ABSTRACT
Prior studies examining posttraumatic stress disorder (PTSD) symptom clusters and the components of the interpersonal theory of suicide (ITS) have yielded mixed results, likely stemming in part from the use of divergent samples and measurement techniques. This study aimed to expand on these findings by utilizing a large military sample, gold standard ITS measures, and multiple PTSD factor structures. Utilizing a sample of 935 military personnel, hierarchical multiple regression analyses were used to test the association between PTSD symptom clusters and the ITS variables. Additionally, we tested for indirect effects of PTSD symptom clusters on suicidal ideation through thwarted belongingness, conditional on levels of perceived burdensomeness. Results indicated that numbing symptoms are positively associated with both perceived burdensomeness and thwarted belongingness and hyperarousal symptoms (dysphoric arousal in the 5-factor model) are positively associated with thwarted belongingness. Results also indicated that hyperarousal symptoms (anxious arousal in the 5-factor model) were positively associated with fearlessness about death. The positive association between PTSD symptom clusters and suicidal ideation was inconsistent and modest, with mixed support for the ITS model. Overall, these results provide further clarity regarding the association between specific PTSD symptom clusters and suicide risk factors.
Subject(s)
Stress Disorders, Post-Traumatic , Suicidal Ideation , Suicide Prevention , Adult , Cluster Analysis , Female , Humans , Male , Military Personnel/psychology , Military Personnel/statistics & numerical data , Models, Psychological , Risk Assessment/methods , Risk Factors , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/psychology , United StatesABSTRACT
BACKGROUND: Prior research has reported that a substantial portion of suicidal behavior occurs impulsively. These studies, however, have been unable to assess for episodic planning. AIMS: To provide preliminary support for the plausibility and utility of assessing episodic, nonlinear planning in suicidal behavior. METHOD: Fifty undergraduates with a prior history of suicidal behavior responded to a series of questions assessing level of attempt, method, and level of planning during their most recent self-reported suicide attempt. RESULTS: Level of intent was positively associated with planning, and the modal individual whose most recent attempt involved clear intent to die endorsed planning for at least 1 year. CONCLUSION: These preliminary data support the plausibility and potential utility of assessing episodic planning and indicate that suicide attempts involving a clear intent to die typically require extensive levels of planning and rarely (if ever) emerge without forethought.
Subject(s)
Suicide, Attempted/psychology , Adolescent , Adult , Female , Humans , Impulsive Behavior , Intention , Male , Young AdultABSTRACT
Although some theorists conceptualize the relationship between emotion dysregulation and suicidal behavior as direct, recent research suggests that this relationship may be indirect and mediated by repeated experiences with certain behaviors (e.g., non-suicidal self-injury; NSSI) common among individuals with heightened emotion dysregulation. To date, however, this research has been limited in both scope (e.g., examining few components of emotion dysregulation) and generalizability (e.g., over-emphasis on undergraduate samples). This study sought to extend the research in this area by examining the mediating role of NSSI in the association between one relevant aspect of emotion dysregulation (i.e., low distress tolerance [DT]) and suicidal behavior with a clear intent to die among an at-risk sample of substance use disorder (SUD) patients in residential treatment. SUD patients (N=93) completed a structured interview assessing past suicidal behavior and questionnaires assessing DT and NSSI. Consistent with hypotheses, results revealed a significant indirect association between low DT and lifetime suicide attempts through NSSI frequency. These results suggest that exposure to painful and provocative events through experience with NSSI may be one pathway through which certain facets of emotion dysregulation increase the risk for suicidal behaviors (consistent with theories that individuals low in DT may be unable and/or unwilling to engage in suicidal behavior unless they have experienced sufficient levels of painful and/or provocative events capable of changing their relationship with and experience of pain and fear of death).
