Personality Disorder, Personality Traits, Impulsive Violence, and Completed Suicide in Adolescents

Allegheny County Coroner's Office.
Journal of the American Academy of Child & Adolescent Psychiatry (Impact Factor: 7.26). 11/1994; 33(8):1080-6. DOI: 10.1097/00004583-199410000-00003
Source: PubMed


This study was designed to assess the association between personality disorders, personality traits, impulsive violence, and suicide.
Personality disorders and traits in 43 adolescent suicide victims and 43 community controls were assessed from the parents, using semistructured interviews and self-report forms.
Probable or definite personality disorders were more common in suicide victims than in controls, particularly Cluster B (impulsive-dramatic) and C type (avoidant-dependent) disorders. Suicide victims also showed greater scores on lifetime aggression, even after controlling for differences in psychopathology between suicides and controls.
Personality disorders and the tendency to engage in impulsive violence are critical risk factors for completed suicide.

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    • "Accordingly, the prevention of suicide in youth demands a focus on the understanding and prevention of SA. Prior suicidal behavior, depression, and externalizing psychopathology (e.g., impulsive aggression, alcohol and drug use disorders, conduct problems) confer risk for SA and suicide during adolescence (Brent, Johnson, Perper et al., 1994; Fergusson, Woodward, & Horwood, 2000; Gould, King, Greenwald et al., 1998; Shaffer, Gould, Fisher et al., 1996). It has been argued that models of suicidal behavior during youth must account for the potential transmission of such risk factors from parents to offspring (Brent & Mann, 2006). "
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    ABSTRACT: Parents with psychopathology such as alcohol use disorder (AUD) that confers risk for suicide attempt (SA) may have children who are more likely to develop such psychopathology and to attempt suicide, suggesting that risk may be "transmitted" from parents to children. We examined this phenomenon during the transition from childhood to adolescence, when risk for SA increases dramatically. A cohort of 418 children were examined at average age 9.4 (range 7-14) years at enrollment (Time 1, childhood) and approximately five years later, prior to reaching age 18 (Time 2, adolescence). One or both biological parents, oversampled for AUD, were also interviewed. Structural equation models (SEM) examined father-child, mother-child, and either/both parent-child associations. The primary outcome was SA over follow-up among offspring, assessed at Time 2. As hypothesized, parental antisocial personality disorder predicted conduct disorder symptoms in offspring both during childhood and adolescence (parent-child model, father-child model) and maternal AUD predicted conduct disorder symptoms during childhood (mother-child model). However, we did not find evidence to support transmission of depression from parents to offspring either during childhood or adolescence, and parent psychopathology did not show statistically significant associations with SA during adolescence. In conclusion, we conducted a rare study of parent-to-child "transmission" of risk for SA that used a prospective research design, included diagnostic interviews with both parents and offspring, and examined the transition from childhood to adolescence, and the first such study in children of parents with AUD. Results provided mixed support for hypothesized parent-child associations.
    Archives of suicide research: official journal of the International Academy for Suicide Research 04/2014; 18(2). DOI:10.1080/13811118.2013.826154
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    • "In addition, a small body of research has established that violence and suicide are strongly correlated (Lubell and Vetter 2006). An empirical relationship has been demonstrated between aggressiveness and suicide (e.g., Plutchik 1995; see also Dumais et al. 2005; Lester 2000:325–32); severe dating violence and attempted suicide (Coker et al. 2000); attacking someone with a knife or shooting at someone and suicide potential (i.e., " I want to hurt/kill myself " ) (Flannery, Singer, and Wester 2001); fighting and attempted suicide (Swahn, Lubell, and Simon 2004); impulsive violence and completed suicide (Brent et al. 1994); and sexual violence and suicide risk (Borowsky et al. 1997). Research has also shown that the strength of the association between violence and suicide increases as suicidal behavior increases in severity from ideation to attempt and completion (e.g., Garrison et al. 1993). "
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    ABSTRACT: Although interpersonal violence and suicide are two of the leading causes of death among young Americans, analyses focusing simultaneously on violence and suicide in sociological inquiry are sparse. Analyses also tend to be limited by their focus on either the individual-level predictors of suicidal behaviors or the aggregate-level predictors of suicide rates, despite the recognition that psychological and sociological forces contribute independently as well as interactively to facilitate suicide. To address these issues, I use data from the Project on Human Development in Chicago Neighborhoods (PHDCN) to examine the direct and moderating effects of individual- and neighborhood-level violence on attempted suicide. Estimates from hierarchical logistic regression models indicate that individual acts of violent aggression, but not neighborhood levels of violence, increase the likelihood of attempting suicide. Furthermore, the well-established relationship between depression and attempted suicide is conditioned by individual- and neighborhood-level violence, such that the effect of depression is (1) amplified for individuals living in neighborhoods characterized by violence and (2) attenuated for individuals engaging in violent behavior. Finally, the combined effect of neighborhood violence and individual violent aggression on the depression/suicide relationship is greater than the partial moderating effects of these variables.
    Social Problems 08/2013; 60(3):357-382. DOI:10.1525/sp.2013.60.3.357 · 1.23 Impact Factor
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    • "We believed that violent offenders may be more prone to killing themselves using guns and knives, as many of these individuals are in possession or have ready access to these weapons. We also reasoned that they would have a greater propensity for taking their lives impulsively without foresight or planning (Brent et al., 1994; Conner, 2004; Gvion and Apter, 2011; McGirr et al., 2008; Turecki, 2005; Zouk et al., 2007), using especially violent methods such as jumping from a height or in front a train, or deliberately crashing a motor vehicle. These methods, along with self-inflicted fatal injuries using a weapon, also tend to be the most painful or disfiguring (Cooper and Milroy, 1994). "
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    ABSTRACT: BACKGROUND: Gaining a greater knowledge of the mechanisms and means by which violent offenders die by suicide can inform tailored preventive strategies. METHODS: Using interlinked national Danish registry data we constructed a nested case-control study dataset of all adult suicides during 1994-2006: N=9708 cases and N=188,134 age and gender matched living controls. Completely ascertained International Classification of Diseases 10th revision cause-specific mortality codes were examined, with all criminal charges since 1980, and covariate information on psychiatric treatment and socio-demographics. Self-poisonings were classified as 'nonviolent' suicide and all other methods as being 'violent' ones. RESULTS: Compared with the general population, risk among male and female violent offenders was strongly and significantly elevated for suicide by either a violent or a nonviolent method, although the relative risk was greater for nonviolent suicide. These patterns were also observed among nonviolent offenders, albeit with smaller effect sizes. Risk was especially raised for self-poisoning with narcotics & hallucinogens. We could only examine the full range of suicide methods in male violent offenders. In these men, hanging was the most frequently used method, although risk was markedly and significantly elevated virtually across the entire range of regularly used suicide methods. LIMITATIONS: We lacked sufficient statistical power for undertaking a detailed profiling of specific suicide methods among female violent offenders. CONCLUSIONS: Our findings indicate that comprehensive and broadly-based preventive approaches are needed for tackling the markedly raised risk of suicide by both violent and nonviolent means in this population. Their high relative risk for self-poisoning by illicit or illegal drugs underlines the importance of access to means and of prevailing subculture.
    Journal of Affective Disorders 05/2013; 150(2). DOI:10.1016/j.jad.2013.04.001 · 3.38 Impact Factor
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