The DOI matches its Crossref record; 116 of the 116 references it cites were found in a registry or an index.
Toward a Clinical Model of Suicidal Behavior in Psychiatric Patients
Abstract
OBJECTIVE: Risk factors for suicide attempts have rarely been studied comprehensively in more than one psychiatric disorder, preventing estimation of the relative importance and the generalizability of different putative risk factors across psychiatric diagnoses. The authors conducted a study of suicide attempts in patients with mood disorders, psychoses, and other diagnoses. Their goal was to determine the generalizability and relative importance of risk factors for suicidal acts across diagnostic boundaries and to develop a hypothetical, explanatory, and predictive model of suicidal behavior that can subsequently be tested in a prospective study. METHOD: Following admission to a university psychiatric hospital, 347 consecutive patients who were 14-72 years old (51% were male and 68% were Caucasian) were recruited for study. Structured clinical interviews generated axis I and axis II diagnoses. Lifetime suicidal acts, traits of aggression and impulsivity, objective and subjective severity of acute psychopathology, developmental and family history, and past substance abuse or alcoholism were assessed. RESULTS: Objective severity of current depression or psychosis did not distinguish the 184 patients who had attempted suicide from those who had never attempted suicide. However, higher scores on subjective depression, higher scores on suicidal ideation, and fewer reasons for living were reported by suicide attempters. Rates of lifetime aggression and impulsivity were also greater in attempters. Comorbid borderline personality disorder, smoking, past substance use disorder or alcoholism, family history of suicidal acts, head injury, and childhood abuse history were more frequent in suicide attempters. CONCLUSIONS: The authors propose a stress-diathesis model in which the risk for suicidal acts is determined not merely by a psychiatric illness (the stressor) but also by a diathesis. This diathesis may be reflected in tendencies to experience more suicidal ideation and to be more impulsive and, therefore, more likely to act on suicidal feelings. Prospective studies are proposed to test this model.
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“The antisuicidal effect estimated here is larger than the effect on mood episodes, 27 28 raising the possibility of a specific effect.33”
From Lithium in the prevention of suicide in mood disorders: updated systematic review and meta-analysis (2013) · cites this paper as [33]
In the citing paper
“Numerous reports of associations between suicidal behavior and a range of neurobiological parameters have emerged from studies of mixed age and younger adult samples (52).”
From Suicide in older adults (2011) · cites this paper as [52]
In the citing paper
“First, suicidal behavior is found in many psychiatric disorders and not just in mood disorders and borderline personality disorder, where it is part of the diagnostic symptom list.”
From A brain-centric model of suicidal behavior (2020) · cites this paper as [13]
In the citing paper
“The stress-diathesis model (13, 14) depicts suicidal behavior as a consequence of an interaction between acute stressors or proximal risk factors and a diathesis or distal factors (Figure 1).”
From A brain-centric model of suicidal behavior (2020) · cites this paper as [13]
In the citing paper
“Second, only a minority of psychiatric patients make suicide attempts, and the presence or absence of suicidal behavior is not simply determined by the presence of a psychiatric illness or the overall severity of illness (12-14).”
From A brain-centric model of suicidal behavior (2020) · cites this paper as [13]
In the citing paper
“Suicidal behavior risk is moderated by a set of psychopathological and cognitive traits that are different from the psychopathology of associated psychiatric illnesses.”
From A brain-centric model of suicidal behavior (2020) · cites this paper as [13]
In the citing paper
“Second, only a minority of psychiatric patients make suicide attempts, and the presence or absence of suicidal behavior is not simply determined by the presence of a psychiatric illness or the overall severity of illness (12-14).”
From A brain-centric model of suicidal behavior (2020) · cites this paper as [13]
In the citing paper
“A stress-diathesis psychological model explains suicide risk as a combination of stressors in vulnerable persons.”
From Suicide (2020) · cites this paper as [31]
In the citing paper
“Individual vulnerability is considered to express itself in suicidal ideation under stress and is magnified by impulsivity and aggression, which increase the likelihood of acting on suicidal ideas.31”
From Suicide (2020) · cites this paper as [31]
Citations
Cites
An inventory for measuring depression
BECK, A. T. (1961) · Archives of General Psychiatry · doi:10.1001/archpsyc.1961.01710120031004 · Cited by 38,032
Hamilton, M. (1960) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp.23.1.56 · Cited by 32,817
The Brief Psychiatric Rating Scale.
Overall, J. E., & Gorham, D. R. (1962) · Psychological Reports · doi:10.2466/pr0.1962.10.3.799 · Cited by 11,090
Mortality in relation to smoking: 40 years' observations on male British doctors
Doll, R., Peto, R., Wheatley, K., Gray, R., & Sutherland, I. (1994) · BMJ · doi:10.1136/bmj.309.6959.901 · Cited by 5,932
The measurement of pessimism: the hopelessness scale
Beck, A. T., Weissman, A., Lester, D., & Trexler, L. (1974) · Journal of Consulting and Clinical Psychology · doi:10.1037/h0037562 · Cited by 5,494
Assessment of suicidal intention: The Scale for Suicide Ideation.
