Dynamic association between suicidal ambivalence and suicide risk among individuals with a history of suicide attempts.
Open accessAbstract
OBJECTIVE: Suicide risk is highly fluctuating. There is a need for predictors of short-term change in suicide risk to optimize risk assessment and treatment, especially among individuals who already attempted suicide. METHODS: Based on 1776 daily assessments of 16 former psychiatric inpatients with a history of suicide attempts, we examined how suicidal ambivalence and, respectively, wish to die (WTD) and wish to live (WTL) predicted same-day and change in perceived suicide risk (i.e., next-day perceived suicide risk, controlled for same-day perceived suicide risk) in multilevel regression models. Additionally, based on the assumptions of nonlinear dynamics, we examined the associations between levels of fluctuations in the WTD/WTL and perceived suicide risk within the same time period. RESULTS: Suicidal ambivalence, WTD, and a WTL significantly correlated with same-day suicide risk. Suicidal ambivalence and WTD significantly predicted change in suicide risk. Fluctuations in WTD were significantly associated with concurrent suicide risk. CONCLUSION: The results suggest that suicidal ambivalence and WTD are drivers of suicide risk among individuals who already attempted suicide. The association between fluctuations in WTD and suicide risk was small and warrants further investigation on the practical utility as a warning sign.
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Acute suicidal behaviors typically fluctuate.
“While acute suicidal behaviors typically fluctuate,31,32 patients need to prove a well-considered and recurrent death wish to be eligible for MAID.”
From Requests for Medical Assistance in Dying by Young Dutch People With Psychiatric Disorders (2025) · cites this paper as [32]
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Requests for Medical Assistance in Dying by Young Dutch People With Psychiatric Disorders
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- Authors
- Fartacek, C., Fartacek, R., Schiepek, G. K., Sturm, J., Aichhorn, W., & Plöderl, M.
- Affiliations
- Paracelsus Medical University (AT)
- Universitätskliniken Salzburg (AT)
- Medical Center Bad Vigaun Salzburg Austria
- Corresponding author
- Fartacek, Clemens
- Venue
- Suicide and Life-Threatening Behavior
- Publisher
- Wiley
- Published
- 2024-06-04
- Volume
- 54
- Issue
- 5
- Pages
- 860-868
- ISSN
- 0363-0234 (ISSN-L)
- 1943-278X
- OpenAlex
- W4399322773
- Cited by
- 6
- References
- 32
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 1
- FWCI
- 2.99
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Suicide and Life-Threatening Behavior (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Social Sciences › Psychology › Social Psychology › Mental Health via Writing
- Keywords
- suicide risk, suicide attempts, desire for death, nonlinear dynamics, daily assessment, psychiatric inpatients, warning signs
- MeSH terms
- Adult, Female, Humans, Male, Middle Aged, Risk Factors, Suicide, Suicide, Attempted, Risk Assessment, Suicidal Ideation
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