Modeling suicide risk among parents during the COVID-19 pandemic: Psychological inflexibility exacerbates the impact of COVID-19 stressors on interpersonal risk factors for suicide

Crasta, Dev; Daks, Jennifer S.; Rogge, Ronald D.

doi:10.1016/j.jcbs.2020.09.003

Cited by 72Suicide and Self-Harm StudiesCOVID-19 and Mental HealthMindfulness and Compassion Interventions

Modeling suicide risk among parents during the COVID-19 pandemic: Psychological inflexibility exacerbates the impact of COVID-19 stressors on interpersonal risk factors for suicide

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Crasta, Dev, Daks, Jennifer S., Rogge, Ronald D.·2020·Journal of Contextual Behavioral Science

DOI 10.1016/j.jcbs.2020.09.003PMC PMC7476891

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Abstract

Public health researchers have raised the concern that both the 2019 coronavirus disease (COVID-19) pandemic and the ensuing public health response will increase interpersonal stressors associated with suicide risk. The Acceptance and Commitment Therapy (ACT) framework conceptualizes psychological flexibility as an important way to reduce the impact of painful and even catastrophic events on psychological suffering. The current study examines psychological flexibility as a potential moderator of the prevailing interpersonal model of suicide risk.Methods A sample of 1003 parents (73% female, 82% Caucasian 86% in romantic relationships) were recruited as part of a larger study on the COVID-19 pandemic and family functioning from Mach 27th to the end of April 2020, the height of the United States' "first wave." Participants completed measures of psychological flexibility (the Multidimensional Psychological Flexibility inventory; MPFI), interpersonal constructs (perceived burdensomeness and thwarted belongingness), desire for death, COVID-19 related stressors (resource strain and loss due to COVID-19).Results Moderated-mediation path models highlighted a significant indirect association between COVID-19 stressors and desire for death mediated by perceived burdensomeness to others. This indirect pathway was moderated by psychological inflexibility such that links were strongest at high levels of inflexibility and weak or non-significant at low levels of inflexibility. Results were generally consistent across five of the six facets of inflexibility.Discussion The findings highlight the value of targeting psychological inflexibility as an important strategy to reduce suicide risk during the COVID-19 pandemic. Implications of patterns of results across different facets for treatment approach are discussed.

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During the pandemic, psychological flexibility moderated the relationship between COVID-19 stressors and suicide risk.
“During the pandemic PF has also been found to moderate the relationships between social isolation and depression and anxiety (Smith et al., 2020), COVID-19 risk factors and mental health difficulties (Pakenham et al., 2020), COVID-19 stressors and suicide risk (Crasta et al., 2020) and psychological distress within family systems (Daks et al., 2020).”
From Behind the masks: A cross-sectional study on intolerance of uncertainty, perceived vulnerability to disease and psychological flexibility in relation to state anxiety and wellbeing during the COVID-19 pandemic (2021) · cites this paper as Crasta et al., 2020
The Results section (‘Moderation of mediation path by psychological inflexibility’) says psychological flexibility did not emerge as a significant moderator after accounting for inflexibility. It was psychological inflexibility that moderated the indirect association between COVID-19 stressors and desire for death through perceived burdensomeness. No page number is available in our copy. (LLM, conf=0.90)
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Psychological flexibility has a moderating role between the psychological impacts of COVID-19 and mental health outcomes and wellbeing.
“and a moderating role between the psychological impacts of COVID-19 and mental health outcomes and wellbeing (Chong et al., 2021; Crasta et al., 2020; Daks et al., 2020; Pakenham et al., 2020; Smith et al., 2020).”
From Behind the masks: A cross-sectional study on intolerance of uncertainty, perceived vulnerability to disease and psychological flexibility in relation to state anxiety and wellbeing during the COVID-19 pandemic (2021) · cites this paper as Crasta et al., 2020
The Results section on moderation (page unavailable) reports that psychological flexibility was not a significant moderator after accounting for psychological inflexibility. It was inflexibility that moderated the pathway from COVID-19 stressors through perceived burdensomeness to desire for death among parents; the paper does not establish moderation of mental health and wellbeing outcomes generally. (LLM, conf=0.90)
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Certain psychosocial studies point to psychological flexibility as a key target for treating and helping affected individuals recover.
“Some of these identify psychological flexibility, or the ability to act with openness, awareness, and engagement (Hayes et al., 2006) as an important target in the treatment and recovery of those adversely affected”
From Health, well-being, and persisting symptoms in the pandemic: What is the role of psychological flexibility? (2022) · cites this paper as Crasta et al., 2020

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Authors: Crasta, D., Daks, J. S., & Rogge, R. D.
Affiliations: United States Department of Veterans Affairs (US)
University of Rochester (US)
Corresponding author: Crasta, Dev
ORCID: Crasta, Dev
Daks, Jennifer S.
Rogge, Ronald D.
Venue: Journal of Contextual Behavioral Science
Publisher: Elsevier BV
Published: 2020-10
Volume: 18
Pages: 117-127
ISSN: 2212-1447 (ISSN-L)
DOI: 10.1016/j.jcbs.2020.09.003
PMC: PMC7476891
OpenAlex: W3084432648
Cited by: 72
References: 50
Citations by year: 2026: 3 · 2025: 6 · 2024: 10 · 2023: 16 · 2022: 17 · 2021: 18 · 2020: 2
FWCI: 5.30
Type: journal article
Language: en
Update notices: erratum (2021-07-01)
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Journal of Contextual Behavioral Science (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: Office of Academic Affiliations, Department of Veterans Affairs
Topics: Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
Keywords: suicide risk, COVID-19 pandemic, psychological inflexibility, psychological flexibility, perceived burdensomeness, thwarted belongingness, desire for death, COVID-19 stressors, resource strain, parents, moderated mediation, acceptance and commitment therapy

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Modeling suicide risk among parents during the COVID-19 pandemic: Psychological inflexibility exacerbates the impact of COVID-19 stressors on interpersonal risk factors for suicide

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