Attachment, loneliness, and social connection as prospective predictors of suicidal ideation during the COVID-19 pandemic: A relational diathesis-stress experience sampling study.

Abstract

Concerns about the impact of the COVID-19 pandemic on mental health have led to efforts to understand how pandemic-specific factors, such as decreased social contact during periods of social distancing, may relate to suicide risk. The present study evaluated personality-based risk factors and frequency of social contact as prospective predictors of suicidal ideation (SI) during the pandemic. We tested a relational diathesis-stress model of suicide focusing on insecure attachment, trait loneliness, and social contact as predictors of SI, using twice-weekly survey data collected via smartphone from a community sample (n=184) over 8 weeks. Multilevel modeling showed that both trait loneliness and anxious attachment predicted the prospective development of SI during the study period. Reduced in-person contact, but not remote contact, was proximally associated with increased SI. Participants with high attachment avoidance were more likely to develop SI in the context of reduced daily in-person contact compared to participants without these traits. Findings support a relational diathesis-stress model of suicide risk during the pandemic, showing that dispositional traits related to emotional connection with others predicted the relative salience of reduced social contact as a proximal risk factor for SI.