Psychache and suicide: a preliminary investigation

Shneidman's Psychological Pain Assessment Scale (PPAS; 1999) was administered to 88 psychiatric patients. Both current and worst-ever psychache were significantly higher in those patients judged by a psychiatrist, on the basis of a structured clinical interview, to be at risk of suicide. However, current and worstever psychache were not associated with having attempted suicide in the past. Thus, for the present sample of psychiatric patients, the PPAS appears to be more sensitive to current suicidality than to past suicidality. Further, there are validity issues with the PPAS, with the need for multi-item measures and probably a multifactor measure.     

A predictive approach to Freud's formulations regarding suicide

This study of suicide notes involved the deduction of 25 protocol sentences that reflected important specific aspects of Freud's formulations regarding suicide. Independent judges noted the incidence of contents corresponding to the protocol sentences in 33 genuine and 33 simulated notes. Comparisons between genuine and simulated notes revealed that the protocol sentences discriminated significantly as a set in favor of the genuine notes. Individual statements found significantly more frequently in genuine notes indicated loss and/or rejection, preoccupation with a lost person, ambivalence toward a lost person, identification with a lost person, communicating feelings of anger toward oneself but appearing to be angry toward someone else, turning back upon oneself murderous wishes or impulses, and seeing the act as a fulfillment of self-punishment. A frequency count of the sentences in the notes indicated that these statements occurred quite frequently (i.e., at least one-third of the time) in the genuine notes. Implications of the results are discussed.     

2 Rick: A Suicide of a Young Adult

A small but concerning percentage of completed suicides are seen as having left no clues. The classical case, albeit a literary one, is Robinson's Richard Cory. These people often dissemble, even about their suicide risk. An even smaller group of these individuals present themselves in therapy without communicating a sign of suicide risk. Utilizing an idiographic approach, the case of a young adult male (Rick) is presented. The narrative reconstruction gives voice behind the man's mask. The autopsy reveals a young man who was in deep pain and unable to adjust to life's demands. Rick lacked ego strength, being overly narcissistic and having deeply troubled, symbiotic attachments to his family in a world of interpersonal isolation. In the end, even the help of his therapist, who tried to reach through the mask, was not enough and Rick killed himself. The pain had become unbearable. A few guiding remarks for such cases are offered, noting that therapists must constantly address the dissembling in some suicidal patients.     

Attitudes toward suicide: a comparison of Canadian and U.S. college students

The Suicide Opinion Questionnaire (SOQ) was administered to two samples (n = 100 each) of college students, one from Canada and one from the United States. A multivariate analysis of variance indicated substantial intergroup differences, but no sex differences. Univariate analyses indicated significant differences on 8 of the 15 SOQ factors, suggesting that Canadian college students perceive suicide as part of everyday life, not to be explained by recourse to religious, personality, or psychopathological constructs. The results are discussed in terms of six themes present in the suicide literature: motivation, acceptability, religion, impulsivity, recidivism, and misconceptions. Speculation is also provided regarding why such differences (despite considerable similarities) might exist.     

An empirical investigation of Shneidman's formulations regarding suicide: age and sex

This study of suicide notes, concerning the demographic variables of age and sex, involved the deduction of 50 classifications (protocol sentences) that reflected important aspects of Shneidman's formulations with regard to suicide. Independent judges noted the incidence of contents corresponding to the protocol sentences in the notes left by 60 suicides-20 notes written by individuals (females and males) in each of the three categories of Young, Middle, and Late Adulthood. Age (notably in regard to Young Adults), but not sex, was found to be a critical discriminating variable on a number of specific classifications and clusters of these classifications (Perturbation, Relations, Cognitions Regarding Self, and Long-Term Instability), although considerable similarities were also noted across the adult life span. Implications of the results are discussed.