Sense of coherence, self-esteem, depression and hopelessness as correlates of reattempting suicide.

Sense of coherence (SOC) has been proposed as a psychological factor that predicts good health and positive adjustment. The three components of SOC: manageability, comprehensibility and meaning were assessed together with depression, hopelessness and self-esteem as factors predicting future suicidal ideation and behaviour in parasuicides. One hundred and fifty hospitalized parasuicides were evaluated on these measures and followed up after six months to determine their current level of suicidal ideation and whether they had been readmitted for a further attempt or killed themselves in the intervening period. Suicidal ideation on admission was best predicted by a low score on the SOC meaning subscale and also significantly related to the other predictor variables. Suicidal ideation at the six-month follow-up was best predicted by the SOC subscales manageability and comprehensibility. These two SOC subscales also emerged as discriminators of suicidal behaviour over the six months following admission. Overall prediction of suicidal behaviour was enhanced by also including the background variables of age, a history of previous attempts, unemployment and whether the attempter was living alone. The study ends with a discussion of the importance of widening the focus when assessing and predicting suicidal risk to include not only predictions based on pathology but also psychological factors that promote adjustment.