Hostname: page-component-7c8c6479df-8mjnm Total loading time: 0 Render date: 2024-03-28T00:42:31.477Z Has data issue: false hasContentIssue false

Increased severity of suicidal behavior in impulsive aggressive patients exposed to familial adversities

Published online by Cambridge University Press:  26 March 2014

J. Lopez-Castroman*
Affiliation:
Inserm U1061, Hôpital La Colombiere, Montpellier, France; University of Montpellier 1, France IIS-Fundacion Jimenez Diaz, Department of Psychiatry, CIBERSAM, Madrid, Spain Department of Emergency Psychiatry, CHRU Montpellier, France
I. Jaussent
Affiliation:
Inserm U1061, Hôpital La Colombiere, Montpellier, France; University of Montpellier 1, France
S. Beziat
Affiliation:
Inserm U1061, Hôpital La Colombiere, Montpellier, France; University of Montpellier 1, France
S. Guillaume
Affiliation:
Inserm U1061, Hôpital La Colombiere, Montpellier, France; University of Montpellier 1, France Department of Emergency Psychiatry, CHRU Montpellier, France
E. Baca-Garcia
Affiliation:
IIS-Fundacion Jimenez Diaz, Department of Psychiatry, CIBERSAM, Madrid, Spain Department of Psychiatry at the New York State Psychiatric Institute and Columbia University, NY, USA
C. Genty
Affiliation:
Inserm U1061, Hôpital La Colombiere, Montpellier, France; University of Montpellier 1, France Department of Emergency Psychiatry, CHRU Montpellier, France
E. Olié
Affiliation:
Inserm U1061, Hôpital La Colombiere, Montpellier, France; University of Montpellier 1, France Department of Emergency Psychiatry, CHRU Montpellier, France
P. Courtet
Affiliation:
Inserm U1061, Hôpital La Colombiere, Montpellier, France; University of Montpellier 1, France Department of Emergency Psychiatry, CHRU Montpellier, France
*
*Address for correspondence: J. Lopez-Castroman, M.D., Ph.D., Inserm U1061, Hôpital La Colombiere, Pavillon 42, 39 av. Charles Flauhault, BP 34493, 34093 Montpellier, France. (Email: jorgecastroman@gmail.com)

Abstract

Background

The mechanisms by which childhood abuse and family history of suicidal behavior (FHS) lead to an increased risk of suicidal behavior are still unknown. Impulsive aggression may play an intermediate role. We investigated whether greater scores for aggression and impulsivity might be associated with the effects of FHS and/or childhood abuse on the severity of suicidal behavior.

Method

We examined the scores of three scales measuring impulsive aggression in a sample of 696 suicide attempters. We compared the highest and lowest scores with regard to reports of childhood abuse and FHS using adjusted multinomial regression models. Genetic polymorphisms of the serotonergic system known to be associated with impulsive aggression were also analyzed.

Results

Patients with high impulsive aggressive scores showed significant differences in sociodemographic, clinical and suicidal features compared with patients with low impulsive aggressive scores. Adjusted results showed that combinations of some types of childhood abuse and FHS, particularly emotional abuse and emotional neglect, are associated with high impulsivity and hostility scores. The SS genotype of the serotonin transporter gene (5-HTTLPR) was associated with high levels of impulsivity when the subjects reported emotional abuse [odds ratio (OR) 5.55, 95% confidence interval (CI) 1.75–17.5] or physical abuse (OR 5.03, 95% CI 1.50–16.9) in their childhood.

Conclusions

Our results support the role of impulsive aggression as one of the links that may connect childhood abuse and FHS with severity of suicidal behavior.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

