Background: Attention Deficit-Hyperactivity Disorder (ADHD) has been associated with suicidal thoughts and behaviours across the lifespan. However, there is a dearth of research into the role of psychological factors in this context, rendering our ability to predict individuals who may be at increased risk of suicide limited. Models such as the Integrated Motivational–Volitional (IMV) Model of Suicidal Behaviour (O‘Connor, 2011, O’Connor & Kirtley, 2018) provide a framework which may further our understanding of the association between ADHD and suicide risk.
Aims: To explore the ADHD-suicide risk relationship in the context of the IMV model of suicidal behaviour.
Methods: 626 participants who had experience of ADHD completed measures online, including recent ADHD symptoms, suicidal thoughts and suicide attempts and key components from the IMV model (e.g. defeat, entrapment, mental imagery, impulsivity).
Key Findings: 93.7% of participants (n=580) had experienced suicidal ideation, and 42.7% (n=259) of participants had attempted suicide. Consistent with the predictions of the IMV model, higher scores on key measures of psychological risk factors, specifically defeat and entrapment were associated with recent suicidal ideation. We also found that the IMV model’s volitional factors, such as impulsivity and mental imagery, differentiated between participants who had attempted suicide and those who had not made a suicide attempt. Multivariate models controlling for recent ADHD symptoms and the other IMV factors were conducted. Defeat and entrapment, mental imagery, and burdensomeness remained significantly associated with suicidal ideation, while the volitional phase factors, namely mental imagery and fearlessness about death remained significantly associated with suicide attempts.
Conclusions: The results suggest that psychological factors in addition to the presence of ADHD are important in understanding the ADHD–suicide risk relationship, and highlights that facets of the IMV model (e.g. defeat, entrapment, impulsivity) may provide a useful context to help us to better understand the ADHD-suicide risk relationship, and the potential importance of these factors in detecting individuals who may be at increased risk of suicide.