J Korean Med Sci.  2021 Feb;36(5):e39. 10.3346/jkms.2021.36.e39.

Self-Transcendence Mediates the Relationship between Early Trauma and Fatal Methods of Suicide Attempts

  • 1Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
  • 2Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
  • 3Department of Psychiatry, Asan Medical Center, Seoul, Korea
  • 4Department of Psychiatry, Seoul Metropolitan Eunpyeong Hospital, Seoul, Korea
  • 5Department of Psychiatry, Inha University Hospital, Incheon, Korea
  • 6Department of Psychiatry and Behavioral Science, National Cancer Center, Goyang, Korea
  • 7Division of Cancer Control & Policy, National Cancer Center, Goyang, Korea
  • 8Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Korea


Early trauma is known to be a risk factor of suicide-related behavior. On the other hand, people who attempt suicide using a fatal method are reported to be more likely to complete suicide. In this study, we assumed that early trauma affects an individual's temperament and character and thereby increases the risk of a fatal method of suicide attempts.
We analyzed 92 people with a history of previous suicide attempts. We compared the Temperament and Character Inventory-Revised scores between the groups with and without early trauma, and between the groups with and without a history of suicide attempt using fatal methods through an analysis of covariance with age, sex, and presence of a psychiatric history as covariates. A mediation analysis was conducted of the relationship between early trauma and fatal methods of suicide attempt with self-transcendence as a mediator.
Higher self-transcendence was reported in the fatal group (27.71 ± 13.78 vs. 20.97 ± 12.27, P = 0.010) and the early trauma group (28.05 ± 14.30 vs. 19.43 ± 10.73, P = 0.001), respectively. The mediation model showed that self-transcendence mediates the relationship between early trauma and fatal methods of suicide attempt. The 95% confidence intervals for the direct and indirect effect were (−0.559, 1.390) and (0.026, 0.947), respectively.
Self-transcendence may mediate the relationship between early trauma and fatal methods of suicide attempt. Self-transcendence may be associated with unhealthy defenses and suicidal behavior for self-punishment and may constitute a marker of higher suicide risk.


Suicide; Suicide Attempt; Temperament; Character
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