An, J, Phillips, MR, Conner, KR (2010). Validity of proxy-based reports of impulsivity and aggression in Chinese research on suicidal behavior. Crisis 31, 137142.CrossRefGoogle ScholarPubMed
Asberg, M, Träskman, L, Thorén, P (1976). 5-HIAA in the cerebrospinal fluid. A biochemical suicide predictor? Archives of General Psychiatry 33, 11931197.Google Scholar
Barzman, DH, Patel, A, Sonnier, L, Strawn, JR (2010). Neuroendocrine aspects of pediatric aggression: can hormone measures be clinically useful? Neuropsychiatric Disease and Treatment 6, 691697.Google Scholar
Beauchaine, TP, Gatzke-Kopp, LM (2012). Instantiating the multiple levels of analysis perspective in a program of study on externalizing behavior. Development and Psychopathology 24, 10031018.Google Scholar
Beauchaine, TP, Klein, DN, Crowell, SE, Derbidge, C, Gatzke-Kopp, L (2009). Multifinality in the development of personality disorders: a biology × sex × environment interaction model of antisocial and borderline traits. Development and Psychopathology 21, 735770.CrossRefGoogle ScholarPubMed
Bender, R, Lange, S (2001). Adjusting for multiple testing – when and how? Journal of Clinical Epidemiology 54, 343349.Google Scholar
Bernstein, DP, Fink, L (1998). Childhood Trauma Questionnaire: A Retrospective Self-Report Manual. The Psychological Corporation: San Antonio, TX.Google Scholar
Braquehais, MD, Oquendo, MA, Baca-García, E, Sher, L (2010). Is impulsivity a link between childhood abuse and suicide? Comprehensive Psychiatry 51, 121129.Google Scholar
Brent, D (2010). What family studies teach us about suicidal behavior: implications for research, treatment, and prevention. European Psychiatry 25, 260263.Google Scholar
Brent, DA, Oquendo, M, Birmaher, B, Greenhill, L, Kolko, D, Stanley, B, Zelazny, J, Brodsky, B, Bridge, J, Ellis, S, Salazar, JO, Mann, JJ (2002). Familial pathways to early-onset suicide attempt: risk for suicidal behavior in offspring of mood-disordered suicide attempters. Archives of General Psychiatry 59, 801807.Google Scholar
Brent, DA, Oquendo, M, Birmaher, B, Greenhill, L, Kolko, D, Stanley, B, Zelazny, J, Brodsky, B, Firinciogullari, S, Ellis, SP, Mann, JJ (2003). Peripubertal suicide attempts in offspring of suicide attempters with siblings concordant for suicidal behavior. American Journal of Psychiatry 160, 14861493.CrossRefGoogle ScholarPubMed
Brezo, J, Paris, J, Vitaro, F, Hébert, M, Tremblay, RE, Turecki, G (2008). Predicting suicide attempts in young adults with histories of childhood abuse. British Journal of Psychiatry 193, 134139.Google Scholar
Brodsky, BS, Mann, JJ, Stanley, B, Tin, A, Oquendo, M, Birmaher, B, Greenhill, L, Kolko, D, Zelazny, J, Burke, AK, Melhem, NM, Brent, D (2008). Familial transmission of suicidal behavior: factors mediating the relationship between childhood abuse and offspring suicide attempts. Journal of Clinical Psychiatry 69, 584596.CrossRefGoogle ScholarPubMed
Buss, AH, Durkee, A (1957). An inventory for assessing different kinds of hostility. Journal of Consulting Psychology 21, 343349.Google Scholar
Carballo, JJ, Harkavy-Friedman, J, Burke, AK, Sher, L, Baca-García, E, Sullivan, GM, Grunebaum, MF, Parsey, RV, Mann, JJ, Oquendo, MA (2008). Family history of suicidal behavior and early traumatic experiences: additive effect on suicidality and course of bipolar illness? Journal of Affective Disorders 109, 5763.CrossRefGoogle ScholarPubMed
Coccaro, EF, Lee, R, Liu, T, Mathé, AA (2012). Cerebrospinal fluid neuropeptide Y-like immunoreactivity correlates with impulsive aggression in human subjects. Biological Psychiatry 72, 9971003.Google Scholar
Courtet, P, Baud, P, Abbar, M, Boulenger, JP, Castelnau, D, Mouthon, D, Malafosse, A, Buresi, C (2001). Association between violent suicidal behavior and the low activity allele of the serotonin transporter gene. Molecular Psychiatry 6, 338341.Google Scholar
Courtet, P, Gottesman, II, Jollant, F, Gould, TD (2011). The neuroscience of suicidal behaviors: what can we expect from endophenotype strategies. Translational Psychiatry 1, e7.Google Scholar
Deffenbacher, JL, Oetting, ER, Thwaites, GA, Lynch, RS, Baker, DA, Stark, RS, Thacker, S, Eiswerth-Cox, L (1996). State-trait anger theory and the utility of the trait anger scale. Journal of Counseling Psychology 43, 131148.Google Scholar
