« Resources

Impulsiveness and the Risk of Suicide Attempts

Klonsky, E., & May, A. (2010). Rethinking Impulsivity in Suicide. Suicide and Life-Threatening Behavior 40(6), 612-619.

A recent study found that one aspect of impulsivity, urgency, was associated with a higher risk of both suicidal ideation and suicide attempts. However, only a lack of premeditation (another aspect of impulsiveness) distinguished young people who reported that they had suffered suicidal ideation and had attempted suicide from young people who reported ideation, but had not attempted suicide. The authors suggest that their findings revealed the importance of using screening tools that can differentiate among several aspects of impulsivity rather than tools that measure impulsivity as a single trait. The research was designed to explore the widely held belief that impulsive people are more likely to attempt suicide than others.  Two sample groups were studied.

The first sample included more than 2,500 military recruits (average age 20). The recruits completed questionnaires that assessed their history of suicidal ideation and attempts, as well as their impulsivity, using a unidimensional definition for impulsivity. The results revealed that participants with histories of suicide attempts or ideation were significantly more impulsive than those with no history of attempts or ideation. However, there was no difference in impulsivity between those who had attempted suicide and those who reported ideation, but had not attempted to take their own lives.

The second sample included approximately 1,700 college and high school students. The Youth Risk Behavior Survey was used to document suicide attempts and ideation. In contrast to the military sample, the students were assessed for four different personality traits associated with impulsivity:

(1) urgency (the “tendency to give in to strong impulses when experiencing intense negative emotions”)
(2) lack of perseverance (an inability “to persist in completing jobs or obligations despite boredom or fatigue”)
(3) lack of premeditation (an inability “to think through the potential consequences of behavior before acting”)
(4) sensation seeking (a “preference for excitement and stimulation”).

The results revealed that that only the lack of premeditation—that is, an inability to think through the consequences of their actions—was uniquely associated with attempts but not ideation, and thus could be used to indicate which young people suffering from ideation might be at most risk for attempting suicide. Both attempters and ideators were characterized by high urgency. Neither attempters nor ideators-only were characterized by high sensation-seeking or lack of perseverance.

The authors suggest that “the diminished ability to think through the consequences of one’s behavior before acting confers risk for suicidal behavior over and above the presence of suicidal thoughts. Because many psychiatric patients experience suicidal ideation, this aspect of impulsivity may carry extra importance in suicide risk assessments.”

Read the abstract at www.ncbi.nlm.nih.gov.