Psychological Inflexibility Predicts Suicidality Over Time in College Students.

OBJECTIVE: It is essential to identify modifiable risk factors that can be targeted to reduce suicidal ideation (SI) and behavior in college students. Psychological inflexibility, a pattern of responding to internal experiences in a literal and rigid way, and attempting to control those experiences even when it interferes with valued living, could theoretically lead to SI or increase its intensity. METHOD: Psychological inflexibility and its component processes were tested as a predictor of SI in a longitudinal survey of college students (n = 603, age M = 20.62, 68.9% female, and 94.0% White) in a series of cross-sectional and longitudinal hierarchical regression models, controlling for relevant predictors such as distress and baseline SI. Interactions were also tested between psychological inflexibility and distress, cognitive defusion, values obstruction, and values progress in predicting SI. RESULTS: Psychological inflexibility predicted SI cross-sectionally and longitudinally, controlling for distress and baseline SI. Psychological inflexibility interacted with distress, cognitive fusion, and values progress such that distress, cognitive fusion, and values progress had the strongest association with suicidal ideation among those who were high in psychological inflexibility. CONCLUSIONS: Psychological inflexibility may be a useful mechanism to target for suicide prevention in college students.

Relational factors critical in the link between childhood emotional abuse and suicidal ideation.

Understanding the pathways leading to suicidal behavior is critical for the development and implementation of effective assessment efforts and suicide prevention programs in public health care systems. Childhood trauma, such as emotional abuse, is one robust risk factor, but only recently have efforts been made to determine mediators of the link between childhood emotional abuse and suicidal ideation. Given that adult survivors of childhood emotional abuse often have attachment difficulties and problems securing positive social support, these interpersonal factors may serve such a mediating role. Using bootstrapping techniques, this investigation tested attachment security and social-support-seeking behaviors as serial mediators of the association between childhood emotional abuse and suicidal ideation in a sample of 150 low-income African American female childhood emotional abuse survivors receiving services in a public health system. Support seeking from family members and friends were tested separately. Results revealed the presence of serial mediation, as predicted. Specifically, increased childhood emotional abuse was associated with decreased attachment security, which, in turn, was related to decreased social support seeking from family members and from friends. These 3 factors combined in sequence subsequently were associated with increased suicidal ideation. Results illuminate the importance of attending to attachment security and social-support-seeking behaviors when designing and implementing assessment and suicide prevention programs for African American women who are survivors of childhood emotional abuse seeking services in public health care systems. Suggestions for universal, selective, and targeted prevention efforts for this population are discussed. (PsycINFO Database Record

Childhood emotional abuse, self/other attachment, and hopelessness in African-American women.

There is evidence that individuals emotionally abused as children endorse more hopelessness, a precursor of suicidal behavior in adulthood. However, there has been little focus on this association among African-Americans or on factors that may mediate the childhood emotional abuse (CEA) - adult hopelessness link. The present study examined whether CEA is linked to hopelessness in adulthood in African-American women suicide attempters and if adult self and other attachment models mediate this association. Participants included 116 African-American women recruited from a large, urban hospital. Results revealed that CEA had no direct effect on hopelessness in adulthood, but did have an indirect effect on hopelessness through attachment models. Bootstrapping analyses showed that higher levels of CEA were related to more negative self and other attachment models, which were then linked to higher levels of hopelessness. Implications for targeting attachment in suicide intervention programs are discussed.