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Distinguishing suicide attempters from suicide ideators May, Alexis Merry

Abstract

Suicidal ideations and attempts are a major public health problem. Most known risk factors predict suicidality overall, rather than attempt or ideation specifically. Limited research has investigated risk factors that distinguish individuals who attempt suicide from individuals who only think about suicide. Existing demographic, psychological, personality, and sociodemographic risk factors were investigated in 3 samples using validated questionnaires and structured interviews. Cross-sectional data was gathered from 1,348 college students and 2,011 military recruits. Ten-year longitudinal data was gathered from 49 clinically depressed adults. Results from the cross-sectional samples (college students and military recruits) suggest that most risk factors for suicidality do not differentiate attempters from ideators. Risk factors that did appear associated with attempts over ideation were female gender, non-suicidal self-injury, amphetamine use, and a domain of impulsivity - lack of premeditation. Among women, the personality trait of manipulativeness was associated with ideation over attempts. Results from the longitudinal sample (depressed adults) suggest that co-morbid personality disorders, co-morbid anxiety disorders, co-morbid substance use disorders, social adjustment difficulties, and a poor maternal relationship predict suicide attempts in the next 10 years among suicide ideators. Co-morbid personality disorder, especially in Cluster B, appear to be the strongest predictors of attempts in the depressed ideating sample. Further research is needed to replicate these findings and identify further unique predictors of suicide attempts among ideators. This will aid in suicide risk assessment and the development of a comprehensive theory of suicidality.

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