Examining aspects of psychological flexibility within the integrated motivational-volitional model of suicidal behavior: A prospective investigation.

BACKGROUND: According to the integrated motivational-volitional model of suicide, feelings of entrapment are related to the emergence of suicidal ideation (SI). However, this relation can be moderated by certain protective factors. METHODS: This study examined whether aspects of psychological flexibility (i.e., experiential avoidance, experiential acceptance, harnessing) moderated the relation between aspects of entrapment and SI severity in college students experiencing SI (N = 553) both cross-sectionally and when SI severity was measured 1 week later (N = 247). RESULTS: At baseline, experiential acceptance, but not experiential avoidance or harnessing, significantly moderated the relation between external entrapment and SI severity and internal entrapment and SI severity. No aspects of psychological flexibility prospectively moderated relations between entrapment and SI severity. CONCLUSIONS: Aspects of psychological flexibility may influence immediate vulnerability to SI severity among young adults experiencing feelings of entrapment. Implications for clinical interventions influencing changes in psychological flexibility are discussed.

Suicide Cognitions Scale: Psychometric Support in a Community Sample Using Bifactor Modeling and Altered Item Content.

The Suicide Cognitions Scale (SCS) measures suicide-related beliefs proposed by the Fluid Vulnerability Theory. A recent investigation of a revised version of the SCS (i.e., SCS-R) which omits items explicitly referencing suicide has indicated that the measure is highly influenced by a general factor and may be useful for distinguishing severity levels of suicidal thoughts and behaviors; however, limited concurrent validity studies with a range of suicide-related experiences have been conducted. As such, this study replicated and extended previous psychometric research on the SCS-R in an online survey study with a community sample of N = 10,625 U.S. adults. Results confirmed the unidimensional structure of the SCS-R. Logistic regression analyses indicated that the total score of the SCS-R is useful in distinguishing varying levels of suicidal thoughts and behaviors such as past-month planning for suicide without attempt versus past-month suicide attempt. Implications and limitations are discussed.

Defeat, Entrapment, and Hopelessness: Clarifying Interrelationships between Suicidogenic Constructs.

Psychological theories of suicide posit conceptually similar constructs related to the development of suicidal thinking. These constructs often evince high-magnitude interrelationships across studies. Within these theories, defeat, entrapment and hopelessness standout as conceptually and quantitatively similar. Theoretical improvements may be facilitated through clarifying the subscale and item-level similarities among these constructs. Factor analytic and phenomenological work has demonstrated equivocal evidence for a distinction between defeat and entrapment; hopelessness is not typically analyzed together with defeat and entrapment despite evidence of large-magnitude interrelationships. This study explored the interrelationships among the foregoing constructs within a sample of undergraduate students (N = 344) from two universities within the Southeastern United States. Participants, oversampled for lifetime history of suicidal ideation and attempts, completed an online cross-sectional survey assessing defeat, entrapment, hopelessness and SI. Exploratory factor and parallel analyses demonstrated support for a one factor solution when analyzed at subscale level of the three measures as well as when all items of the three measures were analyzed together. Ad hoc exploratory structural equation modeling (ESEM) bifactor results evinced support for the existence of a single, general factor at the item level. Item level communalities and bifactor fit indices suggest that hopelessness may be somewhat distinct from defeat and entrapment. Clinical and theoretical implications are discussed in the context of study limitations.

Verbal Response Latency as a Behavioral Indicator of Diminished Wish to Live in a Clinical Sample of Active Duty Army Personnel with Recent Suicidal Ideation.

OBJECTIVE: Research on risk factors of suicide attempt has yielded little improvement in imminent risk detection for clinicians, due in part to the inherent limitations of self-report methodologies. Therefore, objective behavioral indicators of suicide risk that can be implemented practically with little cost in clinical settings are needed. METHOD: The current study examined verbal response latency, measured as the length of time to answer a question asking about reasons for living (i.e., What are your reasons for living or not killing yourself?), as a potential indicator of suicide risk among 97 active duty Army personnel presenting to an emergency department or behavioral health clinic for current suicide ideation and/or a recent suicide attempt. RESULTS: Verbal response latency was significantly correlated with diminished wish to live at the participant level but was not significantly correlated with wish to die or overall severity of suicidal ideation. CONCLUSION: Verbal response latency may serve as an objective indicator of suicide risk. HighlightsResponse latency to a life construct may be an objective indicator of suicide riskDelayed response latency is indicative of diminished wish to livePathological mechanisms may manifest within dyadic interactions via verbal behaviors.

