Hostname: page-component-8448b6f56d-t5pn6 Total loading time: 0 Render date: 2024-04-19T07:19:44.565Z Has data issue: false hasContentIssue false
  • English
  • Français

Clarifying the role of neuroticism in suicidal ideation and suicide attempt among women with major depressive disorder

Published online by Cambridge University Press:  11 April 2017

L. M. Rappaport ,
J. Flint  and
K. S. Kendler
L. M. Rappaport*
Affiliation:
Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
J. Flint
Affiliation:
Department of Psychiatry, University of California at Los Angeles, Los Angeles, CA, USA
K. S. Kendler
Affiliation:
Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA Department of Human Genetics, Virginia Commonwealth University, Richmond, VA, USA
*
*Address for correspondence: L. M. Rappaport, Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, 800 E Leigh Street, Suite 101, Richmond, VA 23219-1534, USA. (Email: Lance.Rappaport@vcuhealth.org)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Prior research consistently demonstrates that neuroticism increases risk for suicidal ideation, but the association between neuroticism and suicidal behavior has been inconsistent. Whereas neuroticism is recommended as an endophenotype for suicidality, the association of neuroticism with attempted suicide warrants clarification. In particular, prior research has not distinguished between correlates of attempted suicide, correlates of suicidal ideation, and correlates of comorbid psychopathology.

Methods

The present study used the CONVERGE study, a sample of 5864 women with major depressive disorder (MD) and 5783 women without MD throughout China. Diagnoses, suicidal ideation, and attempted suicide were assessed with the Composite International Diagnostic Interview (CIDI). Neuroticism was assessed with the neuroticism portion of the Eysenck Personality Questionnaire.

Results

Results replicate prior findings on the correlates of suicidal ideation, particularly elevated neuroticism among individuals who report prior suicidal ideation. Moreover, as compared with individuals who reported having experienced only suicidal ideation, neuroticism was associated with decreased likelihood of having attempted suicide.

Conclusions

The association of neuroticism with suicidality is more complicated than has been previously described. Whereas neuroticism increases risk for suicidal ideation, neuroticism may decrease risk for a suicide attempt among individuals with suicidal ideation. These results have implications for the assessment of risk for a suicide attempt among individuals who report suicidal ideation and addresses prior discordant findings by clarifying the association between neuroticism and attempted suicide.

Keywords

major depressionneuroticismsuicidesuicidal ideationsuicide attempt
Type
Original Articles
Information
Psychological Medicine , Volume 47 , Issue 13 , October 2017 , pp. 2334 - 2344
Copyright
Copyright © Cambridge University Press 2017 

