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Suicide has been identified consistently over the past decade as one of the leading causes of death in the United States. Between the years 2009-2011, suicide was estimated to be one of the top five leading causes of death for people between the ages of five and forty-four (Murphy, Xu, and Kochanek 2012).
Clinical populations are at an especially elevated risk for suicide (Ortigo, Westen, and Bradley 2009), and those with a history of suicide attempts are more likely to make an attempt than those with no suicidal history (Joiner et al. 2005).
Several studies have identified impulsivity as an important risk factor for suicide (e.g., Nock and Kessler 2006; Witte et al. 2008), although the exact role of impulsivity in the development of and capacity for suicidal behavior remains unclear. Hakansson et al. (2011) found that subjects who made multiple suicide attempts throughout their lifetime reported higher impulsivity-related traits, such as difficulty controlling anger and an inability to maintain concentration. However, Nakagawa et al. (2009) found that the level of planning for a recent suicide attempt was unrelated to trait levels of impulsivity—that is, individuals who attempted suicide with little forethought had similar levels of impulsivity compared to those who spent a significant amount of time planning their attempt.
Research has also shown that poor quality of object relations, defined as an internal understanding of the world and others that is poorly differentiated, illogical, or polarized in affective tone, is associated with psychiatric disturbance in several domains, including suicidal behavior (Twomey, Kaslow, and Croft 2000). Kaslow et al. (1998), for example, found that subjects with a recent suicide attempt demonstrated lower complexity and more malevolent affective quality of internal representations in comparison to subjects with no history of suicidal behavior, as well as a lower emotional investment in interpersonal relationships.
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