Momentary Fluctuations in Impulsivity Predicts Suicidal Ideation Among Those With Problematic Alcohol Use.

Abstract

Background: Problematic alcohol use is a recognized risk factor for suicidal thoughts and behaviors. Individuals who misuse alcohol and those experiencing suicidal ideation (SI) often exhibit elevated impulsivity, suggesting that impulsivity may be an underlying mechanism. Impulsivity fluctuates considerably within individuals over short periods, particularly among those engaged in episodic heavy drinking, college students, and those with SI. While impulsivity is associated with suicidal thinking at a trait level, its relationship with SI on a momentary level remains relatively unexplored. This study aimed to (a) replicate cross-sectional findings linking impulsivity and SI in those with problematic alcohol use, and (b) extend these findings to examine the momentary associations between impulsivity and SI within this population.

Method: Two independent undergraduate samples were utilized: the first cross-sectional (n = 653) and the second employing ecological momentary assessment (n = 56). All participants screened for problematic alcohol or substance use.

Results: Our results show a unique association between the impulsivity facet of negative urgency and SI. Results also demonstrate an interactive effect of negative affect and "spur of the moment decisions" in predicting concurrent SI, as well as an interaction between negative affect and "saying things without thinking" in prospectively predicting SI.

Conclusions: Findings highlight the saliency of negative urgency, both at the trait and state level in the prediction of SI. Although in need of replication, results indicate that specific aspects of momentary impulsivity may be uniquely linked with SI, and that this relationship may be context dependent.