What I suppose would be interesting would be to know whether people who researched and planned an attempt were more successful than those who did it impulsively. Not that we'd ever be able to find that out.
There seems to be a link, but no straightforward answer.
1 (2012, n=143):
"Clinicians should not minimize the significance of
impulsive attempts, as they are associated with a similar level of lethality as premeditated attempts."
"Although there were
no group differences in the actual medical lethality of the attempt [...], those who made an impulsive attempt reported significantly lower expectations of death as a result of the attempt than those who made a premeditated attempt [...]. Individuals who made an impulsive attempt reported significantly less depression [...], and hopelessness [...], but reported similar levels of suicide ideation as individuals who made a premeditated attempt [...]."
2 (2024, systematic review & meta-analysis):
"Regarding suicide attempts,
people who had attempted suicide showed greater impulsivity compared to those who have died by suicide. This difference was observed in both men and women [...]. Additionally, females who died by suicide exhibited lower levels of impulsivity compared to men, even though the proportion of highly impulsive individuals was similar between sexes[...]."
"Moreover, the interaction between mental disorders and impulsive traits could vary depending on the specific mental disorder assessed."
"In any case, the findings support hypothesis 1, suggesting that impulsivity is indeed associated with fatal suicide behavior.
Regarding hypothesis 2, which posted that aggression would mediate the relation between impulsivity and fatal suicide behavior, our analysis support this notion. Aggressive traits, as measured by the BGHA and OAS, were indeed identified as a mediator.
Finally, evidence regarding hypothesis 3, which anticipated the presence of confounding factors, such as mental disorders or previous suicide attempts, presents a mixed picture. The association between impulsivity and fatal suicide behaviour was in fact independent of several potentially confounding variables such as sex, age, selected impulsivity scale, presence of mental disorders, and previous suicide attempts. With respect to history of suicide attempts, results are striking as it is extensively linked with both impulsivity traits and death by suicide. However, it may be that the relation between non-lethal and lethal suicide attempts is only effective for specific clinical sub-samples such as people with personality disorders and young adult women with affective or substance abuse disorders, as identified in other works (Go˜ni-Sarri´es et al., 2018) that were under-represented in this work.
In any case, the results of the systematic review highlight the
nuanced role of impulsivity in suicide across different mental disorders. While impulsivity is associated with increased suicidality in the context of BPD and substance use disorders, it appears to be unrelated in schizophrenia spectrum disorders, and in the context of depression, its
predictive power on fatal suicide behavior is influenced by various factors including sex, aggressive traits, comorbid personality disorders and the severity of the depression. Discrepancies between the findings in the systematic review and meta-analysis likely stem from the way mental disorders were categorized in the articles included in the meta-analysis."
3 (2023, n=684):
"The study shows that physical abuse and
impulsivity were associated with greater severity of suicide attempt, while depressive symptoms were associated with less severity of suicide attempt."
"It is known that impulsivity may play an important role in suicidal behaviour; however, there are few studies regarding the association between impulsivity and SSA [serious suicide attempts]. The degree of preparation and planning of suicidal behaviour is a significant factor in determining the severity of the attempt and it is generally used as an indicator of the impulsiveness state. In fact, many people die by suicide or engage in highly lethal behaviours due to their state impulsivity, in each circumstance, with no or poor planning.
Although impulsiveness does not necessarily explain the severity of the suicide attempt, it does facilitate the ability to attempt a more lethal suicide in the future, especially among those patients who originally made an SSA. The inability to control the impulses, coupled with characteristics of aggression and feelings of anger are associated with the suicide attempt severity. According to the model of the acquired capability Component of Joiner's Interpersonal Psychological Theory of Suicide, impulsivity is a risk factor for the capability for suicide that moderates the experience of painful life events. Suicide attempters, particularly severe suicide attempters, experience reduced serotonergic activity that has been associated with impulsivity traits. These individuals are less likely to heed warning signs of fear and pain, leading them to fearlessness and pain insensitivity to the actions and ideas involved in severe suicide attempts."
