Is Impulsive Aggression the Critical Ingredient?
Our understanding of suicide is changing for the better, but this alone may not be enough to save many young lives. If we equate the treatment of depression and other psychological disorders with prevention of suicide, we may leave out the essential (and likely genetic) aspect of suicide that turns psychopathology and social problems into the terrible act of self-murder. The ﬁrst lesson of David Brent’s article is that self-destructive behavior that seems as complex as life itself, and as beyond our coping, may become intelligible when viewed as a specific brain disorder. So it may be with suicide by children, adolescents, and young adults, where a swirling constellation of familial, societal, and psychological factors begin to point in a common direction: toward the impulsively aggressive personality. The second lesson is that the role of genetic inheritance in most brain disorders will prove to be complex. Brent traces how the genetic roots of impulsive aggressiveness interact with those of psychiatric illness. In the end, it is more hopeful to think that youth suicide continues at an appalling rate not because we are helpless, but because we only think we understand it.