Firestone, R.W., & Firestone, L. (1998). Voices in suicide: The relationship between self-destructive thought processes, maladaptive behavior, and self-destructive manifestations. Death Studies, 22(5), 411-443.

Findings from empirical studies demonstrating a significant relationship between parental introjects or “critical inner voices” and self-destructive behavior are presented in this article. The “critical inner voice” is defined as a systematized, integrated pattern of negative thoughts, accompanied by angry affect, that is the basis of an individual’s maladaptive behavior. The studies applied the theoretical construct of the voice to the development of the Firestone Assessment of Self-destructive Thoughts (FAST). Results of administering the scale to 1,358 participants (outpatient, inpatient, and non clinical groups) showed that the instrument distinguished between those individuals with a past history of suicide attempts and those without such a history. An exploratory factor analysis identified three factors representing levels of increasing self-destructiveness. This analysis suggested that Factor Composite 3, labeled “Self-Annihilating,” and the Suicide Intent Composite, a subset of Factor 3, contained the primary factors distinguishing suicide attempters from those individuals who represent a lesser threat to self. Reprint