Deciding to Die: the Relations of Decision-making Styles to Suicide Ideation and Attempts

Research has struggled to distinguish individuals who have attempted suicide from individuals with suicidal thoughts but no history of suicide attempts. Cognitive attributes such as decision-making mediate thought-behavior relationships; we therefore examined whether different decision-making styles distinguished those who had made suicide attempts from those with suicidal ideation only. Six hundred participants were recruited using Amazon’s Mechanical Turk. Measures assessed five decision-making styles, histories of suicide ideation and attempts, and several commonly cited correlates of suicide. Consistent with previous work, depression, anxiety, hopelessness, psychological pain, and belongingness were associated with suicidal ideation, but similar in individuals who made suicide attempts compared to individuals with suicidal ideation but no history of attempts. In contrast, a spontaneous decision-making style was moderately higher in individuals who made suicide attempts compared to individuals with suicidal ideation. To a lesser extent, borderline personality traits, some aspects of impulsivity, and a rational decision-making style also distinguished individuals who made suicide attempts from those with suicidal ideation. Findings can help inform suicide theory and prevention.