title: Personality disorder risk factors for suicide attempts over 10 years of follow-up.
abstract: Identifying personality disorder (PD) risk factors for suicide attempts is an important consideration for research and clinical care alike. However, most prior research has focused on single PDs or categorical PD diagnoses without considering unique influences of different PDs or of severity (sum) of PD criteria on the risk for suicide-related outcomes. This has usually been done with cross-sectional or retrospective assessment methods. Rarely are dimensional models of PDs examined in longitudinal, naturalistic prospective designs. In addition, it is important to consider divergent risk factors in predicting the risk of ever making a suicide attempt versus the risk of making an increasing number of attempts within the same model. This study examined 431 participants who were followed for 10 years in the Collaborative Longitudinal Personality Disorders Study. Baseline assessments of personality disorder criteria were summed as dimensional counts of personality pathology and examined as predictors of suicide attempts reported at annual interviews throughout the 10-year follow-up period. We used univariate and multivariate zero-inflated Poisson regression models to simultaneously evaluate PD risk factors for ever attempting suicide and for increasing numbers of attempts among attempters. Consistent with prior research, borderline PD was uniquely associated with ever attempting. However, only narcissistic PD was uniquely associated with an increasing number of attempts. These findings highlight the relevance of both borderline and narcissistic personality pathology as unique contributors to suicide-related outcomes.
authors.affiliation: Department of Psychiatry, Yale University School of Medicine.
authors.forename: Emily B
authors.initials: EB
authors.lastname: Ansell
authors.affiliation: Department of Psychology, University of Pittsburgh.
authors.forename: Aidan G C
authors.initials: AG
authors.lastname: Wright
authors.affiliation: Department of Psychiatry, Columbia University College of Physicians and Surgeons.
authors.forename: John C
authors.initials: JC
authors.lastname: Markowitz
authors.affiliation: Department of Psychology, Wesleyan University.
authors.forename: Charles A
authors.initials: CA
authors.lastname: Sanislow
authors.affiliation: Department of Psychology, Michigan State University.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Hopwood
authors.affiliation: Department of Psychiatry, Harvard Medical School.
authors.forename: Mary C
authors.initials: MC
authors.lastname: Zanarini
authors.affiliation: Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University.
authors.forename: Shirley
authors.initials: S
authors.lastname: Yen
authors.affiliation: Department of Psychiatry, Columbia University College of Physicians and Surgeons.
authors.forename: Anthony
authors.initials: A
authors.lastname: Pinto
authors.affiliation: Department of Psychiatry, Yale University School of Medicine.
authors.forename: Thomas H
authors.initials: TH
authors.lastname: McGlashan
authors.affiliation: Department of Psychiatry, Yale University School of Medicine.
authors.forename: Carlos M
authors.initials: CM
authors.lastname: Grilo
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009289:Narcissism; D010554:Personality Disorders / Q000523:psychology*; D012307:Risk Factors; D013406:Suicide, Attempted / Q000523:psychology*; D055815:Young Adult