Impulsivity in Suicide Attempters: A Cross-sectional Study from a Teaching Hospital in India

Abstract

Introduction: Studies have consistently reported that a considerable proportion of suicide attempts are impulsive and unplanned. However, data on the characteristics of these impulsive attempters is still limited. The relationship between impulsive behaviour and suicide attempts can be thought of having two dimensions: a suicide attempt can be impulsive or not and the suicide attempter can have impulsive traits or not. The impulsiveness of many attempts and the fluctuating nature of suicidal thinking are of concern, as many prevention strategies rely on the early identification of either suicidal thoughts and/or plans. Aim: The present study was attempted to measure the intensity of the suicide attempt, and to assess the relationship of the suicide intent score with the three second order factors (Attention impulsiveness, motor impulsiveness, non planning impulsiveness) of impulsivity in Barratt Impulsiveness Scale to identify the pattern (if any) of suicidal intent before an impulsive attempt. Materials and Methods: This was a hospital based cross sectional study. Socio-demographic and clinical profile sheet which included different variables was completed on 72 attempters. Beck’s Suicide Intent Scale (SIS) was used to assess the severity of the intent in the patient and Barratt Impulsiveness Scale (BIS-11) was used to measure the personality construct of impulsiveness. Data entry and analysis was done using SPSS 20 statistical software and descriptive statistics, chi-square test, t-test were used to find significance across groups. Statistical significance was assumed at p<0.05. Results: Among the 72 attempters, 38 (52.8%) were male and 34 (47.2%) were females. Majority of the sample were illiterate 30 (42%), from a rural background 61 (84.7%), whose primary method of attempt was by ingestion of poison 51 (70.8%) due to family/ inter personal problems 43 (59.7%). The sample was divided based on their scores of suicide intent scale and the three second order factor scores of BIS. High suicide intent score was present in majority of the patients 35 (48.6%), and 14 (19.5%) patients had low suicide intent score. The mean scores of impulsivity were highest among the low suicide intent group, and were gradually decreasing as the intent of the attempt was increasing (from low to high) in the sub scales of attention impulsiveness (15.6±1.94) and non-planning impulsiveness (31.5±2.65) which suggests that low intent attempts may be impulsive acts. When individual suicidal intent groups were compared, a significant difference found between motor impulsiveness and non-planning impulsiveness within medium intent (p=0.043) and between attention impulsiveness and non-planning impulsiveness within high intent (p=0.012). Conclusion: There is a significant association between impulsivity and intent, and it is an important factor of suicide behaviour in suicide attempters.

Keywords

• impulsiveness
• non-planning
• poisoning
• suicide attempt