Personality Profiles of Older Suicide Attempters: Cross-Sectional And Prospective Differences From Depressed Nonattempter And Nonpsychiatric Comparisons

Abstract

Objectives: Associations between personality and suicide risk in later life have been widely inconsistent, as most traits likely only define subpopulations of older attempters. This study aimed to identify prominent attempter profiles and characterize them clinically. Design: Exploratory study using latent profile analysis (LPA). Setting: Longitudinal Research Program for Late-Life Suicide, Pittsburgh, USA. Participants: The sample comprised 285 participants (mean age = 63.2 years, SD = 7.3), of which 109 were suicide attempters, 111 depressed nonattempters, and 65 nonpsychiatric comparisons. The personality profiles identified in attempters by LPA were compared to nonattempter groups cross-sectionally (N = 285) and at two-year follow-up (N = 171). Measurements: The LPA employed seven personality traits: Big Five dimensions, grandiose narcissism, and need for closure (intolerance to ambiguity). Results: The analysis identified three profiles. “Careless labile” attempters (n = 71) scored highest on neuroticism and lower on conscientiousness than other attempters, and had more borderline traits and childhood trauma than comparisons. “Callous narcissistic” attempters (n = 25) scored highest on grandiose narcissism, and lowest on agreeableness; they had the highest planning score at their most serious attempt. “Rigid extraverted” attempters (n = 13) were characterized by higher need for closure and more extraversion than other depressed groups, and were older at their first attempt than other attempters. At two-year follow-up, rigid extraverted attempters showed more improvement of depression severity but steeper cognitive decline than most other depressed groups. Conclusions: Attempter profiles differed from each other and nonattempters on several key suicidal, clinical, and prospective health-related characteristics. If replicated, these profiles could help with earlier detection of vulnerability and person-centered suicide prevention.