Beyond a dichotomous operationalization of suicide attempts

Suicide attempts (SAs) are commonly assessed by asking patients and study participants face-valid questions about whether an individual has engaged in any self-injurious behavior with the intent to die within a given timeframe. Unfortunately, for most clinical and scientific endeavors, only information about the presence vs. absence of a SA is documented and analyzed. In this Viewpoint, we discuss how such a dichotomous operationalization of SAs obscures important heterogeneity among those who have attempted suicide. There are several facets of SAs, beyond the simple presence vs. absence, that are important to consider because they have implications regarding acute and long-term clinical outcomes. These facets include the level of intent to die, the means used and associated risk for death, the actual medical consequences of the attempt, and the chronicity of the behavior. We discuss how considering these SA facets-in theory testing and refinement, the design, analysis, and interpretation of research findings, and clinical practice-will improve the impact of scientific findings. (PsycInfo Database Record (c) 2024 APA, all rights reserved).