A comparison of first time and repeat intentional self-poisoning patients

Identifying the characteristics associated with those who make repeat suicide attempts by intentional self-poisoning is important for improving treatments and reducing the risk of further attempts and completed suicide. Limited previous research has been conducted examining this group, typically focussing on demographic and psychopathological characteristics and overlooking some important cognitive-behavioural factors and psychophysiology. In addition, the research has primarily focussed on restricted samples such as psychiatric inpatients and has lacked a consistent definition of the concept of repetition. The present research takes a process-based approach by comparing a first attempt group with a repeat attempt group and a community control group with the aim of developing a profile of those who repeat in a clinical adult sample. The first two studies in this research develop descriptive and cognitive-behavioural profiles with the results indicating similarity between the first time and repeat groups. However, the repeat group was differentiated from the first time group by more severe symptomatology, less impulsiveness in taking the overdose, and a greater likelihood of reporting tension reduction reasons for the overdose. In addition, the repeat group experienced significantly greater levels of hopelessness and reported poorer perceived problem solving skills and severely impaired coping resources. The third study extended this profile by examining the psychophysiological and subjective experience of the overdose using guided imagery. The results indicated that the first time and repeat groups demonstrated almost identical psychophysiological and subjective experiences during the process of taking the overdose which reflected a tension reduction pattern. It was concluded from this research that the differences between the first time and repeat groups appear to be quantitative rather than qualitative with the repeat group reflecting more severe symptomatology and cognitive-behavioural impairments, supporting a process approach to suicidal behaviours s. It is not clear from this research if the differential characteristics of the repeat group are vulnerabilities present before the first suicide attempt or represent a deterioration of these factors over time and with subsequent attempts. Future research would benefit from examining a sample of first suicide attempt patients longitudinally to elaborate the processes associated with the differential variables identified in this research.