Patterns of Stressful Life Events: Distinguishing Suicide Ideators from Suicide Attempters
Abstract
Background Suicidal ideation is an important indicator for subsequent suicidal behaviour, yet only a proportion of ideators transit from thought to action. This has led to interest surrounding the factors that distinguish ideators who attempt from non-attempters. The study aimed to identify distinct classes of life event categories amongst a sample of ideators and assess the ability of the classes to predict the risk of a suicide attempt.Methods A subsample of ideators was extracted based on responses to the suicidality section of the Adult Psychiatric Morbidity Survey (N=7403). Fifteen stressful life events (SLEs) were grouped into six broad categories.Results Using Latent Class Analysis (LCA), three distinct classes emerged; class 1 had a high probability of encountering interpersonal conflict, class 2 reported a low probability of experiencing any of the SLE categories with the exception of minor life stressors, whereas class 3 had a high probability of endorsing multiple SLE categories. The Odds Ratio for attempted suicide were highest among members of Class 3.Limitations The use of broad event categories as opposed to discrete life events may have led to an underestimation of the true exposure to SLEs.Conclusions The findings suggest the experience of multiple types of SLEs may predict the risk of transitioning towards suicidal behaviour for those individuals who have contemplated suicide. In application, this re-emphasises the need for a routine appraisal of risk amongst this vulnerable group and an assessment of the variety of events which may signal the individuals who may be at immediate risk.
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Across studies, suicide attempters endorsed more general life stressors than suicide ideators.
“Across studies, suicide attempters endorsed more general life stressors (i.e., events and difficulties) than suicide ideators.”
From Life stress and suicide in adolescents (2019) · cites this paper as McFeeters et al. 2015
Among adults, negative interactions with friends and interpersonal conflicts specifically differentiated suicide attempters from suicide ideators.
“Furthermore, among adults, “negative interactions with friends” (Fairweather et al. 2006) and “interpersonal conflicts” (McFeeters et al. 2015) specifically differentiated these groups.”
From Life stress and suicide in adolescents (2019) · cites this paper as McFeeters et al. 2015
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“Surprisingly, none of these studies have included both psychiatric inpatients and outpatients and only four have looked at psychiatric patients at all [7, 8, 10, 15].”
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Parra, G. R., Smith, G. L., Mason, W. A., Savolainen, J., Chmelka, M. B., Miettunen, J., Järvelin, M., Moilanen, I. K., & Veijola, J. M. (2017) · Journal of Child and Family Studies · doi:10.1007/s10826-017-0935-x · Cited by 4 · see citing works
Denneson, L. M., Williams, H. B., Jacobson, L. E., Nguyen, D. H., & Dobscha, S. K. (2016) · Military Behavioral Health · doi:10.1080/21635781.2016.1199985 · Cited by 3 · see citing works
García-Fernández, A., Martínez-Cao, C., Pérez-Díez, I., Andreo-Jover, J., Ayad‐Ahmed, W., Bobes-Bascarán, T., Canal‐Rivero, M., Cebrià, A. I., Crespo‐Facorro, B., Díaz‐Marsá, M., et al. (2025) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2025.07.035 · Cited by 2 · see citing works
Davies, K., Lappin, J. M., Isobel, S., & Steel, Z. (2026) · Australian and New Zealand journal of psychiatry (Print) · doi:10.1177/00048674251411085 · Cited by 2 · see citing works
“…indicating that those who reported a higher number of lifespan PTEs also reported a higher frequency of suicide attempts (Dube et al., 2001; McFeeters et al., 2015), reinforcing the need for suicide treatment and support to not only focus on assessment of risk but also to help build…”
Suicide attempts in residents of Bam: 17 years after the Bam earthquake in Iran
Amiri, H., Rezapour, M., Nakhaee, N., Nekoei‐Moghadam, M., Jahani, Y., & Moslehi, S. (2022) · Minerva Psychiatry · doi:10.23736/s2724-6612.21.02173-4 · Cited by 2 · see citing works
Xu, Z., Kong, Y., Yang, Y., Tian, M., Liu, Y. H., & Lin, L. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1470371 · Cited by 2 · see citing works
Assessment of mental health of medical personnel during COVID-19: insights from Pakistan
Manzoor, F., Wei, L., Haq, M. Z. U., & Rehman, H. U. (2022) · Heliyon · doi:10.1016/j.heliyon.2022.e11824 · Cited by 2 · see citing works
“The association between pandemics and mental health is well documented in past literature (Galbraith et al., 2020; McFeeters et al., 2015).”
