Variability in suicidal ideation: A better predictor of suicide attempts than intensity or duration of ideation?

Background: Much of the suicidology literature focuses on establishing contextual risk factors for suicidal behavior. However, the study of the parameters of suicidal behavior (e.g., intensity, duration, and variability) has been somewhat neglected [Joiner, T, Rudd, M.D., 2000. Intensity and duration of suicidal crises vary as a function of previous suicide attempts and negative life events. J. Consult. Clin. Psychol. 68, 909-916]. Having previously established a relationship between variability in suicidal ideation and a previous history of suicide attempts [Witte, T.K., Fitzpatrick, K.K., Warren, K.L, Schatschneider, C., Schmidt, N.B., submitted for publication, Naturalistic Evaluation of Suicidal Ideation: Variability and Relation to Attempt Status], we felt it important to assess the liability conferred by a variable pattern of ideation compared to the intensity and duration of suicidal thoughts. We also examined if there was an interaction between gender and the parameters of intensity, duration, and variability. Method: One hundred eight participants (54 non-attempters, 35 single attempters, and 19 multiple attempters) completed the Suicide Probability Scale every day for 4 weeks, allowing us to measure the parameters of interest. These variables were entered into a regression model as predictors of previous suicide attempts. Results: Consistent with prediction, high variability of ideation was the only significant predictor of previous attempt status. In addition, an interaction between gender and variability in suicidal ideation suggested that variability appeared more critical in predicting previous attempts for males. Limitations: The limited number of multiple attempters in our sample and the use of college students limit the current study. Conclusions: Variability appears to be the most potent predictor of attempt status among the parameters of suicidal ideation examined in the current study. This relationship appears to be particularly important in males, suggesting that fluctuating levels of suicidal ideation may confer future risk for suicide. (c) 2005 Elsevier B.V. All rights reserved.