Beck, A. T., Kovacs, M., & Weissman, A. (1979) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.47.2.343 · Cited by 3,419
An inventory for assessing different kinds of hostility.
Buss, A. H., & Durkee, A. (1957) · Journal of Consulting Psychology · doi:10.1037/h0046900 · Cited by 2,614
(1985) · American Journal of Psychiatry · doi:10.1176/ajp.142.5.559 · Cited by 1,723
Mortality in relation to smoking: 20 years' observations on male British doctors.
Doll, R., & Peto, R. (1976) · BMJ · doi:10.1136/bmj.2.6051.1525 · Cited by 1,309
A Hundred Cases of Suicide: Clinical Aspects
Barraclough, B. M., Bunch, J., Nelson, B., & Sainsbury, P. (1974) · British Journal of Psychiatry · doi:10.1192/bjp.125.4.355 · Cited by 1,283
Flagged first, then by citations
Research works printed but not linked: 2
- Centers for Disease Control and Prevention: Advance report of final mortality statistics, 1990. Monthly Vital Statistics Report 1993; 41:1–52
- Acht� VKA, Anttinen EE: Suizide bei Hirngesch�digten des Krieges in Finnland. Fortschr Neurol Psychiatr 1963; 12:645–667
Cited by
Sorted by citations
Items 701–800 of 1,005
Abreu, L. N., Oquendo, M. A., Galfavy, H., Burke, A., Grunebaum, M. F., Sher, L., Sullivan, G. M., Sublette, M. E., Mann, J., & Lafer, B. (2018) · European Psychiatry · doi:10.1016/j.eurpsy.2017.09.005 · Cited by 34
“Although in our study lifetime comorbid of anxiety disorders were not a risk factor for future suicide attempts, we note that the patients with anxiety disorders had higher scores for depression, hopelessness, suicidal ideation, impulsivity, aggression, and hostility, all risk factors for suicide attempts [36].”
BackgroundSelf-citationBelik, S., Stein, M. B., Asmundson, G. J. G., & Sareen, J. (2010) · American Journal of Epidemiology · doi:10.1093/aje/kwq290 · Cited by 34
“Third, personality disorders and non-alcohol substance use disorders, both of which are strong risk factors for suicidal behavior (18, 19), were not assessed in either data set.”
BackgroundSuicidal ideation is associated with nighttime wakefulness in a community sample
Tubbs, A. S., Fernandez, F., Perlis, M. L., Hale, L. E., Branas, C. C., Barrett, M. S., Chakravorty, S., Khader, W., & Grandner, M. A. (2020) · SLEEP · doi:10.1093/sleep/zsaa128 · Cited by 37
“Psychological theories suggest that insomnia increases thwarted belongingness [16–18] and/or that insomnia confers vulnerability to acute stress via the effects of sleep loss [19, 20].”
BackgroundMicroglial Dysregulation and Suicidality: A Stress-Diathesis Perspective
Baharikhoob, P., & Kolla, N. J. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.00781 · Cited by 40
“combination with a trait-like “diathesis” to suicidal tendencies could result in SB (1).”
BackgroundMethodInfluentialAngelakis, I., & Gooding, P. A. (2022) · Psychiatry Research · doi:10.1016/j.psychres.2022.114424 · Cited by 37
Large, M. M. B., Ryan, C. J., Walsh, G., Stein‐Parbury, J., & Patfield, M. (2013) · Australasian Psychiatry · doi:10.1177/1039856213511277 · Cited by 34
Association of limbic system-associated membrane protein (LSAMP) to male completed suicide
Must, A., Tasa, G., Lang, A., Vasar, E., Kõks, S., Maron, E., & Väli, M. M. (2008) · BMC Medical Genetics · doi:10.1186/1471-2350-9-34 · Cited by 35
“Therefore, a stress-diathesis model for suicidal behaviour has been proposed, where stressors include elements like an acute psychiatric disorder and life events, and the diathesis includes biologically determined risk factors for suicidal behaviour such as personality traits of aggression/impulsivity and a heightened…”
BackgroundSeasonal allergies and suicidality: results from the National Comorbidity Survey Replication
Messias, E., Clarke, D. E., & Goodwin, R. D. (2009) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2009.01518.x · Cited by 34
“Suicidal ideation is a predictor of suicide attempts (13) and those attempts, even when non-lethal, will lead to psychiatric hospitalization, family disruption and suffering.”
BackgroundSwogger, M. T., Walsh, Z., Homaifar, B. Y., Caine, E. D., & Conner, K. R. (2011) · Psychological Medicine · doi:10.1017/s0033291711001243 · Cited by 34
“For example, Mann et al. (1999) noted that borderline personality disorder and interpersonal violence are both robust predictors of suicide attempts ; however, the two are strongly interdependent and difficult to separate.”
BackgroundProcess of Suicide: Perspective of the Suicide Attempter
Chesley, K., & Loring-McNulty, N. E. (2003) · Journal of the American Psychiatric Nurses Association · doi:10.1016/s1078-3903(03)00052-1 · Cited by 34
Functional imaging, serotonin and the suicidal brain.
