“Impulsive” youth suicide attempters are not necessarily all that impulsive

Witte, Tracy K.; Merrill, Katherine A.; Stellrecht, Nadia E.; Bernert, Rebecca A.; Hollar, Daniel L.; Schatschneider, Christopher; Joiner, Thomas E.

doi:10.1016/j.jad.2007.08.010

Cited by 118 publications

(94 citation statements)

References 26 publications

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“…Additionally, the increased influence of peers on behavior (Smetana et al 2006), impulsivity (Witte et al 2008), and a sense of invulnerability to known risk consequences (Elkind 1967) may further increase the likelihood of exposure to painful and provocative events. Although acquired capability for suicide is theorized to be relatively stable, it is unknown whether this construct fluctuates in relation to time since first exposure to painful and provocative events.…”

Section: Shortcomings In Literature Guiding This Studymentioning

confidence: 99%

Preliminary Examination of the Interpersonal Psychological Theory of Suicide in an Adolescent Clinical Sample

Horton

Hughes

King

et al. 2015

J Abnorm Child Psychol

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This study offers a preliminary examination of the Interpersonal-Psychological Theory of Suicide (IPTS; Joiner 2005) in an adolescent clinical sample. The IPTS offers a nuanced framework that has many conceptual and practical merits. Although this theory has a growing base of evidence among adults, it has yet to be tested in adolescents using direct measures of its central constructs. Participants were 147 adolescents (76.2 % girls) on an inpatient psychiatric unit, who completed measures of key IPTS constructs of thwarted belongingness, perceived burdensomeness, acquired capability for suicide, as well as depression severity, hopelessness, and severity of suicidal symptoms. Our findings were largely consistent with hypotheses derived from the IPTS: perceived burdensomeness, and at a marginal level, thwarted belongingness, were independently associated with current suicidal ideation. The thwarted belongingness by perceived burdensomeness interaction marginally distinguished between adolescents with passive and active suicidal ideation. Acquired capability for suicide was associated with recent suicidal intent. Examination of all three IPTS constructs simultaneously revealed main effects of each construct (with a marginal effect of thwarted belongingness), and interaction effects for thwarted belongingness by perceived burdensomeness, and thwarted belongingness by perceived burdensomeness by acquired capability for suicide in association with suicidal symptom severity. Sex, age, depression severity, and hopelessness were controlled in all analyses. This study offers strong, albeit preliminary, support of the IPTS in a clinical adolescent sample. Assessment of IPTS constructs may be useful in determining persistent risk for suicide attempt. Prospective tests of the theory, and extensions to intervention and prevention should be considered in future IPTS research.

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Section: Shortcomings In Literature Guiding This Studymentioning

confidence: 99%

Preliminary Examination of the Interpersonal Psychological Theory of Suicide in an Adolescent Clinical Sample

Horton

Hughes

King

et al. 2015

J Abnorm Child Psychol

View full text Add to dashboard Cite

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“…Whilst it might be expected that trait impulsivity would lead to more unplanned self-harm, the alternative hypothesis has also been suggested that greater impulsivity will lead to more planned self-harm (Witte et al, 2008). Specifically, it has been noted that those with high trait impulsivity tend to have a greater likelihood of experiences such as accidental injury, substance use and culturally accepted forms of self-injury (e.g., piercings, scarification) which may ultimately lower an individual's threshold for acting on suicidal thoughts, and possibly engaging in self-harm more generally (Bender et al, 2011;Witte et al, 2008). They may also have more challenging lives as a consequence of their impulsiveness, leading to a greater suicidal and self-injurious thinking (Turecki, 2005).…”

Section: Introductionmentioning

confidence: 99%

Out of the blue: Untangling the association between impulsivity and planning in self-harm

Rawlings

Shevlin

Corcoran

et al. 2015

Journal of Affective Disorders

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“…One example of an inpatient psychiatrist being held liable is the Weatherly v. State of New York (1981) case, which involved a patient who was released from suicide watch in the hospital eight days prior to jumping out of a hospital window. The day after being removed from suicide watch, the patient's mental status began to deteriorate notably, yet he was not placed back on suicide precaution.…”

