Citation

Liu RT. Neurosci. Biobehav. Rev. 2019; 99: 42-48.

Affiliation

Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Bradley Hospital, 1011 Veterans Memorial Parkway, East Providence, RI, 02915, United States. Electronic address: rtliupsych@gmail.com.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.neubiorev.2019.01.024

PMID

30685485

Abstract

Not only is suicidal behavior strongly predicted by its past occurrence, but the risk for recurrence appears to increase with each subsequent attempt. The current paper discusses a potential explanation for this phenomenon, that suicide attempts may leave a residual psychological scar that heightens risk for future attempts. This possibility is evaluated against two alternatives: (i) risk for first and subsequent suicide attempts is accounted for by a shared diathesis pre-existing the first lifetime attempt, and (ii) different rates of developmental decline in risk factors account for differences in prospective number of attempts. In this discussion, a formalized conceptual framework of psychological scarring is presented, along with considerations of particular relevance to its study. Finally, the clinical implications of determining the processes underlying the association between suicide attempts and heightened risk for recurrence are discussed.

Copyright © 2019. Published by Elsevier Ltd.

Language: en

Keywords

differential activation hypothesis; interpersonal theory of suicide; psychological scar; risk factor; suicide