THE SUICIDAL PROCESS AND
Kees van Heeringen
A vast amount of epidemiological data shows considerable differences in sociodemographic and psychopathological characteristics between individuals who communicate suicidal ideation, those who attempt suicide and those who commit suicide. Evidence is, however, accumulating in support of an association between these phenomena. This evidence is provided mainly by longitudinal studies of attempted suicide patients and by retrospective psychological autopsy studies of individuals who died as a result of suicide. These studies will be discussed in more detail in the next chapter, but some of the main findings will be used here to describe the different concepts or models that have been developed to understand the relationship between these suicidal phenomena. These concepts or models include the “suicidal pyramid”, the “suicidal career” and the “suicidal process”.
In this chapter these concepts will be introduced, thus providing the basis for the description of the epidemiological, biological, psychological and psychiatric underpinnings of these concepts, which will be elaborated in the first part of this book. However, preceding these introductory descriptions of the suicidal process and related concepts, the definition of a number of terms as used throughout this book have to be addressed.