Suicide Attempts Are Associated With Personality Dimensions in Croatian War Veterans With Posttraumatic Stress Disorder

Abstract

Background: Patients with combat-related posttraumatic stress disorder (PTSD) have an increased frequency of suicideideations, but also a higher risk of suicide attempts. Of all the known predisposing risk factors of suicide attempts in this population,personality dimensions are one of the least investigated. The main aim of this study was to examine if personality traits, namelytemperament and character dimensions and trait impulsivity, are associated with suicide attempts in war veterans with PTSD.Subjects and methods: This sample included 178 Croatian male war veterans (mean age 49.20 years) treated for PTSD at theDepartment of Psychiatry and Psychological Medicine, University Hospital Center Zagreb. These patients were assessed with theM.I.N.I. diagnostic interview and they filled out several self-report scales: the Beck Depression Inventory-Second Edition (BDI-II),the Temperament and Character Inventory-Revised (TCI-R), the Barratt Impulsiveness Scale-11 (BIS-11), and the Satisfaction withLife Scale (SWLS).Results: It was found that 42 (24%) Croatian war veterans with PTSD had a previous suicide attempt. Comparison between thetwo groups (participants with vs. those without history of suicide attempts) revealed that patients with previous suicide attempts areless educated and more often unemployed, have a longer duration of psychiatric treatment and more psychiatric hospitalizations,and exhibit higher levels of depression and lower life satisfaction. In multivariate logistic regression analyses, temperamentdimension Harm Avoidance and character dimension Self-transcendence were unique predictors of suicide attempts, above theinfluence of age, education level and length of treatment.Conclusions: Croatian war veterans with PTSD have a substantial risk of suicide attempts. In addition to the role of somesociodemographic and clinical factors, it seems that certain personality dimensions are uniquely associated with suicide behavioursamong these individuals.