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

American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association: Washington, DC.Google Scholar
Batterham, PJ, Christensen, H (2012). Longitudinal risk profiling for suicidal thoughts and behaviours in a community cohort using decision trees. Journal of Affective Disorders 142, 306–314.CrossRefGoogle Scholar
Beautrais, AL (2000). Risk factors for suicide and attempted suicide among young people. Australian and New Zealand Journal of Psychiatry 34, 420–436.Google Scholar
Beautrais, AL, Joyce, PR, Mulder, RT (1997). Precipitating factors and life events in serious suicide attempts among youths aged 13 through 24 years. Journal of the American Academy of Child & Adolescent Psychiatry 36, 1543–1551.Google Scholar
Beautrais, AL, Joyce, PR, Mulder, RT (1999). Personality traits and cognitive styles as risk factors for serious suicide attempts among young people. Suicide and Life-Threatening Behavior 29, 37–47.CrossRefGoogle ScholarPubMed
Bi, B, Xiao, X, Zhang, H, Gao, J, Tao, M, Niu, H, Wang, Y, Wang, Q, Chen, C, Sun, N, Li, K, Fu, J, Gan, Z, Sang, W, Zhang, G, Yang, L, Tian, T, Li, Q, Yang, Q, Sun, L, Li, Y, Rong, H, Guan, C, Zhao, X, Ye, D, Zhang, Y, Ma, Z, Li, H, He, K, Chen, J, Cai, Y, Zhou, C, Luo, Y, Wang, S, Gao, S, Liu, J, Guo, L, Guan, J, Kang, Z, Di, D, Li, Y, Shi, S, Li, Y, Chen, Y, Flint, J, Kendler, K, Liu, Y (2012). A comparison of the clinical characteristics of women with recurrent major depression with and without suicidal symptomatology. Psychological Medicine 42, 2591–2598.CrossRefGoogle ScholarPubMed
Bluml, V, Kapusta, ND, Doering, S, Brahler, E, Wagner, B, Kersting, A (2013). Personality factors and suicide risk in a representative sample of the German general population. Ed. B Thombs. PLoS ONE 8, e76646.CrossRefGoogle Scholar
Brezo, J, Paris, J, Turecki, G (2006). Personality traits as correlates of suicidal ideation, suicide attempts, and suicide completions: a systematic review. Acta Psychiatrica Scandinavica 113, 180–206.CrossRefGoogle ScholarPubMed
Chan, S, Chiu, HF, Lam, LC, Wong, CS, Conwell, Y (2014). A multidimensional risk factor model for suicide attempts in later life. Neuropsychiatric Disease and Treatment 10, 1807–1817.CrossRefGoogle ScholarPubMed
Costa, PT, Terracciano, A, McCrae, RR (2001). Gender differences in personality traits across cultures: robust and surprising findings. Journal of Personality and Social Psychology 81, 322–331.CrossRefGoogle ScholarPubMed
Cox, BJ, Enns, MW, Clara, IP (2004). Psychological dimensions associated with suicidal ideation and attempts in the National Comorbidity Survey. Suicide and Life-Threatening Behavior 34, 209–219.CrossRefGoogle ScholarPubMed
DeShong, HL, Tucker, RP, O'Keefe, VM, Mullins-Sweatt, SN, Wingate, LR (2015). Five factor model traits as a predictor of suicide ideation and interpersonal suicide risk in a college sample. Psychiatry Research 226, 217–223.CrossRefGoogle Scholar
Draper, B, Kõlves, K, De Leo, D, Snowdon, J (2014). A controlled study of suicide in middle-aged and older people: personality traits, age, and psychiatric disorders. Suicide and Life-Threatening Behavior 44, 130–138.CrossRefGoogle ScholarPubMed
Dumais, A, Lesage, AD, Alda, M, Rouleau, G, Dumont, M, Chawky, N, Roy, M, Mann, JJ, Benkelfat, C, Turecki, G (2005). Risk factors for suicide completion in major depression: a case-control study of impulsive and aggressive behaviors in men. American Journal of Psychiatry 162, 2116–2124.CrossRefGoogle ScholarPubMed
Eysenck, HJ, Eysenck, SBG (1975). Manual of the Eysenck Personality Questionnaire. Educational and Industrial Testing Service: San Diego, CA.Google Scholar
Fang, L, Heisel, MJ, Duberstein, PR, Zhang, J (2012). Combined effects of Neuroticism and extraversion: findings from a matched case control study of suicide in rural china. Journal of Nervous and Mental Disease 200, 598–602.CrossRefGoogle ScholarPubMed
