Indirect (chronic) self-destructiveness and modes of suicide attempts

INTRODUCTION: Suicides and suicide attempts may be considered as manifestations not only of direct self-destructiveness, but also of indirect (chronic) self-destructiveness. The aim of this work is to assess the relation between intensity of indirect self-destructiveness and suicide attempt modes. MATERIAL AND METHODS: The research was conducted among 147 persons after suicide attempts (114 women and 33 men) aged 14-33 years. The Polish version of the “Chronic Self-Destructiveness Scale” by Kelley (CS-DS) in Suchańska's adaptation was used. RESULTS: Examined persons applied several modes of committing suicide: pharmacological drugs, exsanguination, hanging, jumping from a height, asphyxia, poisoning, and throwing oneself under a moving car. The most frequent are pharmacological drugs (42.31%) and exsanguination (25.60%); the rarest is throwing oneself under a car (1.28%). Relations between indirect self-destructiveness and the following suicide attempt modes were found: pharmacological drugs (0.366, p = 0.00001), poisoning (0.667, p = 0.01), and throwing oneself under a car (0.542, p = 0.04). There were found three clusters regarding the intensity of indirect self-destructiveness (low, medium and high). The largest differences concerned hanging, jumping from a height (medium CS-DS), poisoning and throwing oneself under a car (high CS-DS). There is a relation between indirect self-destructiveness and recurrence of suicide attempts (Kendall Tau = 0.217, p = 0.007); the intensity of indirect self-destructiveness differentiates the risk of consecutive suicide attempts (F = 2.871, p = 0.05). CONCLUSIONS: The implications of the findings are mainly of preventive and therapeutic nature. In the preventative aspect, the subject of interest should be not only persons with a tendency to the active form of indirect self-destructiveness, but also persons exhibiting its passive form.