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Suicidal subtypes, stress responsivity and impulsive aggression.

Barbara Stanley1, Christina A Michel1, Hanga C Galfalvy2

  • 1Department of Molecular Imaging & Neuropathology, New York State Psychiatric Institute, New York, NY USA; Department of Psychiatry, Columbia University, New York, NY USA.

Psychiatry Research
|August 4, 2019
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Summary
This summary is machine-generated.

Suicide attempters with high impulsive aggression show a stronger cortisol stress response. This suggests a distinct stress-responsive subtype of suicidal behavior may exist, differing from other attempters.

Keywords:
AggressionCortisolImpulsivityStressSuicideTSST

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Area of Science:

  • Neuroendocrinology
  • Psychiatry
  • Behavioral Science

Background:

  • Hypothalamic-pituitary-adrenal (HPA) axis dysregulation is implicated in suicidal behavior, but findings are inconsistent.
  • Suicide attempters may represent a heterogeneous group, with HPA axis dysfunction relevant only in specific subgroups.
  • HPA axis dysregulation is also linked to impulsivity and aggression.

Purpose of the Study:

  • To investigate if subgroups of suicide attempters, categorized by impulsivity and aggression levels, exhibit differential HPA axis dysregulation.
  • To explore the relationship between cortisol response during stress and distinct subgroups of suicidal behavior.

Main Methods:

  • Examined baseline cortisol, total cortisol output, and cortisol reactivity in mood-disordered suicide attempters (N=35) and non-attempters (N=37).
  • Utilized the Trier Social Stress Test (TSST) to assess stress response.
  • Categorized suicide attempters into four subgroups based on aggression and impulsivity levels.

Main Results:

  • No significant differences in overall cortisol measures were found between attempters and non-attempters.
  • Cortisol stress response varied significantly among suicide attempter subgroups based on impulsivity and aggression.
  • Attempters exhibiting high impulsive aggression demonstrated a more pronounced cortisol response compared to other groups and non-attempters.

Conclusions:

  • This study identifies a potential stress-responsive subtype of suicidal behavior characterized by high impulsive aggression.
  • Findings highlight the importance of considering subgroups within suicidal behavior for understanding HPA axis dysregulation.
  • The results may aid in identifying individuals with suicidal tendencies who exhibit heightened stress reactivity.