Fluid vulnerability theory: a cognitive approach to understanding the process of acute and chronic suicide risk
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Dysfunctional self-regulatory processes invite maladaptive responses to acute stressors that can interact with various dynamic factors to induce an imminent suicide crisis.
“In contrast, dysfunctional self-regulatory processes invite maladaptive responses to acute stressors (e.g., substance use) that can interact with various dynamic factors (e.g., low mood, social isolation) to induce an imminent suicide crisis (Bryan et al., 2020; Rudd, 2006).”
From Toward objective characterizations of suicide risk: A narrative review of laboratory-based cognitive and behavioral tasks (2023) · cites this paper as Rudd, 2006
Current psychological interventions for suicidal individuals, informed by existing theoretical models, have limitations because they aim to address multiple risk factors and often entail structured multi-session approaches, which may reduce opportunities for clients to speak freely and pose challenges in time/resource-limited settings.
“Current psychological interventions for suicidal individuals, which are informed by existing theoretical models, have limitations.”
From The Psychological Pathway to Suicide Attempts: A Strategy of Control Without Awareness (2021) · cites this paper as Rudd, 2006
Fluctuations in suicide risk and rapid transitions from contemplating suicide to making an attempt may be due to psychological processes that might be different for ideators and attempters.
“It may be, therefore, that these fluctuations in suicide risk and rapid transitions from contemplating suicide to making an attempt are due to psychological processes, which might be different for ideators and attempters (Rudd, 2006; Bryan et al., 2016, 2019).”
From The Psychological Pathway to Suicide Attempts: A Strategy of Control Without Awareness (2021) · cites this paper as Rudd, 2006
It goes beyond recent theoretical accounts of ambivalence about suicide, since we posit that one's combined reasons for living and reasons for dying are simultaneously associated with distress, due to the loss of control they may entail.
“However, it goes beyond recent theoretical accounts of ambivalence about suicide (Linehan et al., 1983; Jobes, 2006; Rudd, 2006), since we posit that one’s combined reasons for living and reasons for dying are simultaneously associated with distress, due to the loss of control they may entail.”
From The Psychological Pathway to Suicide Attempts: A Strategy of Control Without Awareness (2021) · cites this paper as Rudd, 2006
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The psychology of suicidal behaviour
O'Connor, R. C., & Nock, M. K. (2014) · The Lancet Psychiatry · doi:10.1016/s2215-0366(14)70222-6 · Cited by 1,193 · see citing works
Sexual assault victimization and psychopathology: A review and meta-analysis
Dworkin, E. R., Menon, S. V., Bystrynski, J., & Allen, N. E. (2017) · Clinical Psychology Review · doi:10.1016/j.cpr.2017.06.002 · Cited by 825 · see citing works
Ideation-to-action theories of suicide: a conceptual and empirical update
Klonsky, E. D., Saffer, B. Y., & Bryan, C. J. (2018) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2017.07.020 · Cited by 673 · see citing works
The role of defeat and entrapment in depression, anxiety, and suicide.
Taylor, P. J., Gooding, P. A., Wood, A. M., & Tarrier, N. (2011) · Psychological Bulletin · doi:10.1037/a0022935 · Cited by 418 · see citing works
“These may include preexisting mental models for suicidal behavior, beliefs about suicide, or suicidogenic schema (Johnson et al., 2008; Lau, Segal, & Williams, 2004; Pratt, Gooding, Johnson, Taylor, & Tarrier, 2010; Rudd, 2006; Williams et al., 2005).”
BackgroundReal-time assessment of suicidal thoughts and behaviors
Kleiman, E. M., & Nock, M. K. (2018) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2017.07.026 · Cited by 239 · see citing works
“A tenant of the Fluid Vulnerability Theory is that suicidal ideation fluctuates close to a baseline with episodic peaks representing suicidal crises [13,14].”
BackgroundSuicide risk assessment in clinical practice: pragmatic guidelines for imperfect assessments
Fowler, J. C. (2012) · Psychotherapy · doi:10.1037/a0026148 · Cited by 222 · see citing works
“Among the many reason is that suicide risk is fluid, highly state-dependent, and variable over time (Rudd, 2006).”
