Consistency of Self-Reported Suicidal Intent Following a Suicide Attempt

Suicide is a major problem in the U.S., but the empirical basis for assessment of suicidal risk is severely lacking. Critical to understanding the level of risk present after an act of self-harm is the degree to which the self-injuring patient intended to die via the act, which is called the degree of suicidal intent. In most studies, suicidal intent is identified at baseline as the self-reported intent of the self-injurer: however, clinicians commonly encounter cases where patients’ self-reported suicidal intent immediately after an injury episode is denied a few days later. This study tested the hypothesis that subjects would retrospectively report reduced levels of suicidal intent and fewer motives for their self-injury at follow-up (7 to 12 days after the attempt) than they did at baseline (within 48 hours after the attempt). Intent and motives were assessed using the Oxford Reasons for Parasuicide Interview and the Suicide Intent Scale (SIS). Statistical analyses found that subjects scored significantly higher on the SIS at baseline than they did at follow-up, confirming the hypothesis that retrospective self-reported suicidal intent would decrease with increasing time since the event. Although subjects reported fewer motives on average at follow-up than at baseline, the hypothesis that subjects would significantly decrease the number of reported motives at follow-up was not supported due to a lack of statistical significance. The findings of this study suggest that self-reports of suicidal intent are not consistent over time and are thus not necessarily reliable. Therefore, clinicians may do well to group suicide attempters and non-suicidal self-harmers together and treat them with similar precaution, as is done in Europe.