One way to operationalize impulsivity of the suicide attempt is to look at the degree of objective signs of planning, as measured by the planning sub scale of the Suicide Intent Scale (SIS).Impulsivity may also be evaluated by the length of the interval between the decision to attempt suicide and the actual attempt. One of the conservative criterions suggested by Williams, and colleges (1980) is five minutes premeditation. Others suggested longer intervals of 20 minutes,88 two hours89 and 24 hours90. Simon, et al. (2001)91 found that 24 percent of survivors of nearlethal suicide attempts had thought about their attempt for less than five minutes. Those who made their attempt within five minutes of deciding to do so were less likely to have considered another method of suicide. They also had a greater likelihood of discovery and a lower expectation of death. These findings were consistent with the description of such attempts as impulsive. Other authors emphasized the mediatory role of the intent to die and the subject’s intention at the time of the suicide attempt. Hawton (1986)92 found that less than 50 percent of subjects with a history of suicide attempts really wanted to die, and he defined their attempts as littleplanned impulsive acts. Motives reported in impulsive suicides ranged from escaping from an intolerable situation to manipulation.85 The association between aggression, impulsivity and suicidal behavior is documented in research and in clinical practice across different diagnoses.9396 There is also some evidence that this association is stronger in younger individuals and decreases in importance with age.97 However the mechanism by which impulsivity and aggression combine with psychopathology to produce suicidal behavior remains uncertain. Current models suggest that aggression and impulsivity may contribute to a summary factor predictive of suicidal behavior in patients with various types of psychiatric diagnoses.51 This is particularly true for a subtype of aggression—reactive aggression—marked by angry, impulsive responses to perceived acute stress98,99 which is externally directed and related to other manifestations of impulsivity100,101 predisposing individuals to the development of psychopathology strongly associated with suicide (e.g., substance abuse and cluster B personality disorders).97,102 Reactive aggression has been associated