Department of Dynamic and Clinical Psychology, Health Studies, University of Rome Sapienza, Italy.
Department of Educational Sciences, University of Genoa, Italy.
J Affect Disord. 2023 Oct 15;339:571-583. doi: 10.1016/j.jad.2023.07.086. Epub 2023 Jul 17.
The affective, cognitive, and behavioral aspects of impulsivity involved in suicide-related outcomes can be investigated through the UPPS model, which conceptualizes these facets in multidimensional terms related to negative and positive urgency, lack of premeditation and perseverance, and sensation seeking. This systematic review and meta-analysis provided a comprehensive understanding of the role of all facets of impulsivity in the development of suicidal ideation and behaviors.
We conducted a systematic search on six databases (PsycINFO, PsycARTICLES, PubMed, MEDLINE, Scopus, and Web of Science) until May 5,2023. Overall, 49 studies met the criteria for systematic review, of which 37 were included in a meta-analysis of data from 17.898 individuals. Additional moderation analyses included age, gender, sample status, country of study conduct, assessment instruments, type of suicide-related outcome, study quality, and research design.
We found significant relationships between aspects of impulsivity and suicide-related outcomes. Specially, affective facets related to impulsivity showed a stronger association with suicidal ideations and attempts than cognitive and behavioral dimensions, recommending the main involvement of emotional aspects-positive and negative-in suicide-related dimensions.
The limited number of studies may have negatively impacted the power of moderation analyses. In addition, for most dimensions of impulsivity, the limited number of longitudinal studies did not allow to test the moderating role of research design.
This study supports the role of impulsivity in suicidal ideation and behavior, identifying the affective component of impulsivity as the most involved, providing a significant contribution from a clinical and diagnostic point of view.
与自杀相关结果相关的冲动的情感、认知和行为方面可以通过 UPPS 模型进行研究，该模型从与消极和积极冲动、缺乏预谋和毅力以及寻求刺激有关的多维角度来概念化这些方面。本系统评价和荟萃分析全面了解了冲动的所有方面在自杀意念和行为发展中的作用。
我们在六个数据库（PsycINFO、PsycARTICLES、PubMed、MEDLINE、Scopus 和 Web of Science）上进行了系统搜索，直到 2023 年 5 月 5 日。总体而言，有 49 项研究符合系统评价标准，其中 37 项研究纳入了来自 17898 人的数据荟萃分析。额外的调节分析包括年龄、性别、样本状态、研究开展国家、评估工具、自杀相关结果类型、研究质量和研究设计。
我们发现冲动的各个方面与自杀相关结果之间存在显著关系。特别是，冲动的情感方面与自杀意念和自杀企图的关联比认知和行为维度更强，这表明在自杀相关维度中情绪方面（积极和消极）主要涉及。
研究数量有限可能对调节分析的效力产生负面影响。此外，对于冲动的大多数维度，纵向研究的数量有限，无法测试研究设计的调节作用。
本研究支持冲动在自杀意念和行为中的作用，确定冲动的情感成分是最相关的，从临床和诊断的角度来看，这是一个重要的贡献。
