Suicide attempts in men and women suffering from post-traumatic stress disorder: role of hopelessness and personality traits
Authors: Rozanov V.A. , Vuks A.Ja. , Karavaeva T.A. , Altynbekova G.I. 
Published: December 2024

The problem of the relationship between posttraumatic states and suicidal behavior (SB) has recently become increasingly relevant. Despite the fact that most often the presence of posttraumatic stress disorder (PTSD) increases the risk of suicide, the features of non-fatal suicidal behavior among women and men against the background of PTSD are insufficiently studied. The aim is to study the features of nonfatal suicidal behavior of men and women diagnosed with PTSD in comparison with suicides without psychiatric disorders. Materials and
Methods. The present cross-sectional study utilizes the database of the GISS genetic project, in which more than 1300 families with the proband who made a suicide attempt (SA) were assessed using a number of psychometric instruments. The sample features were: the relatively young age of the suicide attempters (23,96±7,84 years), monoethnicity (Russians or Ukrainians in 3 generations), and standardized evaluation of the medical severity of SA (at least 2 points on the Beck scale). Data on 160 cases with an established diagnosis of PTSD and 637 cases
without psychiatric diagnoses were extracted from the database. The Beck Medical Damage Scale (MDS), Suicide Intent Scale (BSIS), Beck Depression Scale (BDS), Spielberger State and Trait Anger Scale (STAS), Plutchik Feelings and Acts of Violence Scale (PFAV), and NEO PIR (Big Five) personality inventory were used.
Psychiatric diagnosis was made using the CIDI 2.0. computerized questionnaire. Statistical analysis of the data was performed using the IBM SPSS Statistics program, version 26; various criteria were applied, taking into account the nature of variables and distribution. Results. The frequency of PTSD among women in the whole sample (N=1328) was 16,64%, among men – 7,97%. Among suicide attempters with PTSD there were significantly more women (65%, p<0,001). Comorbid diagnoses were found in about half of the cases both among women and men with PTSD, with addictions predominating among men (40,51%) and anxiety and stress disorders predominating among women (58,62%). Comorbid depression in male suicidal patients with PTSD was identified in 10,13% of cases, and in women – in 19,82% of cases. All suicide attempters with PTSD demonstrated more severe medical outcomes of SA and higher intentionality, women with PTSD were more often choosing lethal methods of suicide, thus displaying features of the masculine scenario. Women with PTSD showed more pronounced violent tendencies, higher depression scores, more anger, and more hopelessness, while in men presence of PTSD had no effect on these indicators. In women PTSD was associated with such
traits as sharply increased Angry Hostility and decreased Agreeableness and Straightforwardness. Men with PTSD had lower Extraversion subscales (Assertiveness, Activity, and Positive Emotions), lower Trust and Tender-Mindedness and higher Modesty as compared with suicide attempters without diagnosis. The analysis of correlations between the SA severity and intentionality and other variables suggests that aggression plays the leading role in the psychological structure of SA on the background of PTSD in men, while anger plays the leading role under the same conditions in women. Conclusions. Non-fatal SB in individuals of Slavic origin with PTSD is characterized by higher lethality, intent, and is associated with more pronounced hopelessness and depressive symptoms. Women are more sensitive to the influence of PTSD as an additional factor, showing a number of behavioral traits characteristic of the "male" type of suicidal actions. Their main psychological and emotional problem is anger and they are more susceptible to the influence of hopelessness as a sign of pessimism
about the future. The obtained data clarify the characteristics of non-fatal SB in men and women and may be useful for developing psychotherapeutic measures and during psychological counseling of patients who attempted suicide against the background (or in combination) with PTSD.
Keywords: suicide attempt, post-traumatic stress disorder, suicidal intent, hopelessness, personality traits, Big Five, men and women