Suicidal behavior and aggression-related disorders
Section snippets
Intermittent explosive disorder and suicidal behavior
Intermittent explosive disorder (IED) is the only disorder for which excessive levels of aggressive behavior is a required for receiving the diagnosis. Within IED, excessive aggression is defined as frequent (two or more times a week, on average, over three months) acts of minor aggression in excess of provocation that does not cause physical harm, and/or less frequent (three or more acts in a year) acts of major aggression in excess of provocation that does cause physical harm [6]. IED is a
Borderline personality disorder and suicidal behavior
Borderline personality disorder (BPD) is a serious, chronic psychological disorder that affects approximately 1–2% of individuals in the community [16] and up to 20% of psychiatric inpatient samples [17]. Marked by an unstable self-concept and affective dysregulation, BPD is one of the psychological disorders most associated with suicidal behavior. Anywhere from 50% to 90% of BPD clients report engaging in suicidal behavior at some point [18], with up to 10% of individuals with BPD committing
Antisocial personality disorder and suicidal behavior
Aggression, specifically repeated physical assaults, is also a part of the criteria set for antisocial personality disorder (ASPD). Characterized by aggressiveness, impulsiveness, lack of social conformity and disregard for others, individuals with ASPD self-report high levels of aggression and display higher levels of aggressive responding on laboratory tasks (e.g. [35]). These individuals also demonstrate high rates of violent crime, with ASPD present in almost 50% of the prison population [36
Conduct disorder and suicidal behavior
Conduct disorder (CD) is the childhood disorder most associated with aggression, with bullying, physical fights, and use of a weapon representing three of the 15 possible CD symptoms [6]. Conduct disorder is also a required precursor to ASPD [6] and the presence of CD is significantly associated with adult aggression and other antisocial behavior (e.g. substance abuse), as well as educational problems, especially among those with callous-unemotional traits [45].
Several studies have shown a
Conclusions
As expected, aggressive disorders do appear to convey increased suicidal risk. The evidence is strongest for suicide attempts, with IED, BPD and CD all showing increased risk of suicide attempts independent of comorbid psychopathology, with more mixed findings among those with ASPD. Aggression-related disorders were also associated with completed suicide, with suicide rates in ASPD and BPD at approximately 5% and 10% respectively [19, 40], though studies on suicide mortality risk in IED are
Conflict of interest statement
Nothing declared.
References and recommended reading
Papers of particular interest, published within the period of review, have been highlighted as:
• of special interest
•• of outstanding interest
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Gender differences in the predictive effect of depression and aggression on suicide risk among first-year college students
2023, Journal of Affective DisordersAssociation between childhood physical abuse and suicidal behaviors among Chinese adolescents: The mediation of aggression
2022, Journal of Affective DisordersCitation Excerpt :Therefore, more research is needed to examine the effect of CPA on facilitating whole process of suicidal behaviors. In addition to CPA, recent theories suggest that aggression may increase one's ability to enact lethal self-injury (Gvion, 2018; McCloskey and Ammerman, 2018). Aggression is a psycho-behavioral symptom defined as overt, often harmful, social interaction, which intend to inflict damage or other unpleasantness on another people (Anderson and Bushman, 2002).
Sex differences in suicidal behaviors and aggression in US Veterans
2021, Psychiatry ResearchAssociations of plasma androgens with suicidality among men and women: A 9-year longitudinal cohort study: Associations of androgens with suicidality
2020, Journal of Affective DisordersCitation Excerpt :It has been hypothesized that besides the suggested direct effect of testosterone on suicidality, reactive aggression mediates this association (Lenz et al., 2019). This follows from studies that showed increased rates of suicidality among those with aggressive traits (McCloskey and Ammerman, 2018; Turecki and Brent, 2016), and from studies that showed -though more consistently in other primates than humans- associations between androgen levels and aggression (Archer et al., 2004; Carré et al., 2011; Coccaro, 2017). The revised Leiden Index of Depression Sensitivity (LEIDS-R) measures cognitive changes that may occur during depressed mood (for the purpose of this paper, reactive aggression will refer to aggressive cognitive reactivity) (Solis et al., 2017).
Interactions of the GABRG2 polymorphisms and childhood trauma on suicide attempt and related traits in depressed patients
2020, Journal of Affective DisordersCitation Excerpt :Aggression can predict depression after 7-years follow-up (Blain-Arcaro and Vaillancourt, 2017). Aggression is commonly related with suicidal behavior (McCloskey and Ammerman, 2018). A possible reason for the discrepancy in findings with results from our present study is the adjusted p-value cutoff set at 0.01, which combined with the relatively modest sample size of this study, limits the power to detect smaller effect sizes.
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Both authors contributed equally to this article.