Self-regulation in adults with intermittent explosive disorder and a history of suicide attempts

Abstract

Both suicide attempts and aggression aim to cause harm and are associated with numerous personal and societal consequences but differ on intended targets. Aggression towards others is associated with increased risk of suicidal behavior. Research has demonstrated commonalities with impulsiveness and affect regulation for both. This study's purpose was to compare self-regulation between those meeting criteria for a psychiatric condition characterized by unplanned aggression (intermittent explosive disorder [IED]), a lifetime history of a suicide attempt (SA), and those with both (IED + SA), as well as compared to participants meeting criteria for non-aggressive psychopathology (PC) or no psychiatric disorder (HC). Adult community participants (n = 735) completed diagnostic assessments and self-report measures on suicidal behaviors, aggression, trait anger, impulsivity, and affect regulation as part of a larger aggression research program. Pairwise comparisons found IED + SA was associated with the highest scores on all outcome variables except compared to IED on anger. IED had higher aggression and anger scores than SA but did not differ on general impulsivity and affect regulation scores. PC did not differ from SA on anger or from IED and SA on affect regulation; PC scored lower on aggression and anger than IED + SA and IED. HC scored lowest on all variables. Such results imply IED with past suicidal behavior may be associated with heightened self-regulation difficulties overall compared to IED alone and non-aggressive psychopathology. Future research may build upon this by further recruiting for both unplanned aggression and suicidal behavior, as well as including comparisons with other impulsivity-related diagnoses.