Maladaptive Personality Traits and Psychopathological Symptoms in Individuals with the First Suicidal Attempt and with Chronic Suicidal Behavior

The paper compares the severity of maladaptive personality traits and psychopathological symptoms in patients with primary and repeated suicide attempts. The study involved patients of the somatopsychiatric department of the Sklifosovsky Research Institute of Emergency Care (N=61), who committed the first suicide attempt (n=31) or a repeated attempt (n=30). The results of the study did not reveal differences between the two groups in the severity of symptoms of social anxiety, depression and trait anxiety. However, indicators of such maladaptive personality traits as perfectionism and hypersensitive narcissism were significantly higher in the group of patients with a repeated suicide attempt. This group also manifested higher rates of the severity of borderline personality disorder traits and significant correlations between measures of psychopathology and maladaptive personality traits listed above. Conclusion: timely diagnostics of maladaptive traits and psychotherapy targeting socially prescribed perfectionism, hypersensitive narcissism, and borderline personality features after the first suicide attempt is necessary to prevent repeated ones.

1. Beck A., Freeman A. Kognitivnaya psikhoterapiya rasstroistv lichnosti [Cognitive therapy of personality disorders]. Saint Petersburg: Piter, 2017. 279 p. (In Russ.).
2. Bateman A.W., Fonagy P. Lechenie pogranichnogo rasstroistva lichnosti s oporoi na mentalizatsiyu: prakticheskoe posobie [Mentalization based treatment for personality disorders: a practical guide]. Moscow: Institut obshchegumanitarnykh issledovanii, 2014. 248 p. (In Russ.).
3. Vorsina O.P., Simutkin G.G. Suitsidal’noe povedenie naseleniya Irkutskoi oblasti [Suicidal behavior in the population of Irkutsk region]. Tomsk: Ivan Fedorov, 2012. 330 p.
4. Garanyan N.G., Kholmogorova A.B., Yudeeva T.Yu. Perfektsionizm, depressiya i trevoga [Perfectionism, depression and anxiety]. Moskovskii psikhoterapevticheskii zhurnal [Moscow Psychotherapeutic Journal], 2001, no. 4, pp. 18—48.
5. Garanyan N.G., Kholmogorova A.B. Ocharovanie nartsissizma [Charm of narcissism]. Moskovskii psikhoterapevticheskii zhurnal [Moscow Psychotherapeutic Journal], 2002, no. 2, pp. 102—112.
6. Garanyan N.G. Aprobatsiya metodiki diagnostiki nartsissicheskikh chert lichnosti na vyborke studentov rossiiskikh vuzov [Testing the methods of diagnosis of narcissistic personality traits on a sample of students of Russian universities]. Konsul’tativnaya psikhologiya i psikhoterapiya [ Counseling Psychology and Psychotherapy], 2016. Vol. 24 (4), pp. 8—32. doi:10.17759/cpp.2016240402. (In Russ., abstr. in Engl.).
7. Garanyan N.G., Kholmogorova A.B., Yudeeva T.Yu. Faktornaya struktura i psikhometricheskie pokazateli oprosnika perfektsionizma: razrabotka trekhfaktornoi versii [Factor Structure and Psychometric Properties of Perfectionism Inventory: Developing 3-Factor Version]. Konsul’tativnaya psikhologiya i psikhoterapiya [Counseling Psychology and Psychotherapy], 2018. Vol. 26 (3), pp. 8—32. doi:10.17759/cpp.2018260302. (In Russ., abstr. in Engl.).
8. Erezin A.I., Semenova T.S., Anokhin E.Yu. Cherty lichnosti i rannie dezadaptivnye skhemy kak prediktory suitsidal’nogo riska u podrostkov-gomoseksualov [Personality traits and early maladaptive schemas as predictors of suicidal risk in adolescents homosexuals]. Suitsidologiya [Suicidology], 2017. Vol. 8 (4), pp. 81—90.
9. Karelin D.O. Trevozhnost’ kak lichnostnyi faktor suitsidal’nogo riska u studentov VUZA [Anxiety as a personal factor of suicidal risk in students of the higher education] [Elektronnyi resurs]. Vestnik novykh meditsinskikh tekhnologii: elektronnyi zhurnal [Journal of New Medical Technologies, E-edition], 2018, no. 4. Available at: http://vnmt.ru/Bulletin/E2018-4/1-3.pdf (Accessed 1.12.2019).