Diaconu, G, Turecki, G (2009). Family history of suicidal behavior predicts impulsive-aggressive behavior levels in psychiatric outpatients. Journal of Affective Disorders 113, 172178.CrossRefGoogle ScholarPubMed
Forgays, DK, Spielberger, CD, Ottaway, SA, Forgays, DG (1998). Factor structure of the State-Trait Anger Expression Inventory for middle-aged men and women. Assessment 5, 141155.Google Scholar
Gonda, X, Fountoulakis, KN, Csukly, G, Bagdy, G, Pap, D, Molnár, E, Laszik, A, Lazary, J, Sarosi, A, Faludi, G, Sasvari-Szekely, M, Szekely, A, Rihmer, Z (2011). Interaction of 5-HTTLPR genotype and unipolar major depression in the emergence of aggressive/hostile traits. Journal of Affective Disorders 132, 432437.Google Scholar
Gvion, Y, Apter, A (2011). Aggression, impulsivity, and suicide behavior: a review of the literature. Archives of Suicide Research 15, 93112.CrossRefGoogle ScholarPubMed
Hamilton, M (1960). A rating scale for depression. Journal of Neurology, Neurosurgery, and Psychiatry 23, 5662.Google Scholar
Henna, E, Hatch, JP, Nicoletti, M, Swann, AC, Zunta-Soares, G, Soares, JC (2013). Is impulsivity a common trait in bipolar and unipolar disorders? Bipolar Disorders 15, 223227.Google Scholar
Howells, FM, Stein, DJ, Russell, VA (2012). Childhood trauma is associated with altered cortical arousal: insights from an EEG study. Frontiers in Integrative Neuroscience 6, 120.Google Scholar
Joiner, TE Jr, Sachs-Ericsson, NJ, Wingate, LR, Brown, JS, Anestis, MD, Selby, EA (2007). Childhood physical and sexual abuse and lifetime number of suicide attempts: a persistent and theoretically important relationship. Behaviour Research and Therapy 45, 539547.Google Scholar
Jollant, F, Bellivier, F, Leboyer, M, Astruc, B, Torres, S, Verdier, R, Castelnau, D, Malafosse, A, Courtet, P (2005). Impaired decision making in suicide attempters. American Journal of Psychiatry 162, 304310.Google Scholar
Jollant, F, Buresi, C, Guillaume, S, Jaussent, I, Bellivier, F, Leboyer, M, Castelnau, D, Malafosse, A, Courtet, P (2007). The influence of four serotonin-related genes on decision-making in suicide attempters. American Journal of Medical Genetics. Part B, Neuropsychiatric Genetics 144B, 615624.Google Scholar
Jollant, F, Lawrence, NL, Olié, E, Guillaume, S, Courtet, P (2011). The suicidal mind and brain: a review of neuropsychological and neuroimaging studies. World Journal of Biological Psychiatry 12, 319339.Google Scholar
Lee, R, Ferris, C, Van de Kar, LD, Coccaro, EF (2009). Cerebrospinal fluid oxytocin, life history of aggression, and personality disorder. Psychoneuroendocrinology 34, 15671573.Google Scholar
Lopez-Castroman, J, Jaussent, I, Beziat, S, Genty, C, Olié, E, de Leon-Martinez, V, Baca-García, E, Malafosse, A, Courtet, P, Guillaume, S (2012). Suicidal phenotypes associated with family history of suicidal behavior and early traumatic experiences. Journal of Affective Disorders 142, 193199.Google Scholar
Lopez-Castroman, J, de las Mercedes Perez-Rodriguez, M, Jaussent, I, Alegria, AA, Artes-Rodriguez, A, Freed, P, Guillaume, S, Jollant, F, Leiva-Murillo, JM, Malafosse, A, Oquendo, MA, de Prado-Cumplido, M, Saiz-Ruiz, J, Baca-Garcia, E, Courtet, P; European Research Consortium for Suicide (2011). Distinguishing the relevant features of frequent suicide attempters. Journal of Psychiatric Research 45, 619625.CrossRefGoogle ScholarPubMed
Mann, JJ, Arango, VA, Avenevoli, S, Brent, DA, Champagne, FA, Clayton, P, Currier, D, Dougherty, DM, Haghighi, F, Hodge, SE, Kleinman, J, Lehner, T, McMahon, F, Mościcki, EK, Oquendo, MA, Pandey, GN, Pearson, J, Stanley, B, Terwilliger, J, Wenzel, A (2009). Candidate endophenotypes for genetic studies of suicidal behavior. Biological Psychiatry 65, 556563.Google Scholar
Mann, JJ, Waternaux, C, Haas, GL, Malone, KM (1999). Toward a clinical model of suicidal behavior in psychiatric patients. American Journal of Psychiatry 156, 181189.Google Scholar
Manuck, SB, Flory, JD, Ferrell, RE, Dent, KM, Mann, JJ, Muldoon, MF (1999). Aggression and anger-related traits associated with a polymorphism of the tryptophan hydroxylase gene. Biological Psychiatry 45, 603614.Google Scholar
Manuck, SB, Flory, JD, Ferrell, RE, Mann, JJ, Muldoon, MF (2000). A regulatory polymorphism of the monoamine oxidase-A gene may be associated with variability in aggression, impulsivity, and central nervous system serotonergic responsivity. Psychiatry Research 95, 923.Google Scholar
