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Based on the material of over one hundred cases of attempted suicide, Hendin confirms Zilboorg's statement that there is a need for a differential diagnosis to
cover the varying dynamic motivational forces etiological among suicidal patients. He describes three groups.
1Those motivated by spite and the desire to force affection. One may be dominant but evidence of the other will be present. Where there are approximately equal motivations the seriousness of the suicidal attempt is mild. This motivation is typical in cases of 'lover's quarrels'. These patients are classified in the reactive depression group in which emotional immaturity is the most characteristic feature. Children with the desire to punish their parents (Bender and Schilder) belong in this group. The same motivation is found in patients with character disorders who may act under the influence of alcohol and are characterized by a mild degree of intent. Their essential narcissism and their inability to form strong object attachments seem to be protective factors.
2Those who suffer loss of a loved object. These patients attempted suicide after the breaking of strong love-object attachments. Their own neurotic behavior contributed to the termination of these relationships. Then they tried to establish other similar relationships and, when they failed, made serious suicidal attempts after an interval of six months to three years. Their problems centered in difficulties involving the expression of aggression which, after the loss of the loved object, turned against the self. Patients in their fifties and of a passive dependent disposition were particularly endangered when they lost the person without whom satisfaction was impossible.
3Those who have guilt. This was outstanding in schizophrenic suicidal patients who showed the greatest degree of depression, evidence of incestuous longing, reactions to perverse sexual behavior and overt hostility to parental figures.
Hendin feels that the assumpt