Affiliation:
1. Department of Clinical Psychology, Psychotherapy and Psychoanalysis, Institute of Psychology University of Klagenfurt Klagenfurt am Wörthersee Austria
2. Suicidal Behaviour Research Lab, Mental Health and Wellbeing, School of Health and Wellbeing University of Glasgow Glasgow UK
3. Department of Psychosomatic Medicine and Psychotherapy University Medical Center of the Johannes Gutenberg‐University Mainz Mainz Germany
Abstract
AbstractIntroductionSuicidal ambivalence is increasingly understood as the result of the interplay of two conflicting motivational orientations, the wish to die (WTD) and wish to live (WTL). However, research is scarce regarding the nature of their relationship, their temporal structure, and their relevance in predicting suicidal desire.MethodsFifty psychosomatic/psychiatric inpatients (17 reporting suicide attempts) took part in an intensive longitudinal design with 10 signal‐contingent prompts per day over 10 days; assessing WTD, WTL, and suicidal desire. We calculated mean values and variability of WTD, WTL, suicidal ambivalence, and suicidal desire and tested mixed‐effects models of suicidal desire.ResultsThe mean number of answered prompts was 40.98 (SD = 21.68). Repeated‐measures correlation of WTD and WTL was r = −0.60. Patients with a history of suicide attempts reported higher WTD, lower WTL, more suicidal ambivalence, stronger suicidal desire, and showed higher variability in all constructs. At the same assessment, WTD was the strongest statistical predictor of suicidal desire. Only WTL and the interaction of WTD and WTL predicted suicidal desire prospectively.ConclusionWish to die and WTL are likely two distinct (although correlated) constructs that should not be reduced to a single ambivalence score. A stronger focus on WTL holds potential for suicide research and practice.