Suicidal ideation is associated with safety behavior usage among trauma-exposed individuals

Abstract

Background: Long-standing theoretical perspectives on suicidal ideation (SI) have posited that SI arises, in part, as a way to obtain relief from intense emotional pain. Yet, little research has examined whether SI is linked with other relief-driven behaviors. The present study sought to provide preliminary support for the link between SI and relief-driven safety behavior usage, a commonly used strategy for managing distress among trauma-exposed individuals.

Methods: Trauma-exposed participants (n = 95) recruited for a larger study assessing mechanisms of posttraumatic stress disorder symptomology and completed a battery of self-report measures, including SI and their use of safety behaviors. Zero-inflated negative binomial regressions were utilized to examine the association of safety behavior usage with the presence/absence of SI (i.e., zero-inflation) and SI severity.

Results: In bivariate models, safety behaviors were associated with a greater likelihood of experiencing any SI and reporting more severe SI. When covariates were added to the model, safety behavior usage remained significantly and positively associated with SI severity.

Limitations: The present study employed cross-sectional analyses of self-report data. Future research should use neurobehavioral tasks and intensive longitudinal data to test whether an underlying sensitivity to, or propensity to engage in, relief-driven behaviors contributes to SI.

Discussion: Among trauma-exposed individuals, those who more frequently engage in negatively reinforced safety behaviors also report more severe SI. These findings dovetail with theoretical foundations of suicide linking SI with relief-driven motivations and provide further support that a propensity to engage in relief-driven behaviors is associated with SI.