Examining the relationship of dissociation to suicide ideation and suicide attempts

Suicide is a leading cause of death worldwide. Despite decades of research, knowledge is lacking regarding which individuals who think about suicide will go on to attempt suicide. This distinction is important, as most people who think about suicide will never attempt. Identifying factors associated with increased risk of attempting suicide among those with suicide ideation is critical for improving suicide prevention. Dissociation (e.g., feeling detached from one’s body and/or surroundings) is proposed to facilitate engaging in lethal self-harm and may play a role in decreasing the fear and perception of pain involved in attempting suicide. However, previous research is unable to discern whether dissociation is a correlate of suicide ideation, suicide attempts, or both. Thus, this study examines whether dissociation exhibits a relationship to suicide attempts over and above a relationship to suicide ideation. Undergraduates oversampled for histories of suicide ideation and attempts were recruited from the University of British Columbia (n=754). The sample was divided into three groups: no history of ideation or attempts (nonsuicidal; n=356), ideation and no attempts (ideators; n=276), and ideation and attempts (attempters; n=122). All participants completed a battery of self-report questionnaires assessing key study variables. Results show that dissociation was elevated not only among ideators compared to nonsuicidal participants (d=0.19, p=.021), but also among attempters compared to ideators (d=0.28, p=.009). Dissociation maintained its unique association to suicide attempt history when controlling for suicide capability, but not when controlling for current suicidal desire, emotion dysregulation, symptoms of Borderline Personality Disorder (BPD), symptoms of Posttraumatic Stress Disorder (PTSD), or nonsuicidal self-injury (NSSI). Similarly, dissociation no longer related to suicide ideation history controlling for low belongingness, emotion dysregulation, symptoms of BPD, or PTSD. Main findings suggest that dissociation is associated with suicide attempt history over and above suicide ideation, however, this relationship does not persist when controlling for covariates. Among these, symptoms of BPD and NSSI emerged as relatively stronger predictors of suicide attempt history. Findings highlight the unique contribution of dissociation to suicide attempts and the relative importance of different clinical variables in understanding the presentation of undergraduates with a history of suicide attempts.Arts, Faculty ofPsychology, Department ofGraduat