Entrapment and social problem-solving in suicidal behavior across the adult lifespan

Background: Feelings of entrapment and deficits in social problem-solving skills have been associated with risk for suicidal behavior in the context of depression. However, few studies have examined the effect of age on the association between these risk factors and suicidal behavior across most of the adult lifespan.Methods: In a three-site study, we tested interactions of age with feelings of entrapment and social problem -solving style in 105 depressed patients with a recent suicide attempt, 95 depressed patients with no history of suicide attempt, and 97 demographically similar non-psychiatric participants (age 16-80). Attempter/non-attempter differences, age interactions, and the relative contribution of entrapment and social problem -solving style to past attempter were examined.Results: Entrapment significantly interacted with age such that it discriminated past attempters from depressed non-attempters better at older ages. Social Problem-Solving Inventory (SPSI) total score and most subscales did not distinguish past attempters, but the SPSI Impulsive Style Problem-Solving was an effective discriminator of past suicide attempts across the full adult lifespan and did not interact with age. In a multipredictor model, both the entrapment by age interaction and SPSI Impulsive Style Problem-Solving score were significant predictors for the classification of attempters. Limitations: The cross-sectional nature of our research design limited conclusions that may be drawn about in-dividual change over time or cohort effects.Conclusions: Entrapment did not distinguish past attempters at younger ages but became a better discriminator in middle to late adulthood. An impulsive problem-solving style was associated with past suicide attempts across the full adult lifespan.

Automated summary

This study found that feelings of entrapment and deficits in social problem-solving skills are associated with risk for suicidal behavior in individuals with depression. The association between these risk factors and suicidal behavior varies with age, with entrapment being a better discriminator in older adults. Impulsive problem-solving style is associated with past suicide attempts across the adult lifespan.