Testing Whether Suicide Capability Has a Dynamic Propensity: The Role of Affect and Arousal on Momentary Fluctuations in Suicide Capability.

Keyne C Law,Michael D Anestis

doi:10.3389/fpsyg.2021.590187

Abstract

To prevent suicidal behaviors, it is crucial to understand the mechanisms and processes that enable an individual to act on suicidal thoughts. Suicide capability, which involves an increased pain tolerance and fearlessness of death, is a critical factor that enables an individual to endure the physical pain necessary to make a lethal suicide attempt. Extant research has largely conceptualized suicide capability as developing linearly in response to painful and provocative experiences, but the emerging literature on the temporal dynamics of suicide has been challenging the notion of linearity in suicide risk. Few studies have directly measured and compared changes in suicide capability in response to rumination on different affective states. We sought to experimentally test if rumination in the context of low vs. high arousal emotions will prompt distinct changes in two core components of suicide capability: pain tolerance and fearlessness of death on two undergraduate student samples. In both studies, participants provided measures of subjective emotional state as well as pain threshold, tolerance, and persistence before and after completing experimental manipulations which included both emotion and rumination induction procedures. In the second study, measures of fearlessness about death and physiological arousal (heart rate) were added to the experimental procedures. We found significant decreases in pain threshold, tolerance, and persistence following the experimental manipulations but found no main effects of rumination or suicide risk. These findings suggest that suicide capability can fluctuate but these changes may occur through a different mechanism and/or differ between individuals at varying levels of suicide risk.

Highlights

Suicide is a worldwide public health issue that claims the lives of ∼800,000 individuals annually (World Health Organization, 2014) and demands our attention
This is supported by existing research on suicide capability, which has found that increased fearlessness of death and dying differentiates individuals who only ideate about suicide from those who have made a suicide attempt (Smith et al, 2010, 2016; Dhingra et al, 2015)
We examined zero-order correlations to determine if Age and Trait Rumination, as measured by the Ruminative Response Scale (RRS; Treynor et al, 2003), were associated with changes in pain threshold, tolerance, and persistence

Summary

INTRODUCTION

Suicide is a worldwide public health issue that claims the lives of ∼800,000 individuals annually (World Health Organization, 2014) and demands our attention. In addition to enduring physical pain, attempting suicide requires an individual to overcome their innate fear of death to inflict lethal self-injury This is supported by existing research on suicide capability, which has found that increased fearlessness of death and dying differentiates individuals who only ideate about suicide from those who have made a suicide attempt (Smith et al, 2010, 2016; Dhingra et al, 2015). We designed these studies to test the differential effects of rumination in the context of a high arousal (anger) vs low arousal (sadness) emotional state on changes in suicide capability using two undergraduate student samples. Given the association between cardiovascular reactivity, emotion, and decreased pain sensitivity (Appelhans and Luecken, 2008) it is reasonable to anticipate that rumination in the context of different emotional states may impact change suicide capability through arousal as measured by cardiovascular reactivity

METHODS

RESULTS

DISCUSSION