Characteristics of Impulsive Suicide Attempts and Attempters

Suicide and Life-Threatening Behavior (Impact Factor: 1.4). 11/2002; 32(Supplement to I):49 - 59. DOI: 10.1521/suli.


Suicide attempts often are impulsive, yet little is known about the characteristics of impulsive suicide. We examined impulsive suicide attempts within a population-based, case-control study of nearly lethal suicide attempts among people 13–34 years of age. Attempts were considered impulsive if the respondent reported spending less than 5 minutes between the decision to attempt suicide and the actual attempt. Among the 153 case-subjects, 24% attempted impulsively. Impulsive attempts were more likely among those who had been in a physical fight and less likely among those who were depressed. Relative to control subjects, male sex, fighting, and hopelessness distinguished impulsive cases but depression did not. Our findings suggest that inadequate control of aggressive impulses might be a greater indicator of risk for impulsive suicide attempts than depression.

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    • "The first principle is that moments of elevated suicide risk are often brief and fleeting. In a case-control study of 153 attempters, 24% decided to make an attempt less than 5 minutes before the event, and 70% less than an hour before (Simon et al., 2001). The short latency of risk is important because reducing risk during these brief periods has the potential for long-term effects as only 10% of individuals who make medically serious attempts make a subsequent attempt that results in death (Owens, Horrocks, & House, 2002). "
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    ABSTRACT: The restriction of potentially lethal means during periods of high risk has been identified as one of the more promising suicide prevention strategies. The purpose of this paper is to introduce clinicians to means restriction counseling and to describe a Motivational Interviewing (MI) based approach for use with ambivalent or challenging patients. This paper examines empirical support behind legislative efforts for means restriction along with the limitations. It explains the need for means restriction counseling with adults and requisite challenges. For patients who are reluctant, it describes an MI-based approach to means restriction counseling and provides a case example. By the end of the paper, readers should be aware of the potential importance of means restriction counseling and the possible use of an MI-based approach with challenging patients. Means restriction counseling is a promising clinical intervention for suicidal patients and research on MI-based and other approaches is sorely needed.
    Cognitive and Behavioral Practice 10/2014; DOI:10.1016/j.cbpra.2014.09.004 · 1.33 Impact Factor
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    • "First, suicidal acts are often impulsive. Miller and Hemenway cite the research by Simon et al. (2001) which shows that among individuals who made near-lethal suicide attempts, 24 % took <5 minutes between the decision to kill themselves and the actual attempt and 70 % took <1 hour. Impulsivity may lead some to grab a nearby gun and act on those impulses. "
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    ABSTRACT: Scholars and public health officials alike have expressed significant concern over the dramatic growth in suicide among young Black males. Work in this area has focused primarily on the 1980s and early 1990s as key evidence of this concern. In the current study, we use a longer time series from 1982 to 2001 to examine exactly what these suicide trends look like as well as how and why they vary across US cities. The findings show that trends are more complex than originally perceived, that despite an average national trend there is significant variation in suicide trajectories across cities, that the general rise in rates into the early 1990s was followed by a substantial decline by the turn of the century, and that concentrated disadvantage and gun availability emerge as important predictors of differences in trends across cities.
    Journal of African American Studies 03/2014; 18(1). DOI:10.1007/s12111-013-9256-3
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    • "Some authors reported evidence of higher levels of impulsivity in individuals who died by suicide than those who did not [28] [36] whereas others found that although people who attempt suicide tend to be more impulsive than people who do not, the actual act of completed suicide is often not made impulsively (e.g., Anestis et al. 37]). Simon et al. [38] reported that only 24% of survivors of near-lethal suicide attempts had thought about their attempt for less than 5 minutes. Those who made their attempt within 5 minutes of deciding to do so were less likely to have considered another method of suicide. "
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    ABSTRACT: Unbearable mental pain, depression, and hopelessness have been associated with suicidal behavior in general, while difficulties with social communication and loneliness have been associated with highly lethal suicide attempts in particular. The literature also links aggression and impulsivity with suicidal behavior but raises questions about their influence on the lethality and outcome of the suicide attempt. To evaluate the relative effects of aggression and impulsivity on the lethality of suicide attempts we hypothesized that impulsivity and aggression differentiate between suicide attempters and non-attempters and between medically serious and medically non-serious suicide attempters. The study group included 196 participants divided into four groups: 43 medically serious suicide attempters; 49 medically non-serious suicide attempters, 47 psychiatric patients who had never attempted suicide; and 57 healthy control subjects. Data on sociodemographic parameters, clinical history, and details of the suicide attempts were collected. Participants completed a battery of instruments for assessment of aggression-impulsivity, mental pain, and communication difficulties. The medically serious and medically non-serious suicide attempters scored significantly higher than both control groups on mental pain, depression, and hopelessness (p<.001 for all) and on anger-in, anger-out, violence, and impulsivity (p<.05 for all), with no significant difference between the two suicide attempter groups. Medically serious suicide attempters had significantly lower self-disclosure (p<.05) and more schizoid tendencies (p<.001) than the other three groups and significantly more feelings of loneliness than the medically non-serious suicide attempters and nonsuicidal psychiatric patients (p<.05). Analysis of aggression-impulsivity, mental pain, and communication variables with suicide lethality yielded significant correlations for self-disclosure, schizoid tendency, and loneliness. The interaction between mental pain and schizoid traits explained some of the variance in suicide lethality, over and above the contribution of each component alone. Aggression-impulsivity and mental pain are risk factors for suicide attempts. However, only difficulties in communication differentiate medically serious from medically non-serious suicide attempters. The combination of unbearable mental pain and difficulties in communication has a magnifying effect on the risk of lethal suicidal behavior.
    Comprehensive psychiatry 10/2013; 55(1). DOI:10.1016/j.comppsych.2013.09.003 · 2.25 Impact Factor
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