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UBC Theses and Dissertations

The relationship of self-reported executive functioning to suicidal ideation and suicide attempts Saffer, Boaz Y.


Introduction: Suicide has a devastating impact on individuals and communities worldwide yet few risk few factors reliably predict future suicide attempts. A growing body of research suggesting that that risk factors commonly associated with suicide (such as depression) are more predictive of suicidal thoughts, not suicidal acts – an important distinction since most people who think about suicide do not act on their thoughts. Executive functioning abilities mediate the relationship between thoughts and behaviours and therefore might be uniquely implicated in the progression from suicidal thoughts to suicidal acts. Our study examined whether two multidimensional measures of executive functioning differentiated those with a history of suicidal ideation from those with a history of suicide attempts using an online platform. Participants and Methods: Five-hundred and seventy seven participants (Mean age=34.6, SD=11.6) participated in study. Participants were divided into five groups based on lifetime, greater than past-12 month, and past-12 month histories of suicide ideation and suicide attempts: nonsuicidal (n=180), non-recent ideation (n=136), recent ideation (n=61), non-recent attempts (n=103), recent attempts (n=21). Executive functioning (EF) was measured using the Behavioural Rating Inventory of Executive Functions – Adult Version (BRIEF-A) and the Frontal Systems Behaviour Scale (FrSBe). Several covariates including impulsivity and other known suicide risk factors and potential confounds were also assessed. Results: Moderate to large differences (d range=.53-1.08) in executive functioning were obtained comparing recent attempters to recent ideators. Attempters and ideators differed most on the FrSBe disinhibition scale (d=1.08), BRIEF Behaviour Regulation Index (d=1.02), and BRIEF-A Global Executive Composite (d=1.01), with attempters reporting worse executive functioning. Interestingly, comparing lifetime attempters to ideators as well as non-recent attempters to ideators revealed only weak to small differences (d range=.11-.38 and .03 – .3, respectively). This pattern remained robust when controlling for covariates. Discussion: Lifetime attempters and ideators did not meaningfully differ on self-reported executive functioning. Executive functioning did, however, clearly differentiate recent attempters from recent ideators suggesting that impaired executive functioning might represent an important state risk factor for suicide attempts. However, findings may also represent a reporting bias, and it will be important for future studies to utilize prospective designs.

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