A significant number of adolescents treated for attempted suicide have made previous attempts and will make subsequent attempts. These youths have a high risk of actually committing suicide. To find predictive factors of suicide risk, the authors compared 43 adolescent patients who had attempted suicide once with 38 who reported multiple attempts. The repeaters were less successful in school, displayed more hostility, reported more dysphoria, and had undergone more long-term stress. The authors believe assessing suicide risk requires evaluating the repeater's internal state of rage and dysphoria; they recommend that future studies look closely at these internal states as well as at external factors.