Parasuicidal behaviour and interpersonal problem solving performance in older adults.

OBJECTIVES: To test the hypothesis that interpersonal problem-solving performance in older adults with a recent episode of parasuicide is poorer than that of depressed patients and community controls.
DESIGN: A cross-sectional design was used to assess differences between older parasuicidal patients, depressed patients, and community controls in interpersonal problem solving performance.
METHOD: An existing outcome measure of interpersonal problem-solving, the Means End Problem-Solving (MEPS) procedure, was modified in order to make it more suitable for older adults. It was then administered to 18 older adults with an episode of parasuicide in the previous 14 days, 18 older adults who were being treated for clinical depression, and 22 older adults attending community groups. Comparisons between the groups in terms of performance on the MEPS were made.
RESULTS: When level of depression was controlled for, parasuicidal patients were poorer at generating relevant means of reaching given outcomes to interpersonal problems than community controls. There was no difference between the parasuicidal and depressed groups in terms of relevancy scores. There were no significant differences between groups in terms of other MEPS outcome variables.
CONCLUSIONS: Parasuicide in older adults is related to a deficit in interpersonal problem solving performance that cannot be completely explained in terms of depression. Further investigation of interpersonal problem-solving in relation to parasuicide and depression in older adults is required, perhaps using process measures of interpersonal problem solving to clarify the nature of the difficulties. The modified MEPS is acceptable to older adults and can be easily administered.