BackgroundGUILT, SHAME, AND SUICIDAL IDEATION IN A MILITARY OUTPATIENT CLINICAL SAMPLE
Bryan, C. J., Morrow, C. E., Etienne, N., & Ray-Sannerud, B. N. (2012) · Depression and Anxiety · doi:10.1002/da.22002 · Cited by 204 · see citing works
Miranda, R., SCOTT, M., Hicks, R. C., Wilcox, H. C., Munfakh, J. L. H., & Shaffer, D. (2008) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/chi.0b013e31815a56cb · Cited by 201 · see citing works
Bryan, C. J., Griffith, J. E., Pace, B. T., Hinkson, K. D., Bryan, A. O., Clemans, T. A., & Imel, Z. E. (2015) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12163 · Cited by 195 · see citing works
Miranda, R., Ortin‐Peralta, A., Scott, M., & Shaffer, D. (2014) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12245 · Cited by 177 · see citing works
Bryan, C. J., Butner, J. E., May, A. M., Rugo, K. F., Harris, J. A., Oakey, D. N., Rozek, D. C., & Bryan, A. O. (2020) · New Ideas in Psychology · doi:10.1016/j.newideapsych.2019.100758 · Cited by 169 · see citing works
“…(e.g., Bryan & Rudd, 2016; Mishara, 1996; Rogers, 2003; Schiepek et al., 2011) and has even been explicitly articulated by the fluid vulnerability theory of suicide (Rudd, 2006), researchers have only recently started to employ methods able to capture this particular property of suicide risk.”
BackgroundMethodMiranda, R., Gallagher, M., Bauchner, B., Vaysman, R., & Marroquín, B. (2012) · Depression and Anxiety · doi:10.1002/da.20915 · Cited by 159 · see citing works
“Fluid vulnerability theory,[27] which draws upon Beck’s theory of modes,[28] proposes that when individuals engage in suicidal behavior, the connections between suicide-related thoughts, feelings, and behaviors are strengthened in memory, thus lowering the threshold for triggering future suicidal thoughts and attempts.”
BackgroundSurrence, K., Miranda, R., Marroquín, B. M., & Chan, S. (2009) · Behaviour Research and Therapy · doi:10.1016/j.brat.2009.06.001 · Cited by 161 · see citing works
“Sensitization theories of depression and suicide (e.g., Joiner, 2002; 2005; Lau et al., 2004; Rudd, 2006) suggest that among former suicide attempters, suicidal thoughts are more chronically accessible.”
Reformulating Suicide Risk Formulation: From Prediction to Prevention
Pisani, A. R., Murrie, D. C., & Silverman, M. M. (2015) · Academic Psychiatry · doi:10.1007/s40596-015-0434-6 · Cited by 143 · see citing works
“Risk formulation should capture the fluid nature of suicide risk in the life of an individual patient [10, 14, 15] and explicitly state: (a) how the person’s current risk compares to risk at previous time points, and (b) how risk might change in response to future events.”
BackgroundBryan, C. J., Rudd, M. D., Wertenberger, E. G., Etienne, N., Ray-Sannerud, B. N., Morrow, C. E., Peterson, A. L., & Young‐McCaughan, S. (2014) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.02.021 · Cited by 134 · see citing works
“A more contemporary, transdiagnostic approach to understanding suicide risk is fluid vulnerability theory (Rudd, 2006), Contents lists available at ScienceDirect”
BackgroundInfluentialSelf-citationPsychological Models of Suicide
Barzilay, S., & Apter, A. (2014) · Archives of Suicide Research · doi:10.1080/13811118.2013.824825 · Cited by 131 · see citing works
“, & Rudd, M. D. (2009). Main predictions of the interpersonal–psychological theory of suicidal behavior:”
BackgroundInfluentialThe importance of temporal dynamics in the transition from suicidal thought to behavior.
Bryan, C. J., & Rudd, M. D. (2016) · Clinical Psychology Science and Practice · doi:10.1111/cpsp.12135 · Cited by 123 · see citing works
“One model that provides a framework for understanding the dynamic process of suicide risk over time is the fluid vulnerability theory (FVT; Rudd, 2006).”
BackgroundSelf-citationGlenn, C. R., Cha, C. B., Kleiman, E. M., & Nock, M. K. (2017) · Clinical Psychological Science · doi:10.1177/2167702616686854 · Cited by 113 · see citing works
“Diathesis-stress models conceptualize suicide as resulting from the complex interplay between underlying vulnerability (distal) factors and acute (proximal) stressors, which can be examined at both biological and psychological units of analysis (Nock, Deming, et al., 2013; Rudd, 2006; Turecki & Brent, 2016).”
BackgroundResultInfluentialEcological momentary assessment is a neglected methodology in suicidology
Davidson, C. L., Anestis, M. D., & Gutierrez, P. M. (2017) · Archives of Suicide Research · doi:10.1080/13811118.2015.1004482 · Cited by 108 · see citing works
“Individuals with chronic suicide risk are posited to react more strongly to objectively less stressful events and to maintain the elevated state of suicide risk for a longer period of time (Rudd, 2006).”
