The mediating role of non-suicidal self-injury in the relationship between impulsivity and suicidal behavior among inpatients receiving treatment for substance use disorders.
Several theories posit a direct role of impulsivity in suicidal behavior. The interpersonal-psychological theory of suicidal behavior (IPTS) argues that the relationship between impulsivity and suicidal behavior is explained by the painful and/or provocative experiences (PPEs) often encountered by impulsive individuals. It thus seems plausible that nonsuicidal self-injury (NSSI), itself associated with impulsivity, might account for the relationship between impulsivity and suicidal behavior. We examined data from 93 adult inpatients (54.8% male) seeking treatment for substance use disorders. Patients completed a structured interview assessing prior suicidal behavior and a series of self-report questionnaires examining impulsivity, NSSI, and psychopathology. Four impulsivity dimensions (negative urgency, positive urgency, lack of premeditation, lack of perseverance) were associated with lifetime number of suicide attempts and/or suicide potential. Furthermore, results supported our hypotheses, as all but one relation was better accounted for by NSSI and, in the one exception, the direct effect was non-significant. Findings are consistent with the IPTS and suggest that suicidal behavior may not be a direct manifestation of impulsivity, but facilitated through exposure to PPEs capable of altering an individual׳s relationship to pain and fear of death.
Department of Psychology, The University of Southern Mississippi, Hattiesburg, MS, USA. Electronic address: michael.anestis@usm.edu.
Michael D
MD
Anestis
Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA.
Matthew T
MT
Tull
Neuropsychiatric Research Institute, Fargo, ND, USA; University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA.
Jason M
JM
Lavender
Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA.
Kim L
KL
Gratz
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007175:Impulsive Behavior; D007297:Inpatients / Q000523:psychology; D008297:Male; D008875:Middle Aged; D057566:Self Report; D016728:Self-Injurious Behavior / Q000523:psychology*; D019966:Substance-Related Disorders / Q000523:psychology / Q000628:therapy*; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult
Impulsivity; Non-suicidal self-injury; Suicide