Behind impulsive suicide attempts: Indications from a community study

Wyder, Marianne; Leo, Diego De

doi:10.1016/j.jad.2007.02.015

Cited by 104 publications

(90 citation statements)

References 27 publications

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“…14 For the purposes of our study, impulsivity entailed not only overt behaviour but also cognitive and psychological components. 15 In accord with contemporary research, we hypothesized that assessing motor impulsivity (that is, acting without thinking), attentional impulsivity (that is, racing thoughts), and nonplanning components (that is, lack of future planning) may assist in identifying older adults at risk of self-harm.…”

Section: Impulsivity and Suicide Riskmentioning

confidence: 99%

Impulsivity and Hopelessness as Predictors of Suicide-Related Ideation among Older Adults

Neufeld

O’Rourke

2009

Can J Psychiatry

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Objective: Research has demonstrated that impulsivity is strongly associated with suicide-related ideation and behaviour among young adults. However, to date, the potential importance of impulsivity as a predictor of suicide-related ideation in later life has yet to be determined. Our study examined impulsivity, hopelessness, depressive symptomatology, and sociodemographic factors vis-à-vis suicide-related ideation among older adults at risk of self-harm. Method:A sample (n = 117) of older adults was recruited from multiple sources for this study over a 1-year period. Suicide-related ideation was measured with the Geriatric Suicide Ideation Scale, a multidimensional measure of suicide-related ideation developed for use with older adults.Results: Canonical correlation identified 2 pairings of linear composites in which impulsivity emerged along both as significantly associated with facets of suicide-related ideation. Of note, the greater proportion of variance in impulsivity was subsumed along the second set of vectors with somatic depressive symptoms. Conclusion:Our findings suggest that the impulse to self-harm may be even more pronounced among older adults less likely to present as typically depressed. It is further suggested that impulsivity is more broadly associated with suicide-related ideation than hopelessness, and that screening for impulsivity as well as hopelessness may increase clinicians' ability to identify older adults at greatest risk of self-harm.Can J Psychiatry. 2009;54(10):684-692. Clinical Implications· Suicide-related ideation is significantly associated with hopelessness, depressive symptomatology, and impulsivity. · At-risk older adults who are more impulsive may be less likely to appear depressed. · Assessing impulsivity in addition to hopelessness could aid in suicide prevention and intervention. Limitations· A predominantly Caucasian, female, self-selected sample may limit generalizability of findings. · A single recruitment source might have yielded different outcomes as opposed to multiple sources. · Canonical correlation is more exploratory than hypothesis-driven modes of analysis.

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Section: Impulsivity and Suicide Riskmentioning

confidence: 99%

Impulsivity and Hopelessness as Predictors of Suicide-Related Ideation among Older Adults

Neufeld

O’Rourke

2009

Can J Psychiatry

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“…For example, some findings indicate that the process would be better characterized as fluctuating, rather than smooth [13] while others suggest that it varies according to culture [14], and there may be three types of suicidal process-not one [15].…”

Section: Introductionmentioning

confidence: 99%

The suicidal process: age of onset and severity of suicidal behaviour

Thompson

Dewa

Phare

2011

Soc Psychiatry Psychiatr Epidemiol

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The results support the notion that the early onset of a supposed precursor of suicidal behaviour, a death wish in this case, adds to its ability to portend more serious problem levels in later stages of life. Furthermore, mood operates independently in its association with the timing of such suicidal behaviour, suggesting that the effect of a relatively youthful appearance of a wish to die cannot be explained by early onset depression.

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“…Although less planned and more impulsive suicide attempts may be less lethal, they may still result in death, particularly when violent means are available (O'Donnell et al, 1996; Conner et al, 2005). A better understanding of the characteristics of suicide attempters with higher versus lower levels of suicide planning may improve identification and treatment of these patients (Kessler et al, 1999;Wyder and De Leo, 2007).…”

Section: Introductionmentioning

confidence: 99%

Clinical correlates of planned, more lethal suicide attempts in major depressive disorder

Nakagawa

Grunebaum

Oquendo

et al. 2009

Journal of Affective Disorders

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Background-Assessment of suicide plans is standard in acute psychiatric care, but there is a limited evidence base to guide this routine clinical practice. The purpose of this study was to investigate clinical correlates of suicide planning in depressed patients.Methods-151 patients with major depressive disorder and a lifetime history of suicide attempt were studied. Subjects received a comprehensive evaluation including structured diagnostic interview for Axis I and II disorders, current symptoms, impulsivity, and systematic assessment of suicide planning prior to the most recent suicide attempt.Results-Seriousness of suicide attempt planning correlated with lethality of suicidal acts. Comorbid anxiety disorder and anxiety correlated with less suicide planning. Specifically, this negative correlation was with comorbid panic disorder. Planning did not correlate with severity of depression or aggressive/impulsive traits.Limitations-Cross-sectional design, retrospective recall of suicide planning data, limited applicability to completed suicide or other psychiatric disorders.Conclusions-In major depression, comorbid panic disorder appears protective against more carefully planned, higher lethality suicide attempts. Surprisingly, severity of depression and aggressive impulsive traits do not predict planning or lethality of suicide attempts. We have previously reported that anxiety severity protects against the probability of a suicide attempt and now extend that observation to show there is protection against lethality of a suicide attempt. Treatment of anxiety without directly treating major depression may place patients at greater risk of suicidal behavior.

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Behind impulsive suicide attempts: Indications from a community study

Cited by 104 publications

References 27 publications

Impulsivity and Hopelessness as Predictors of Suicide-Related Ideation among Older Adults

Impulsivity and Hopelessness as Predictors of Suicide-Related Ideation among Older Adults

The suicidal process: age of onset and severity of suicidal behaviour

Clinical correlates of planned, more lethal suicide attempts in major depressive disorder

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