Fanous, AH, Prescott, CA, Kendler, KS (2004). The prediction of thoughts of death or self-harm in a population-based sample of female twins. Psychological Medicine 34, 301–312.CrossRefGoogle ScholarPubMed
Farmer, A, Redman, K, Harris, T, Webb, R, Mahmood, A, Sadler, S, McGuffin, P (2001). The Cardiff sib-pair study. Crisis: Journal of Crisis Intervention and Suicide Prevention 22, 71.CrossRefGoogle ScholarPubMed
Fergusson, DM, Beautrais, AL, Horwood, LJ (2003). Vulnerability and resiliency to suicidal behaviours in young people. Psychological Medicine 33, 61–73.CrossRefGoogle ScholarPubMed
Fergusson, DM, Woodward, LJ, Horwood, LJ (2000). Risk factors and life processes associated with the onset of suicidal behaviour during adolescence and early adulthood. Psychological Medicine 30, 23–39.CrossRefGoogle ScholarPubMed
Fox, J (2003). Effect displays in R for generalized linear models. Journal of Statistical Software 8, 1–27.CrossRefGoogle Scholar
Fox, J, Weisberg, S (2011). An {R} Companion to Applied Regression. Sage: Thousand Oaks, CA.Google Scholar
Gan, Z, Li, Y, Xie, D, Shao, C, Yang, F, Shen, Y, Zhang, N, Zhang, G, Tian, T, Yin, A, Chen, C, Liu, J, Tang, C, Zhang, Z, Liu, J, Sang, W, Wang, X, Liu, T, Wei, Q, Xu, Y, Sun, L, Wang, S, Li, C, Hu, C, Cui, Y, Liu, Y, Li, Y, Zhao, X, Zhang, L, Sun, L, Chen, Y, Zhang, Y, Ning, Y, Shi, S, Chen, Y, Kendler, KS, Flint, J, Zhang, J (2012). The impact of educational status on the clinical features of major depressive disorder among Chinese women. Journal of Affective Disorders 136, 988–992.CrossRefGoogle ScholarPubMed
Hothorn, T (2008). Simultaneous inference in Geometic parametric models. Biometrical Journal 50, 346–363.CrossRefGoogle Scholar
Jardine, R, Martin, NG, Henderson, AS (1984). Genetic covariation between neuroticism and the symptoms of anxiety and depression. Genetic Epidemiology 1, 89–107.CrossRefGoogle ScholarPubMed
Jimenez-Trevino, L, Blasco-Fontecilla, H, Braquehais, MD, Ceverino-Dominguez, A, Baca-Garcia, E (2011). Endophenotypes and suicide behaviour. Actas Esp Psiquiatr 39, 61–69.Google ScholarPubMed
Joiner, TE (2005). Why People Die by Suicide. Harvard University Press: Cambridge, MA.Google Scholar
Joiner, TE, Steer, RA, Abramson, LY, Alloy, LB, Metalsky, G, Schmidt, NB (2001). Hopelessness depression as a distinct dimension of depressive symptoms among clinical and non-clinical samples. Behavior Research and Therapy 39, 523–536.CrossRefGoogle ScholarPubMed
Katz, C, Yaseen, ZS, Mojtabai, R, Cohen, LJ, Galynker, II (2011). Panic as an independent risk factor for suicide attempt in depressive illness: findings from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC). Journal of Clinical Psychiatry 72, 1628–1635.CrossRefGoogle Scholar
Kendler, KS, Gardner, CO, Prescott, CA (2003). Personality and the experience of environmental adversity. Psychological Medicine 33, 1193–1202.CrossRefGoogle ScholarPubMed
Kendler, KS, Karkowski, LM, Prescott, CA (1998). Stressful life events and major depression: risk period, long-term contextual threat, and diagnostic specificity. Journal of Nervous and Mental Diseases 186, 661–669.CrossRefGoogle ScholarPubMed
Kendler, KS, Kessler, RC, Neale, MC, Heath, AC, Eaves, LJ (1993 a). The prediction of major depression in women: toward an integrated etiologic model. American Journal of Psychiatry 150, 1139–1148.Google ScholarPubMed
Kendler, KS, Neale, MC, Kessler, RC, Heath, AC, Eaves, LJ (1993 b). A longitudinal twin study of personality and major depression in women. Archives of General Psychiatry 50, 853–862.CrossRefGoogle ScholarPubMed
Kendler, KS, Prescott, CA (2006). Genes, Environment, and Psychopathology. Guilford Press: New York.Google Scholar
Kessler, RC, Borges, G, Walters, EE (1999). Prevalence of and risk factors for lifetime suicide attempts in the National Comorbidity Survey. Archives of General Psychiatry 56, 617–626.CrossRefGoogle ScholarPubMed
Lester, D (1987). Suicidal preoccupation and dysthymia in college students. Psychological Reports 61, 762–762.CrossRefGoogle ScholarPubMed
