Adolescent boys who attempt suicide more likely to be aggressive toward partners

Young men who attempt suicide before age 18 are much more likely as adults to be aggressive toward their girlfriends or wives, including hitting and injuring their partners, according to a new study.

This groundbreaking new research provides further evidence of the need for intervention with suicidal teens. It is based on data from 153 males from higher-crime neighborhoods who were assessed yearly from ages 10 to 32, and their romantic partners who participated when the men were ages 18 to 25.

The study, funded by the National Institutes of Health, is published online in the journal Psychological Medicine.

According to the study's authors, David Kerr of Oregon State University and Deborah Capaldi of the Eugene-based Oregon Social Learning Center, the magnitude of the association between a suicide attempt and injury of a partner was surprising: 58 percent of youth in that study group who attempted suicide went on to injure a partner, compared to 23 percent of young men who did not attempt suicide.

"The study began when these men were kids, before anyone knew who was going to become violent," said Kerr, an assistant professor of psychology at OSU who studies youth suicide, depression, and health-risking behaviors. "That is quite different from research that starts with violent men, or women from a domestic violence shelter, and tries to look back in time for explanations."

The study also did not rely on just one source of information, such as men's own reports of aggression. Instead, the researchers had data from official domestic violence arrest records, women's own reports of injury, and live observations of the couples.

The researchers controlled for other problems suicidal youth can have which are also linked to violence to partner, such as aggression, depression, substance use, and family abuse history. The researchers still found that young men who attempted suicide were more aggressive toward their partners.

"It was fascinating that this link just refused to be explained away," said Kerr.

Capaldi, who is a senior scientist with Oregon Social Learning Center and has studied issues around domestic violence for many years, said the study indicates the risk factors for men's violence toward women differ from much of what is accepted.

"Conventional wisdom portrays men's violence to women as more cold, controlled and calculated," she said. "The findings of this study indicate that for some men violence is related to a history of impulsive aggression that includes self-harm as well as aggression to others."

Capaldi added that this finding is consistent with a growing body of recent work indicating that both men and women who are physically aggressive toward a partner have histories of problems with aggressive and impulsive behavior.

"The study has critically important implications for prevention and treatment," she said. "When men are told domestic abuse is solely due to cold, controlling and systematic battering, they may dismiss their own problem since such a pattern may not apply to them. If men understood that it may more be related to controlling anger and impulsive reactions when under stress, they may become more aware that they are at risk and take the responsibility for learning how to avoid this."

"These findings do not mean that violent men can claim, 'I can't help myself,' " Kerr added. "Partner violence is a huge problem for women and children, and men are responsible for their behavior."

The researchers say that thinking about (rather than attempting) suicide in adolescence has been found to predict mental health problems and suicide risk in adulthood, but was not related to partner abuse or injury in this study.

The difference between suicidal thoughts versus actual suicidal behavior could be important to understanding why suicide attempts predicted later partner abuse. "One can be intensely distressed and suicidal without acting on it," said Kerr. "It may be a man's capacity to hurt himself that makes him more likely to hurt a romantic partner."

Both researchers said this study shows further evidence that intervention and prevention programs are needed for youth who attempt suicide. In addition to previous studies that associate suicide attempts in youth with completed suicide - or negative outcomes such as depression, repeated suicide attempts and substance abuse - risk for partner abuse is another potentially serious threat.

"Suicidal behavior is not trivial at any age," Kerr said, "It is not just teenage drama or angst. Rather, it reflects a vulnerability that can have long-term consequences for individuals, and now we know, for their partners too."

Capaldi said effective prevention and treatment programs can strike at a whole host of underlying issues in a troubled child or teen.

"Adolescent boys who attempt suicide are at risk for serious long-term problems," she said, "and thus targeted prevention aimed at decreasing future aggression and increasing behavioral and emotional control is really necessary."