Category: Suicide and Self-Injury

Symposium

The Role of Impulsiveness in the Pathway to Suicide

Saturday, November 18
12:15 PM - 1:45 PM
Location: Aqua Salon A & B, Level 3, Aqua Level

Keywords: Suicide
Presentation Type: Symposium

The relationship between suicide and impulsiveness has been examined for over 100 years, but most prior studies on this topic have severe limitations, such as relying on self-report scales of general trait impulsiveness. These studies have also failed to compare suicide attempters with ideators, which is crucial to understanding whether impulsiveness is involved in the transition from ideation to attempt. To address these limitations, we conducted two studies. In study 1, we compared suicide attempters (n=30), suicide ideators (n=31), and community controls (n=34) on 10 impulsiveness constructs. We also tested whether answering questions about suicide attempts before answering questions about impulsiveness leads to higher levels of self-reported impulsiveness (i.e., attempters may report that they are more impulsive if they are primed to think about their suicide attempt). In study 2, we collected a sample online (n=346) and compared similar groups on several of the same constructs as study 1. In study 1, three impulsiveness constructs were elevated among attempters, compared to ideators: attentional impulsiveness, lack of premeditation and negative urgency. However, compared to ideators, attempters showed higher attentional impulsiveness and lack of premeditation only when clinical scales preceded impulsiveness scales; the groups showed no differences when the administration order of the scales was reversed. In study 1, the only construct higher among attempters than ideators and unaffected by order effects was negative urgency—acting rashly during negative affect. In study 2, none of the impulsiveness scales were significantly different among attempters and ideators, including the three constructs elevated among attempters in study 1. Order effects may be caused by questions about suicide leading to artificially inflated self-report or reminding attempters of elevated state-level impulsiveness around the time of their attempts. Overall, these results suggest that trait-level dimensions of impulsiveness are not involved in the transition from ideation to attempt. Future studies in this area should focus on state-level decision-making during negative contexts.

Alexander J. Millner

Postdoctoral Fellow
Harvard University

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