An Exploratory Study of the Relationship between Diverse Life Events and Specific Personality Disorders in a Sample of Suicide Attempters

Abstract

Personality disorder (PD) increases risk for suicidal behavior. Certain life events (LE) can precipitate suicidal behaviors in patients with PD. A fundamental question is whether specific combinations of LE and PD increase suicidal risk. 446 suicide attempters (SA) were recruited from emergency rooms. We used a healthy control group (n= 515) to identify the best cut-off point for the instrument used to diagnose PD. We used the DSM-IV version of the International Personality Disorder Questionnaire–Screening Questionnaire, the Mini International Neuropsychiatric Interview, and the Social Adjustment Scale to assess PD, Axis I disorders and LE respectively. After controlling for Axis I disorders, we found that “Death of spouse” preceded suicidal acts in those with antisocial PD (FET p=0.024) and patients with narcissistic PD attempted suicide after being “Fired at work” (FET p=0.002), among others. Our data suggest the presence of particular LE-PD associations in suicide attempters. Some LE-PD relationships appear independent of Axis I disorders in suicide attempters. This may offer a basis for specific targeted therapies or prevention programs aimed at decreasing suicidal risk.

From the Serotonin Model of Suicide to a Mental Pain Model of Suicide

“…When the third author arrived to help the second author, the third man decided to pursue analysis to verify and clarify how life events and personality traits contribute to SB [14]. Then he proposed that, rather than biological or genetic variables, life stressors may be the best way to identify psychiatric patients at risk of suicide [15].…”

Suicide attempts in bipolar I patients: impact of comorbid personality disorders

“…6,10,18 Although SB is included in the diagnostic criteria for borderline PD only, individuals with any cluster B PDs appear more inclined to experience stressful life events (e.g., ending a romantic relationship, social rejection, family conflicts, and loss of employment) that may trigger SA. [18][19][20][21] It is important to note that other studies have reported that up to 41.2% of euthymic patients with BD present at least one comorbid PD. Regardless of symptomatic state, cluster B PDs are among the most frequent comorbidities in patients with BD, affecting up to 23% of patients evaluated during euthymia 8 and approximately 30% of patients in whom symptomatic state was not strictly evaluated.…”

Las múltiples caras del suicidio en la clínica psicológica

“…Se trata de una llamada de atención con diversas finalidades: vengarse de EnriquE EchEburúa alguien, mostrar lo desesperado que se está, buscar ayuda, averiguar si alguien le quiere realmente, huir temporalmente de algo insoportable o mostrar lo mucho que le quiere a una persona. Con frecuencia el sujeto está en una posición ambivalente: desea morir si su vida continúa de la misma manera y desea vivir si se producen cambios significativos en ella (Blasco-Fontecilla et al, 2010).…”

“…Acerca de las tensiones vitales múltiples, como la conflictividad familiar, la pérdida de empleo y una situación económica desfavorable, el descubrimiento de un escándalo político o económico, los desengaños amorosos o el fallecimiento reciente de un familiar cercano, éstas tienen un valor predictivo sólo en personalidades vulnerables con tendencias impulsivas y agresivas y con pocas respuestas de afrontamiento (Blasco-Fontecilla et al, 2010 (Mann et al, 2005, modif. ) Figura 1.…”

“…La vulnerabilidad psicológica se acentúa si se suman ciertas circunstancias psicosociales, como estar separado o sin pareja o verse obligado a hacer frente a situaciones vitales estresantes intensas o duraderas, como una enfermedad crónica, el abandono de sus seres queridos o la pérdida de estatus social. En concreto, el aislamiento social es especialmente relevante en ancianos y adolescentes (Blasco-Fontecilla et al, 2010).…”