[Psychopathological dynamics of suicidal behavior in childhood and puberty]

The oversimplifying and scientifically untenable separation of suicide (successful) and attempted suicide (unsuccessful) was overcome by Stengel's fundamental findings that only very few attempted suicides are failed suicides, and that the majority of attempted suicides are acts a qualitatively distinct character. Psycho(patho)dynamic analyses of suicidal acts disclosed that in a portion of the suicide attempts there is no or at least no determined suicidal intent. The definition of 'suicidal attempt' which has come into general use is therefore imprecise, because in many cases suicide is not "attempted" but the technique of suicidal behaviour is only used for a primary non-suicidal purpose. A differential typology of the entire content of the concept of 'suicide attempt' which includes vague non-homogeneous matters has become unavoidable and is being discussed here. In the suicidal behaviour of children the problems become even clearer. The 'suicide attempt' in children does not meet Stengel's criteria. The great majority of cases are not 'attempted' suicides, do not show a final determination, do not come about in a calculated manner, and are not based on an ambivalence about life and death, but are rather a potentially fatal substitution by suicidal behaviour for a demonstrative appeal for help, for a resigned escape signal or for an impulsive cry. Neither can one recognize the development of the pre-suicidal syndrome described by Ringel.