Entrapment and suicidal ideation: The protective roles of presence of life meaning and reasons for living.

OBJECTIVE: The integrated motivational-volitional model of suicide proposes that feelings of entrapment play a key role in the development of suicidal ideation. The model also posits a set of motivational moderators which either facilitate or hinder the development of suicidal thinking when entrapment is present. These motivational moderators include factors such as attitudes, future goals, thwarted belongingness, and social support. Two previously studied protective factors against suicide, reasons for living and life meaning, have received support in suicidology and might serve as motivational moderators in this model. METHODS: The current cross-sectional study included college students (N=195) oversampled for recent suicidal ideation who took a series of self-report questionnaires online. RESULTS: Our findings demonstrated that both reasons for living and life meaning are protective against the relation between entrapment and suicidal ideation, especially when presence of life meaning and reasons for living of high. Search for life meaning was found demonstrated a less protective relation with SI severity, particularly when reasons for living were low. CONCLUSION: Both motivational moderators demonstrated protective relationships with suicidal ideation and may be relevant to suicide prevention strategies. Limitations and future directions are discussed.

Internal entrapment and fearlessness about death as precipitants of suicidal thoughts and planning in the context of post-traumatic stress disorder.

BACKGROUND: The relationship between post-traumatic stress disorder (PTSD) and suicidal thoughts and behaviors (STB) has been extensively studied but explanatory mechanisms remain inconclusive. Entrapment is one variable that evinces a mechanistic relationship with PTSD and STB. The current study examined the indirect effect of PTSD screen on suicide ideation (SI), planning, and likelihood of future suicide attempt through internal (IE) and external entrapment (EE), moderated by levels of fearlessness about death (FAD). METHOD: The cross-sectional sample consisted of military service members and civilians recruited from primary care clinics across the United States (N = 2690). RESULTS: Moderated mediation models indicated an indirect relationship between a positive PTSD screen, past-month SI, and past-month suicide planning through IE but not EE at low, moderate, and high levels of FAD. These relationships were replicated for the association between positive PTSD screen and concurrent self-rated likelihood of a future suicide attempt through both IE and EE at moderate and high levels of FAD. CONCLUSIONS: Phenomenological implications are discussed, including IE as a mechanism of action in the PTSD/SI pathway and FAD as necessary to potentiate suicidal planning for those experiencing IE.

Unwanted sexual experiences and retraumatization: Predictors of mental health concerns in veterans.

OBJECTIVE: Repeated exposure to traumatic events has consistently been shown to negatively impact mental health functioning; however, the role of timing of such events has received less attention. The present study evaluated the role of trauma that has occurred prior to military service, during service, and across both points in contributing to the most common and deleterious mental health concerns experienced by military personnel: posttraumatic stress, depression, suicide ideation, and suicide attempts. METHOD: Utah and Idaho National Guard personnel (n = 997) completed online self-report questionnaires of their current posttraumatic stress and depression symptoms, as well as history of potentially traumatic experiences, suicidal thoughts, and actions. RESULTS: Results indicated that history of trauma across time points is associated with negative outcomes across each of these outcomes, with the exception of suicide attempts. Exploratory analyses further revealed that unwanted or uncomfortable sexual experiences (not sexual assault) is the most robust predictor of negative outcomes, with approximately 2 to 7.5 times increased risk for PTSD, depression, suicide ideation, and suicide attempts. CONCLUSIONS: The present findings suggest that individuals with history of trauma prior to military service are at increased risk for developing clinically significant mental health problems if exposed to additional potentially traumatic experiences. Further, other unwanted sexual experiences appear to be particularly detrimental to mental health functioning. Potential implications for military recruitment and conceptualization of traumatic events are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).