Psychopathy and Suicide: The Mediating Effects of Emotional and Behavioral Dysregulation

Self-injurious thoughts and behaviors are positively associated with secondary psychopathy (impulsive-antisocial behaviors) and negatively associated or unrelated to primary psychopathy (interpersonal-affective deficits). While there is evidence that both psychopathy subtypes are associated with the capability for suicide (i.e., pain tolerance, fearlessness about death), a critical risk factor for moving an individual from suicidal ideation to suicidal action, only secondary psychopathy possesses traits associated with both suicidal desire and capability. The following study investigated if certain cognitive, affective, and behavioral features underlying secondary psychopathy could explain the distinct patterns in suicide-related outcomes. In a sample of 201 male and female offenders, we found the association between secondary psychopathy and future suicidal intention was best explained by the indirect path of emotion dysregulation, rumination, recent suicidal ideation, and non-suicidal self-injury (NSSI). Primary psychopathy correlated with NSSI, a key component in acquiring the capability for suicide, but not suicidal ideations or intention. Results are consistent with ideation-to-action models of suicide, whereby suicidal desire and capability independently contribute to suicidal action.