Relations of psychological characteristics to suicide behaviour: Results from a large sample of male prisoners

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Abstract

Aim was to investigate psychological characteristics that may predict suicide ideation and behaviour in male prisoners. Sample consisted of 1117 prisoners detained in jails of the District of Abruzzo-Molise in Italy. All underwent psychiatric interviews and comprehensive psychometric assessments related to different psychological characteristics. Principal component analysis of psychometric variables derived four components. Multivariate logistic regression was designed to test them as predictors of suicidal ideation and attempt. Main findings: (1) approximately 40% prisoners reported lifetime suicide ideation and 13% attempted suicide; (2) different psychometric variables tend to associate in male prisoners. Three of them – childhood trauma, emotional lability and substance abuse – seem to increase the risk of suicide ideation and attempt, while sensation seeking behaviour might decrease it; (3) ideators and attempters scored higher on scales measuring aggression, hostility, childhood trauma, depression, psychoticism and neuroticism, when compared to non-ideators and non-attempters; (4) suicide ideators and attempters scored lower on extraversion and resilience scales; and (5) childhood trauma was the strongest positive predictor for suicide ideation and attempt. This is the first report on psychological characteristics in a large sample of prisoners. We believe it might add new value to evidence-based suicide prevention strategies in prisons.

Introduction

Prisoners are at increased risk for suicide ideation and attempt (Fazel and Danesh, 2002, Jenkins et al., 2005, Preti and Cascio, 2006). Previous studies detected various risk factors such as psychiatric disorders (Marcus & Alcabes, 1993), substance misuse (Roy, 2001, Roy, 2003), previous attempt (Fruehwald and Frottier, 2005, Fruehwald et al., 2003) and long sentences after highly violent crimes (DuRand, Burtka, Federman, Haycox, & Smith, 1995). Moreover, it has been suggested that psychological characteristics are strongly associated with suicidal behaviour and that individual personality differences might predict suicide attempts. However, no large study examining psychological profiles of suicide attempters in prisons has ever been conducted. In 2006, Brezo and co-authors analysed 90 original studies exploring different personality traits in the context of suicide ideation, attempts and completions (Brezo, Paris, & Turecki, 2006). They concluded that hopelessness, neuroticism and extraversion might be of greatest help when aiming to detect those at increased risk for suicide ideation or attempt. Traits such as aggression, impulsivity and social introversion may be useful in differentiating between ideators, attempters and completers.

In the present study we investigated a variety of psychological characteristics, such as depression, aggression, hostility, impulsivity, psychoticism, extraversion and neuroticism, childhood trauma, diagnosis of mental disorder and substance abuse. This is the first study of such a large sample of male prisoners in which we searched for new features of psychological proneness to suicide.

Section snippets

Participants

A total of 1177 male prisoners detained in jails of the District of Abruzzo-Molise in Italy took part in the study. We included both high and low security correctional facilities. All prisoners that were present in the jails were considered eligible for the study. The only inclusion criterion was willingness to participate with a signed informed consent. Exclusion criteria were absence of sufficient linguistic abilities in Italian, inability to read, mental retardation or severe mental

Results

A total of 515 participants (43.8%) reported having suicide ideation, while 155 (13.2%) attempted suicide at some point in their lives. There were no age and education differences between them. Attempters differed from non-attempters in marital status, χ2(3) = 10.08, p = .018; the percentage of married, divorced, single, and widowed participants was 27.5, 17.4, 51.0 and 4.0 among attempters. The two subgroups also differed in employment status, χ2(2) = 23.27, p = .000; the percentage of unemployed,

Discussion

The main findings of our study are: (1) in a large sample of more than a thousand male prisoners, approximately 40% reported lifetime SI and 13% had a history of SA; (2) different psychometric variables tend to associate in male prisoners. Childhood trauma, emotional lability and substance abuse seem to increase the risk of suicide ideation and suicide attempt, while sensation seeking behaviour might decrease it; (3) ideators and attempters were significantly more often single and unemployed

Conclusion

We succeeded in reducing a large set of psychological variables to four components of psychological proneness to suicide: emotional lability, childhood trauma, sensation seeking behaviour and substance abuse. Prisoners who are more likely to have SI are characterized by experience of childhood trauma, emotional lability and substance abuse. All these components might be present among attempters, with childhood trauma being the strongest predictor. Sensation seeking behaviour might decrease the

Acknowledgements

The paper is dedicated to the memory of Andrej Marušič, a leading Slovenian psychiatrist and psychologist and a visionary suicidologist who passed away on June 1, 2008.

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