Talk:Parasuicide

Confusing/Inaccurate?

Hi, I found this article confusing and I dispute the idea that any suicide attempt or self-injury that is non-lethal is 'parasuicide'. In my academic background in Psychology, I have always been exposed to the concept of parasuicide as a kind of maladaptive attention-seeking behaviour where there is no true intent to actually die; this is evident in the prefix 'para', indicating 'semblance of'. The article gets right at this when it discusses shallow cuts that aren't made to relieve psychological distress, as is the case for self-harm.

This is a really important distinction, because it would bring different personality traits (eg. Borderline PD) and interventions (improving communication skills) into the picture (theoretically, regardless of whether of not intent is easily measured). As ClaireMKelly noted below, losing this distinction means there is no use for the term -- just call it suicide attempt then! I know that some academic authors define parasuicide as any suicide attempt, but I believe that is just a measurement/coding convenience (it is hard to determine intent, and most suicide attempts fail anyway) rather than an actual argument against the construct.

At my university, this wiki has led to students writing papers (and supervisors editing papers) in which any suicidal behaviour is casually referred to as 'parasuicide', which I strongly believe is inappropriate given references such as the following: "The greatest predictor of eventual suicide is parasuicide, which, defined broadly, includes both suicide attempts and deliberate self-harm inflicted with no intent to die" (Welch, 2001, The Epidemiology of Suicide and Parasuicide" http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0447.1993.tb05368.x/pdf. and the WHO/EURO Multicenter Study defines parasuicide as “an act with nonfatal outcome, in which an individual deliberately initiates a non-habitual behaviour that, without intervention from others, will cause self-harm, or deliberately ingests a substance in excess of the prescribed or generally recognized therapeutic dosage, and which is aimed at realizing changes which the subject desired via the actual or expected physical consequences (see the intro of this paper http://link.springer.com/article/10.1023%2FA%3A1009652607078#page-1 ). See the end there again, not 'aimed at killing onself' but rather 'aimed at realizing changes which the subject desired...'. To illustrate, a parasuicidal young woman might take pills with the intent not of death, but rather aimed at keeping her partner from leaving.

Edward Laurence (talk) 15:36, 28 October 2013 (UTC)

Dubious

Should DSH really be called "suicide attempts"? Such strong statements definitely need citations.. --Kiwibird 20:06, 9 May 2006 (UTC)

See Suicide Section Suicide 7 and Suicide 7.1 for a better explanation of the differences between DSH (deliberate self-harm) and Parasuicide (suicide attempt).

"An important distinction has also been made (see Erwin Stengel, 'Suicide and Attempted Suicide') between those who kill themselves and did not mean to, and those who did not kill themselves but did mean to. Thus a 'Suicide' (noun) may either succeed or fail in his/her goal (i.e. succeed in killing himself/herself or not) and an 'Attempted Suicide' (noun) may either succeed or fail in his/her goal (e.g., succeed in 'making a cry for help' or fail and, in doing so, probably die)."

The writer cites Stengel in the article, but does not include it in the reference section. A quick search found the following info about Erwin Stengel Suicide & Attempted Suicide. 1964. Harmondsworth: Penguin Books Ltd., 1966.

Since I did not write the article and have no knowledge of Stengal's work, I don't feel comfortable adding it the reference section.

Clairemkelly 04:37, 3 January 2007 (UTC)I work in the areas of suicide, deliberate self-injury and attempted suicide and the term parasuicide is of no value. It is a term which is used to denote any kind of self-injurious behaviour regardless of intention and as such has no real value in psychological terminology.

In this article I believe that "suicide attempt" is a better title. Deliberate self-harm is a term which should be avoided, using instead self-injury or suicide attempt. Use of non-specific terms are not helpful in any way, particularly when a topic is as poorly understood as this one is.

---

I agree, self-harm is distinct: Self-harm is not meant to end in the person's death whereas suicide attempts are. That distinction does not appear to be applied in the article.Dogsdontknowimnotbacon 22:37, 31 August 2007 (UTC)

NPOV?

