Sandbox:Vindhya

Suicidal events

Completed suicide-A self-injurious behavior that resulted in fatality and was associated with at least some intent to die as a result of the act. 1) After a long argument with his girlfriend, which resulted in the end of their relationship, the patient collected a rope and rode his bike to an isolated area where he fatally hanged himself. A suicide note was later found. 2) After four documented attempts at suicide, the patient stole his uncle’s gun and shot himself and was fatally injured. Suicide attempt A potentially self-injurious behavior, associated with at least some intent to die, as a result of the act. Evidence that the individual intended to kill him/ herself, at least to some degree, can be explicit or inferred from the behavior or circumstance. A suicide attempt may or may not result in actual injury. 1) After a fight with her friends at school, in which they discontinued speaking with her, the patient ingested approximately 16 aspirin and eight other pills of different types on the school grounds. She said that she deserved to die, which was why she swallowed the pills. 2) The patient used a razor blade to lacerate his wrists, his antecubital fossae, and his back bilaterally. He told his therapist that the “the main objective was to stop feeling like that,” and he knew that he could die but didn’t care. According to the patient, he also ingested a bottle of rubbing alcohol because in his health class he heard “that the medulla will get more suppressed that way,” thereby increasing the chances that he would be “successful” and die. Preparatory acts toward imminent suicidal behavior The individual takes steps to injure him- or herself, but is stopped by self or others from starting the self-injurious act before the potential for harm has begun. 1) The patient had run away from home overnight because his father had gone to school and retrieved a recent “bad” report card. He was fearful of his father’s reaction. Upon his return home, a 5- to 6-hour argument with his parents ensued, and he took a vegetable (broad, sharp) knife and went to his room. He reported putting the knife to his wrist but never puncturing the skin. 2) The patient stated that he “couldn’t stand being depressed anymore” and “wanted to die.” He decided to hang himself. He tied a telephone cord to the door knob and placed the cord loosely around his neck. Then, he stopped himself and did not follow through with the attempt. Suicidal ideation Passive thoughts about wanting to be dead or active thoughts about killing oneself, not accompanied by preparatory behavior by preparatory behavior.a 1) Active: The patient reported to the doctor that he was thinking about hanging himself in the closet. He was taken to the hospital and admitted. 2) Passive: The patient reported ideas about wanting to be dead but denied acting on these feelings.

elf-injurious behavior, no suicidal intent Self-injurious behavior associated with no intent to die. The behavior is intended purely for other reasons, either to relieve distress (often referred to as “self-mutilation,” e.g., superficial cuts or scratches, hitting/banging, or burns) or to effect change in others or the environment. 1) The patient was feeling ignored. She went into the family kitchen where her mother and sister were talking. She took a knife out of the drawer and made a cut on her arm. She denied that she wanted to die at all (“not even a little”), but she just wanted them to pay attention to her. 2) The patient reported feeling agitated and anxious after a fight with her parents. She went into her room, locked the door, and made several superficial cuts on the inside of her arms. She stated that she felt relieved after cutting herself and that she did not want to die. She reported that she had done this before at times of distress and that it usually helped her feel better. 3) The patient was in class, where a test was about to begin, and stabbed himself with a pencil in order to be taken to the nurse’s office. 4) A 14-year-old girl wrote her name on her arm with a penknife and said that she often does so in order to reduce her anxiety. 5) The patient was noted to have multiple superficial burns on his arms. Upon questioning, he denied trying to kill himself. Other, no deliberate self-harm No evidence of any suicidality or deliberate self-injurious behavior associated with the event. The event is characterized as an accidental injury, psychiatric or behavioral symptoms only, or medical symptoms or procedure only. 1) The patient had a cut on the neck from shaving. 2) The patient was hospitalized for worsening of OCD or depressive symptoms with no suicidal thoughts or actions or 3) aggressive behavior. 4) Hospitalization was becaus