Lester, D (1998). Suicide and homicide rates in American states classified as introverted and neurotic. Psychological Reports 83, 686–686.CrossRefGoogle ScholarPubMed
Lester, D (2005). National character, suicide, and homicide. Perceptual and Motor Skills 100, 760.CrossRefGoogle ScholarPubMed
Lester, D, Voracek, M (2013). Big five personality scores and rates of suicidality in the United States. Psychological Reports 112, 637–639.CrossRefGoogle ScholarPubMed
Livingston, NA, Heck, NC, Flentje, A, Gleason, H, Oost, KM, Cochran, BN (2015). Sexual minority stress and suicide risk: identifying resilience through personality profile analysis. Psychology of Sexual Orientation and Gender Diversity 2, 321–328.CrossRefGoogle ScholarPubMed
Li, Y, Aggen, S, Shi, S, Gao, J, Li, Y, Tao, M, Zhang, K, Wang, X, Gao, C, Yang, L, Liu, Y, Li, K, Shi, J, Wang, G, Liu, L, Zhang, J, Du, B, Jiang, G, Shen, J, Zhang, Z, Liang, W, Sun, J, Hu, J, Liu, T, Wang, X, Miao, G, Meng, H, Li, Y, Hu, C, Li, Y, Huang, G, Li, G, Ha, B, Deng, H, Mei, Q, Zhong, H, Gao, S, Sang, H, Zhang, Y, Fang, X, Yu, F, Yang, D, Liu, T, Chen, Y, Hong, X, Wu, W, Chen, G, Cai, M, Song, Y, Pan, J, Dong, J, Pan, R, Zhang, W, Shen, Z, Liu, Z, Gu, D, Wang, X, Liu, X, Zhang, Q, Flint, J, Kendler, KS (2014). Subtypes of major depression: latent class analysis in depressed Han Chinese women. Psychological Medicine 44, 3275–3288.CrossRefGoogle ScholarPubMed
MacLean, CJ (1988). Assessing changes in risk factor effect over multiple levels of severity. American Journal of Epidemiology 127, 663–673.CrossRefGoogle ScholarPubMed
Mandelli, L, Nearchou, FA, Vaiopoulos, C, Stefanis, CN, Vitoratou, S, Serretti, A, Stefanis, NC (2015). Neuroticism, social network, stressful life events: association with mood disorders, depressive symptoms and suicidal ideation in a community sample of women. Psychiatry Research 226, 38–44.CrossRefGoogle Scholar
Martin, PC, Zimmer, TJ, Pan, LA (2015). Magnetic resonance imaging markers of suicide attempt and suicide risk in adolescents. CNS Spectrums 20, 355–358.CrossRefGoogle ScholarPubMed
Maser, JD, Akiskal, HS, Schettler, P, Scheftner, W, Mueller, T, Endicott, J, Solomon, D, Clayton, P (2002). Can temperament identify affectively ill patients who engage in lethal or near-lethal suicidal behavior? A 14-year prospective study. Suicide and Life-Threatening Behavior 32, 10–32.CrossRefGoogle ScholarPubMed
McCrae, RR, Costa, PT (1987). Validation of the five-factor model of personality across instruments and observers. Journal of Personality and Social Psychology 52, 81–90.CrossRefGoogle ScholarPubMed
Naragon-Gainey, K, Watson, D (2011). The anxiety disorders and suicidal ideation: accounting for co-morbidity via underlying personality traits. Psychological Medicine 41, 1437–1447.CrossRefGoogle ScholarPubMed
Nock, MK, Hwang, I, Sampson, NA, Kessler, RC (2010). Mental disorders, comorbidity and suicidal behavior: results from the National Comorbidity Survey Replication. Molecular Psychiatry 15, 868–876.CrossRefGoogle ScholarPubMed
O'Boyle, M, Brandon, EA (1998). Suicide attempts, substance abuse, and personality. Journal of Substance Abuse Treatment 15, 353–356.CrossRefGoogle ScholarPubMed
Pallis, DJ, Jenkins, JS (1977). Extra version, neuroticism, and intent in attempted suicides. Psychological Reports 41, 19–22.CrossRefGoogle Scholar
Pickles, A, Aglan, A, Collishaw, S, Messer, J, Rutter, M, Maughan, B (2010). Predictors of suicidality across the life span: the Isle of Wight study. Psychological Medicine 40, 1453–1466.CrossRefGoogle ScholarPubMed
Posner, K, Brown, GK, Stanley, B, Brent, DA, Yershova, KV, Oquendo, MA, Currier, GW, Melvin, GA, Greenhill, L, Shen, S, Mann, JJ (2011). The Columbia–suicide severity rating scale: initial validity and internal consistency findings from three multisite studies with adolescents and adults. American Journal of Psychiatry 168, 1266–1277.CrossRefGoogle ScholarPubMed
Rappaport, LM, Moskowitz, DS, Galynker, I, Yaseen, ZS (2014). Panic symptom clusters differentially predict suicide ideation and attempt. Comprehensive Psychiatry 55, 762–769.CrossRefGoogle ScholarPubMed
