"Impulsive" youth suicide attempters are not necessarily all that impulsive.
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.


METHODS
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.


CONCLUSIONS
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.
Witte
Tracy K
TK
Department of Psychology, Florida State University, FL 32306-1270, USA. witte@psy.fsu.edu
Merrill
Katherine A
KA
Stellrecht
Nadia E
NE
Bernert
Rebecca A
RA
Hollar
Daniel L
DL
Schatschneider
Christopher
C
Joiner
Thomas E
TE
D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D002423:Cause of Death; D002648:Child; D015897:Comorbidity; D003625:Data Collection; D005260:Female; D006801:Humans; D007175:Impulsive Behavior / Q000175:diagnosis* / Q000523:psychology; D033182:Intention; D008297:Male; D018570:Risk Assessment; D012309:Risk-Taking; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology; D013405:Suicide / Q000706:statistics & numerical data; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology