Negative Urgency and Lack of Perseverance Predict Suicidal Ideation and Attempts Among Young Adolescents

Impulsivity has been recognized as an important factor in suicidal thoughts and behaviors (STBs). However, previous research linking impulsivity to STBs has largely relied on cross-sectional designs, considered only a subset of impulsivity measures, and typically focused on middle-to-older adolescents. Here, we explored multiple measures of impulsivity and assessed their predictive relation to suicidal ideation and suicide attempts.

In a sample of 10,286 adolescents (ages 9-12; 47.4% female, 76.4% White, 19.4% Black, 6.4% Asian, 3.5% American Indian/Alaskan Native, 0.6% Native Hawaiian/Pacific Islander, 6.4% Other, 19.4% Hispanic, 12.1% Mixed/Multiple Race) from the Adolescent Brain Cognitive Development℠ Study (ABCD Study®), we assessed impulsivity when youth were 9-10 years old, and suicidal ideation and attempts when youth were 11-12 years old. We measured impulsivity in three ways: a trait-like measure (UPPS-P Impulsive Behavior Scale), a behavioral measure (delay discounting task), and a neural measure (Cortical Delay Discounting [C-DD]). Suicidal ideation and attempts were assessed using the Kiddie Schedule for Affective Disorder and Schizophrenia (KSADS) suicide module.

Negative urgency and lack of perseverance (at ages 9-10) significantly predicted a higher likelihood of suicidal ideation (Negative Urgency: Odds Ratio [OR] = 1.254, p < .001; Lack of Perseverance: OR = 1.152, p = .035) and suicide attempts (Negative Urgency: OR = 1.328, p = .009; Lack of Perseverance: OR = 1.270, p = .009) when youth were 11-12 years old.

Negative urgency and lack of perseverance are robust predictors of future suicidal ideation and suicide attempts in young adolescents. These findings highlight the importance of assessing for and targeting these dimensions of impulsivity in clinical settings.