Abstract
Background: The study of Suicidal ideation (SI) in people bereaved through suicide (Suicide Survivors, SSs) could be hampered by the person's willingness to admit it, or by their limited awareness of it. Our main hypothesis is that SI is common in these people, especially if they are parents or children of the victim. For its potential in shedding light on specific unconscious processes, Rorschach test was chosen for our investigation, for the first time in SSs literature. Rorschach suicide ideation and selected variables were further analyzed to better delineate their psychological profile.Method: Rorschach according to Exner's Comprehensive System was administered to 21 people bereaved through suicide presenting as outpatients at SOPROXI Project Service—Padova Mental Health Center- and 23 healthy controls. Beck Depression Inventory (BDI) was routinely administered to SSs and considered in the study.Results: T-tests showed significantly higher mean SI score (S-Con) as it emerged from the Rorschach test S-Con scores in SSs compared to control participants. SI found only weak correlation with the BDI item in which SSs can explicitly state the desire for their death. Within-group analysis revealed higher S-Con mean scores in bereaved children and parents of the victim compared to other kind of kinships. Morbid content (MOR) has been fund as the most characterizing variable in SSs' S-Con in terms of effect size, followed by a low number of responses with an ordinary form (X +%). Human movements (M), Special Scores related to thought slippage (ALOG, FABCOM2, INCOM2, and CONTAM) and poor human representations (PHR) have been shown to be more significantly present in SSs compared controls.Discussion: Psychodynamic interpretations of our results are provided. Clinical practice should consider Rorschach as one of eligible tools of investigation on this field.
Highlights
A person who lost a friend, family member, or other loved ones through suicide have been defined as suicide survivor (SSs)
The Rorschach Comprehensive System [CS; [44]] we used in our study includes the CS suicide constellation “S-Con” [23], on which we focused our study, is an index composed by the number of variables exceeding specific threshold values, among a set of 12 variables (Sum VF + FD > 2; color shading blends (C-S Bl) >0; Ego > 0.31>0,44; morbid content (MOR) > 3; Zd> ± 3,5; es>EA; CF + C > FC; X+% < 70; S< 3; P 8; Pure H< 2; R < 17); a value equal or > 8 in S-Con is considered as a cut-off sensitive in detecting people with significant suicidal ideations on the basis of empirical findings
Further four variables were considered in our analysis: the number of Human Movements (M), which reflect, respectively mental abilities; since impaired reality testing and illogical combination of ideas can occur in loss and dysphoria, we grouped indices reflecting more serious forms of cognitive disarray; we considered poor Human Representation, i.e., Human or quasi-human images that are illogical, aggressive, damaged, or poorly formed, as they reflect disturbed and maladaptive understanding of others
Summary
A person who lost a friend, family member, or other loved ones through suicide have been defined as suicide survivor (SSs). A recent study by Cerel et al. Rorschach Assessment in Suicide Survivors [2], on a huge U.S sample, calculated that each suicide resulted in an average of 135 people exposed (i.e., who knew the deceased person) during their lifetime (resulting, in that case, in 5.5 million of people only in the Kentucky State). Rorschach Assessment in Suicide Survivors [2], on a huge U.S sample, calculated that each suicide resulted in an average of 135 people exposed (i.e., who knew the deceased person) during their lifetime (resulting, in that case, in 5.5 million of people only in the Kentucky State) This estimation provides an idea of the strong need of deepening the comprehension of the psychological consequences of being a person bereaved through suicide, in order to inform and guide the clinical practice. Rorschach suicide ideation and selected variables were further analyzed to better delineate their psychological profile
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