Recent advances in differentiating suicide attempters from suicide ideators
Abstract
PURPOSE OF REVIEW: This article summarizes findings from recent studies (published since 2015) examining differences between suicide attempters and suicide ideators. RECENT FINDINGS: Converging evidence suggests that the capability to attempt suicide (e.g., acquired capability, painful and provocative experiences, high tolerance for pain and distress) is higher in suicide attempters than suicide ideators. Other psychosocial and biological differences have also been identified but require replication. SUMMARY: Recent literature reviews find that traditional risk factors for suicide - such as depression, hopelessness, most psychiatric disorders, and even impulsivity - robustly predict suicide ideation but poorly predict suicide attempts among ideators. To address this knowledge gap, studies are increasingly employing an ideation-to-action framework. This framework views the development of suicide ideation and the progression from ideation to potentially lethal attempts as distinct processes with distinct explanations and predictors. Converging evidence suggests that factors associated with diminished fear of pain, injury, and death can increase one's capability to attempt suicide and facilitate the progression from suicidal thoughts to suicidal acts. Recent studies have also identified other variables that may differentiate attempters from ideators, but these require replication. Theories of suicide positioned within the ideation-to-action framework provide testable and promising hypotheses about the progression from ideation to attempts. These include the Interpersonal Theory, Integrated Motivational-Volitional Model, and Three-Step Theory.
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The factors that most consistently predict suicide attempts among people with ideation relate to suicide capability.
“According to a recent review,8 the factors that most consistently predict suicide attempts among people with ideation relate to suicide capability (ie, the degree to which an individual feels able to make a suicide attempt).”
From Predictors of future suicide attempt among adolescents with suicidal thoughts or non-suicidal self-harm: a population-based birth cohort study (2019) · cites this paper as [8]
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- Authors
- Klonsky, E. D., Qiu, T., & Saffer, B. Y.
- Affiliations
- University of British Columbia (CA)
- Corresponding author
- Klonsky, E. David
- Venue
- Current Opinion in Psychiatry
- Published
- 2017-01
- Volume
- 30
- Issue
- 1
- Pages
- 15-20
- ISSN
- 0951-7367 (ISSN-L)
- OpenAlex
- W2540513568
- Semantic Scholar
- cbea48f123f88ad85a207303b46f30ddb2452e06
- Cited by
- 193
- References
- 38
- Citations by year
- 2026: 7 · 2025: 20 · 2024: 33 · 2023: 30 · 2022: 17 · 2021: 26 · 2020: 22 · 2019: 16 · 2018: 18 · 2017: 4
- FWCI
- 1.87
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Current Opinion in Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Keywords
- suicide attempters, suicidal ideation, ideation-to-action framework, acquired capability, pain tolerance, fear of death, suicide risk factors, interpersonal theory of suicide, integrated motivational-volitional model, depression, hopelessness
- MeSH terms
- Female, Humans, Suicide, Attempted, Suicidal Ideation
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