Intimate Partner Problems and Suicide Impulsivity: A Mixed-Methods Analysis of National Violent Death Reporting System

Introduction: Intimate partner problems (IPP), such as relationship conflict, divorce, and violence are well known risk factors for suicide. However, there is limited research on how IPP affect suicide risk among immigrant populations. Our team reviewed National Violent Death Reporting System (NVDRS) cases involving 774 immigrant women who died by suicide in situations involving IPP. Nearly half of these deaths (47.2%) were identified as impulsive suicides which occurred suddenly and without prior planning. This finding led us to explore which types of IPP are associated with impulsive suicide and what contextual factors are associated with impulsive suicides. Accordingly, we examined factors associated with impulsive suicide among immigrant women who experienced IPP.

Methods: This study used secondary data from the NVDRS, focusing on 774 suicide cases involving immigrant women experienced IPP. First, we analyzed NVDRS narrative data using content analysis to identify specific types of IPP and relevant contextual information. Narrative data were independently double-coded by four research team members using a codebook updated from previous work (Brown & Seals, 2019; Kafka et al., 2022). Second, we merged the quantitative variables derived from the narrative analysis with existing NVDRS quantitative data. Logistic regression analyses were then conducted to examine associations between IPP indicators and impulsive suicide, adjusting for multiple relationship factors and contextual variables.

Results: The findings showed that fight/argument (OR = 2.76, p < .001), recent intimate partner problems within one month (OR = 2.06, p = .004), infidelity (OR = 1.56, p = .039), and firearm use (OR = 1.59, p = .035) were associated with higher odds of impulsive suicide. In contrast, a history of suicide attempts (OR = 0.17, p < .001), mental health problems (OR = 0.52, p < .001), and disclosure of suicide intent (OR = 0.53, p = .006) were associated with lower odds of impulsive suicide. Race/ethnicity and immigration-related challenges were not significant after adjustment.

Discussion: Although common risk factors for suicide include mental health disorders, previous suicide attempts, and suicide disclosure, our findings suggest that IPP may show a different pathway to suicide. In these cases, suicide can occur without prior mental health problems or planning. IPP such as relationship crises and challenges adding to immigrant acculturation stress can become sudden and overwhelming life stressors. When these stressors occur in the context of social isolation and limited support in the host country, they may lead to life-threating crises. These findings highlight the importance of suicide prevention and risk assessment tools that recognize different pathways to suicide, rather than treating suicidality as a single pathway, especially for immigrant populations experiencing relationship conflict.

References

Brown, S., & Seals, J. (2019). Intimate partner problems and suicide: are we missing the violence?. Journal of Injury and Violence Research, 11(1), 53.

Kafka, J. M., Moracco, K. B. E., Taheri, C., Young, B. R., Graham, L. M., Macy, R. J., & Proescholdbell, S. (2022). Intimate partner violence victimization and perpetration as precursors to suicide. SSM-Population Health, 18, 101079.