Lewis, Katie (5/14) The relationship between personality organization, object relations, impulsivity, and suicidal behavior (Kevin B. Meehan, Ph.D.; Philips S. Wong, Ph.D.; Nicole M. Cain, Ph.D.)
While empirical research on suicide has focused on population-based risk factors, the successful prediction of suicide in specific individuals has remained a difficult task. Contemporary theories have improved upon risk factor research by highlighting the connections between precipitating stressors and personality functioning; however, these theories remain limited in their assumption that all suicidal individuals are equally vulnerable to the same sources of psychological trauma. The present study hypothesized that specific risk factors for suicide would operate differentially depending on broader personality style. Subjects included 131 patients currently undergoing intensive psychodynamic residential treatment. Multiple regression analyses revealed that impairments in object representations were associated with more frequent past suicide attempts in interpersonally-oriented individuals, but not in individuals oriented more towards issues of autonomy, and achievement. Similarly, subjects diagnosed with borderline personality disorder (BPD) showed a relationship between object relational impairments and suicidal behavior, while non-BPD subjects did not. Finally, a relationship between aggressive internalized object representations and more frequent suicide attempts was found in subjects with, higher levels of non-planning impulsivity. These results confirm the utility of considering risk factors for suicide within the broader context of personality organization, and suggest directions for future research and treatment with suicidal populations.