BackgroundBryan, C. J., Ray-Sannerud, B. N., & Heron, E. A. (2015) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2015.10.002 · Cited by 111 · see citing works
The deadly gap: Understanding suicide among veterans transitioning out of the military
Sokol, Y., Gromatsky, M. A., Edwards, E. R., Greene, A. L., Geraci, J. C., Harris, R. E., & Goodman, M. S. (2021) · Psychiatry Research · doi:10.1016/j.psychres.2021.113875 · Cited by 87 · see citing works
The ebb and flow of the wish to live and the wish to die among suicidal military personnel.
Bryan, C. J., Rudd, M. D., Peterson, A. L., Young-McCaughan, S., & Wertenberger, E. G. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.05.049 · Cited by 82 · see citing works
Self-citationRizk, M. M., Choo, T.-H., Galfalvy, H., Biggs, E., Brodsky, B. S., Oquendo, M. A., Mann, J. J., & Stanley, B. (2019) · Psychiatry · doi:10.1080/00332747.2019.1600219 · Cited by 74 · see citing works
“Individuals typically experience suicidality in distinct, time-limited time periods and the intensity of SI naturally declines over prolonged periods of negative emotions (Rudd, 2006).”
BackgroundCrisis of Meaning Predicts Suicidality in Youth Independently of Depression
Schnell, T., Gerstner, R., & Krampe, H. (2018) · Crisis · doi:10.1027/0227-5910/a000503 · Cited by 79 · see citing works
“) Baseline risk and protective factors were related to suicidality as expected (Allison et al., 2001; Beautrais, 2003; Borowsky et al., 2001; Fortuna et al., 2007; González Forteza et al., 2003; Haquin et al., 2004; Jang et al., 2014; King et al., 2001; Rudd, 2006).”
BackgroundInfluentialBarnhofer, T., Crane, C., Brennan, K., Duggan, D. S., Crane, R. S., Eames, C., Radford, S., Silverton, S., Fennell, M. J. V., & Williams, J. M. G. (2015) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000027 · Cited by 80 · see citing works
“Following initial suggestions by Beck (1996), Rudd (2000, 2006) has introduced the concept of a suicidal mode, referring to a cognitive-affective-behavioral network that, once activated, guides synchronous processes that manifest on a number of different levels including suicidal cognitions,…”
BackgroundBryan, C. J., Rozek, D. C., Butner, J., & Rudd, M. D. (2019) · Behaviour Research and Therapy · doi:10.1016/j.brat.2019.04.001 · Cited by 71 · see citing works
“A uthor M anuscript A uthor M anuscript A uthor M anuscript A uthor M anuscript conceptualization of suicidal behavior as an emergent phenomenon associated with nonlinear dynamic change processes within individuals over time (Rudd, 2006; Bryan & Rudd, 2016).”
BackgroundResultInfluentialSelf-citationPredictors of Emerging Suicide Death Among Military Personnel on Social Media Networks
Bryan, C. J., Butner, J., Sinclair, S., Bryan, A. O., Hesse, C. M., & Rose, A. E. (2017) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12370 · Cited by 70 · see citing works
“This aligns with a central premise of the fluid vulnerability theory, which is that suicide risk has stable properties over time (Rudd, 2006).”
BackgroundMethodInfluentialCognition and Suicide: Two Decades of Progress
Ellis, T. E., & Rutherford, B. (2008) · International Journal of Cognitive Therapy · doi:10.1521/ijct.2008.1.1.47 · Cited by 72 · see citing works
“It is proposed as a means of understanding the waxing and waning of suicidal urges over time and of reconciling conflicting observations regarding both traitlike and statelike features of hopelessness (Rudd, 2006).”
BackgroundResultRogers, M. L., & Joiner, T. E. (2018) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000373 · Cited by 71 · see citing works
Bryan, C. J., Sinclair, S., & Heron, E. A. (2015) · Clinical Psychological Science · doi:10.1177/2167702615595000 · Cited by 65 · see citing works
“This perspective aligns with the fluid vulnerability theory of suicide (Rudd, 2006), which proposes that suicide risk exists on two dimensions: baseline and acute.”
BackgroundJobes, D. A., Rudd, M. D., Overholser, J. C., & Joiner, T. E. (2008) · Professional Psychology Research and Practice · doi:10.1037/a0012896 · Cited by 66 · see citing works
“Both of these issues relate to the broader problem of appropriately understanding, differentiating, assessing, and responding to the variable or “fluid nature of suicide risk” (Rudd, 2006, p. 358).”
BackgroundSelf-citationBryan, C. J., McNaughton-Cassill, M. E., Osman, A., & Hernandez, A. M. (2013) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12011 · Cited by 66 · see citing works
Self-forgiveness, posttraumatic stress, and suicide attempts among military personnel and veterans.
