Maria Dolores Braquehais Conesa, M.D., Ph.D.

Current psychiatric models of suicidal acts, such as Mann’s (1;2), Oquendo’s (3) and Turecki’s (4), have tried to summarize findings obtained in epidemiological, clinical and neurobiological studies in holistic frameworks. However, those models have serious theoretical and methodological limitations. Those limitations are not exclusive to models of suicide but are present in other models used in Psychiatry.

One of their theoretical weaknesses is related with the categories or “constructs” that are being used and their validity. Different definitions may be grouped under the same construct, i.e., definitions of psychological features related to suicide. Ideally, the validity of a psychometric test should include all theoretical considerations about the construct it belongs to. This problem has to do with Frege’s (1848-1925) philosophical distinction between the “reference” and the “sense” of a proper name (5). The “reference” is the object the proper name denotes or indicates while its “sense” is whatever meaning it has.  Therefore, it is not unusual to use the same “sense” when it does not have the same “reference” (i.e.: “impulsivity” measured by the Barrat Impulsivity Scale (6) does not refer to the same object in nature that “impulsivity” measured by the Whiteside & Lynam Upps Impulsive Behavior Scale (7)).

This fact may lead researchers to incorrect conclusions when analyzing the results obtained in research studies that share constructs (“senses”) that have, in fact, different “references”. 

References

(1)   Mann JJ. The neurobiology of suicide. Nat Med 1998;4(1):25-30.

(2)   Mann JJ, Waternaux C, Haas GL, Malone KM. Toward a clinical model of suicidal behavior in psychiatric patients. Am J Psychiatry 1999 Feb;156(2):181-9.

(3)   Carballo JJ, Akamnonu CP, Oquendo MA. Neurobiology of suicidal behavior. An integration of biological and clinical findings. Arch Suicide Res 2008;12(2):93-110.

(4)   Turecki G. Dissecting the suicide phenotype: the role of impulsive-aggresive behaviours. J Psychiatry Neurosci 2005 Nov;30(6):398-408.

(5)   Internet Encyclopedia of Phylosophy. Frege and Language. http://www.ieputm.edu/freg-lan/ 2011

(6)   Barrat ES. Impulsiveness and aggression. In: Monahan J, Steadman HJ, editors. Violence and mental disorder. Development in risk assesssmnet.Chicago: The university of Chicago Press; 1994. p. 285-302.

(7)   Whiteside SP, Lynam DR. The Five Factor Model and impulsivity: using a structural model of personality to understand impulsivity. Personality and Individual Differences 2001 Mar;30(4):669-89.