Impulsivity, Affective Lability, and Affective Intensity

Joiner's (2005) interpersonal-psychological theory of suicidal behavior builds upon previous theories to provide a potentially more useful framework for differentiating between those who do and do not die by suicide. According to Joiner, three jointly necessary conditions must be met for an individual to both desire and have the ability to die by suicide: 1) feelings of perceived burdensomeness (i.e., feeling as though one's death is worth more than one's life), 2) a sense of thwarted belongingness (i.e., sense of disconnection with others), and 3) an acquired capability to engage in acts of self-harm. Joiner contends that not everyone has the ability to die by suicide; the human will to live is a strong force that is difficult to overcome. Engaging in behaviors meant to cause death can be a frightening experience that very few individuals are able to endure. According to the theory, the fear-inducing aspects of such behaviors can be overcome only through practice and gradual habituation. This can occur when an individual is exposed to life events (i. e., painful and provocative experiences) that inure him or her to the pain and fear associated with suicide. The purpose of the following studies was to explore three potential traits (i.e., affective lability, affective intensity, and impulsivity) that could confer distal risk for suicide insofar as they contribute toward individual acquiring the ability for suicide through increased exposure to painful and provocative experiences. Study 1 focused on the relationship between affective lability and intensity and exposure to painful and provocative events. Based upon prior research, we predicted a significant interaction between gender and affective lability and intensity, such that men with high levels of affective lability and intensity would have the highest likelihood of engaging in painful and provocative events. Contrary to expectation, gender did not interact with affective lability or intensity to predict exposure to painful and provocative experiences; however these variables did interact to predict acquired capability for suicide. Specifically, there was a negative association between affective lability/intensity and acquired capability for suicide for men, whereas there was no such relationship for women. Study 2 focused on the nature of the relationship between impulsivity (as measured by several different self-report and one behavioral measure) and acquired capability for suicide (as measured by self-report and physical pain tolerance and threshold), with the prediction that it is mediated by exposure to painful and provocative events. Results conformed to expectations; effect sizes were largest for facets of impulsivity related to sensation seeking behavior. Theoretical implications as well as implications for suicide prevention, risk assessment, and treatment are discussed.