Bryan, A. O., Theriault, J. L., & Bryan, C. J. (2014) · Traumatology An International Journal · doi:10.1037/trm0000017 · Cited by 72 · see citing works
The Brief Suicide Cognitions Scale: Development and Clinical Application
Rudd, M. D., & Bryan, C. J. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.737393 · Cited by 65 · see citing works
Self-citationBennett, S., Robb, K. A., Zortea, T. C., Dickson, A., Richardson, C., & O’Connor, R. C. (2023) · Psychological Bulletin · doi:10.1037/bul0000397 · Cited by 66 · see citing works
Ellis, T. E., & Rufino, K. A. (2016) · Archives of Suicide Research · doi:10.1080/13811118.2015.1093983 · Cited by 60 · see citing works
“Specifically targeting experiential avoidance in suicidal patients would be consistent with the ‘‘residual risk’’ model proposed by Rudd (2006) and supported in a recent report by Ellis and Rufino (2015).”
ResultEllis, T. E., Rufino, K. A., & Allen, J. G. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2017.01.032 · Cited by 59 · see citing works
“Finally, these fi ndings provide indirect support for the notion of “ residual risk ” (Rudd, 2006), which maintains that factors beyond depression and associated symptoms create vulnerability to later suicidal episodes.”
BackgroundResultPredicting acute suicidal ideation on Instagram using ensemble machine learning models
Lekkas, D., Klein, R. J., & Jacobson, N. C. (2021) · Internet Interventions · doi:10.1016/j.invent.2021.100424 · Cited by 59 · see citing works
“Borrowing from the Fluid Vulnerability Theory of suicidal ideation, we conceptualized acute SI as an episodic, short-term manifestation of SI's dynamic phenomenology, namely, the current heightened expression of suicidal thoughts and feelings (Kleiman and Nock, 2018; Rudd, 2006).”
MethodBryan, C. J., & Rudd, M. D. (2012) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2012.03.012 · Cited by 60 · see citing works
Self-citationBryan, C. J., Bryan, A. O., & Clemans, T. A. (2015) · Psychiatry Research · doi:10.1016/j.psychres.2015.01.030 · Cited by 59 · see citing works
“The observed patterns in the current study are consistent with the fluid vulnerability theory (FVT) of suicide (Rudd, 2006), which posits that risk for suicide ideation and suicide attempts occurs due to the interaction of relatively static or chronic risk factors (i.”
ResultDugal, C., Bigras, N., Godbout, N., & Bélanger, C. (2016) · A Multidimensional Approach to Post-Traumatic Stress Disorder - from Theory to Practice · doi:10.5772/64476 · Cited by 62 · see citing works
“Based on the Suicidal Mode Theory [121] and the Interpersonal-Psychological Theory of Suicide [122, 123], childhood interpersonal trauma may lead to feelings of social alienation and produce emotions and cognitions (e.g., involving helplessness and hopelessness) that leave survivors with a…”
MethodDoes unstable mood increase risk of suicide? Theory, research and practice
Palmier-Claus, J. E., Taylor, P. J., Varese, F., & Pratt, D. (2012) · Journal of Affective Disorders · doi:10.1016/j.jad.2012.05.030 · Cited by 57 · see citing works
“It is also theorised that through repeated activation these suicide schema are believed to be strengthened or elaborated, so that they become more sensitive to re-activation at subsequent time points (Lau et al., 2004; Rudd, 2006).”
BackgroundResultInfluentialA psychometric study of the Suicide Cognitions Scale with psychiatric inpatients.
Ellis, T. E., & Rufino, K. A. (2014) · Psychological Assessment · doi:10.1037/pas0000028 · Cited by 58 · see citing works
Rogers, M. L., Gallyer, A. J., & Joiner, T. E. (2021) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2021.03.031 · Cited by 57 · see citing works
Bryan, C. J., Bryan, A. O., Ray-Sannerud, B. N., Etienne, N., & Morrow, C. E. (2013) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2013.10.006 · Cited by 56 · see citing works
“Furthermore, previous suicide attempts are associated with more intense current suicidal ideation among active duty service members even when controlling for a large number of suicide risk factors including depression, hopelessness, gender, and personality traits [13].”
BackgroundTreating PTSD Within the Context of Heightened Suicide Risk
Bryan, C. J. (2016) · Current Psychiatry Reports · doi:10.1007/s11920-016-0708-z · Cited by 55 · see citing works
The use of advanced technology and statistical methods to predict and prevent suicide
Kleiman, E. M., Glenn, C. R., & Liu, R. T. (2023) · Nature Reviews Psychology · doi:10.1038/s44159-023-00175-y · Cited by 63 · see citing works
Kirshenbaum, J. S., Pagliaccio, D., Bitran, A., Xu, E., & Auerbach, R. P. (2024) · Translational Psychiatry · doi:10.1038/s41398-024-02914-y · Cited by 63 · see citing works
“Last, the review highlights novel inroads for the integration of biological processes; however, there is limited research integrating these factors into extant ideation-to-action theories of suicide.”
