ABSTRACT
Traditional approaches for managing and treating self-directed violence have primarily adopted a psychiatric syndromal model that focuses on the classification and treatment of behaviors based on their topographical features, which typically include signs (i.e., what is directly observable, such as psychomotor agitation or repetitive behaviors) and symptoms (i.e., what is reported by the patient but not directly observable, such as depressed mood or worrying) of associated psychiatric disorders. From this perspective, suicidal ideation and suicide attempts are viewed as symptoms of an underlying psychiatric disorder (Jobes, 2006). Treatment of suicidal ideation and suicide attempts is therefore directed toward the resolution of the psychiatric condition that is presumed to underlie suicide risk (e.g., depression, borderline personality disorder). Unfortunately, this perspective has considerable limitations and has slowed our progress in understanding suicide, due in large part to the fact that suicidal ideation and suicide attempts are associated with all psychiatric disorders (Harris & Barraclough, 1997), suggesting there is no single psychiatric condition that serves as a core etiology for suicide. Furthermore, although psychiatric conditions serve as risk factors for suicide attempts, the vast majority of individuals with psychiatric conditions will not make suicide attempts or die by suicide, suggesting that psychiatric disorders are not particularly specific to understanding suicide risk. The fact that only some, but not all, individuals with psychiatric conditions engage in suicide attempts further suggests there must be other factors that more directly give rise to suicide attempts, regardless of an individual’s specific diagnostic profile.
