Outward and inward directed aggressiveness: the interaction between violence and suicidality.

This paper examines the relations and interactions between suicidality and violence. It reviews the recent literature indicating that more than 40 variables have been identified as risk factors for suicide. Evidence is presented to indicate that the differences between suicide attempters and suicide completers are a matter of degree, and that most conclusions that apply to one also apply to the other. A review of the recent literature on violence revealed that 37 variables are risk factors for violence and that 23 of them are risk factors for suicide as well. Evidence indicates that at least 17 variables have been identified as protective factors that decrease the risk of both suicide and violence. These considerations and others have led to the development of a Two-Stage Model of Countervailing Forces that systematically relates suicide to violence.