Impulsivity and Suicide

Researchers from the University of Pennsylvania and LaSalle University warn that focusing on depression and hopelessness as indicators of suicide risk may result in overlooking persons at high risk for making impulsive suicide attempts, which, according to their research, are as likely to result in death as premeditated attempts. Compared to persons making premeditated suicide attempts, persons making impulsive attempts have lower expectations that their attempt will be fatal, less depression and hopelessness, less of a likelihood of a history of childhood sexual abuse, and a higher likelihood of an alcohol use disorder. The authors warn clinicians not to “assume that a person is not at risk for making an impulsive attempt if he or she does not exhibit impulsivity as a general personality trait,” since research indicates that people making impulsive suicide attempts do not necessarily score high on impulsivity tests.

The authors also found that “There were no statistically significant differences between individuals who made an impulsive attempt and those who made a premeditated attempt on any demographic characteristics (i.e. gender, race, marital status, employment status, education level).” This research used data from subjects who were “recent suicide attempters participating in a preliminary or full clinical trial investigating the use of cognitive therapy in reducing repeat suicide attempts.” Of these subjects, 43 percent had made an impulsive attempt (that is, reporting no premeditation prior to the attempt) and 36 percent had made a premeditated attempt (that is, had contemplated for three hours or more prior to making an attempt). The remaining 21 percent “reported considering suicide for three hours or less prior to the attempt” and were excluded from the data analysis.

Spokas, M., Wenzel, A., Brown, G. K., & Beck, A. T. (2012). Characteristics of individuals who make impulsive suicide attempts.  Journal of Affective Disorders, 136(3), 1121-1125.