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It is rare to see a suicidology study using qualitative methodology
like the one by Sinclair and Green (1). It is refreshing to see such topic
can be studied in a different perspective. However, three narratives
mentioned in this study, family stress, alcoholism, and depression, have
long been identified as important risk factors for suicidal behavior.
Those risk factors also co-occur often for a same individual who commit
self harm. Comorbidity of risk factors was not discussed in this paper.
One thing new from this study is how remission ("resolution") from
deliberate self harm is perceived by the individual with such history.
However, it would be interesting to know how comorbid condition (people
with at least two out of the three aforementioned risk factors) might have
impeded treatment effectiveness and the "resolution." Also, how frequent
for each type of risk factors is distributed among recovering former
suicide attempters. To achieve this, a quantitative study design with a
much larger sample will still be needed. Mixed study design method with
sequential exploratory strategy (2) can be utilized to further advance
this study.
1. Sinclair J and Green J. Understanding resolution of deliberate
self harm: qualitative interview study of patients' experiences. BMJ 2005;
330: 1112-4
2. Creswell J.W. Research design: qualitative, quantitative, and
mixed methods approach. Sage Publications, 2003
The article does provide an alternate perspective but it would have
been interesting to know whether resolution of adolescent chaos and
recognition of alcohol as a factor was also present in any of the 59 other
patients who are still being followed up and continue to self harm and if
so why has it not stopped them from repeated self harm.
Lack of comparison with the other group limits the significance of the
findings.
Competing interests:
None declared
Competing interests:
No competing interests
14 May 2005
Jatinder P Babbar
PG Yr 1 Resident
UVA Roanoke/Salem Psychiatry Residency Program , 1970 Roanoke Blvd., Salem, VA 24153, USA
Quantitative design for future study
It is rare to see a suicidology study using qualitative methodology
like the one by Sinclair and Green (1). It is refreshing to see such topic
can be studied in a different perspective. However, three narratives
mentioned in this study, family stress, alcoholism, and depression, have
long been identified as important risk factors for suicidal behavior.
Those risk factors also co-occur often for a same individual who commit
self harm. Comorbidity of risk factors was not discussed in this paper.
One thing new from this study is how remission ("resolution") from
deliberate self harm is perceived by the individual with such history.
However, it would be interesting to know how comorbid condition (people
with at least two out of the three aforementioned risk factors) might have
impeded treatment effectiveness and the "resolution." Also, how frequent
for each type of risk factors is distributed among recovering former
suicide attempters. To achieve this, a quantitative study design with a
much larger sample will still be needed. Mixed study design method with
sequential exploratory strategy (2) can be utilized to further advance
this study.
1. Sinclair J and Green J. Understanding resolution of deliberate
self harm: qualitative interview study of patients' experiences. BMJ 2005;
330: 1112-4
2. Creswell J.W. Research design: qualitative, quantitative, and
mixed methods approach. Sage Publications, 2003
Competing interests:
None declared
Competing interests: No competing interests