Capability for suicide interacts with states of heightened arousal to predict death by suicide beyond the effects of depression and hopelessness
Open accessAbstract
Background States of heightened arousal (e.g., agitation, sleep disturbance) have been repeatedly linked to suicidal thoughts and behaviors, including attempts and death. Studies have further indicated that these states may be particularly pernicious among individuals who evidence high suicidal capability. The objective of this study was to examine the interactive effects of heightened arousal and the capability for suicide in the prospective prediction of death by suicide. We examine this relation beyond the effects of robust predictors of suicide, namely depression and hopelessness.Methods Participants were drawn from a larger study of undergraduates who completed baseline assessments during their freshman year and were then followed to time of death. The sample in this study only included individuals who had died by suicide (n=96) or other causes (n=542). Proxy measures to assess predictor variables were constructed using items from the MMPI, which was administered at baseline. An independent sample of clinical outpatients (n=was used to evaluate the construct validity of the proxy measures).Results Results were in line with expectation: heightened arousal interacted with capability for suicide to prospectively predict death by suicide, such that, as severity of heightened arousal symptoms increased, the likelihood of death by suicide increased among individuals high but not low on capability for suicide.Limitations Limitations include the use of proxy measures, the extended length of follow-up, and the homogeneity of the sample (i.e., primarily White males).Conclusion These findings add to an emerging literature that supports the moderating influence of capability for suicide on the relationship between states of heightened arousal on the likelihood of death by suicide.
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Sleep disruption has been conceptualized as a manifestation of the over-arousal characteristic of acute suicide risk.
“sleep disruption has been conceptualized as a manifestation of the over-arousal characteristic of this period of acute suicide risk (Ribeiro et al., 2015; Rogers et al., 2016; Tucker et al., 2016).”
From Sleep and suicide: A systematic review and meta-analysis of longitudinal studies (2020) · cites this paper as Ribeiro et al., 2015
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- Authors
- Ribeiro, J. D., Yen, S., Joiner, T., & Siegler, I. C.
- Affiliations
- Harvard University (US)
- Brown University (US)
- Florida State University (US)
- Duke Medical Center (US)
- Corresponding author
- Ribeiro, Jessica D.
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2015-12
- Volume
- 188
- Pages
- 53-59
- ISSN
- 0165-0327 (ISSN-L)
- PMC
- PMC4770567
- OpenAlex
- W1879295202
- Cited by
- 48
- References
- 38
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 2 · 2023: 2 · 2022: 2 · 2021: 6 · 2020: 9 · 2019: 4 · 2018: 10 · 2017: 5 · 2016: 2 · 2015: 1
- FWCI
- 7.45
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (T32 MH 18921, T32MH018921)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Keywords
- suicide, agitation, sleep disorders, depression, hopelessness, suicide risk prediction, moderating effect, undergraduate students
- MeSH terms
- Adult, Arousal, Cause of Death, Depression, Female, Forecasting, Humans, Male, Middle Aged, Prospective Studies, Risk Factors, Suicide, Case-Control Studies, Suicidal Ideation, Hope
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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