10. Klimenkova E.N., Kholmogorova A.B. Validizatsiya metodik diagnostiki sotsial’noi trevozhnosti na rossiiskoi podrostkovoi vyborke [Validation Of Methods Of Diagnosis Of Social Anxiety On The Russian Adolescents]. Konsul’tativnaya psikhologiya i psikhoterapiya [Counseling Psychology and Psychotherapy], 2017. Vol. 25 (1), pp. 28— 39. doi:10.17759/cpp.2017250103. (In Russ., аbstr. in Engl.).
11. Konina M.A., Kholmogorova A.B. Oprosnik disfunktsional’nykh ubezhdenii pri pogranichnom rasstroistve lichnosti (PBQ-BPD): adaptatsiya dlya russkoyazychnoi vyborki [The Personality Beliefs Questionnaire in borderline personality disorder (PBQ-BPD): adaptation for Russian-speaking selection]. Konsul’tativnaya psikhologiya i psikhoterapiya [Counseling Psychology and Psychotherapy], 2016. Vol. 24 (3), pp. 126—143. doi:10.17759/cpp.2016240308. (In Russ., аbstr. in Engl.).
12. Krasnova V.V., Kholmogrova A.B. Sotsial’naya trevozhnost’ i studencheskaya dezadaptatsiya [Social anxiety and student disadaptation] [Elektronnyi resurs]. Psikhologicheskaya nauka i obrazovanie psyedu.ru [Psychological Science and Education psyedu.ru], 2011. Vol. 3 (1). Available at: https://psyjournals.ru/psyedu_ ru/2011/n1/39944.shtml (Accessed 01.12.2019). (In Russ., аbstr. in Engl.).
13. Linehan M. Kognitivno-povedencheskaya terapiya pogranichnogo rasstroistva lichnosti [Cognitive-behavioral treatment of borderline personality disorder]. Moscow: Vil’yams, 2008. 590 p. (In Russ.).
14. Lapitskii M.A., Vaulin C.B., Voitsekh V.F., et al. Suitsidal’nye otravleniya. Epidemiologicheskie i kliniko-toksikologicheskie aspekty [Suicidal poisoning. Epidemiological, clinical and toxicological aspects]. Sotsial’naya i klinicheskaya psikhiatriya [Social and Clinical Psychiatry], 2004, no. 1, pp. 28—33.
15. Lasovskaya T.Yu. Samopovrezhdayushchee povedenie pri pogranichnom lichnostnom rasstroistve [Self-injurious behavior in borderline personality disorder]. Konsul’tativnaya psikhologiya i psikhoterapiya [Counseling Psychology and Psychotherapy], 2014. Vol. 22 (2), pp. 38—47. (In Russ., аbstr. in Engl.).
16. Polozhii B.S. Suitsidal’noe povedenie (kliniko-epidemiologicheskie i etnokul’tural’nye aspekty) [Suicidal behavior (clinical, epidemiological and ethno-cultural aspects)]. Moscow: FGU GNTs SSP imeni Serbskogo Publ., 2010. 232 p.
17. Polskaya N.A. Prichiny samopovrezhdeniya v yunosheskom vozraste (na osnove shkaly samootcheta) [The reasons of self-injurious behavior in youth (based on a self-report scale)]. Konsul’tativnaya psikhologiya i psikhoterapiya [Counseling Psychology and Psychotherapy], 2014. Vol. 22 (2), pp. 140—152. (In Russ., abstr. in Engl.).
18. Polskaya N.A., Vlasova N.V. Autodestruktivnoe povedenie v podrostkovom i yunosheskom vozraste [Self-destructive behavior in adolescence and youth]. Konsul’tativnaya psikhologiya i psikhoterapiya [Counseling Psychology and Psychotherapy], 2015. Vol. 23 (4), pp. 176—190. doi:10.17759/cpp.2015230411. (In Russ., аbstr. in Engl.).
19. Starshenbaum G.V. Suitsidologiya i krizisnaya psikhoterapiya: uchebnik [Suicidology and crisis psychotherapy: A handbook]. Moscow: Kogito-tsentr, 2005. 376 p.
20. Tarabrina N.V. Praktikum po psikhologii posttravmaticheskogo stressa [Workshop on the psychology of post-traumatic stress]. Saint Petersburg: Piter, 2001. 268 p.
