taylor and Francis.Google Scholar
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