Differentiating suicide attempters from suicide ideators: A critical frontier for suicidology research

Most individuals who consider suicide do not make suicide attempts. It is therefore critical to identify which suicide ideators are at greatest risk of acting on their thoughts. However, few seminal theories of suicide address which idea-tors go on to make attempts. In addition, perhaps surprisingly, most oft-cited risk factors for suicide—such as psychiatric disorders, depression, hopelessness, and even impulsivity—distinguish poorly between those who attempt suicide and those who only consider suicide. This special section of Suicide and Life-Threatening Behavior serves to highlight this knowledge gap and provide new data on differences (and similarities) between suicide attempters and suicide ideators. Suicide is a leading cause of death in the United States and worldwide (Centers for Disease Control and Prevention, 2011; World Health Organization, 2011). Unfor-tunately, despite increased prevention efforts, suicide rates over the past several decades appear to be increasing (World Health Organization, 2011). To reduce sui-cide deaths, the field must meaningfully improve its understanding of suicide. One reason for limited progress in suicide prevention may be a lack of knowl-edge about the transition from suicidal thoughts to suicidal actions. Most people who consider suicide do not go on to make a suicide attempt. For example, in a large population-based study, only 7.4 % of those with baseline suicidal ideation reported a suicide attempt over the subsequent 2 years (ten Have et al., 2009). Overall, lifetime rates of suicide ideation are many times higher than lifetime rates of attempts (Fer