AN EMPIRICAL-STUDY OF THE PSYCHODYNAMICS OF SUICIDE

This paper presents results from an empirical study of four key psycho dynamic concepts (self-directed aggression, object loss, ego functioni ng disturbance, pathological object relations) of suicidal behavior. T he sample consists of hospitalized psychiatric patients following a su icide attempt (attempters: n = 52) and demographically similar hospita lized psychiatric patients with no history of suicidal behavior (contr ols: n = 47). The study was designed to ascertain whether attempters d iffered from matched psychiatric control patients on the four psychody namic constructs hypothesized to be associated with suicide. It was pr edicted that attempters would manifest higher levels of depression and self-targeted anger, a more significant history of loss, less adaptiv e defenses, and more primitive object representations. Results strongl y supported an object-relational view of suicidal behavior, In additio n, support for the loss hypothesis was found in the identification of one specific constellation of losses. Namely, attempters were signific antly more likely to report a history of childhood loss combined with a recent loss in adulthood than were their nonattempter counterparts. Limited support was provided for the other two hypotheses in different iating suicidal from nonsuicidal severely ill psychiatric patients. Th is unexpected finding is examined and suggestions are made for the ref inement and greater specification of psychodynamic theories regarding the etiology of suicidal behavior, with the aim of differentiating ind ividuals prone to such action from those with similar psychopathology and dynamic issues who do not actually attempt suicide. Limitations of the study are discussed and implications of the findings for the theo ry and treatment of suicidal behavior are offered.