Suicide Attempts Associated With Externalizing Psychopathology in an Epidemiological Sample

Abstract

Suicidal behavior among individuals with externalizing symptoms is not necessarily a result of comorbid depressive or other internalizing disorder. Thus, persons exhibiting antisocial behaviors should receive rigorous assessment for suicidal ideation and behavior.

A Dimensional Model of Psychopathology Among Homeless Adolescents: Suicidality, Internalizing, and Externalizing Disorders

“…Confirmatory factor analysis results provided support for a three-factor model in which suicidality (measured with lifetime suicidal ideation and suicide attempts), internalizing disorders (assessed with lifetime diagnoses of major depressive episode and post-traumatic stress disorder), and externalizing disorders (indicated by lifetime diagnoses of conduct disorder, alcohol abuse, and drug abuse) were positively intercorrelated. These results are consistent with previous research that examined suicidality and broadly-defined internalizing and externalizing disorders (Breton et al 2002;Hills et al 2005;Verona et al 2004). That the suicidal ideation and suicide attempt variables loaded on one factor also supports current conceptualizations of a suicide spectrum (e.g., Lewinsohn et al 1996;Van Heeringen 2001).…”

“…Three studies reported a significant relationship between suicidality and both disorder categories (Breton et al 2002;Hills et al 2005;Verona et al 2004), and one study reported a significant relationship between suicidality and the internalizing disorder category only (Esposito and Clum 2003).…”

“…Psychopathology; Suicidality; Internalizing; Externalizing; Homeless adolescents Dimensions of adolescent suicidality and psychopathology are of increased concern to clinicians and researchers (Bridge et al 2006;Verona et al 2004). This interest can be attributed to the relatively high prevalence of adolescent suicidal ideation and suicide attempts (Evans et al 2005) and to suicide being the third leading cause of death among youths ages 15-24 in the USA (Hoyert et al 2006).…”

“…Krueger (1999), informed by the work of Achenbach (Achenbach and McConaughy 1997), developed a dimensional model of psychopathology and clustered psychiatric diagnoses into internalizing and externalizing disorders. As specific psychiatric disorders from both clusters are related to suicidal ideation and attempts, there is interest in linking the suicide spectrum to these broader dimensions of psychopathology (Hills et al 2005;Verona et al 2004). …”

“…Our study is also one of the few that uses both suicidal ideation and suicide attempts as indicators of suicidality. Three of the previous cited studies focused only on one aspect of suicidality -suicidal ideation (Esposito and Clum 2003) or suicide attempts (Hills et al 2005;Verona et al 2004). …”