Differentiating suicide attempters from suicide ideators using the Integrated Motivational-Volitional model of suicidal behaviour

Abstract Background Suicidal behaviour is a significant public health concern, yet little is known about the factors that enable or impede behavioural enactment (engaging in a suicide attempt). Aims Drawing on the Integrated Motivational-Volitional (IMV) Model of Suicidal Behaviour (2011), this study examined the factors associated with having thoughts of suicide (ideation) versus those associated with suicide enaction (attempts). Within a multivariate context, it was predicted that the factors associated with ideation formation (motivational factors) would be distinct from those factors which governed behavioural enaction (volitional moderators). Method Healthy adults (N=1, 288) completed an anonymous self-report survey. Analyses compared three groups: suicide attempters (n=230), suicide ideators (n=583), and those without any suicide history (n=475). Results Suicide attempters differed from suicide ideators on all volitional factors (fearlessness about death, impulsivity, and exposure to suicidal behaviour), with the exception of discomfort tolerance. Compared to ideators, attempters were more likely to have a family member and close friend who had self-injured or attempted suicide, and were more impulsive and fearless about death. Conversely, the two suicide groups did not differ on any of the variables (motivational factors) associated with the development of thoughts of death by suicide. Limitations This is a cross-sectional study based on self-report measures. Conclusions Further research efforts to distinguish between suicide ideators and suicide attempters is crucial to inform the development of intervention and treatment approaches.