Factors associated with the increased risk for suicide in the case of Krystal based on practice guideline from the American Psychiatric Association*
| Risk factors | Episodes or details | Availability |
|---|---|---|
| Demographic features | ||
| Adolescent and young adult age group | Adolescent (16 years old) | |
| Race | Caucasian | |
| Psychiatric disorders | ||
| Cluster B personality disorder | Antisocial personality trait | |
| Other substance use disorders | Cigarette and marijuana | |
| Physical illness | Not available | |
| Psychosocial features | ||
| Recent lack of social support | Death of Mr Fairbrother | |
| Poor relationship with family | Conflicts with mother | |
| Recent stressful life event | Rape by mother’s boyfriend | |
| Drowning of brother | ||
| Childhood trauma | ||
| Physical abuse | Exposure to adverse experiences | |
| Genetic and familial effects | ||
| Family history of mental illness | Mother’s substance use disorder | |
| Trans-generational antisocial traits | ||
| Psychological features | ||
| Hopelessness | Poverty, no shelter | |
| Shame | Guilt of her brother’s drowning | |
| Decreased self-esteem | Turning against self | |
| Impulsiveness | Aggressive and violent behaviours | |
| Cognitive features | Not available | |
| Suicidal thoughts/behaviors | ||
| Lethality of suicidal plans or attempts | Critical heroin overdose | |
| Additional features | ||
| Unstable or poor therapeutic relationship | Insufficient rapport with the social worker |
* American Psychiatric Association. Practice guideline for the assessment and treatment of patients with suicidal behaviors. November 2003 [10].