Audenaert, K., Peremans, K. Y., Goethals, I., & Heeringen, C. V. (2006) · PubMed · Cited by 34
Lifetime rhythmicity and mania as correlates of suicidal ideation and attempts in mood disorders
Balestrieri, M., Rucci, P., Sbrana, A., Ravani, L., Benvenuti, A., Gonnelli, C., Dell’Osso, L., & Cassano, G. B. (2006) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2006.01.004 · Cited by 35
“As observed byMann et al [13], such approach fails to determine whether risk factors are specific to a single diagnosis or allow generalizations across diagnostic boundaries.”
BackgroundDependency and suicidality in addictive disorders
Loas, G., Guilbaud, O., Pérez-Díaz, F., Verrier, A., Stéphan, P., Lang, F., Bizouard, P., Venisse, J. L., Corcos, M., Flament, M. F., et al. (2005) · Psychiatry Research · doi:10.1016/j.psychres.2004.06.022 · Cited by 34
“This higher risk could be explained by psychopathic or borderline features in alcoholic subjects and also by the fact that the alcoholic sample included male subjects, unlike the anorectic and bulimic samples (Vilhjalmsson et al., 1998; Mann et al., 1999).”
BackgroundResultInfluentialvan Praag, H. M. (2002) · Crisis · doi:10.1027//0227-5910.23.2.77 · Cited by 33
“Hopelessness, moreover, may occur independent of depression or to a degree discrepant with depression severity (Mann et al., 1999).”
Rihmer, Z., & FAWCETT, J. A. (2010) · Wiley eBooks · doi:10.1002/9780470661277.ch7 · Cited by 34
Mindfulness-based cognitive therapy for depression and suicidality
Barnhofer, T., & Crane, C. (2009) · Clinical Handbook of Mindfulness · doi:10.1007/978-0-387-09593-6_13 · Cited by 33
The Relationship between Mood Instability and Suicidal Thoughts
Bowen, R., Balbuena, L., Peters, E. M., Leuschen-Mewis, C., & Baetz, M. (2015) · Archives of Suicide Research · doi:10.1080/13811118.2015.1004474 · Cited by 33
Anestis, M. D., Tull, M. T., Lavender, J. M., & Gratz, K. L. (2014) · Psychiatry Research · doi:10.1016/j.psychres.2014.03.031 · Cited by 33
Joo, Y. Y., Moon, S., Wang, H., Kim, H., Lee, E., Kim, J. H., Posner, J. E., Ahn, W., Choi, I., Kim, J.-W., et al. (2022) · JAMA Network Open · doi:10.1001/jamanetworkopen.2021.48585 · Cited by 36
McCloskey, M. S., Ben‐Zeev, D., Lee, R., & Coccaro, E. F. (2008) · Psychiatry Research · doi:10.1016/j.psychres.2007.09.011 · Cited by 33
“However, one area of interest is serotonergic dysregulation, a theorized biological mechanism for MDD and IED that has also been implicated in self-aggression (Mann et al., 1999).”
BackgroundClinical Features Associated with Suicide Attempts versus Suicide Gestures in an Inpatient Sample
Nieto, R. G., Blasco-Fontecilla, H., de León-Martínez, V., & Baca‐García, E. (2014) · Archives of Suicide Research · doi:10.1080/13811118.2013.845122 · Cited by 33
“It is estimated that up to 20–50% of these patients will make a suicide attempt in their lifetime (Radomsky, Haas, Mann et al., 1999).”
BackgroundVanyukov, P. M., Szántó, K., Hallquist, M. N., Moitra, M., & Dombrovski, A. Y. (2016) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.4526 · Cited by 37
“Further, to understand the broader psychological context in which extreme feelings of burdensomeness may emerge, we examined its association with personality traits and interpersonal styles, which also play an important role in suicide diathesis (Mann et al., 1999).”
The narrative interview with the suicidal patient.
Michel, K., & Valach, L. (2010) · American Psychological Association eBooks · doi:10.1037/12303-004 · Cited by 33
López-Moríñigo, J.-D., Ayesa‐Arriola, R., Torres-Romano, B., Fernandes, A. C., Shetty, H., Broadbent, M. T. M., Dominguez-Ballesteros, M.-E., Stewart, R. J., David, A. S., & Dutta, R. (2016) · BMJ Open · doi:10.1136/bmjopen-2016-011929 · Cited by 34
“54 55 Moreover, a previous population-level community-based survey conducted in South-East London found poor mental health, low socioeconomic status and being unmarried to be associated with a history of previous suicide attempts, while black African ethnicity was protective.”
Rorschach Measures of Aggressive Drive Derivatives: A College Student Sample
Mihura, J. L., Nathan-Montano, E., & Alperin, R. J. (2003) · Journal of Personality Assessment · doi:10.1207/s15327752jpa8001_12 · Cited by 33
Obsessive–Compulsive Disorder and Suicidal Experiences: The Role of Experiential Avoidance
Angelakis, I., & Gooding, P. (2020) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12593 · Cited by 32
Risk for suicidal behaviors associated with alcohol and energy drink use in the US Army
Mash, H. B. H., Fullerton, C. S., Ramsawh, H. J., Ng, T. H. H., Wang, L., Kessler, R. C., Stein, M. B., & Ursano, R. J. (2014) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-014-0886-0 · Cited by 32
“Impulsivity and impulse-control disorders in general have been associated with elevated risk for suicide and suicidal behavior [48–50].”