21. Kholmogorova A.B., Garanyan N.G. Nartsissizm, perfektsionizm i depressiya [Narcissism, perfectionism and depression]. Moskovskii psikhoterapevticheskii zhurnal [Moscow Psychotherapeutic Journal], 2004, no. 1, pp. 18—35.
22. Kholmogorova A.B., Garanyan N.G., Gorshkova D.A., et al. Suitsidal’noe povedenie v studencheskoi populyatsii [Suicidal behavior in a student population]. Kul’turno-istoricheskaya psikhologiya [Cultural-Historical Psychology], 2009, no. 3, pp. 101—110. (In Russ., Abstr. in Engl.).
23. Kholmogorova A.B., Garanyan N.G., Evdokimova Ya.G., et al. Psikhologicheskie faktory emotsional’noi dezadaptatsii u studentov [Personal Factors of Students’ Emotional Disadaptation]. Voprosy Psikhologii, 2009, no. 3, pp. 16—26.
24. Kholmogorova A.B. Kognitivnaya psikhoterapiya suitsidal’nogo povedeniya: istoriya razrabotki, sovremennoe sostoyanie, perspektivy razvitiya [Cognitive psychotherapy of suicidal behavior: history of development, current state, development prospects] [Elektronnyi resurs]. Meditsinskaya psikhologiya v Rossii [ Medical Psychology in Russia], 2013, no. 2. Available at: http://www.medpsy.ru/mprj/archiv_ global/2013_2_19/nomer/nomer16.php (Accessed 18.01.2020).
25. Kholmogorova A.B. Suitsidal’noe povedenie: teoreticheskaya model’ i praktika pomoshchi v kognitivno-bikhevioral’noi terapii [Suicidal Behavior: Theoretical Model and Practical Implications in Cognitive-Behavioral Therapy]. Konsul’tativnaya psikhologiya i psikhoterapiya [Counseling Psychology and Psychotherapy], 2016. Vol. 24 (3), pp. 144—163. doi:10.17759/cpp.20162403009. (In Russ., abstr. in Engl.).
26. Tsygankov B.D., Vaulin S.V. Suitsidy i suitsidal’nye popytki (klinika, diagnostika, lechenie) [Suicides and suicidal attempts (clinic, diagnostics, treatment)]. Smolensk: SGMA, 2012. 256 p.
27. Chernaya M.I., Kholmogorova A.B., Zubareva O.V., et al. Klinicheskie i sotsial’no-psikhologicheskie kharakteristiki patsientov s suitsidal’nymi popytkami [Clinical and socio-psychological characteristics of patients with suicidal attempts]. Konsul’tativnaya psikhologiya i psikhoterapiya [ Counseling Psychology and Psychotherapy], 2016. Vol. 24 (3), pp. 69—88. doi:10.17759/cpp.2016240305. (In Russ., аbstr. in Engl.).
28. Chistopol’skaya K.A., Enikolopov S.N., Magurdumova L.G. Mediko-psikhologicheskie i sotsial’no-psikhologicheskie kontseptsii suitsidal’nogo povedeniya [Medical and socio-psychological approaches to suicidal behavior]. Suitsidologiya [Suicidology], 2013. Vol. 4 (3), pp. 26—36.
29. Yasnaya V.A., Enikolopov S.N. Sovremennye modeli perfektsionizma [Contemporary models of perfectionism] [Elektronnyi resurs]. Psikhologicheskie issledovaniya [Psychological Studies], 2013. Vol. 6 (29), p. 1. Available at: http:// psystudy.ru (Accessed 16.04.2019).
30. Arble E.P. Evaluating the psychometric properties of the hypersensitive narcissism scale: Implications for the distinction of covert and overt narcissism [Elektronnyi resurs]. Master’s Theses and Doctoral Dissertations, 2008. 236 p. Available at: https:// commons.emich.edu/theses/236/ (Accessed 10.12.2019).
31. Blatt S.J., Zuroff D.C. Interpersonal relatedness and self-definition: Two prototypes for depression. Clinical Psychology Review, 1992. Vol. 12 (5), pp. 527—562. doi:10.1016/0272-7358(92)90070-O
32. Blatt S.J. The destructiveness of perfectionism: Implications for the treatment of depression. American Psychologist, 1996. Vol. 50 (12), pp. 1003—1020. doi:10.1037//0003-066x.50.12.1003
33. Egan S.J., Wade T.D., Shafran R. Perfectionism as a transdiagnostic process: A clinical review. Clinical Psychology Review, 2011. Vol. 31 (2), pp. 203—212. doi:10.1016/j.cpr.2010.04.009
34. Flett G., Hewitt P., Nepon T., et al. Perfectionism cognition theory: The cognitive side of perfectionism. In Stoeber J. (ed.). The Psychology of Perfectionism: Theory, Research, Applications. Abingdon, Oxon; New York, NY: Routledge, 2018, pp. 101—123.
