Impulsiveness indirectly affects suicidal ideation through depression and simultaneously moderates the indirect effect: A moderated mediation path model

OBJECTIVE: This study aims to investigate the indirect effect of impulsiveness on suicidal ideation through depression and the moderating effect of impulsiveness on the indirect effect in an integrated path model. METHODS: Self-rating depression scale (SDS), Barratt impulsiveness scale-11th version (BIS-11), and self-rating idea of suicide scale (SIOSS) were applied. A moderated mediation path model was established including impulsiveness, depression, and suicidal ideation as observed variables. RESULTS: The main results revealed that the moderated mediation path model fit well in describing the relationships among impulsiveness, depression, and suicidal ideation. The indirect effect of impulsiveness mediated by depression and the moderating effect of impulsiveness on suicidal ideation was significant. Multiple comparisons showed that the indirect effects under different conditions of impulsiveness had statistical differences. The higher the impulsiveness was, the stronger the predictive effect of depression on suicidal ideation was. CONCLUSIONS: The present study confirms that people who have impulsive traits are riskier to generate suicidal thoughts because they are more likely to suffer from depression and that people who are depressive have even higher risk to develop suicidal thoughts when they simultaneously have impulsive traits. In clinical and health care work, when considering depression to prevent suicidal ideation, impulsiveness needs to be monitored throughout the process of premorbid and onset stages of depression.