BackgroundGutierrez, P. M., Brenner, L. A., & Huggins, J. (2008) · Archives of Suicide Research · doi:10.1080/13811110802324961 · Cited by 32
“( 1999 ) which determined that lifetime, externally directed aggression and impulsivity distinguished past suicide attempters from non-attempters.”
BackgroundÍndice de riesgo para el intento suicida en México
Borges, G. L. G., Orozco, R., & Mora, M. E. M. (2012) · Salud Pública de México · doi:10.1590/s0036-36342012000600008 · Cited by 32
Temperament, Character and Suicide Attempts in Unipolar and Bipolar Mood Disorders
Jylhä, P. J., Rosenström, T. H., Mantere, O., Suominen, K. H., Melartin, T. K., Vuorilehto, M. S., Holma, M., Riihimäki, K., Oquendo, M. A., Keltikangas‐Järvinen, L., et al. (2016) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.14m09472 · Cited by 32
Depressed Multiple-SuicideAttempters – A High-Risk Phenotype
Sher, L., Grunebaum, M. F., Burke, A. K., Chaudhury, S. R., Mann, J. J., & Oquendo, M. A. (2017) · Crisis · doi:10.1027/0227-5910/a000475 · Cited by 33
Self-citationGuo, L., Wang, W., Gao, X., Huang, G., Li, P., & Lu, C. (2018) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2018.01.032 · Cited by 32
“This model also shows that in contrast to individuals without a history of suicide attempts, those having attempted suicide report fewer reasons for living.(6) Moreover, previous studies also indicate that there might be differences in characteristics between individuals with a history of 1 suicide attempt and those w…”
ResultTraumatic Brain Injury and Suicidal Behavior: A Review
Wadhawan, A., Stiller, J. W., Potocki, E., Okusaga, O. O., Dagdag, A., Lowry, C. A., Benros, M. E., & Postolache, T. T. (2019) · Journal of Alzheimer s Disease · doi:10.3233/jad-181055 · Cited by 40
Ji, X., Zhao, J., Li, H., Pizzagalli, D. A., Law, S., Lin, P., Fan, L., Zhang, P., Fang, S., Wang, X., et al. (2021) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2021.05.007 · Cited by 35
Do Antipsychotic Drugs Influence Suicidal Behavior in Schizophrenia?
Aguilar, E. J., Siris, S. G., Siris, P. A. S. G., & MD (2025) · Psychopharmacology Bulletin · doi:10.64719/pb.4116 · Cited by 32
Noradrenergic Function in Suicide
Pandey, G. N., & Dwivedi, Y. (2007) · Archives of Suicide Research · doi:10.1080/13811110701402587 · Cited by 32
Suicidal Behavior in Young Women
Baca‐García, E., Pérez-Rodríguez, M. M., Mann, J. J., & Oquendo, M. A. (2008) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2008.01.002 · Cited by 34
Self-citationThe Psychological Autopsy, Part I
Knoll, J. L. (2008) · Journal of Psychiatric Practice · doi:10.1097/01.pra.0000341894.35877.1b · Cited by 34
Lineberry, T. W., Allen, J. D., Nash, J., & Galardy, C. W. (2009) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2009.01.004 · Cited by 34
“Numerous critical risk factors are associated with both suicide and smoking including hostility, aggression, impulsivity, serotonergic and hypothalamic-pituitaryadrenal axis abnormalities, and psychiatric illness [18-25].”
BackgroundAssessing Suicide Risk in Cluster C Personality Disorders
Chioqueta, A. P., & Stiles, T. C. (2004) · Crisis · doi:10.1027/0227-5910.25.3.128 · Cited by 32
Eating disorders and aggressiveness among adolescents
Miotto, P., Coppi, M. D., Frezza, M., Петретто, Д. Р., Masala, C., & Preti, A. (2003) · Acta Psychiatrica Scandinavica · doi:10.1034/j.1600-0447.2003.00121.x · Cited by 32
“higher for lifetime aggression and impulsivity than non-attempters with the same psychiatric illness (24).”
BackgroundIntact alternation performance in high lethality suicide attempters
Keilp, J. G., Wyatt, G., Gorlyn, M., Oquendo, M. A., Burke, A. K., & John Mann, J. (2014) · Psychiatry Research · doi:10.1016/j.psychres.2014.04.050 · Cited by 31
“Other clinical ratings have been described previously (Mann et al., 1999) and are listed in Table 1.”