BackgroundAllan, N. P., Gorka, S., Saulnier, K., & Bryan, C. (2023) · Current Psychiatry Reports · doi:10.1007/s11920-023-01413-z · Cited by 53 · see citing works
Suicide risk assessment and formulation: An update
Menon, V. (2013) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2013.07.005 · Cited by 52 · see citing works
Association of solitary binge drinking and suicidal behavior among emerging adult college students.
Gonzalez, V. M. (2012) · Psychology of Addictive Behaviors · doi:10.1037/a0026916 · Cited by 51 · see citing works
Bryan, C. J., & Rudd, M. D. (2017) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12361 · Cited by 51 · see citing works
“The fluid vulnerability theory hypothesizes that increased risk for repeated suicidal behavior observed among multiple attempters is attributable to elevated baseline risk, which serves to sensitize multiple attempters to both internal and external triggers (Rudd, 2006).”
BackgroundInfluentialSelf-citationMonteith, L. L., Holliday, R. P., Schneider, A. L., Forster, J. E., & Bahraini, N. H. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.04.038 · Cited by 52 · see citing works
Allan, N. P., Volarov, M., Koscinski, B., Pizzonia, K. L., Potter, K., Accorso, C., Saulnier, K. G., Ashrafioun, L., Stecker, T. A., Suhr, J. A., et al. (2021) · Psychiatry Research · doi:10.1016/j.psychres.2021.114144 · Cited by 51 · see citing works
“The fluid vulnerability model posits that triggering of a suicidal vulnerability state is enhanced when there are many potential risk factors at play (Rudd, 2006).”
BackgroundInfluentialMiranda, R., Jaegere, E. D., Restifo, K., & Shaffer, D. (2013) · Depression and Anxiety · doi:10.1002/da.22194 · Cited by 50 · see citing works
Young Men, Masculinities, and Suicide
Rasmussen, M. L., Haavind, H., & Dieserud, G. (2017) · Archives of Suicide Research · doi:10.1080/13811118.2017.1340855 · Cited by 50 · see citing works
“In line with Shneidman (1993) and Rudd (2006), our findings suggest that suicidal individuals should receive help specifically related to his/her crisis/problem situation.”
BackgroundSmall but Mighty: Affective Micropatterns for Quantifying Mental Health from Social Media Language
Loveys, K., Crutchley, P., Wyatt, E., & Coppersmith, G. (2017) · Workshop on Computational Linguistics and Clinical Psychology (CLPsych) · doi:10.18653/v1/w17-3110 · Cited by 51 · see citing works
“…baseline risk, even a severe stressor will not elicit suicidality or exacerbations in mental illness symptoms; alternatively, for people with high baseline risk, situational factors conducive to suicidality or mental illness episodes need not be as high for an episode to be triggered (Rudd, 2006).”
BackgroundPsychometric evaluation of the Suicide Cognitions Scale-Revised (SCS-R)
Bryan, C. J., May, A. M., Thomsen, C. J., Allen, M. H., Cunningham, C. A., Wine, M. D., Taylor, K. B., Baker, J. C., Bryan, A. O., Harris, J. A., et al. (2021) · Military Psychology · doi:10.1080/08995605.2021.1897498 · Cited by 46 · see citing works
Bryan, C. J., Roberge, E. M., Bryan, A. O., Ray-Sannerud, B. N., Morrow, C. E., & Etienne, N. (2015) · International Journal of Cognitive Therapy · doi:10.1521/ijct.2015.8.2.143 · Cited by 47 · see citing works
“of suicide (Rudd, 2006).”
Sinclair, S., Bryan, C. J., & Bryan, A. O. (2016) · International Journal of Cognitive Therapy · doi:10.1521/ijct.2016.9.1.87 · Cited by 46 · see citing works
Neurocognition and Suicide Risk in Adults
Allen, J. D., Bozzay, M. L., & Edenbaum, E. R. (2019) · Current Behavioral Neuroscience Reports · doi:10.1007/s40473-019-00189-y · Cited by 45 · see citing works
Pistorello, J., Jobes, D. A., Gallop, R., Compton, S. N., Locey, N. S., Au, J. S., Noose, S. K., Walloch, J. C., Johnson, J., Young, M., et al. (2021) · Archives of Suicide Research · doi:10.1080/13811118.2020.1749742 · Cited by 46 · see citing works
“Another possibility is that the weekly measures are more likely to capture the dynamic process of suicide risk, as proposed by the fluid vulnerability theory (Rudd, 2006), where fluctuations in risk occur as a function of the ongoing ebband-flow of proximal risk and protective factors.”
