Personality Subtypes of Adolescents Who Attempt Suicide

Abstract

Research suggests that personality pathology is shared among a considerable portion of adolescents presenting suicidal behavior. Furthermore, heterogeneity of personality within this population suggests a need to tease apart different types of attempters. The goal of this study was to identify the personality subtypes of adolescents who attempt suicide. We analyzed data on 266 adolescents, ages 13 to 18 years, with a history of at least one suicide attempt who were selected by treating clinicians for having at least some degree of personality problems. We used a Q-factor analysis to identify subtypes based on the Shedler-Westen Assessment Procedure-II for Adolescents (a 200-item measure of personality pathology used by clinically experienced observers). We derived six subtypes: Externalizing, Internalizing, Emotionally dysregulated, High functioning, Narcissistic, and Immature. The subtypes differed on measures of adaptive functioning, axis I and II pathology, and etiology. Adolescents who attempt suicide constitute a heterogeneous group, and they vary meaningfully on a measure of personality pathology. Interventions targeting suicidal behaviors in adolescents should consider individual differences.

Discrete Subgroups of Adolescents Diagnosed With Borderline Personality Disorder: A Latent Class Analysis of Personality Features

“…The expression of the two subgroups in this sample was definitely gendered, replicating findings that externalizing problems are more common among male patients and internalizing problems are predominant among female patients (Bradley et al, 2005;Cross, Westen, & Bradley, 2011). These results can be framed using the hypothesis put forward by Beauchaine, Klein, Crowell, Derbidge, and Gatzke-Kopp (2009), which suggests that the internalizing and externalizing spectra are associated with both antisocial personality disorder (ASPD) and BPD in adulthood, reflecting multifinal outcomes of a single etiology.…”

Suicidal Ideation and Sex Differences in Relation to 18 Major Psychiatric Disorders in College and University Students

“…Finally, previous investigators have noted that suicide ideation and attempts can occur without high levels of depression (Arria et al, 2009a;Levy and Deykin, 1989;Schilling et al, 2009), that suicide can occur without the presence of psychiatric disorder (Eisenberg et al, 2013;Keyes et al, 2012), and that suicide phenomenology is best conceptualized as a separate syndrome, with its own dedicated characterization, that can exist comorbidly with other conditions (Ahrens et al, 2000;Cross et al, 2011;Hawkins and Cougle, 2013;Panagioti et al, 2012b). These considerations argue for the importance of elucidating the underpinnings of suicide as a unique psychopathological entity that either independently or in combination with other psychiatric symptoms may increase the risk for mortality (Gonda et al, 2012).…”

Pathological Narcissism and Nonsuicidal Self-Injury

“…Further, the presence of comorbid depression is associated with an increased risk of suicide for individuals with NPD (Conner et al, 2001;Heisel, Links, Conn, van Reekum, & Flett, 2007). However, it is important to note that narcissistic individuals are at heightened risk for suicide even when not clinically depressed (Cross, Westen, & Bradley, 2011;Links, 2013;Ronningstam & Maltsberger, 1998;Ronningstam, Weinberg, & Malstberger, 2008). Moreover, NPD is associated with suicide attempts characterized by lower impulsivity but higher expected lethality (Blasco-Fontecilla et al, 2009), and these attempts tend to be associated with certain life stressors/changes (e.g., being fired from a job, having more arguments with a spouse; Blasco- Fontecilla et al, 2010).…”