Associations between aggression, executive functioning, and suicidality in adults with psychotic disorders

It is imperative to identify risk factors related to suicidal behavior in persons with Schizophrenia Spectrum Disorders given the high prevalence of these behaviors among this clinical population. Aggression has been regarded as a risk factor for suicidal behavior; however, relatively few investigations have examined relationships between suicidality and aggression in people with Schizophrenia Spectrum Disorders. In addition, recent studies have linked suicidal behavior to aspects of neurocognitive functioning, including executive functioning. Although investigations have found relationships between executive functioning impairment and higher levels of suicidal behavior, among people with Schizophrenia relatively better executive functioning performance has been linked to higher levels of suicidal behavior. Therefore, further investigation is needed to clarify these relationships. The present study examined relationships between aggression, executive functioning, and suicidal behavior among an ethnically diverse sample of 85 adults diagnosed with Schizophrenia or Schizoaffective Disorder. Demographic and psychiatric data were obtained, and measures of aggression, executive functioning, and suicidal behavior were administered to explore study hypotheses. The first hypothesis, which examined whether aggression was positively associated with suicidal behavior, was partially supported. The second hypothesis examined whether executive functioning was positively correlated with suicidal behavior, and was partially supported. The third hypothesis, which examined whether aggression was positively associated with executive functioning, was not supported. Finally, the fourth hypothesis, which examined whether aggression and executive functioning would serve as predictors of suicidal behavior after accounting for the effects of symptom severity, was partially supported. Overall, higher levels of aggression and less impaired executive functioning performance were associated with higher levels of suicidal behavior. These results highlight the importance of monitoring levels of aggression given that increased aggression may help identify persons at risk for suicidal behavior. Furthermore, the findings demonstrate that less impaired or normal executive functioning performance may not always be associated with better outcomes for persons with Schizophrenia Spectrum Disorders. Thus, suicide prevention efforts should be tailored to the unique needs of this clinical population