Whiteside Ursula, Angerhofer Richards Julie, Fruhbauerova Martina, Shokouhaghaei Ghazaleh
NowMattersNow.org, Seattle, WA, USA.
Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA.
Perm J. 2024 Sep 16;28(3):117-129. doi: 10.7812/TPP/24.035. Epub 2024 Aug 6.
More than half of those who die by suicide do not communicate about suicide prior to their death. This project describes the emotional state and decision-making among "unplanned" attempt survivors to inform a conceptual model and suicide prevention interventions.
This qualitative study purposefully sampled patients who reported having no suicidal thoughts on a standardized mental health questionnaire within 60 days (about 2 months) prior to a nonfatal suicide attempt documented in the health record. Participants verbally consented to telephone interview participation. Semistructured audio-recorded interviews elicited suicide attempt survivor descriptions of their emotional state and experiences in the days, hours, and minutes leading up to their suicide attempt. Interviews were transcribed and analyzed using grounded theory. The biopsychosocial theory of emotion regulation informed conceptual model development.
Participants (N = 26) described 2 distinct "phases" prior to the attempt. First, a phase of increasing life stressors, transitory and nonspecific suicidal thoughts, and a reluctance to disclose experiences. Second, an overwhelming emotional state led to a sudden suicide attempt and nondisclosure due to the rapidity and intensity of the experience. These results informed the conceptual model and intervention development to manage unplanned and overwhelming urges to attempt suicide.
Qualitative analysis informed the development of an intervention for the high-intensity "hot" period preceding an attempt, including specific steps to manage a highly intense emotional state in combination with overwhelming urges to kill oneself.
Future research is needed to evaluate whether and how this intervention helps support people with a chance of "unplanned" suicide attempts.
超过半数的自杀身亡者在死前未提及自杀相关事宜。本项目描述了“非计划型”自杀未遂幸存者的情绪状态和决策过程，以形成一个概念模型和自杀预防干预措施。
这项定性研究有目的地选取了一些患者，这些患者在健康记录中记录的非致命性自杀未遂事件发生前60天（约2个月）内，在标准化心理健康问卷中报告没有自杀念头。参与者口头同意参与电话访谈。半结构化的录音访谈引出了自杀未遂幸存者对其在自杀未遂前几天、几小时和几分钟内的情绪状态和经历的描述。访谈内容被转录并采用扎根理论进行分析。情绪调节的生物心理社会理论为概念模型的发展提供了依据。
参与者（N = 26）描述了自杀未遂前两个不同的“阶段”。首先，一个生活压力源不断增加、出现短暂且不具特异性的自杀念头以及不愿透露经历的阶段。其次，一种压倒性的情绪状态导致突然的自杀未遂，且由于这种经历的快速性和强烈程度而未透露相关情况。这些结果为概念模型和干预措施的制定提供了依据，以应对非计划型且压倒性的自杀冲动。
定性分析为自杀未遂前高强度“热”期的干预措施制定提供了依据，包括管理高度强烈情绪状态并结合压倒性自杀冲动的具体步骤。
需要未来的研究来评估这种干预措施是否以及如何有助于支持有“非计划型”自杀未遂风险的人群。
