(PS9-D78) Implications of BPD, ASPD, and Other Serious Mental Illness for Suicide Spectrum Behaviors in Correctional Settings

Cluster B disorders -- especially borderline personality disorder (BPD) and antisocial personality disorder (ASPD) -- and other serious mental illness (SMI) are highly prevalent in correctional settings and pose a significant risk for engaging in suicide spectrum behaviors. Research thus far examining the implications of Cluster B disorders and SMI for suicide spectrum behaviors primarily consider whether or not there is a history of suicidal behavior, and in some cases also consider whether single or multiple incidents of suicide spectrum behaviors occurred, but without considering the number of incidents.  In the current study, we examined the relationships of SMI and Cluster B, as well as their interaction, to suicide spectrum behaviors. It may be that while both SMI and Cluster B are uniquely related to suicide spectrum behaviors, the combination of the two may be especially risky. Using a hurdle regression model, we examined how Cluster B disorders and SMI as well as their interaction relate to the risk of engaging in single versus multiple incidents. Within the multiple incidents group, we then examined how these disorders relate to the number of incidents of suicide spectrum behaviors. Further, we separated out the Cluster B disorders and examined how BPD and ASPD each relate to suicide spectrum behaviors along with SMI. Among a sample of 1,634 individuals (88.2% male) incarcerated in different municipal jails and state correctional facilities, BPD, ASPD, and other SMI were each associated with a greater likelihood of engaging in multiple vs. single suicide spectrum behaviors, consistent with previous studies.  Extending the literature, among those engaging in multiple suicide spectrum behaviors, BPD and ASPD (but not other SMI) were associated with more incidents. Interactions between Cluster B and SMI were not significant in any of the models. The lack of interactions suggests that SMI does not exacerbate the effect of Cluster B disorders on the risk of suicide spectrum behaviors. In terms of clinical implications, the knowledge of which particular disorders relate to repeated incidents of suicide spectrum behaviors would help clinicians in accurately assigning diagnoses, assessing risk, and developing preventive plans.