Relationship Between Impulsivity, Self-Harm Behavior, and Suicidal Ideation in a Preadolescent Sample From the Adolescent Brain Cognitive Development (ABCD) Study

Background: When assessing for suicide risk, research has shown that individual propensity to act impulsively is a predictive factor in adolescent clinical samples. To determine whether this relationship is also present in younger children, this study aims to identify the relationship between motivational systems and suicidal ideation (SI) with/without non-suicidal self-injury (NSSI) among preadolescents. Methods: The BIS/BAS questionnaire and K-SADS interview were used to examine the interaction between motivational systems and suicidal behavior in children who endorsed both prior NSSI and SI (n = 90; mean age = 10.1 yrs), past NSSI only (n = 132; mean age = 9.88 yrs), past SI only (n = 285; mean age = 9.98 years), and controls who endorsed neither NSSI or SI (n = 285; mean age = 10.08). Results: NSSI+SI children scored higher in BIS, BAS-drive, BAS-fun seeking, and BAS-reward responsiveness scales (all p < 0.05) compared to controls. Past NSSI only (all p <0.05) and past SI only (all p < 0.001) children scored higher in both BAS-fun seeking and BAS-reward responsiveness domains compared to controls. Conclusion: Children who endorsed NSSI, SI, or both scored higher on indices of impulsivity than controls. Additionally, children who endorsed both NSSI and SI scored higher on inhibition measures than controls. These results suggest that NSSI and SI children are experiencing greater deficits in approach and avoidance systems. Future research should aim to identify neural correlates of these systems to better understand impulsivity and inhibition as a risk factor for self-injurious behavior and suicidal ideation in youth.