Impulsivity, aggression, and suicidality relationship in adults: A systematic review and meta-analysis

EClinicalMedicine. 2022 Feb 18:45:101307. doi: 10.1016/j.eclinm.2022.101307. eCollection 2022 Mar.

Abstract

Background: The aim of the study was to crystallize the nature of relationships between impulsivity, aggression, and suicidality. We reviewed studies of adults with published, psychometric measures of impulsivity and aggression, and measures of suicidality.

Methods: Our primary data source was Web of Science (from inception to 31st December 2021). Quality of articles was assessed using a Joanna Briggs Appraisal Tool and publication bias using Trim and Fill. We synthesised results using random effects meta-analyses and explored moderation by measure of impulsivity, aggression, and suicidality, and population.

Findings: 77 studies were included in our analysis. We found weak positive relationships between impulsivity (r = 0·19 [95% CI: 0·15-0·22]), aggression (0·23 ([0·17, 0·29]), and impulsive aggression (0·16 [0·1, 0·22]) with suicidality. Heterogeneity was significant and only partially explained by moderators. Limitations included the lack of studies which assess impulsivity or aggression proximal to suicidality.

Interpretation: Given small effect sizes and significant heterogeneity, the study suggests that additional studies are needed in the field to analyze the relation between impulsivity and aggression with suicidality.

Funding: None.

Keywords: Aggression; Impulsive aggression; Impulsivity; Meta-analysis; Suicide.