Relationship between suicidal behavior and metacognitive characteristics in antisocial personality disorder

Objective: This study aimed to investigate the relationship between metacognitive characteristics and suicidal behavior in patients with Antisocial Personality Disorder (ASPD). Materials and Methods: Between October 2020 and April 2021, 74 patients diagnosed with ASPD according to DSM-5 diagnostic criteria, who applied to Çukurova University Faculty of Medicine Balcalı Hospital, Department of Psychiatry, were included in the study as the patient group and 74 healthy volunteers as the control group. Sociodemographic data form, Metacognition Scale (MCQ), Beck Suicidal Ideation Scale (BSIS), Suicidal Behavior Scale (ISS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) were applied to the sample group. Results: The results show that individuals with ASPD generally show worse metacognitive characteristics compared to the control group, and individuals with ASPD who have previously attempted suicide have higher uncontrollability and danger (U/D) and need to control thoughts (NCT) subscale scores than those who have not attempted suicide. The ISS, which measures the severity of suicidal behavior, and the DMI subscale were correlated in the patient and control groups; ISS was also found to be correlated with the cognitive confidence (CC) subscale in the ASPD group and with the positive beliefs (PB) subscale in the control group. Conclusion: According to the results of our study, metacognitive beliefs and the severity of suicidal behavior, depression and anxiety symptoms can be associated in individuals with ASPD. It should be considered that poor metacognitive abilities (beliefs about the need to control thought and cognitive confidence sub-dimensions) may be useful in determining the risk of suicide in individuals with ASPD and that patients may benefit from metacognitive therapy methods.