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The prediction of parasuicide repetition in a high-risk group
1Department of Clinical Psychology, North Manchester General Hospital, UK.
Objectives:
This study explores whether the specificity of risk assessment for parasuicide repetition can be improved by measurement of two psychological variables (over-generality of autobiographical memory and future fluency for positive events) in the immediate aftermath of the index parasuicide.
Design:
In a longitudinal study, parasuicide patients deemed to be at high risk of repetition on the basis of sociodemographic factors (Kreitman & Foster, 1991) were followed-up over a 12-month period.
Method:
As soon as practicable after taking a deliberate drug overdose, patients completed the Autobiographical Memory Test, the Personal Future Test and the Beck Hopelessness Scale. The relative power of each of these measures, together with the number of sociodemographic risk factors, in predicting parasuicide repetition was investigated using a forward step-wise logistic regression analysis.
Results:
The most potent short-term predictor of parasuicide repetition was found to be scores on the Beck Hopelessness Scale, whereas in the longer term the number of previous para-suicides was the major predictor.
Conclusion:
For the heterogeneous parasuicide population as a whole, psychological variables are unlikely to improve upon the Beck Hopelessness Scale, sociodemographic risk factors and clinical interview in the prediction of parasuicide repetition.