BackgroundSelf-citationPeñas‐Lledó, E., Guillaume, S., Naranjo, M. E. G., Delgado, A., Jaussent, I., Blasco-Fontecilla, H., Courtet, P., & LLerena, A. (2014) · The Pharmacogenomics Journal · doi:10.1038/tpj.2014.42 · Cited by 31
Beier, A. M., Lauritzen, L., Galfalvy, H., Cooper, T. B., Oquendo, M. A., Grunebaum, M. F., Mann, J. J., & Sublette, M. E. (2014) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2014.06.012 · Cited by 31
Self-citationCardona, E. Y. B., & Villalba, L. E. M. (2016) · CES Psicología · doi:10.21615/cesp.9.2.12 · Cited by 34
Differentially methylated regions in bipolar disorder and suicide
Gaine, M. E., Seifuddin, F., Sabunciyan, S., Lee, R. S., Benke, K. S., Monson, E. T., Zandi, P. P., Potash, J. B., & Willour, V. L. (2019) · American Journal of Medical Genetics Part B Neuropsychiatric Genetics · doi:10.1002/ajmg.b.32754 · Cited by 30
Cheng, G., Liu, J., Yang, Y., Wang, Y., Xiong, X., & Liu, G. (2021) · Children and Youth Services Review · doi:10.1016/j.childyouth.2021.106047 · Cited by 31
“The results also supported the stress-diathesis model (Mann et al., 1999).”
BackgroundMethodResultInfluentialMolecular genetics in the analysis of suicide
Souery, D., Oswald, P., Linkowski, P., & Mendlewicz, J. (2003) · Annals of Medicine · doi:10.1080/07853890310008242 · Cited by 31
Subtyping Borderline Personality Disorder by Suicidal Behavior
Soloff, P. H., & Chiappetta, L. (2012) · Journal of Personality Disorders · doi:10.1521/pedi.2012.26.3.468 · Cited by 32
Substance-induced suicidal admissions to an acute psychiatric service: Characteristics and outcomes
Ries, R. K., Yuodelis‐Flores, C., Comtois, K. A., Roy‐Byrne, P., & Russo, J. E. (2007) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2006.12.033 · Cited by 31
“Such patients have also been described (but not SIS rated or analyzed as in this study) by other studies (Beck & Steer, 1989; Blow et al., 1998; Hufford, 2001; Leon et al., 1998; Mann et al., 1999; Zouk et al., 2006).”
ResultRelationship of recent stress to amygdala volume in depressed and healthy adults
Sublette, M. E., Galfalvy, H., Oquendo, M. A., Bart, C. P., Schneck, N., Arango, V., & Mann, J. J. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.05.036 · Cited by 31
“…to psychopathology have increasingly focused on the role of stress, e.g. the stress-diathesis model of suicidal behavior proposed by Mann et al. (Mann et al., 1999); the role of childhood adversity in development of psychosis (Fisher et al., 2013, Wolke et al., 2014, Fisher et al., 2012,…”
BackgroundSelf-citationSher, L., Oquendo, M. A., Grunebaum, M. F., Burke, A. K., Huang, Y., & Mann, J. J. (2006) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2006.04.011 · Cited by 31
Self-citationCurrier, D., Spittal, M. J., Patton, G., & Pirkis, J. (2016) · BMC Public Health · doi:10.1186/s12889-016-3702-9 · Cited by 31
“suicidal behaviour when exposed to stressors [3].”
Dobbertin, M. D., Blair, K. S., Carollo, E., Blair, J., Dominguez, A. J., & Bajaj, S. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1083244 · Cited by 34
“These include the “Cry of Pain” model (12), the Interpersonal model (7), the Integrated Motivational model (13), the Clinical Stress-Diathesis model (8, 14), and Jollant’s Neurocognitive model (5).”
BackgroundPrognostic models to detect and monitor the near-term risk of suicide: state of the science.
Claassen, C., Harvilchuck-Laurenson, J. D., & Fawcett, J. (2014) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2014.06.003 · Cited by 28
Colborn, V. A., LaCroix, J. M., Neely, L. L., Tucker, J., Perera, K. U., Daruwala, S. E., Grammer, G. G., Weaver, J. J., & Ghahramanlou‐Holloway, M. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2017.03.026 · Cited by 32
“…individuals with multiple suicide attempts are at an elevated risk for suicide, partially due to more severe psychopathology (Forman et al., 2004); however, impulsivity has been postulated as a transdiagnostic risk indicator for suicide above and beyond psychopathology (Mann et al., 1999).”
Cole, A. B., Littlefield, A. K., Gauthier, J. M., & Bagge, C. L. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.07.038 · Cited by 33
Green, J. A., Berry, K., Danquah, A., & Pratt, D. (2020) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2445 · Cited by 35
Lalovic, A., Wang, S., Keilp, J. G., Bowie, C. R., Kennedy, S. H., & Rizvi, S. J. (2021) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2021.11.007 · Cited by 33
Rogerson, O., Baguley, T. S., & O'Connor, D. B. (2022) · Crisis · doi:10.1027/0227-5910/a000886 · Cited by 35
Thyroid hormones and personality traits in attempted suicide
Sinai, C., Hirvikoski, T., Vansvik, E. D., Nordström, A., Linder, J., Nordström, P., & Jokinen, J. (2009) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2009.05.009 · Cited by 30
“Individuals with a past history of attempting suicide exhibited greater lifetime aggression and impulsivity than non-attempters with the same psychiatric illness (Mann et al., 1999).”