BackgroundMomentary interpersonal processes of suicidal surges in borderline personality disorder
Kaurin, A., Dombrovski, A. Y., Hallquist, M. N., & Wright, A. G. C. (2022) · Psychological Medicine · doi:10.1017/s0033291720004791 · Cited by 44 · see citing works
“Because impulsivity accelerates the transition from thoughts to action, it has long been conceptualized as a central risk factor for suicide attempts in general (Bryan & Rudd, 2006), and in BPD in particular (Brodsky et al., 2006; Soloff et al., 2000).”
BackgroundBryan, C. J., Kanzler, K. E., Grieser, E., Martinez, A., Allison, S., & McGeary, D. D. (2016) · Pain Practice · doi:10.1111/papr.12464 · Cited by 44 · see citing works
“The notion of chronic vulnerability for suicidal thoughts and behaviors as a distinct dimension of suicide risk is a core tenet of the fluid vulnerability theory of suicide.(1,2)”
BackgroundBarriers toward help-seeking among young men prior to suicide
Rasmussen, M. L., Hjelmeland, H., & Dieserud, G. (2017) · Death Studies · doi:10.1080/07481187.2017.1328468 · Cited by 43 · see citing works
“Consistent with a cognitive-behavioral model of suicidality (Rudd, 2006), in this study, we found that “a total defeat” as a barrier to help-seeking was closely connected to the problem situation that activated the suicidal mode; an intense negative affect (shame, worthlessness, being a failure,…”
BackgroundResultInfluentialSuicide in Transgender Veterans: Prevalence, Prevention, and Implications of Current Policy
Tucker, R. P. (2019) · Perspectives on Psychological Science · doi:10.1177/1745691618812680 · Cited by 44 · see citing works
Using resting-state intrinsic network connectivity to identify suicide risk in mood disorders
Stange, J. P., Jenkins, L. M., Pocius, S. L., Kreutzer, K. A., Bessette, K. L., DelDonno, S. R., Kling, L. R., Bhaumik, R., Welsh, R. C., Keilp, J. G., et al. (2019) · Psychological Medicine · doi:10.1017/s0033291719002356 · Cited by 42 · see citing works
“However, existing predictive models have had only modest success in estimating suicide risk (Franklin et al., 2017; Chang et al., 2016; May and Klonsky, 2016; Rudd, 2006; Panagioti et al., 2009).”
MethodDillon, K. H., Voorhees, E. E. V., & Elbogen, E. B. (2019) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2019.12.011 · Cited by 45 · see citing works
“The fluid vulnerability theory (FVT; Rudd, 2006) proposes that risk for suicide fluctuates as function of both chronic and acute risk factors.”
BackgroundResultKnorr, A. C., Ammerman, B. A., Hamilton, A. J., & McCloskey, M. S. (2019) · Psychiatry Research · doi:10.1016/j.psychres.2019.01.067 · Cited by 43 · see citing works
Shame, pride, and suicidal ideation in a military clinical sample
Bryan, C. J., Ray-Sannerud, B. N., Morrow, C. E., & Etienne, N. (2012) · Journal of Affective Disorders · doi:10.1016/j.jad.2012.11.006 · Cited by 42 · see citing works
Kyron, M. J., Hooke, G. R., & Page, A. C. (2018) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000305 · Cited by 41 · see citing works
Skala Suizidales Erleben und Verhalten (SSEV)
Teismann, T., Forkmann, T., Glaesmer, H., Juckel, G., & Cwik, J. C. (2021) · Diagnostica · doi:10.1026/0012-1924/a000269 · Cited by 45 · see citing works
Integrating Two Theoretical Models to Understand and Prevent Military and Veteran Suicide
Wolfe-Clark, A. L., & Bryan, C. J. (2016) · Armed Forces & Society · doi:10.1177/0095327x16646645 · Cited by 41 · see citing works
“behavioral, and physiological domains (Rudd, 2006).”
BackgroundInfluentialMind full of life: Does mindfulness confer resilience to suicide by increasing zest for life?
Collins, K. R. L., Stritzke, W. G. K., Page, A. C., Brown, J. D., & Wylde, T. J. (2017) · Journal of Affective Disorders · doi:10.1016/j.jad.2017.09.043 · Cited by 41 · see citing works
“One recent conceptualization of suicide that explicitly accounts for the dynamic interplay of risk and resilience factors is the fluid vulnerability theory (Rudd, 2006).”
BackgroundThe association between suicidal behavior, attentional control, and frontal asymmetry.
