Clinical and community-based studies indicate that adolescents with histories of multiple suicide attempts are at greater risk for future suicide attempts and tend to have more severe psychopathology (e.g., Goldston et al. 1998; Hawton et al. 1999; Rudd et al. 1996). In a large non-referred sample, adolescents with histories of multiple suicide attempts more often made a subsequent attempt across a 6 year follow-up than those with histories of a single attempt (Miranda et al. 2008). Furthermore, adolescents who had made multiple previous suicide attempts more often reported wishing to die, being uncertain or sorry about having recovered from their attempt, and planning their attempt so that intervention was unlikely (Miranda et al. 2008). In a sample recruited from an emergency department, those with a history of multiple attempts were more likely than those with a single attempt history to have a mood or disruptive behavior disorder, and to report greater depression severity, affect dysregulation, hopelessness, and self-mutilation (Esposito et al. 2003). Thus, a history of multiple suicide attempts increases subsequent risk for suicide attempts and is associated with more severe ratings of psychopathology.
