Suicidal Behaviour and Stressful Life Events: The Mediating Role of the Impulsivity-Aggression-Hostility Triad Through Psychological Autopsy

Background: Stressful life events (SLEs), impulsivity, aggression, and hostility are known risk factors for suicide. The existence of an "I-A-H Triad" (composed of impulsiveness, aggressiveness and hostility) is proposed as a mediating factor between SLEs and suicide. Method: Data on 399 deceased people (274 from suicide, 125 from other causes) were collected through psychological autopsy. The Paul Ramsey Life Experience Scale (to collect SLE history), the Barrat Impulsivity Scale (BIS-11) and the Buss-Durkee Hostility Inventory (BDHI) were applied, using versions adapted for psychological autopsy. Results: Comparative analysis of the two groups showed significant differences in the variables of interest (SLE: t = 7.280; BDHI: t = 4.201; BIS-11: t = 3.812; I-A-H Triad: t = 4.84). Mediation analysis confirmed the role of the I-A-H Triad in mediation of the presence of SLEs and the type of death. Conclusions: High levels of impulsivity, aggression, and hostility increase the risk of suicide when a person is faced with SLEs.