Another challenge is that items querying STB are frequently embedded in diagnostic interview sections assessing major depressive or bipolar disorder, such that only individuals reporting mood-related symptoms or episodes are presented with these questions. In addition, a majority of studies have disregarded intensity and duration of ideation (Joiner and Rudd, 2000) and the distinction between planned and unplanned attempts, even though their etiology may differ. In particular, planned attempts are more common in samples that require presence of dysphoric or anhedonic mood in the assessment of suicide (Simon et al., 2002) and their relationship with substance use may also vary. For example, Borges et al. (2000) showed that using one or more substances was related to suicide attempts without planning (SANP), but not to suicide attempts that were planned (SAP). The authors attributed this difference to the disinhibition hypothesis, which proposes that, when using drugs, inhibitions to make an impulsive attempt are reduced, therefore increasing the risk of suicide attempts (Mayfield and Montgomery, 1972; Rossow and Wichström, 1994), although whether attempts were in the context of substance use was not