Thompson, C., & Ong, E. L. C. (2018) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2018.00079 · Cited by 41 · see citing works
Optimism Reduces Suicidal Ideation and Weakens the Effect of Hopelessness Among Military Personnel
Bryan, C. J., Ray-Sannerud, B. N., Morrow, C. E., & Etienne, N. (2013) · Cognitive Therapy and Research · doi:10.1007/s10608-013-9536-1 · Cited by 40 · see citing works
“For instance, although suicidal individuals frequently report depressed mood, this emotional experience is much less specific to the suicidal state than future-oriented beliefs about the self and others (cf. Rudd 2006).”
BackgroundResultUsing Machine Learning to Predict Suicide Attempts in Military Personnel
Rozek, D. C., Andres, W. C., Smith, N. B., Leifker, F. R., Arne, K., Jennings, G., Dartnell, N., Bryan, C. J., & Rudd, M. D. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.113515 · Cited by 40 · see citing works
“The ability to self-regulate in response to stressful situations theoretically explains why different situations and stressors lead to suicidal crises in some individuals but not others (e.g., Beck & Haigh, 2014; Rudd, 2006).”
BackgroundSelf-citationLiving a life worth living: Spirituality and suicide risk in military personnel.
Bryan, C. J., Graham, E., & Roberge, E. M. (2015) · Spirituality in Clinical Practice · doi:10.1037/scp0000056 · Cited by 38 · see citing works
Rogers, M. L., Law, K. C., Houtsma, C., Tucker, R. P., Anestis, M. D., & Joiner, T. E. (2021) · Assessment · doi:10.1177/10731911211033897 · Cited by 38 · see citing works
“Given increased interest in realtime monitoring approaches to understanding suicide (Kleiman & Nock, 2018) and theoretical approaches highlighting the dynamic, nonlinear nature of acute suicide risk (Bryan et al., 2020; Rudd, 2006), adapting the SRS to these methodologies may be useful.”
BackgroundLi, Y., & Kwok, S. Y. C. L. (2022) · Journal of Youth and Adolescence · doi:10.1007/s10964-022-01698-y · Cited by 37 · see citing works
Edershile, E. A., & Wright, A. G. C. (2021) · Social and Personality Psychology Compass · doi:10.1111/spc3.12649 · Cited by 40 · see citing works
Managing suicide risk in primary care: Practice recommendations for behavioral health consultants.
Bryan, C. J., Corso, K. A., Neal‐Walden, T. A., & Rudd, M. D. (2009) · Professional Psychology Research and Practice · doi:10.1037/a0011141 · Cited by 37 · see citing works
“Specifically, multiple attempters (those who have made two or more previous suicide attempts) are at much greater risk for suicide than nonmultiple attempters (those who have made no previous suicide attempts or one previous suicide attempt only; Rudd, 2006).”
BackgroundSelf-citationUnderstanding the suicidal moment in adolescence
Miranda, R., & Shaffer, D. (2013) · Annals of the New York Academy of Sciences · doi:10.1111/nyas.12291 · Cited by 36 · see citing works
Gratz, K. L., Spitzen, T. L., & Tull, M. T. (2020) · Journal of Clinical Psychology · doi:10.1002/jclp.22950 · Cited by 36 · see citing works
“Although prominent suicide models (e.g., Fluid Vulnerability Theory [Rudd, 2006]; Three-Step Theory [Klonsky & May, 2015]) suggest that suicide capability is comprised of practical (i.e., logistical components that increase the ease with which an individual may employ lethal means), dispositional…”
BackgroundMethodResultInfluentialThe Structure of Suicidal Beliefs: A Bifactor Analysis of the Suicide Cognitions Scale
Bryan, C. J., & Harris, J. A. (2018) · Cognitive Therapy and Research · doi:10.1007/s10608-018-9961-2 · Cited by 35 · see citing works
“Hopelessness, in particular, has played a central role in suicide research and is a commonlyrecommended treatment target for clinicians working with suicidal individuals (e.g., Bryan and Rudd 2006; Wenzel et al.”
BackgroundNichter, B., Hill, M. L., Norman, S. B., Haller, M. M., & Pietrzak, R. H. (2020) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2020.07.041 · Cited by 36 · see citing works
Naturally occurring language as a source of evidence in suicide prevention
Resnik, P., Foreman, A., Kuchuk, M., Schafer, K. M., & Pinkham, B. (2020) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12674 · Cited by 33 · see citing works
BELONGING PROTECTS AGAINST POSTDEPLOYMENT DEPRESSION IN MILITARY PERSONNEL
Bryan, C. J., & Heron, E. A. (2015) · Depression and Anxiety · doi:10.1002/da.22372 · Cited by 35 · see citing works
Effect of Patient and Therapist Factors on Suicide Risk Assessment
Berman, N. C., Stark, A., Cooperman, A., Wilhelm, S., & Cohen, I. G. (2015) · Death Studies · doi:10.1080/07481187.2014.958630 · Cited by 33 · see citing works
“Although applying a formal Bayesian approach to the assessment of suicide would minimize the likelihood of biased clinical judgment, this is an impossible task given the state-dependent nature of suicide-related behavior and the perpetual shifting of interacting risk factors (Rudd, 2006).”
