Suicidality and Personality Pathology in Adolescence: A Systematic Review

Abstract

This work presents a review of research papers examining the role of emerging personality pathology in suicidal ideation and behaviours in adolescence. Initially, 226 studies were selected in line with PRISMA guidelines, and 33 articles were finally included in this review. The data show percentages of any personality disorder diagnosis ranging from 19.5 to 22.8% in suicide attempters, while in autopsy studies, the rate of personality disorder diagnosis varied between 29.6 and 42.1%. The overwhelming majority of the studies focus on the role of borderline personality disorder (BPD) in suicidal behaviours, also highlighting its predictive role at a longitudinal level. Furthermore, the literature review shows that personality traits supposed to underlie BPD, such as affective instability, impulsivity and identity diffusion, have specific predictive links with suicidal conduct. Other personality pathology dimensions, such as aggressiveness, sadism and perfectionism that are associated with other personality disorders, namely, antisocial and narcissistic personality disorders, have also shown a significant mediating role for suicidal risk. Overall, these results seem to parallel the role of personality pathology in predicting suicide in adulthood and point to the relevance of assessing the presence of emerging patterns of personality disorders for the clinical management of suicidal risk in adolescence.

A Pre-Adolescent and Adolescent Clinical Sample Study about Suicidal Ideation, Suicide Attempt, and Self-Harming

“…This result is consistent with most published studies showing that suicidal behavior is associated with a higher number of hospitalizations, mainly due to suicidality or affective disorders: these data may indicate greater severity of the clinical condition, fewer personal and family resources, and probably a lower response to therapy [ 11 ]. Moreover, the finding about borderline personality functioning aligns with the literature that supports the association between borderline personality functioning/disorder and suicidal attempt in adolescence [ 86 , 87 , 88 , 89 ].…”

“…NSSI, suicidal ideation, and suicide attempt share several risk factors, psychiatric comorbidity, and high prevalence in young people. At a symptomatological and psychopathological level, the main risk factors associated with suicidal and nonsuicidal self-harm are impulsiveness [ 32 , 33 , 58 , 59 ], alexithymia [ 60 , 61 , 62 , 63 , 64 ]—considered a transdiagnostic risk factor [ 65 , 66 , 67 , 68 ]—somatic problems [ 69 , 70 , 71 , 72 , 73 , 74 , 75 ], emotion dysregulation [ 76 , 77 , 78 , 79 , 80 ], affective disorders [ 81 , 82 , 83 , 84 , 85 ], borderline functioning and borderline personality disorder [ 86 , 87 , 88 , 89 ]. However, it seems still unclear what differences exist in the psycho-behavioral profiles of patients with both suicidal ideation/attempt and NSSI.…”

From a Symptom-Based to a Person-Centered Approach in Treating Depressive Disorders in Adolescence: A Clinical Case Formulation Using the Psychodynamic Diagnostic Manual (PDM-2)’s Framework

“…The diffuse state of irritability and aggressive impulses are described as appearing at the beginning of adolescence and experienced as an unbearable condition that he experiences as meaningless and makes him feel out of control. Notably, the suicidal ideation is mild in intensity and not recurrent; it intensified by conditions of social isolation due to the lock-down or to more conspicuous external frustrations (with peers or in the context of school) that are experienced as irreparable personal failures in peculiar personological functioning [60].…”

Text-Based Automatic Personality Prediction Using KGrAt-Net; A Knowledge Graph Attention Network Classifier

“…Indeed, the personality of people has a substantial influence on their lives. Several psychological investigations have been carried out to demonstrate the influence of personality on various aspects of human life; for instance decision making [29], innovativeness and satisfaction with life [30], good citizenship and civic duty [31], romantic relationship [32], forgiveness [33], consumers' behaviors [34], job performance [35], antisocial online behaviors [36], suicidality [37], getting a pandemic like COVID-19 [38], and many others. They are fundamentally established to understand and appraise individual personality differences that characterize people, for a variety of purposes during receiving psychotherapy services [39].…”