Variables associated with familial suicide attempts in a sample of suicide attempters
Baca‐García, E., Pérez-Rodríguez, M. M., Saiz-González, D., Basurte-Villamor, I., Sáiz, P. A., Leiva-Murillo, J. M., de Prado‐Cumplido, M., Mozos, R. S., Artés-Rodrı́guez, A., & de León, J. (2007) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2007.05.019 · Cited by 30
“The tendency to act upon suicidal thoughts may be a specific genetic component of suicidal behavior (Mann et al., 1999).”
BackgroundABCG1 gene variants in suicidal behavior and aggression-related traits
Gietl, A. F., Giegling, I., Hartmann, A. M., Schneider, B., Schnabel, A., Maurer, K., Möller, H., & Rujescu, D. (2006) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2006.11.004 · Cited by 30
“Serotonergic function was regarded to be crucial for the regulation of impulsive and aggressive behavior, which in turn has been demonstrated to correlate with suicidal behavior in various studies (Plutchik et al., 1989; Mann et al., 1999; reviewed in Kamali et al., 2001).”
ResultSwann, A. C., Lijffijt, M., Lane, S. D., Steinberg, J. L., & Moeller, F. G. (2012) · Journal of Affective Disorders · doi:10.1016/j.jad.2012.06.027 · Cited by 34
“This is consistent with reported relationships between increased impulsivity and risk for suicide (Dougherty et al., 2004; Dumais et al., 2005; Mann et al., 1999; Simon et al., 2001; Swann et al., 2005).”
BackgroundResultCSF 5-HIAA, attempted suicide and suicide risk in schizophrenia spectrum psychosis
Carlborg, A., Jokinen, J., Nordström, A., Jönsson, E. G., & Nordström, P. (2009) · Schizophrenia Research · doi:10.1016/j.schres.2009.04.006 · Cited by 29
“Suicide attempters in general show more impulsiveness than psychiatric controls (Mann et al., 1999) and serotonergic dysfunction has been linked to aggressive and impulsive traits which may be a clinical mediator of suicidal behavior in depression (Placidi et al., 2001), and its role in a diathesis…”
BackgroundAbnormal stress responsiveness and suicidal behavior: a risk phenotype
Steinberg, L. J., & Mann, J. J. (2020) · Biomarkers in Neuropsychiatry · doi:10.1016/j.bionps.2020.100011 · Cited by 29
Self-citationBrenner, L. A., Bahraini, N. H., Homaifar, B. Y., Monteith, L. L., Nagamoto, H. T., Holliman, B. D., & Forster, J. E. (2015) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2015.04.010 · Cited by 29
Lifetime Suicide Attempts in Juvenile Assessment Center Youth
Nolen, S., McReynolds, L. S., DeComo, R. E., John, R., Keating, J. M., & Wasserman, G. A. (2008) · Archives of Suicide Research · doi:10.1080/13811110701857087 · Cited by 29
Medical, psychiatric and demographic factors associated with suicidal behavior in homeless veterans
Goldstein, G., Luther, J. F., & Haas, G. L. (2012) · Psychiatry Research · doi:10.1016/j.psychres.2012.03.029 · Cited by 29
Self-citationThe Relation of Self-Hatred and Suicidality in People With Schizophrenia-Spectrum Symptoms
Joiner, T. E., Gençöz, F., Gençöz, T., Metalsky, G. I., & Rudd, M. D. (2001) · Journal of Psychopathology and Behavioral Assessment · doi:10.1023/a:1010915709011 · Cited by 29
“Mann, Waternaux, Haas, & Malone, 1999; but see Young et al., 1998).”
How suicidal bipolar patients are depends on how suicidal ideation is defined
Valtonen, H. M., Suominen, K. H., Sokero, P., Mantere, O., Arvilommi, P., Leppämäki, S., & Isometsä, E. T. (2009) · Journal of Affective Disorders · doi:10.1016/j.jad.2009.02.008 · Cited by 31
A stubborn behaviour: The failure of antidepressants to reduce suicide rates
van Praag, H. M. (2003) · The World Journal of Biological Psychiatry · doi:10.1080/15622970310029917 · Cited by 29
“Hopelessness, moreover, may occur independent of depression or to a degree discrepant with depression severity (Mann et al. 1999).”
Milak, M. S., Keilp, J., Parsey, R. V., Oquendo, M. A., Malone, K. M., & Mann, J. J. (2010) · Journal of Affective Disorders · doi:10.1016/j.jad.2010.03.002 · Cited by 28
“…et al., 2004), responds more slowly to antidepressant treatment (Adda et al., 1997; Ambrosini et al., 1999; Posternak and Miller, 2001; Thase et al., 1991), and is a stronger predictor of suicide attempts (Grunebaum et al., 2005; Mann et al., 2008, 1999; Oquendo et al., 2007;Oquendo et al., 2004).”
