Personality traits as prospective predictors of suicide attempts.
OBJECTIVE
To examine higher order personality factors of negative affectivity (NA) and disinhibition (DIS), as well as lower order facets of impulsivity, as prospective predictors of suicide attempts in a predominantly personality disordered sample.


METHODS
Data were analyzed from 701 participants of the Collaborative Longitudinal Personality Disorders Study with available follow-up data for up to 7 years. Cox proportional hazards regression analyses was used to examine NA and DIS, and facets of impulsivity (e.g. urgency, lack of perseverance, lack of premeditation and sensation seeking), as prospective predictors of suicide attempts.


RESULTS
NA, DIS and all facets of impulsivity except for sensation seeking were significant in univariate analyses. In multivariate models which included sex, childhood sexual abuse, course of major depressive disorder and substance use disorders, only NA and lack of premeditation remained significant in predicting suicide attempts. DIS and the remaining impulsivity facets were not significant.


CONCLUSIONS
NA emerged as a stronger and more robust predictor of suicide attempts than DIS and impulsivity, and warrants greater attention in suicide risk assessment. Distinguishing between facets of impulsivity is important for clinical risk assessment.
Yen
S
S
Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI 02906, USA. shirley_yen_phd@brown.edu
Shea
M T
MT
Sanislow
C A
CA
Skodol
A E
AE
Grilo
C M
CM
Edelen
M O
MO
Stout
R L
RL
Morey
L C
LC
Zanarini
M C
MC
Markowitz
J C
JC
McGlashan
T H
TH
Daversa
M T
MT
Gunderson
J G
JG
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010554:Personality Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D012720:Severity of Illness Index; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data*; D055815:Young Adult