Section: The Role Of Impulsivity In the Foreseeability Of Suicidementioning

confidence: 99%

“…This standard was set by Speer v. United States (1981,5 th Circuit), which involved an outpatient psychiatrist prescribing a month's worth of medicine, which was used by a patient to make a fatal overdose. The court ruled that the psychiatrist was not responsible for this suicide because as an outpatient, the suicide victim could not be directly monitored and kept under his therapist's control.…”

Section: The Role Of Impulsivity In the Foreseeability Of Suicidementioning

confidence: 99%

“…Notably, no differences were found on a measure of trait impulsivity between "impulsive" attempters and non-impulsive attempters. Additionally, "impulsive" suicide attempters were less likely to believe that their attempt would be lethal.Lastly, Witte et al (2008) compared three groups of suicidal adolescents in a large epidemiological study: those who planned a suicide attempt, but did not actually attempt; those who did not plan an attempt, but did attempt (i.e., "impulsive" attempters); and those who both planned for and attempted suicide. Given that planful attempts are considered a more serious form of suicidal behavior (e.g., Baca-Garcia et al, 2005), the authors predicted that the individuals who had habituated to fear and pain associated with self-injury (i.e., those who had engaged in the largest number of impulsive behaviors and had the highest trait impulsivity) would be more likely to have made a planful attempt (i.e., non-impulsive attempt).…”

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confidence: 99%

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Revisiting impulsivity in suicide: Implications for civil liability of third parties

Smith

Witte

Teale

et al. 2008

Behavioral Sci & The Law

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Previous research and popular conceptualizations of suicide have posited that many suicides are the result of impulsive, "on a whim" decisions. However, recent research demonstrates that most suicides are not attempted impulsively, and in fact involve a plan. Legally, suicide has historically been considered to be a superseding intervening cause of death that exonerates other parties from liability, but currently there are two general exceptions to this view. Specifically, another party may be found responsible for a suicide if that party either caused the suicide or failed in its duty to prevent the suicide from occurring. Both of these exceptions assume that the resulting suicide was foreseeable. Given that recent research has indicated that most suicides are planned, and thereby foreseeable to a certain extent under many circumstances, this article discusses issues of foreseeability as they pertain to litigation involving third party liability for the suicide of university students, prison inmates, and mental health patients. The authors contend that the surest way for universities, prison staff, and mental health practitioners to avoid being held liable for a suicide is to appropriately assess for suicidal intent.Suicide is the third leading cause of death for people aged 15 to 24 and the 11 th leading cause of death overall (Centers for Disease Control [CDC], 2004). Approximately 30,000 people die by suicide every year in the U.S. Moreover, four times that many people are hospitalized due to injuries sustained while attempting suicide (CDC, 2004). For the purposes of this paper we will use Silverman and colleagues ' (Silverman, Berman, Sanddal, O'Carroll, & Joiner, 2007) definition of a "suicide attempt," which is "a self-inflicted, potentially injurious behavior with a nonfatal outcome for which there is evidence (either explicit or implicit) of intent to die." Suicide is thus a serious mental health issue and public health problem. In the wake of a suicide, loved ones are often left looking for answers. When family members or friends feel something more should have been done for the decedent, they may ultimately try to settle things in a court of law. In fact, the most common type of lawsuit brought against psychiatrists is in regard to patient suicide (Simon, 2002). Furthermore, records from the American Psychological Association's Insurance Trust indicate that of claims closed by 1990, patient suicide was the second most costly claim for psychiatrists and psychologists insured by the company (Bongar, Maris, Berman, & Litman, 1998). As our society has become more litigious, the number of malpractice suits filed against therapists has risen dramatically and will likely continue to rise (Berman, 1986).Although the causes of suicide are complex, they are not mysterious, and in fact are becoming better understood thanks to decades of scientific research. One comprehensive (Van Orden, et al., 2008). According to this theory three proximal, jointly necessary, and sufficient causes must be present befo...

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“Impulsive” youth suicide attempters are not necessarily all that impulsive

Cited by 118 publications

References 26 publications

Preliminary Examination of the Interpersonal Psychological Theory of Suicide in an Adolescent Clinical Sample

Preliminary Examination of the Interpersonal Psychological Theory of Suicide in an Adolescent Clinical Sample

Out of the blue: Untangling the association between impulsivity and planning in self-harm

Revisiting impulsivity in suicide: Implications for civil liability of third parties

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