An Integrated View of Suicidal Ideation: A Look at Individual Difference Vulnerabilities and Day-to-day Risk Factors of Suicidal Thoughts

Prediction of the severity and occurrence of suicidal ideation has been a challenge for decades, possibly due to an almost exclusive focus on predictors months to years prior to suicidal ideation assessment. The primary aim of this dissertation was to provide an integrative view of suicidal ideation by examining vulnerability and risk factors as predictors of suicidal ideation severity (baseline assessment) and occurrence (momentary assessment). Three overarching areas were investigated: (1) emotions as predictors of ideation; (2) beliefs about suicide as an escape or as a solution to a problem; and (3) the intersection between emotions and beliefs about suicide in predicting/maintaining ideation. A relationship between baseline emotion dysregulation and suicidal ideation severity (baseline and 6-months later) was found, along with momentary increases in sadness, hopelessness, and general negative affect as predictors of increased probability of ideation occurrence. Emotional intensity across seven emotional states in day-to-day assessments was found to immediately increase following ideation occurrence, while stress and anxiety reduced in intensity nearly three hours after ideation occurrence. Further, belief in suicide as a solution predicted greater intensity of hopelessness, sadness, stress, and overall negative affect following the occurrence of a thought. Belief in suicide as an escape only predicted greater intensity of anger following occurrence in day-to-day reports. Notably, difficulties generating relevant solutions to a problem predicted greater likelihood of suicidal ideation occurrence in real-time and greater frequency in a two-week period. Regarding the intersection between emotions and beliefs, belief in suicide as an escape moderated the relationship between baseline emotion dysregulation and baseline and 6-month suicidal ideation severity, such that this relationship was stronger for individuals who endorsed this belief. No other significant intersection between emotions and beliefs was found. This dissertation offers a view of the cognitive-emotional aspects of ideation severity and occurrence, with novel results illustrating (a) the importance of beliefs about suicide, (b) the potential maintenance of suicidal ideation through a vicious cycle of increasing negative emotion intensity, and (c) the relationship between difficulties generating relevant solutions to a problem and suicidal ideation. These findings have the potential to inform future assessment and intervention efforts.Ph.D