Competing Strength-Based Models of Trauma and Suicidality in a High-Risk Primary Care Sample

There is limited research on the relationship between trauma exposure, depression, and suicidality, particularly in high-risk primary care samples. The present study aims to: 1) characterize the prevalence of suicidality, depression, and trauma exposure in this sample; 2)develop and test models of the relationships between suicidality, depression, and trauma exposure in this sample; 3) augment the selected model with key protective factors, including social support and religiosity; and 4) further elaborate the nature of religiosity as a potential protective factor using the subscales of the Attitudes toward God scale, Anger toward God and Comfort with God. Patients (n=207) in a safety net primary care clinic waiting room completed measures assessing childhood and adult trauma, depression, and suicidal ideation. Approximately half of patients in this sample report having experienced at least four traumatic events, 82.13% of individuals were in the clinical range for depression, and nearly half of the sample endorsed some level of suicidality. In the first model, trauma exposure moderated the relationship between depression and in the second model, suicidality and depression mediated the relationship between trauma exposure and suicidality. Both models were then augmented with social support, religiosity, Anger toward God, and Comfort with God. All moderated moderational and moderated mediational models were nonsignificant, though certain paths were found to be significant. Social support had some protective effects, but all three aspects of religiosity exacerbated the models tested, in contrast to existing literature. These findings may be used to encourage more extensive and nuanced assessment for suicidality