International study of definitions of English-language terms for suicidal behaviours: A survey exploring preferred terminology

Objectives Explore international consensus on nomenclatures of suicidal behaviours and analyse differences in terminology between high-income countries (HICs) and low/middle-income countries (LMICs). Design An online survey of members of the International Organisation for Suicide Prevention (IASP) used multiple-choice questions and vignettes to assess the four dimensions of the definition of suicidal behaviour: outcome, intent, knowledge and agency. Setting International. Participants Respondents included 126 individuals, 37 from 30 LMICs and 89 from 33 HICs. They included 40 IASP national representatives (65% response rate), IASP regular members (20% response rate) and six respondents from six additional countries identified by other organisations. Outcome measures Definitions of English-language terms for suicidal behaviours. Results The recommended definition of a € suicide' describes a fatal act initiated and carried out by the actors themselves. The definition of a € suicide attempt' was restricted to non-fatal acts with intent to die, whereas definition of a € self-harm' more broadly referred to acts with varying motives, including the wish to die. Almost all respondents agreed about the definitions of a € suicidal ideation', a € death wishes' and a € suicide plan'. a € Aborted suicide attempt' and a € interrupted suicide attempt' were not considered components of a € preparatory suicidal behaviour'. There were several differences between representatives from HICs and LMICs. Conclusion This international opinion survey provided the basis for developing a transcultural nomenclature of suicidal behaviour. Future developments of this nomenclature should be tested in larger samples of professionals, including LMICs may be a challenge.