Symposia
Suicide and Self-Injury
Rebecca G Fortgang, Ph.D.
Postdoctoral Fellow
Harvard University
Cambridge, Massachusetts
Daniel Coppersmith, M.A.
PhD Candidate
Harvard University
CAMBRIDGE, Massachusetts
Alexander Millner, Ph.D.
Research Associate
Harvard University
Cambridge, Massachusetts
Evan M. Kleiman, PhD
Assistant Professor
Rutgers, The State university of new jersey
Piscataway, New Jersey
Matthew Nock, Ph.D.
Professor
Harvard University
Cambridge, Massachusetts
Theories of suicide suggest that it often occurs in response to strong suicidal urges that become difficult to resist. Accordingly, impulsivity (i.e., tendency to make decisions in accord with momentary urges and impulses rather than control them and prioritize future outcomes) has long been considered a risk factor for suicide. Prior work on this topic has primarily used single-time-point retrospective assessments. This is limited in what it can tell us because both impulsivity and suicidal urges fluctuate substantially over time. It is unclear whether impulsivity is only related to suicide at a between-person level, or whether within-person variation is relevant to suicide risk. Use of mobile technology for real-time intensive longitudinal monitoring permits this question to be directly interrogated. We investigated these associations using multilevel modeling at the momentary and day level in 108 participants with past-week suicidal thinking, recruited online for a 42-day smartphone monitoring study with 5x/daily random surveys assessing state impulsivity and suicidal thinking and one interval-contingent survey at night assessing the prior day’s impulsivity and suicidal thinking (total completed assessments = 9,771). At the momentary level, we found state impulsivity was significantly associated with stronger suicidal urges, reduced ability to resist, and higher intent (all associations significant at p< .001). At the daily level, we similarly found that daily impulsivity was significantly associated with daily strength of suicidal urges and intent and reduced ability to resist, and likelihood of having a suicide plan (all associations significant at p< .001). Taken together, these results suggest a within-person association between elevations in impulsivity and suicide risk and indicate that when individuals experience a more impulsive decision-making style, they may be at greater short-term risk for suicidal thinking.