The Narrative-Crisis Model of Suicide
GALYNKER, I. I. (2023) · doi:10.1093/med/9780197582718.003.0003 · Cited by 1 · see citing works
Developmental perspective on the exogenous homosexual behavior and sexual minorities
Shen, Z. (2015) · Chinese Science Bulletin (Chinese Version) · doi:10.1360/n972015-00346 · Cited by 1 · see citing works
Fishburn, K. E., & Alfred, L. (2020) · Evidence-Based Nursing · doi:10.1136/ebnurs-2020-103301
Parveen, M. K., Hannan, M. J., Hasan, M. S., Chowdhury, T. K., Afroz, R. D., Ferdoush, J., Hoque, M. M., & Nandy, A. (2021) · Research Square · doi:10.21203/rs.3.rs-143880/v1
Guo, C., Wang, X., Xia, Z., Cui, Y., Hu, J., Xue, Y., Huang, X., Wan, Y., Zhang, B., Song, X., et al. (2021) · Research Square · doi:10.21203/rs.3.rs-735158/v1
“McFeeters et al. examined the subclasses of stressful life events related to suicide [27], and Bernanke et al. identi�ed the relationship between mental health problems and SBs [28].”
da Costa, A. D. P. V., dos Santos, L. M., Medeiros, M. L., Hansen, C. O., Formiga, Y. C. M., & de Miranda, C. T. (2022) · Psico · doi:10.15448/1980-8623.2022.1.37342
“The most common SLE identified in a British study involving 1066 patients with psychological morbidity and SI were loss of family or friend, interpersonal conflicts, severe illness, financial crisis, and interpersonal violence (McFeeters et al., 2015).”
BackgroundHOW THE COVID-19 PANDEMIC HAS CHANGED THE IMAGE OF PSYCHIATRY
Moraru, C., Rădulescu, I.-D., Cojocariuiu, R.-I., Nechita, P., & Ciubară, A. (2021) · Archiv Euromedica · doi:10.35630/2199-885x/2021/11/5.11
Silva, K. A. D. S. S., & Campos, V. R. (2024) · Revista de Medicina · doi:10.11606/issn.1679-9836.v103i1e-210341
“This phenomenon can stem from various factors and is perceived as a non-conscious act 1 .”
BackgroundStreet ketamine use and differential risk of suicidality among adults in Taiwan
Kuo, Y.-C., Wang, S., & Chen, C. (2025) · Harm Reduction Journal · doi:10.1186/s12954-025-01308-7
“…challenges, recent ketamine users often face ongoing legal and social stressors [1, 21]—such as involvement with the criminal justice system, unemployment, and social isolation—that can exacerbate feelings of hopeless-ness and increase the likelihood of suicidal behavior [20, 24, 25].”
Stressful Life Events and Suicidality in First‐Episode Psychosis
Colomer-Salvans, A., Serra‐Arumí, C., Vila‐Badia, R., Corbella-Sotil, A., Abella, M., Rubio‐Abadal, E., Leal‐Pujol, R., Dolz, M., Bustos‐Cardona, T., Rolduà‐Ros, J., et al. (2026) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.70278
Liu, M., He, X., Mo, P., Luo, W., & Luo, J. (2026) · BMC Health Services Research · doi:10.1186/s12913-026-15512-z
- Authors
- McFeeters, D., Boyda, D., & O`Neill, S.
- Affiliations
- University of Ulster (GB)
- Corresponding author
- McFeeters, Danielle
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2015-04
- Volume
- 175
- Pages
- 192-198
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W2091182718
- Cited by
- 53
- References
- 53
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 2 · 2023: 4 · 2022: 8 · 2021: 6 · 2020: 5 · 2019: 4 · 2018: 3 · 2017: 4 · 2016: 6 · 2015: 5
- FWCI
- 5.90
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Wolverhampton Intellectual Repository and E-Theses (University of Wolverhampton) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
- Social Sciences › Psychology › Social Psychology › Mental Health via Writing
- Keywords
- suicidal ideation, suicide attempts, life events, interpersonal conflict, suicide risk prediction, latent class analysis, Adult Psychiatric Morbidity Survey
- MeSH terms
- Adult, Female, Humans, Life Change Events, Male, Middle Aged, Risk Factors, Suicide, Attempted, Suicidal Ideation
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