Impulsivity and Suicide Attempts in Adolescence: A New Perspective on the Old Story
Abstract
Background: The common risk factors of suicidality in adolescents could be psychological, behavioral, cognitive, interpersonal, and personal. Major depressive disorder and impulsive behavior are crucial predictors or mediators for suicidality. This study aims to show the multidirectional links between the predictors of suicidality in adolescents.
Methods: The study included 49 suicide attempters (15.82±1.24 years) and 41 controls (15.67±1.40 years). The instruments were sociodemographic form and Barratt Impulsivity Scale-11 (BIS-11). The Kiddie Schedule for Affective Disorders and Schizophrenia was used to assess the psychiatric diagnoses.
Results: Among the suicide attempters, 93.9% (n = 46) were female, while 58.5% (n = 24) of the control group were female (χ2=16.131, p<0.001). More adolescents in suicide attempters had motor, cognitive and non-planning impulsivity problems, major depressive disorder, and family history of suicide attempt than in the control (p<0.05). Cognitive impulsivity, major depressive disorder, and family history of suicide were found to predict suicidality in logistic regression analyses. The mediation model reveals that effect of depression or family history of suicide on suicidality were not mediated through the severity of cognitive impulsivity.
Conclusion: Although cognitive impulsivity, depression, and family history of suicide directly enhance suicidality, the indirect path between depression/family history of suicide and suicidality were not mediated by cognitive impulsivity. This study provides a novel perspective on established risk factors that have been shown to predict suicide in adolescents and helps clarifying their role. Understanding multidimensional risk factors of suicide attempts might ultimately help to reduce completed suicide in adolescents.
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References
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