McGirr, A, Alda, M, Séguin, M, Cabot, S, Lesage, A, Turecki, G (2009). Familial aggregation of suicide explained by cluster B traits: a three-group family study of suicide controlling for major depressive disorder. American Journal of Psychiatry 166, 11241134.Google Scholar
McGirr, A, Turecki, G (2007). The relationship of impulsive aggressiveness to suicidality and other depression-linked behaviors. Current Psychiatry Reports 9, 460466.Google Scholar
Melhem, NM, Brent, DA, Ziegler, M, Iyengar, S, Kolko, D, Oquendo, M, Birmaher, B, Burke, A, Zelazny, J, Stanley, B, Mann, JJ (2007). Familial pathways to early-onset suicidal behavior: familial and individual antecedents of suicidal behavior. American Journal of Psychiatry 164, 13641370.CrossRefGoogle ScholarPubMed
Michaelis, BH, Goldberg, JF, Davis, GP, Singer, TM, Garno, JL, Wenze, SJ (2004). Dimensions of impulsivity and aggression associated with suicide attempts among bipolar patients: a preliminary study. Suicide and Life-Threatening Behavior 34, 172176.Google Scholar
Miller, JM, Kinnally, EL, Ogden, RT, Oquendo, MA, Mann, JJ, Parsey, RV (2009). Reported childhood abuse is associated with low serotonin transporter binding in vivo in major depressive disorder. Synapse 63, 565573.Google Scholar
Nishikawa, S, Nishitani, S, Fujisawa, TX, Noborimoto, I, Kitahara, T, Takamura, T, Shinohara, K (2012). Perceived parental rejection mediates the influence of serotonin transporter gene (5-HTTLPR) polymorphisms on impulsivity in Japanese adults. PLoS One 7, e47608.Google Scholar
Patton, JH, Stanford, MS, Barratt, ES (1995). Factor structure of the Barratt Impulsiveness Scale. Journal of Clinical Psychology 51, 768774.3.0.CO;2-1>CrossRefGoogle ScholarPubMed
Preisig, M, Fenton, BT, Matthey, ML, Berney, A, Ferrero, F (1999). Diagnostic Interview for Genetic Studies (DIGS): inter-rater and test-retest reliability of the French version. European Archives of Psychiatry and Clinical Neuroscience 249, 174179.Google Scholar
Rihmer, A, Szilágyi, S, Rózsa, S, Gonda, X, Faludi, G, Rihmer, Z (2009). The role of childhood abuse in adult suicidal behaviour [in Hungarian]. Neuropsychopharmacologia Hungarica 11, 237246.Google Scholar
Rothman, KJ (1990). Statistics in nonrandomized studies. Epidemiology 1, 417418.Google Scholar
Roy, A (2011). Combination of family history of suicidal behavior and childhood trauma may represent correlate of increased suicide risk. Journal of Affective Disorders 130, 205208.Google Scholar
Savitz, DA, Olshan, AF (1998). Describing data requires no adjustment for multiple comparisons: a reply from Savitz and Olshan. American Journal of Epidemiology 147, 813814; discussion 815.Google Scholar
Sheehan, DV, Lecrubier, Y, Sheehan, KH, Amorim, P, Janavs, J, Weiller, E, Hergueta, T, Baker, R, Dunbar, GC (1998). The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry 59, 2233, quiz 34–57.Google Scholar
Silverman, MM, Berman, AL, Sanddal, ND, O'Carroll, PW, Joiner, TE (2007). Rebuilding the Tower of Babel: a revised nomenclature for the study of suicide and suicidal behaviors. Part 1: Background, rationale, and methodology. Suicide and Life-Threatening Behavior 37, 248263.Google Scholar
Slama, F, Courtet, P, Golmard, JL, Mathieu, F, Guillaume, S, Yon, L, Jollant, F, Misson, H, Jaussent, I, Leboyer, M, Bellivier, F (2009). Admixture analysis of age at first suicide attempt. Journal of Psychiatric Research 43, 895900.CrossRefGoogle ScholarPubMed
Stoltenberg, SF, Christ, CC, Highland, KB (2012). Serotonin system gene polymorphisms are associated with impulsivity in a context dependent manner. Progress in Neuropsychopharmacology and Biological Psychiatry 39, 182191.Google Scholar
Swann, AC (2005). Increased impulsivity associated with severity of suicide attempt history in patients with bipolar disorder. American Journal of Psychiatry 162, 16801687.Google Scholar
Turecki, G (2005). Dissecting the suicide phenotype: the role of impulsive-aggressive behaviours. Journal of Psychiatry and Neuroscience 30, 398408.Google Scholar
Zouk, H, McGirr, A, Lebel, V, Benkelfat, C, Rouleau, G, Turecki, G (2007). The effect of genetic variation of the serotonin 1B receptor gene on impulsive aggressive behavior and suicide. American Journal of Medical Genetics. Part B, Neuropsychiatric Genetics 144B, 9961002.Google Scholar