35. Hendin H.M., Cheek J.M. Assessing hypersensitive narcissism: A reexamination of Murray’s Narcissism Scale. Journal of Research in Personality, 1997. Vol. 31, pp. 588—599. doi:10.1006/jrpe.1997.2204
36. Hewitt P., Flett G. Perfectionism and depression: a multidimensional analysis. Journal of Social Behavior & Personality, 1990. Vol. 5, pp. 423—438.
37. Hewitt P., Flett G. Perfectionism in the self and social contexts: Conceptualization, assessment, and association with psychopathology. Journal of Personality and Social Psychology, 1991. Vol. 60 (3), pp. 456—470. doi:10.1037//0022-3514.60.3.456
38. Hewitt P., Newton J., Flett G., et al. Perfectionism and suicide ideation in adolescent psychiatric patients. Journal of Abnormal Child Psychology, 1997. Vol. 25 (2), pp. 95— 101.
39. Kohut H. Narcissism and narcissistic rage. The Psychoanalytic Study of the Child, 1972. Vol. 27, pp. 360—400.
40. Linehan M.M, Armstrong H.E., Suarez A., et al. Cognitive-behavioral treatment of chronically parasuicidal borderline patients. Archives of General Psychiatry, 1991. Vol. 48 (12), pp. 1060—1064. doi:10.1001/archpsyc.1991.01810360024003
41. Linehan M.M., Rizvi S.L., Welch S.S., et al. Psychiatric aspects of suicidal behavior: Personality disorders. In Hawton K., van Heeringen K. (eds.). The International Handbook of Suicide and Attempted Suicide. Chichester, UK: Wiley, 2000, pp. 147—178.
42. Pincus A., Lukowitsky M. Pathological narcissism and narcissistic personality disorder. Annual Review of Clinical Psychology, 2010. Vol. 6, pp. 421—446. doi:10.1146/annurev.clinpsy.121208.131215
43. Pincus A., Roche M. Narcissistic Grandiosity and narcissistic vulnerability. In Campbell W., Miller J. (eds.). The handbook of narcissism and narcissistic personality disorder. Hoboken, NJ: Wiley, 2011, pp. 31—40. doi:10.1002/9781118093108.ch4
44. Rahman А., Bairagi А., Kumar B.D., et al. Loneliness and depression in university students. The Chittagong University Journal of Biological Science, 2012. Vol. 7 (1—2), pp. 175—189.
45. Roxborough H.M., Hewitt P.L., Kaldas J., et al. Perfectionistic self-presentation, socially prescribed perfectionism, and suicide in youth: A test of the perfectionism social disconnection model. Suicide and Life-Threatening Behavior, 2012. Vol. 42 (2), pp. 217—233. doi:10.1111/j.1943-278X.2012.00084.x
46. Russell, D., Peplau L.A., Cutrona C.E. The revised UCLA Loneliness Scale: Concurrent and discriminant validity evidence. Journal of Personality and Social Psychology, 1980. Vol. 39 (3), pp. 472—480. doi:10.1037/0022-3514.39.3.472
47. Smith M.M., Sherry B.S., Chen S., et al. The perniciousness of perfectionism: A meta-analytic review of the perfectionism-suicide relationship. Journal of Personality, 2018. Vol. 86 (3), pp. 522—542. doi:10.1111/jopy.12333
48. Soloff P.H., Lynch K.G., Kelly T.M., et al. Characteristics of suicide attempts with major depressive episode and borderline personality disorder: A comparative study. American Journal of Psychiatry, 2000. Vol. 157 (4), pp. 601—608. doi:10.1176/appi.ajp.157.4.601
49. Stanley B., Jones J. Risk for suicide behavior in personality disorders. In Wasserman D., Wasserman C. (eds.). Oxford textbook of suicidology and suicide prevention: A Global perspective. New York: Oxford University Press, 2009, pp. 287—292.