Love, spirituality, and regret: thematic analysis of last statements from death row, Texas (2006-2011).

Individuals awaiting execution have high rates of mental illness and psychological problems. We examined themes and psychological factors in last statements before execution in Texas between December 2006 and July 2011 (n = 79) and compared them to our previous research on last statements between April 2002 and November 2006 (n = 100). We used the Thematic Guide for Suicide Prediction to examine the state of mind of the prisoners facing imminent death. The most common themes in last statements were love (82%), spirituality (52%), and regret (39%). The most common psychological factors were indirect expressions (43%), identification-egression (i.e., identification with a lost or rejecting person or with any lost ideal) (40%), rejection-aggression (38%), and unbearable psychological pain (37%). These features were constant over time. Evidence of deteriorating mental health, unbearable psychological pain, and increased suicide risk suggests an ethics-related medical duty for psychiatrists to object to the death sentence.