Using Life Trajectories Analysis to Characterize Suicide Attempts in Prison.

Abstract

Background: Suicide in prison is a major problem and several risk factors have been identified in the literature (e.g., period of incarceration, depressive disorders). Aims: The study examined the impact of several risk factors for suicide attempts before and during incarceration using life trajectory analysis of inmates by interviews with informants. Method: The lifetime of inmates with a history of suicide attempts (ISA; n = 20) or without (IWSA; n = 29) was recounted on a life chart according to four main domains (health, life events, relationships, and judiciary domain) organized in two different periods (predetention and current detention). Life charts were compared between the two groups and a predictive model of suicide risk was constructed using logistic regression and receiving operating characteristic curve analysis. Results: Before detention, more depressive experiences were observed in ISA than in IWSA, and ISA reported more behavioral disorders than IWSA during current detention. Moreover, the total burden for ISA was greater than that for IWSA. The predictive model identified three dimensions for differentiating ISA from IWSA: mood disorders before detention, behavioral disorders, and the quality of relationships with nuclear family during detention. Limitations: Interviews with inmates would have been informative. Conclusion: The accumulation of life events and behavioral manifestations should be incorporated in the developmental trajectory as a therapeutic model regarding suicide in prison.