Self-citationPhysical and Psycho-Social Predictors of Adolescents’ Suicide Behaviors
Kim, Y. J., Moon, S. S., & Kim, M. J. (2011) · Child and Adolescent Social Work Journal · doi:10.1007/s10560-011-0241-1 · Cited by 28
“Mann et al. (1999) have introduced an explanatory model for suicide-related behavior based on a stress-diathesis model.”
MethodAn urge to jump affirms the urge to live: An empirical examination of the high place phenomenon
Hames, J. L., Ribeiro, J. D., Smith, A. R., & Joiner, T. E. (2011) · Journal of Affective Disorders · doi:10.1016/j.jad.2011.10.035 · Cited by 28
“Although several theories (Baumesiter, 1990; Mann et al., 1999) and empirical studies (e.”
BackgroundCanal‐Rivero, M., Barrigón, M. L., Garcelán, S. P., Testal, J. F. R., Giner, L., Obiols, J. E., & Ruíz-Veguilla, M. (2016) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2016.08.014 · Cited by 28
Cameron, S., Brown, V. J., Dritschel, B., Power, K., & Cook, M. (2017) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/papt.12123 · Cited by 32
Plöderl, M., Kunrath, S., Cramer, R. J., Wang, J., Hauer, L., & Fartacek, C. (2017) · BMC Psychiatry · doi:10.1186/s12888-017-1337-8 · Cited by 30
“These three instruments are typically used to assess treatment outcome in related studies [52–55], since they are established measures of suicide risk [56, 57] with sound psychometric properties [57, 58] and therefore recommended in suicide prevention research [59].”
MethodMental health of caregivers of individuals with disabilities: Relation to Suicidal Ideation
Huang, Y., Hsu, S., Hung, C., Wang, L., & Chong, M. (2017) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2017.11.003 · Cited by 31
Misiak, B., Samochowiec, J., Gawęda, Ł., & Frydecka, D. (2023) · European Psychiatry · doi:10.1192/j.eurpsy.2023.14 · Cited by 28
“These include the diathesis–stress model [6, 7], the biopsychosocial model [8], the integrated motivational–volitional model [9], the interpersonal theory of suicide [10], and the narrative crisis model [11].”
Emotions and Suicidal Ideation among Depressed Women with Childhood Sexual Abuse Histories
You, S., Talbot, N. L., He, H., & Conner, K. R. (2012) · Suicide and Life-Threatening Behavior · doi:10.1111/j.1943-278x.2012.00086.x · Cited by 28
Improving the accuracy of suicide attempter classification
Delgado‐Gómez, D., Blasco-Fontecilla, H., Alegría, A. A., Legido, T., Artés-Rodrı́guez, A., & Baca‐García, E. (2011) · Artificial Intelligence in Medicine · doi:10.1016/j.artmed.2011.05.004 · Cited by 28
Personality Style and Impulsivity as Determinants of Suicidal Subgroups
Fazaa, N., & Page, S. (2009) · Archives of Suicide Research · doi:10.1080/13811110802572122 · Cited by 28
Brådvik, L., & Berglund, M. (2005) · Depression and Anxiety · doi:10.1002/da.20134 · Cited by 28
“…a stress-diathesis model has been proposed in which the risk for suicidal acts is determined not merely by a psychiatric illness (the stressor) but also by a diathesis, such as a tendency to experience more suicidal ideation and to be more likely to act on suicidal feeling (Mann et al , 1999).”
Personality disorders and suicide attempts in unipolar and bipolar mood disorders
Jylhä, P. J., Rosenström, T. H., Mantere, O., Suominen, K. H., Melartin, T. K., Vuorilehto, M. S., Holma, M., Riihimäki, K., Oquendo, M. A., Keltikangas‐Järvinen, L., et al. (2015) · Journal of Affective Disorders · doi:10.1016/j.jad.2015.11.006 · Cited by 28
“Multiple interacting risk (e.g. above mentioned) and protective (e.g. meaningful and important relationships) factors influence suicidal behavior (Mann et al., 1999).”
BackgroundSher, L. (2005) · Medical Hypotheses · doi:10.1016/j.mehy.2005.07.003 · Cited by 28
“The contemporary scientific literature confirms that individuals with alcohol abuse or dependence (alcoholism) have higher suicidal ideation, and a higher risk for attempted and completed suicide compared to persons without alcoholism [3–7].”
BackgroundInfluentialPompili, M., Innamorati, M., Lester, D., Brunetti, S., Tatarelli, R., & Girardi, P. (2007) · Personality and Individual Differences · doi:10.1016/j.paid.2007.06.019 · Cited by 28
Rojas, S. M., Leen‐Feldner, E. W., Blumenthal, H., Lewis, S. F., & Feldner, M. T. (2014) · Cognitive Therapy and Research · doi:10.1007/s10608-014-9650-8 · Cited by 30
“Prior suicidal behavior has repeatedly been identified as a key predictor of subsequent suicide (Borowsky et al. 2001; Mann et al. 1999; Miranda et al. 2014; Nanayakkara et al. 2013; Shaffer et al. 1996).”
