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Impulsivity and teen suicide

What does adolescence have to do with suicide risk?

A couple of weeks ago, I wrote about the Suicide Trigger Scale, a tool used to gauge feelings associated with suicide attempts. The goal of a tool like this one is to more accurate predict - and prevent - suicide attempts.

The research team at New York's Beth Israel Medical Center developing this scale made an important distinction between what's going on for people who are thinking about suicide and what happens for people who attempt suicide. Another research team at the University of British Columbia has also been trying to figure out what factors influence suicidal ideation and attempts.

E. David Klonsky and Alexis May published an article last year in the journal Suicide and Life-Threatening Behavior about a study of 2,500 military recruits (with an average age of 20) and 1,700 college and high school students.

What they found is that "a particular trait, the diminished ability to think through the consequences of one's behavior before acting, confers risk for suicidal behavior over and above the presence of suicidal thoughts."

I am really intrigued by this idea. It fits snugly next to the idea that the Suicide Trigger Scale team offered - that asking individuals about plans to attempt suicide isn't the only thing that's going to lead to more accurate predictions about suicide risk.

It's also incredibly important for people working with young people at risk for suicide. The inability to think through one's actions is a trait of adolescence - it's pretty much par for the course developmentally. So, for those who care about youth suicide prevention, the implications of this finding are for you.

Youth is a time of impulsivity. Understanding this particular piece of impulsivity might be a key to preventing youth suicide.

*Thanks to Dr. Klonsky, who clarified the findings of his research in a comment which you can read below. Just in case, though, and in the interest of translating research to practice correctly, I wanted to include his words up here, and I've edited the post to accurately reflect the research findings:

"The post states in part, "expressed suicidal thinking isn't as important as the ability to think about the consequences of a suicide attempt." This isn't quite what the study showed. When it comes to assessing suicide risk, suicidal thinking is probably more relevant than the ability to think through
consequence of an attempt. But, the question we addressed is this: once someone expresses suicidal thinking, what next? Most people who have suicidal thoughts don't make an attempt. So a key challenge is to identify what predicts a suicide attempt beyond the presence of suicidal thoughts, that is, what predicts transition from suicidal thoughts to a suicide attempt.

We found that a particular aspect of impulsivity -- diminished ability to think through consequences of one's actions -- was more common in those who had made suicide attempts than those who had only considered suicide. In other words, among those with suicidal thoughts, being high on this type of impulsivity increases the chances of progressing to an actual attempt. Notably, other aspects of impulsivity, such as sensation seeking and negative urgency (acting rashly in the face of negative emotions), did not distinguish those who attempted suicide from those who only considered suicide."

Copyright 2011 Elana Premack Sandler, All Rights Reserved

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