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

https://doi.org/10.1016/j.jad.2007.08.010Get rights and content

Abstract

Background

The relationship between impulsivity and suicide has been conceptualized in the literature as a direct one. In contrast, Joiner's [Joiner, T.E., 2005. Why people die by suicide. Harvard University Press, Cambridge, MA.] theory posits that this relationship is indirect in that impulsive individuals are more likely to engage in suicidal behavior because impulsivity makes one more likely to be exposed to painful and provocative stimuli.

Method

Adolescents were selected from the Youth Risk Behavior Survey (YRBS) sample between the years of 1993–2003 who had planned for a suicide attempt but did not actually attempt (n = 5685), who did not plan but did attempt (“impulsive attempters;” n = 1172), and who both planned and attempted (n = 4807). Items were selected from the YRBS to assess demographic variables, suicidal behaviors, and impulsive behaviors.

Results

Participants who had planned suicide without attempting were significantly less impulsive than those who had attempted without planning and than those who had both planned and attempted. Crucially, participants who had made a suicide attempt without prior planning were less impulsive than those who had planned and attempted.

Limitations

We were unable to conduct a multi-method assessment (i.e., measures were self-report); the measure of impulsivity consisted of items pulled from the YRBS rather than a previously validated impulsivity measure.

Conclusions

The notion that the most impulsive individuals are more likely to plan for suicide attempts is an important one for many reasons both theoretical and clinical, including that it may refine risk assessment and attendant clinical decision-making.

Section snippets

Sample

Data from the national school-based Youth Risk Behavior Survey (YRBS) were used for this study (years 1993–2003). These data are part of the public domain and are available on the internet for use by researchers (National Center for Chronic Disease Prevention and Health Promotion, 2006). The YRBS is one component of an epidemiologic study called the Youth Risk Behavior Surveillance System (YRBSS). It was established by the Centers for Disease Control and Prevention (CDC) to assess and monitor

Main analyses

Results were consistent with expectations; the groups significantly differed with regard to the selected impulsivity items (F (20, 23,304) = 37.88, p < 0.001). The effect size for this omnibus tests and all other tests were calculated using the procedure outlined by Olejnik and Algina (2000). The ω2 value was 0.53, which can be considered a large effect. Planned contrasts on the first canonical variate revealed that each group was significantly different from one another. The correlations between

Discussion

The purpose of the current study was to pit two competing views against one another. If impulsivity's involvement in suicide attempts relates to “spur of the moment” behavior, our group who attempted but did not plan a suicide attempt should be at least as impulsive as the group that planned and attempted. If, on the other hand, the mechanism through which impulsive people are at high suicide risk is through their exposure to repeated painful and provocative experiences, the group that showed

Role of funding source

This research was supported, in part, by a grant from the National Institute of Mental Health to Tracy K. Witte and Thomas Joiner (1 F31 MH077386-01). The NIMH had no further role in the study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication.

Conflict of interest

The authors of this manuscript have no conflict of interest in the publication of this manuscript.

Acknowledgments

We wish to thank the National Center for Chronic Disease Prevention and Health Promotion for making their data publicly available for sue by researchers.

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    This paper was presented in November 2005 at the 39th Annual Association for the Advancement of Behavior Therapy Convention in Washington, D.C.

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    Recipient for reprint requests. Address: Department of Psychology, Florida State University 32306-1270. Tel.: +1 850 644 1454; fax: +1 850 645 7518.

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