R Core Team (2015). R: A Language and Environment for Statistical Computing. Vienna, Austria. https://www.R-project.org/.Google Scholar
Revelle, W (2015). psych: Procedures for Personality and Psychological Research. Northwestern University: Evanston, Illinois, USA.Google Scholar
Roy, A (2003 a). Characteristics of drug abuse addicts who attempt suicide. Psychiatry Research 121, 99–103.CrossRefGoogle ScholarPubMed
Roy, A (2003 b). Distal risk factors for suicidal behavior in alcoholics: replications and new findings. Journal of Affective Disorders 77, 267–271.CrossRefGoogle ScholarPubMed
Rozanov, VA, Mid'ko, AA (2011). Personality patterns of suicide attempters: gender differences in Ukraine. Spanish Journal of Psychology 14, 693–700.CrossRefGoogle ScholarPubMed
Sharif, F, Parsnia, A, Mani, A, Vosoghi, M, Setoodeh, G (2014). Comparison of personality traits, coping styles, and psychiatric disorders in adult suicidal and non-suicidal individuals. International Journal of Community Based Nursing and Midwifery 2, 148.Google ScholarPubMed
Sokolowski, M, Wasserman, J, Wasserman, D (2014). Genome-wide association studies of suicidal behaviors: a review. European Neuropsychopharmacology 24, 1567–1577.CrossRefGoogle ScholarPubMed
Statham, DJ, Heath, AC, Madden, PA, Bucholz, KK, Bierut, L, Dinwiddie, SH, Slutske, WS, Dunne, MP, Martin, NG (1998). Suicidal behaviour: an epidemiological and genetic study. Psychological Medicine 28, 839–855.CrossRefGoogle ScholarPubMed
Tanji, F, Kakizaki, M, Sugawara, Y, Watanabe, I, Nakaya, N, Minami, Y, Fukao, A, Tsuji, I (2015). Personality and suicide risk: the impact of economic crisis in Japan. Psychological Medicine 45, 559–573.CrossRefGoogle ScholarPubMed
van Heeringen, K, Mann, JJ (2014). The neurobiology of suicide. Lancet. Psychiatry 1, 63–72.CrossRefGoogle ScholarPubMed
Velting, D (1999). Suicidal ideation and the five-factor model of personality. Personality and Individual Differences 27, 943–952.CrossRefGoogle Scholar
Vrshek-Schallhorn, S, Czarlinski, J, Mineka, S, Zinbarg, RE, Craske, M (2011). Prospective predictors of suicidal ideation during depressive episodes among older adolescents and young adults. Personality and Individual Differences 50, 1202–1207.CrossRefGoogle ScholarPubMed
Wickham, H (2009). ggplot2: Elegant Graphics for Data Analysis. Springer-Verlag: New York.CrossRefGoogle Scholar
World Health Organization (ed.) (2014). Preventing Suicide: A Global Imperative. World Health Organization: Geneva.Google Scholar
Yang, F, Li, Y, Xie, D, Shao, C, Ren, J, Wu, W, Zhang, N, Zhang, Z, Zou, Y, Zhang, J, Qiao, D, Gao, C, Li, Y, Hu, J, Deng, H, Wang, G, Du, B, Wang, X, Liu, T, Gan, Z, Peng, J, Wei, B, Pan, J, Chen, H, Sun, S, Jia, H, Liu, Y, Chen, Q, Wang, X, Cao, J, Lv, L, Chen, Y, Ha, B, Ning, Y, Chen, Y, Kendler, KS, Flint, J, Shi, S (2011). Age at onset of major depressive disorder in Han Chinese women: relationship with clinical features and family history. Journal of Affective Disorders 135, 89–94.CrossRefGoogle Scholar
Yang, J, McCrae, RR, Costa, PT, Dai, X, Yao, S, Cai, T, Gao, B (1999). Cross-cultural personality assessment in psychiatric populations: The NEO-PI—R in the People's Republic of China. Psychological Assessment 11, 359–368.CrossRefGoogle Scholar
Zhu, Y, Zhang, H, Shi, S, Gao, J, Li, Y, Tao, M, Zhang, K, Wang, X, Gao, C, Yang, L, Li, K, Shi, J, Wang, G, Liu, L, Zhang, J, Du, B, Jiang, G, Shen, J, Zhang, Z, Liang, W, Sun, J, Hu, J, Liu, T, Wang, X, Miao, G, Meng, H, Li, Y, Hu, C, Li, Y, Huang, G, Li, G, Ha, B, Deng, H, Mei, Q, Zhong, H, Gao, S, Sang, H, Zhang, Y, Fang, X, Yu, F, Yang, D, Liu, T, Chen, Y, Hong, X, Wu, W, Chen, G, Cai, M, Song, Y, Pan, J, Dong, J, Pan, R, Zhang, W, Shen, Z, Liu, Z, Gu, D, Wang, X, Liu, X, Zhang, Q, Li, Y, Chen, Y, Kendler, KS, Flint, J, Liu, Y (2013). Suicidal risk factors of recurrent major depression in Han Chinese women. Ed. Hashimoto, K. PLoS ONE 8, e80030.CrossRefGoogle ScholarPubMed