Data from 463 patients with self inflicted injuries, comparing 99 multiple suicide attempters (MSAs) with 1st attempters were rated on lethality, intent & hopelessness scales. 14% of the total suicide attempt population were found to be chronic. MSAs showed more chronicity, poorer coping histories of suicidal behavior & positive histories of substance abuse. MSAs also had higher lethality & depression ratings, were less impulsive & more often admitted following an attempt.