Attempted suicide and social support

Investigation of the role of social support in the development and maintenance of attempted suicide has rarely gone beyond the relatively uncontrolled clinical study. The present series of control group studies of suicidal and non-suicidal individuals investigated the role of social support deficits in the occurrence of attempted suicide, and documented changes in social support after the act using well-defined measures of this variable. An initial study comparing suicide attempters interviewed at the time of their attempt and again six weeks later with non-suicidal controls, revealed a range of social support deficits. However the suicidal group recorded significant improvement on several indices of social support and a lessening of the wish to die over the period of study. Two further sets of analyses were performed upon this data set in order to identify relatively homogeneous subtypes within the sample, and to study the quality and changing status of social support for each of the subtypes. Application of cluster analyses to demographic and background data produced three clusters within the suicidal group, which when compared with the non-suicidal control group, demonstrated few readily interpretable subtype differences in social support. In a second control group study, two suicidal subtypes formed on the basis of the existence of psychiatric disorder, revealed different patterns of change over a follow-up period. The results of attempts to replicate these findings with a new sample which included a non-suicidal psychiatric control group suggested that the reported social support deficits were not unique to suicide attempters. The occurrence of a suicide attempt rendered change in social support much more likely, but such changes were also influenced by the presence and nature of psychiatric disorder within the suicidal groups. The results of this study, which found a relationship between other symptomatology, personality measures such as self competence, and social support variables, also raised questions regarding the nature of reported deficits. The findings of this thesis support two directions for future research. The first is a further investigation of the social support of the suicidal individual and the second is study of the cognition and emotion of such individuals. Despite the evident difficulties with a discrete, relatively uncommon behaviour like attempted suicide, it is proposed that future design strategies might encompass the single case experimental design or post hoc cross-sectional study of larger samples.