A Prospective Investigation of the Impact of Distinct Posttraumatic (PTSD) Symptom Clusters on Suicidal Ideation

Maria Panagioti,Ioannis Angelakis,Nicholas Tarrier,Patricia Gooding

doi:10.1007/s10608-016-9829-2

Abstract

Inconsistent findings have been reported by previous cross-sectional studies regarding the association between specific posttraumatic stress disorder (PTSD) symptom clusters and suicidality. To advance the understanding of the role of specific PTSD symptoms in the development of suicidality, the primary aim of this study was to investigate the predictive effects of the three specific PTSD symptom clusters on suicidal ideation prospectively. Fifty-six individuals diagnosed with PTSD completed a two-stage research design, at baseline and 13–15 months follow-up. The clinician administered PTSD scale (CAPS) was used to assess the severity of the PTSD symptom clusters and validated self-report measures were used to assess suicidal ideation, severity of depressive symptoms and perceptions of defeat entrapment. The results showed that only the hyperarousal symptom cluster significantly predicted suicidal ideation at follow-up after controlling for baseline suicidal ideation, severity of depressive symptoms and perceptions of defeat and entrapment. These findings suggest that both disorder-specific and transdiagnostic factors are implicated in the development of suicidal ideation in PTSD. Important clinical implications are discussed in terms of predicting and treating suicidality in those with PTSD.

Highlights

The link between a diagnosis of posttraumatic stress disorder (PTSD) and suicidal ideation is well-established in the literature (Jakupcak et al 2010; Panagioti et al 2009, 2012; Richardson et al 2012; Tarrier and Gregg 2004)
Defeat/entrapment and severity of depressive symptoms at baseline were entered in the first step of the regression analyses and the three PTSD symptom clusters at baseline were entered in the second step of the regression analyses
The aim of this study was to examine the effects of distinct PTSD symptom clusters on suicidal ideation using a prospective design

Summary

Introduction

The link between a diagnosis of posttraumatic stress disorder (PTSD) and suicidal ideation is well-established in the literature (Jakupcak et al 2010; Panagioti et al 2009, 2012; Richardson et al 2012; Tarrier and Gregg 2004). A category of negative appraisals, central to the SAMS, refers to defeat and entrapment, which are viewed as the proximal mechanism to suicidal ideation (Johnson et al 2008) Consistent with this view, a number of recent cross-sectional studies has demonstrated that defeat/entrapment is strongly associated with suicidal ideation in a range of research populations including those with PTSD (Panagioti et al 2012; Taylor et al 2010, 2011). The SAMS argues that perceptions of defeat and entrapment should be best represented as a single construct, because they are conceptually synonymous and originate from the same cognitive mechanism (a negatively biased appraisal system; Johnson et al 2008; Taylor et al 2011) This suggestion has been confirmed by a study that employed an explanatory factor analysis in a student population (Taylor et al 2009). Consistent with our previous work (Panagioti et al 2012; Schnurr et al 2000; Taylor et al 2010a, b), defeat and entrapment in this study was conceptualized as a single construct (referred to as defeat/entrapment hereafter)

Participants

Procedure

Results

Discussion