Risk Factors for Suicide Completion in Borderline Personality Disorder
Bibliographic record
Abstract
BACKGROUND: Borderline personality disorder is a major risk factor for suicidal behavior, yet prediction of suicide completion remains unclear. It has been proposed that impulsivity and aggression interact to increase suicide risk. Death by suicide in borderline personality disorder, then, may be the result of impulsivity, a core feature of the disorder, interacting with violent-aggressive tendencies. Using a case-control design, this study investigated clinical and behavioral risk factors for suicide completion in borderline personality disorder. METHOD: One hundred twenty subjects meeting DSM-IV criteria for borderline personality disorder, 50 controls and 70 who died by suicide between 2001 and 2005, were investigated by means of proxy-based interviews using structured diagnostic instruments and personality trait assessments. RESULTS: Borderline personality disorder suicides had fewer psychiatric hospitalizations and suicide attempts than borderline personality disorder controls. Borderline personality disorder suicides were also more likely to meet criteria for current and lifetime substance dependence disorders. They had higher levels of current and lifetime Axis I comorbidity, novelty seeking, impulsivity, hostility, and comorbid personality disorders, while exhibiting lower levels of harm avoidance. Most importantly, borderline personality disorder suicides were more likely to have cluster B comorbidity. Impulsivity and aggression interacted to predict suicide, though not after controlling for cluster B comorbidity. CONCLUSIONS: Borderline personality disorder individuals who die by suicide differ from those borderlines typically encountered in acute psychiatric settings. Our results suggest that the lethality of borderline personality disorder suicide attempts results from an interaction between impulsivity and the violent-aggressive features associated with cluster B comorbidity. Further, the anxious trait of harm avoidance appears to be protective against suicidal behavior resulting in death.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".