Torn between living or dying-analyses of influencing factors on suicide ambivalence and its longitudinally impact on suicidal ideation and behavior in a high-risk sample

Inken Höller; Thomas Forkmann; Heide Glaesmer; Tobias Teismann; Lena Spangenberg; Dajana Schreiber; Nina Hallensleben; Jannis Kraiss

doi:10.1111/sltb.13091

Torn between living or dying-analyses of influencing factors on suicide ambivalence and its longitudinally impact on suicidal ideation and behavior in a high-risk sample

Suicide Life Threat Behav. 2024 May 17. doi: 10.1111/sltb.13091. Online ahead of print.

Authors

Inken Höller^{1

2}, Thomas Forkmann^{1

2}, Heide Glaesmer³, Tobias Teismann⁴, Lena Spangenberg³, Dajana Schreiber^{1

2}, Nina Hallensleben³, Jannis Kraiss⁵

Affiliations

¹ Department of Clinical Psychology and Psychotherapy, University of Duisburg-Essen, Essen, Germany.
² Department of Clinical Psychology and Psychotherapy, Charlotte Fresenius Hochschule, Düsseldorf, Germany.
³ Department of Medical Psychology and Medical Sociology, University Leipzig, Leipzig, Germany.
⁴ Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-University of Bochum, Bochum, Germany.
⁵ Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands.

PMID: 38758343
DOI: 10.1111/sltb.13091

Abstract

Introduction: Findings on the role of suicide ambivalence, an individual's wish to live (WL), and wish to die (WD) in the development of suicidality have been heterogenous. The main goal of this study was to examine associations of these constructs within the past week with sociodemographic factors and to longitudinally investigate their predictive power for suicidal ideation (SI) and suicide attempts (SA).

Methods: N = 308 patients (54% female; M = 36.92 years, SD = 14.30), admitted to a psychiatric ward due to suicidality, were assessed for all constructs after admission, after six, nine, and 12 months. Data were analyzed with univariate fixed-effect models and lagged mixed-effect regression models.

Results: Decreased, WL increased post-baseline. Gender showed no significant link to ambivalence, WD, and WL. Ambivalence and WD correlated negatively with age and positively with depressiveness. More participants in a relationship showed a WL compared with single/divorced/widowed participants. More single participants or those in a relationship showed ambivalence than divorced/widowed participants. More single participants showed a WD than participants in a relationship/divorced/widowed. Longitudinally, ambivalence and WD predicted SI and SA.

Conclusion: The findings underscore the importance of taking suicide ambivalence and WD into account in risk assessment and treatment.

Keywords: suicidal ideation; suicide ambivalence; suicide attempt.

Abstract

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