MethodAouidad, A., Cohen, D., Mirkovic, B., Pellerin, H., Garny de La Rivière, S., Consoli, A., Gérardin, P., & Guilé, J.-M. (2020) · BMC Psychiatry · doi:10.1186/s12888-020-02930-4 · Cited by 32 · see citing works
“Cumulative or chronic stress rather than discrete life events could be more relevant among adolescent suicide attempters [25, 65, 66].”
BackgroundResultPsychological pain and suicidal behavior: A review
Baryshnikov, I., & Isometsä, E. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.981353 · Cited by 33 · see citing works
“Among contemporary psychological theories of suicidal behavior, the most important and empirically tested are Beck’s hopelessness theory (8), the Three-Step Theory (9), the interpersonal theory of suicide (10, 11), the motivational-volitional model of suicidal behavior (12) and the fluid vulnerability theory (13).”
BackgroundBryan, C. J., Wood, D. S., May, A. M., Peterson, A. L., Wertenberger, E. G., & Rudd, M. D. (2017) · Archives of Suicide Research · doi:10.1080/13811118.2017.1319313 · Cited by 30 · see citing works
“the suicidal mode, which serves as the cognitive behavioral framework for understanding and targeting the emergence of suicidal thoughts and behaviors (Rudd, 2006).”
BackgroundSelf-citationRethinking Suicidal Behavior Disorder
Obegi, J. H. (2018) · Crisis · doi:10.1027/0227-5910/a000543 · Cited by 35 · see citing works
Areán, P. A., Pratap, A., Hsin, H., Huppert, T. K., Hendricks, K. E., Heagerty, P. J., Cohen, T., Bagge, C. L., & Comtois, K. A. (2021) · Journal of Medical Internet Research · doi:10.2196/27918 · Cited by 27 · see citing works
Oakey-Frost, N., Moscardini, E. H., Cowan, T., Cohen, A., & Tucker, R. P. (2023) · Behavior Therapy · doi:10.1016/j.beth.2022.12.011 · Cited by 31 · see citing works
Cumulative Stressors and Traumas and Suicide: A Non-Linear Cusp Dynamic Systems Model
Kira, I. A., Barger, B. D., Shuwiekh, H. A. M., Kucharska, J., & Alhuwailah, A. (2019) · Psychology · doi:10.4236/psych.2019.1015128 · Cited by 30 · see citing works
“Further, the concept of nonlinear dynamic systems is consistent with the fluid vulnerability theory of suicide (Rudd, 2006), in that it models the fluctuations and ebb and flow of suicide risk over time and over different unique individual characteristics.”
ResultGender differences in the association of agitation and suicide attempts among psychiatric inpatients
Bryan, C. J., Hitschfeld, M. J., Palmer, B. A., Schak, K. M., Roberge, E. M., & Lineberry, T. W. (2014) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2014.09.013 · Cited by 30 · see citing works
Theory-driven models of self-directed violence among individuals with PTSD
Bryan, C. J., Grove, J. L., & Kimbrel, N. A. (2016) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2016.09.007 · Cited by 31 · see citing works
O'Connor, S. S., Mcclay, M. M., Choudhry, S., Shields, A. D., Carlson, R., Alonso, Y., Lavin, K., Venanzi, L., Comtois, K. A., Wilson, J. E., et al. (2020) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2018.08.001 · Cited by 29 · see citing works
- Authors
- Rudd, M. D.
- Affiliations
- Baylor University (US)
- Corresponding author
- Rudd, M. David
- ORCID
- Rudd, M. David
- Venue
- Cognition and suicide: Theory, research, and therapy.
- Publisher
- American Psychological Association
- Published
- 2006
- Pages
- 355-368
- OpenAlex
- W1744999525
- Cited by
- 463
- References
- 0
- Citations by year
- 2026: 38 · 2025: 51 · 2024: 45 · 2023: 44 · 2022: 41 · 2021: 48 · 2020: 33 · 2019: 34 · 2018: 19 · 2017: 29 · 2016: 19 · 2015: 18 · 2014: 13 · 2013: 7 · 2012: 9
- FWCI
- 20.02
- Type
- book chapter
- Language
- en
- Open access
- closed
- Locations
- American Psychological Association eBooks (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Social Psychology › Death Anxiety and Social Exclusion
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- suicide risk, cognitive approach, suicide prevention
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