BackgroundOhtaki, Y., Doki, S., Kaneko, H., Hirai, Y., Oi, Y., Sasahara, S., & Matsuzaki, I. (2019) · PLoS ONE · doi:10.1371/journal.pone.0220493 · Cited by 27
Serum endocannabinoid levels in suicide attempters: A pilot study
Herranz-Herrer, J., Gil-Benito, E., Ponte-López, T., Ortega‐Gutiérrez, S., Macicior, J., Rosado, S., Sánchez, A., & Blasco-Fontecilla, H. (2020) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2020.09.005 · Cited by 29
Where is the social in the biopsychosocial model of suicide prevention?
Rodríguez-Otero, J. E., Mouriño, X. C., Meilán-Fernández, D., Pintos-Bailón, S., & Escribano, G. C. (2021) · International Journal of Social Psychiatry · doi:10.1177/00207640211027210 · Cited by 26
“Examples of them are the diathesis-stress-hopelessness model (Schotte & Clum, 1987), the Mann psychobiological model (Mann et al., 1999) and the cognitive model of suicidal behavior (Wenzel & Beck, 2008).”
BackgroundDepression and suicide are natural kinds: Implications for physician-assisted suicide
Tsou, J. Y. (2013) · International Journal of Law and Psychiatry · doi:10.1016/j.ijlp.2013.06.013 · Cited by 27
“In articulating this argument, I presuppose a diathesis-stress model wherein individuals may inherit a neurobiological vulnerability to depression and suicide (Mann et al., 1999).”
BackgroundGorodetsky, E. K., Carli, V., Sarchiapone, M., Roy, A., Goldman, D. A., & Enoch, M. (2016) · Genes Brain & Behavior · doi:10.1111/gbb.12293 · Cited by 27
“Environmental risk factors for suicidal behavior include childhood trauma (Mann et al. 1999).”
BackgroundBauer, B. W., Gustafsson, H., Nigg, J. T., & Karalunas, S. L. (2017) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-017-9635-5 · Cited by 30
Impulsivity in the prediction of suicidal behavior in adolescent population
Gorlyn, M. (2005) · International Journal of Adolescent Medicine and Health · doi:10.1515/ijamh.2005.17.3.205 · Cited by 27
“By examining suicide risk factors across psychiatric diagnoses, aggressive and impulsive behavior have been shown to comprise a personality trait that strongly contributes to the likelihood of a suicide attempt when combined with other essential conditions such as the presence of a psychiatric disorder (6).”
BackgroundDaniel, S. S., Goldston, D. B., Erkanli, A., Heilbron, N., & Franklin, J. C. (2017) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12305 · Cited by 25
Subica, A. M., Allen, J. G., Frueh, B. C., Elhai, J. D., & Fowler, J. C. (2016) · British Journal of Clinical Psychology · doi:10.1111/bjc.12098 · Cited by 26
Stewart, J. G., Polanco-Roman, L. A., Duarte, C. S., & Auerbach, R. P. (2019) · Current Behavioral Neuroscience Reports · doi:10.1007/s40473-019-00194-1 · Cited by 31
Gender-Specific Differences in Depressive Behavior Among Forensic Psychiatric Patients
Streb, J., Ruppel, E., Möller-Leimkühler, A. M., Büsselmann, M., Franke, I., & Dudeck, M. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.639191 · Cited by 27
Zhang, J., Zhang, X., Yang, G., & Feng, Z. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.913680 · Cited by 29
“The bridge role of depression does not agree with the clinical diathesis-stress model (9), in which depression interacts with impulsiveness.”
Background
Metadata
- Authors
- Mann, J. J., Waternaux, C., Haas, G. L., & Malone, K. M.
- Affiliations
- New York State Psychiatric Institute (US)
- Venue
- American Journal of Psychiatry
- Published
- 1999-02-01
- Volume
- 156
- Issue
- 2
- Pages
- 181-189
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- OpenAlex
- W2157574219
- Cited by
- 1,791
- References
- 115
- Citations by year
- 2026: 44 · 2025: 62 · 2024: 45 · 2023: 52 · 2022: 55 · 2021: 70 · 2020: 71 · 2019: 69 · 2018: 82 · 2017: 80 · 2016: 99 · 2015: 76 · 2014: 104 · 2013: 91 · 2012: 102
- FWCI
- 41.72
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (MH48514, MH46745, MH48492, R01MH048492, R01MH048514)
- 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 › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- suicide attempts, suicide risk factors, suicidal behavior, diathesis-stress model, suicidal ideation, impulsivity, aggression, depression severity, psychosis severity, borderline personality disorder, substance use disorders, alcoholism, family history of suicide, childhood abuse, traumatic brain injury, smoking, psychiatric inpatients
- MeSH terms
- Adolescent, Adult, Aged, Mental Disorders, Child Abuse, Female, Craniocerebral Trauma, Humans, Impulsive Behavior, Life Change Events, Male, Middle Aged, Models, Psychological, Personality Disorders, Personality Inventory, Psychiatric Status Rating Scales, Risk Factors, Severity of Illness Index, Sex Factors, Suicide, Attempted, Comorbidity, Chi-Square Distribution, Substance-Related Disorders
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