Psychopathy facets and suicide risk among violently injured adults

Suicide risk remains difficult to predict, particularly among populations exposed to interpersonal violence. Although psychopathic traits have been linked to suicidal behavior, emerging evidence suggests these associations vary across psychopathy domains. The present study examined whether overall psychopathy and specific psychopathy facets were associated with suicide risk among violently injured adults.

Participants were 458 violently injured adults (72% male; M_age  = 32.76 years) recruited from an urban trauma center in the United States. Participants completed measures assessing psychopathic traits, suicide risk, post-traumatic stress disorder (PTSD), and substance use. Hierarchical regression analyses were conducted to examine associations between psychopathy and suicide risk while controlling for age, sex, race, PTSD and substance use.

After controlling for age, sex, race, PTSD, and substance use, total psychopathy was positively associated with suicide risk. When psychopathy facets were examined, only the Lifestyle facet emerged as a significant independent predictor of suicide risk. Sex did not moderate associations between psychopathy and suicide risk.

These findings suggest that the association between psychopathy and suicidality in violence-exposed populations may be more strongly related to traits reflecting behavioral dysregulation and impulsivity than to other psychopathy domains. Lifestyle-related psychopathic traits may be associated with greater suicide vulnerability through elevated impulsivity and increased engagement in risk-taking during periods of distress. Results highlight the importance of examining psychopathy as a multidimensional construct and suggest that externalizing personality traits may represent one potential pathway associated with suicide risk among violently injured adults.