Psychopathy and suicide: the mediating effects of emotional and behavioral dysregulation

Date of Award


Degree Name

M.A. in Psychology, Clinical


Department of Psychology


Advisor: Catherine Lutz Zois


Psychopathy is recognized as a heterogeneous condition with empirical support behind the subtypes primary and secondary (Skeem, Poythress, Edens, Lilienfeld, & Cale, 2003). Research indicates differential patterns of associations between psychopathy subtypes and suicide whereby secondary psychopathy is positively related to suicidal ideations and attempts, and primary psychopathy is either negatively or unrelated to suicidal ideations and attempts (Verona, Hicks, & Patrick, 2005; Verona, Patrick, & Joiner, 2001). In seeking to explain the differential pattern of associations between psychopathy subtypes and suicide, the present study drew upon two modern frameworks for understanding self-injury: the emotional cascade model (Selby, Anestis, & Joiner, 2008) and interpersonal theory of suicide (IPTS; Joiner, 2005). The emotional cascade model attempts to understand how emotional and cognitive dysfunction combine to predict behavioral dysregulation such as non-suicidal self-injury (NSSI). The IPTS hypothesizes that an attempt at suicide requires the presence of both the desire for death and the capability to act on said desire and that these processes operate independently of one another. A history of painful and provocative experiences, such as NSSI, is believed to incrementally contribute to an acquired capability for suicide, increasing a tolerance for pain and decreasing the fear of death. Likewise, research has found that a history of NSSI is elevated in individuals that act on their suicidal ideations versus those that do not (Klonsky, May, & Glenn, 2013). In the present study, specific cognitive, affective, and behavioral features integral to the emotional cascade model and IPTS, as well as present in secondary psychopathy, were hypothesized to contribute to a history of suicide attempts in a sample of 204 male and female offenders. A serial mediation analysis was conducted to test if the association between secondary psychopathy and suicide attempts was best explained through the indirect path of emotion dysregulation, rumination, suicidal ideation, and NSSI. The results supported this pattern of events, as the above variables sequentially mediated the relationship between secondary psychopathy and suicide attempts. Additional findings related to further differentiating psychopathy subtypes will be discussed, as will implications, limitations, and future directions.


Suicide Psychology Research, Suicide victims Psychology Research, Self-injurious behavior Research, Clinical Psychology, Personality, suicide, psychopathy, emotion dysregulation, non-suicidal self-injury, rumination, suicidal ideation, acquired capability, distress tolerance

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Copyright © 2017, author