Self-reference in suicidal behaviour

Introduction: Several lines of evidence suggest a perturbed sense of self in people who attempt suicide, but it has rarely been experimentally studied. Here, we aimed to explore in this population the narrative self through explicit self-perception and the self-reference effect in memory. Methods: Forty-seven patients with a mood disorder, including 20 with a personal history of suicide attempt, completed a self-referential task. During the encoding phase, they were presented with personality traits and had to successively judge whether each trait described themselves ("self condition") or was a desirable trait, in general ("general condition"). Then, they were unexpectedly asked to retrieve as many previously presented traits as possible (free recall phase). Results: Suicide attempters did not differ from non-attempter patients in any self-reference measures. Moreover, none of these measures correlated with current suicidal ideas. During the encoding phase, patients in both groups attributed negative traits to themselves more often than they considered them to be desirable, in general, with an opposite pattern for positive traits. The number of negative traits during the self but not the general condition was correlated with depression, anxiety, and mental pain levels, whereas depression and mental pain levels were correlated with suicidal ideas. No self-reference effect in memory was found. Conclusions: Overall, measures of the narrative self were not directly associated with suicidality. However, biased self-perception was related to painful and depressive feelings, which were in turn related to suicidal ideas. More research on self-related processing during the suicidal process is warranted.