I agree with the above criticism and would add a question about POV. It seems that this article asserts hypotheses about the nature of the behavior without offering opposing viewpoints (i.e. the article rejects the possibility of attempted suicides' actually being suicide and merely states that they are acts of deliberate self-harm without evidence thereof). Aleta 06:48, 7 December 2006 (UTC) Aleta

Parasuicide is more of a histoirical term now

Parasuicide was used in mental health but was phased out in the 1990s as the idea was artificial - there is often no clearcut boundary between high risk and low risk attempts and many people who exhibit low risk can infact end up killing themselves.

Dismissing attempts of low perceived lethality is dangerous. In reality all attempts are care-eliciting gestures of some sort. cheers Cas Liber 20:54, 30 December 2006 (UTC)

Is self-harm/self-injury even relevant?

Firstly: self-harm/self-injury != suicide attempt

Now that's out of the way...

"Those who attempt to harm themselves are, as a group, quite different from those who actually die from suicide."
Those who attempt to harm themselves are, as a group, very often quite different from those who even attempt suicide, or are suicidal.

"Although they [people who self-harm/self-injure] are rarely physically ill, they are considered psychiatrically unstable."
Depending on your definition of "psychiatrically unstable", this sentence almost certainly not true.

"Individuals under these stresses become anxious and depressed and then, usually in reaction to crisis, be it considered small or huge to others, they attempt to harm themselves."
The reasons people self-harm/self-injure are so varied, one cannot make a generalisation like this.

"Self-harm may also result from an inner conflict between the desire to end life and to continue living."
Can we please avoid saying self-harm/self-injury is linked to suicide like this? Statistically, yes, there are links between the two, but the feelings and motivations behind them are often very different; suicide is wanting to end one's life, self-harm/self-injury is often a coping mechanism, a way to keep on living.

i agree in many ways. personally, self-harm is at one end of a spectrum, suicide ideation at the other. self-harm is my mechanism for coping - inflicting pain on myself as a means of distracting my attention away from another type of pain - note the general idea of wanting to feel a certain type of pain over another type of pain. contrast this with episodes of suicidal ideation, when it seems that no coping mechanism can help. the goal becomes to eliminate pain (in all its forms) by terminating my life - the pain involved in the process of terminating my life becomes a consequence of the goal - note the careful planning and selection of a suicide method, driven by the general desire for a "quick and painless" death.

it's a thin line between suicide and parasuicide. lack of adequate planning due to a hurried decision made in an impulsive suicidal state, not caring about whether the suicide attempt works or not, surviving a suicide attempt that would ordinarily have worked - whatever the reason for the distinction between suicide and parasuicide, the attempter is likely to have accepted death (the end of all pain) as a possible outcome, to some degree. choosing death and flirting with death both have death as a possible "solution" to pain... this is not always the case with self-harm (a fairly broad, blanket term) 195.189.142.198 05:38, 23 June 2007 (UTC)Thinkerboy

• As a very uninterested observer, the article seems to be saying to me that suicide attempts that don't succeed are invariably forms of attention-getting. Just because somebody's not very good at killing themselves doesn't mean they were doing it for attention. Sometimes people simply don't succeed in what they're attempting, like poor Jerry Hadley today. --Charlene 22:01, 11 July 2007 (UTC)
  • Yeah, or AJ Reed. I think when someone shoots himself in the head with a 12-gauge shotgun, he probably wasn't just crying out for attention (unless he used birdshot or something). Wrist-cutting is the classic way of doing that. Tisane (talk) 07:52, 3 April 2010 (UTC)

Neutrality on Suicide Generally

"Regardless of the intention of the parasuicide, it must be treated seriously, due to the risk of future suicide attempts by these individuals."

This statement is particularly troubling, in my opinion. The very statement implies the belief that suicides should be prevented which, while it may be a commonly held position, does take a stance on the issue, rather than maintaining the neutrality that Wikipedia intends to maintain. While the entire statement need not necessarily be struck from the article, it certainly at least needs revision, to maintain neutrality. -- Rev. S. Alexander Normandy 20:30, 4 October 2007 (UTC)

I concur - I feel this is a systemic problem on all of the articles referencing suicide. 123.3.79.158 (talk) 19:35, 19 November 2011 (UTC)

WikiProject class rating

This article was automatically assessed because at least one WikiProject had rated the article as stub, and the rating on other projects was brought up to Stub class. BetacommandBot 16:30, 10 November 2007 (UTC)