Cited by 463Suicide and Self-Harm StudiesDeath Anxiety and Social ExclusionAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

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Fluid vulnerability theory: a cognitive approach to understanding the process of acute and chronic suicide risk

Rudd, M. David·2006·Cognition and suicide: Theory, research, and therapy.

DOI 10.1037/11377-016

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Items 101–200 of 436

Maladaptive schemas mediate poor parental attachment and suicidality in college students
Langhinrichsen-Rohling, J., Thompson, K., Selwyn, C., Finnegan, H. A., & Misra, T. A. (2017) · Death Studies · doi:10.1080/07481187.2017.1280714 · Cited by 23
“© 2017 Taylor & Francis between acute episodes of suicidality (Rudd, 2006).”
BackgroundInfluential
Psychotic Experiences and Schizotypy in Early Adolescence Predict Subsequent Suicidal Ideation Trajectories and Suicide Attempt Outcomes From Age 18 to 38 Years
O’Hare, K., Poulton, R., & Linscott, R. J. (2020) · Schizophrenia Bulletin · doi:10.1093/schbul/sbaa151 · Cited by 31
Recent Suicidality in the General Population
Briere, J., Madni, L. A., & Godbout, N. (2015) · Journal of Interpersonal Violence · doi:10.1177/0886260515584339 · Cited by 28
“For example, both the Suicidal Mode Theory (SMT; Rudd, 2006) and the Interpersonal-Psychological Theory of Suicide (IPTS; Joiner, 2005; Van Orden et al., 2010) propose that interpersonal trauma may produce emotions and cognitions that leave survivors with a persisting vulnerability for suicidal ideation and behaviors.”
BackgroundMethod
Normlessness, Anomie, and the Emotions
TenHouten, W. D. (2016) · Sociological Forum · doi:10.1111/socf.12253 · Cited by 28
Prospective Validity of the Suicide Cognitions Scale Among Acutely Suicidal Military Personnel Seeking Unscheduled Psychiatric Intervention
Bryan, C. J., Rozek, D. C., & Khazem, L. R. (2019) · Crisis · doi:10.1027/0227-5910/a000639 · Cited by 28
The role of depression and suicidal cognitions as contributors to suicide risk among active duty soldiers reporting symptoms of posttraumatic stress disorder
Rugo, K. F., Tabares, J. V., Crowell, S. E., Baucom, B., Rudd, M. D., & Bryan, C. J. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.01.095 · Cited by 30
Self-citation
Lethality of Previous Suicidal Behavior among Patients Hospitalized for Suicide Risk Predicts Lethality of Future Suicide Attempts
Rojas, S. M., Skinner, K. D., Feldner, M. T., Rodante, D., Puppo, S., Vidjen, P., Portela, A., Grendas, L. N., & Daray, F. M. (2018) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12538 · Cited by 30
Mood variability predicts the course of suicidal ideation in individuals with first and second episode psychosis
Palmier‐Claus, J. E., Shryane, N. M., Taylor, P. J., Lewis, S. W., & Drake, R. (2012) · Psychiatry Research · doi:10.1016/j.psychres.2012.11.014 · Cited by 29
“In contrast, suicidality associated with a more sustained and stable period of mood may naturally decline, as suicidality is typically time-limited (Rudd, 2006).”
Background
Measuring Suicidality Using the Personality Assessment Inventory
Patry, M. W., & Magaletta, P. R. (2014) · Assessment · doi:10.1177/1073191114539381 · Cited by 27
“Although ours is a psychometric validity study of a scale and an index from the PAI, it is worth noting that the variables demonstrating significant relationships during the simultaneous regression modeling do map nicely upon the fluid vulnerability theory presented by Rudd (2006).”
Method
Suicide in Correctional Settings: Assessment, Prevention, and Professional Liability
Knoll, J. L. (2010) · Journal of Correctional Health Care · doi:10.1177/1078345810366457 · Cited by 27
“Professional challenges associated with caring for suicidal patients include the ‘‘inability to predict behaviors with low base rates’’ such as suicide and the variable or ‘‘fluid nature of suicide risk’’ (Jobes et al., 2008; Rudd, 2006).”
Background
Perceiving a Problem–Solving Task as a Threat and Suicidal Behavior in Adolescents
Orbach, I., Blomenson, R., Mikulincer, M., Gilboa‐Schechtman, E., Rogolsky, M., & Retzoni, G. (2007) · Journal of Social and Clinical Psychology · doi:10.1521/jscp.2007.26.9.1010 · Cited by 27
Assessing interpersonal and mood factors to predict trajectories of suicidal ideation within an inpatient setting
Kyron, M. J., Hooke, G. R., & Page, A. C. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.04.029 · Cited by 32
The Psychological Pathway to Suicide Attempts: A Strategy of Control Without Awareness
Macintyre, V. G., Mansell, W., Pratt, D., & Tai, S. J. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.588683 · Cited by 32
“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).”
BackgroundInfluential
Disentangling depression and anxiety in relation to neuroticism, extraversion, suicide, and self−harm among adult psychiatric inpatients with serious mental illness.
Subica, A. M., Allen, J. G., Frueh, B. C., Elhai, J. D., & Fowler, J. C. (2016) · British Journal of Clinical Psychology · doi:10.1111/bjc.12098 · Cited by 26
Differential effects of state and trait social anhedonia on suicidal ideation at 3-months follow up
Yang, X., Liu, S., Wang, D., Liu, G., & Harrison, P. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.10.056 · Cited by 26
Resilience buffers the effects of sleep problems on the trajectory of suicidal ideation from adolescence through young adulthood
Chang, L., Chang, Y., Wu, C.-C., Chang, J. J., Yen, L.-L., & Chang, H. (2021) · Social Science & Medicine · doi:10.1016/j.socscimed.2021.114020 · Cited by 27
Impact of lifetime traumatic experiences on suicidality and likelihood of conversion in a cohort of individuals at clinical high-risk for psychosis
Grivel, M. M., Leong, W., Masucci, M. D., Altschuler, R., Arndt, L. Y., Redman, S. L., Yang, L. H., Brucato, G., & Girgis, R. R. (2017) · Schizophrenia Research · doi:10.1016/j.schres.2017.09.006 · Cited by 25
“…were no significant associations with baseline diagnoses, except PTSD, which was positively associated with TH. Consistent with previous research, baseline SI was a predictor of SB at follow-up, but was not related to baseline diagnoses or conversion to psychosis (Rudd, 2006; Simon et al., 2013).”
ResultInfluential
Examination of the indirect effects of combat exposure on suicidal behavior in veterans
Dillon, K. H., Cunningham, K. C., Neal, J. M., Wilson, S. M., Dedert, E. A., Elbogen, E. B., Calhoun, P. S., Beckham, J. C., & Kimbrel, N. A. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.04.031 · Cited by 26
“This conceptualization of the relationship between combat exposure and suicide is consistent with the fluid vulnerability theory of suicide (Rudd, 2006), which proposes that suicide risk fluctuates over time as a function of both chronic and acute risk factors.”
Result
How Behavioral Economics and Nudges Could Help Diminish Irrationality in Suicide-Related Decisions
Bauer, B. W., & Capron, D. W. (2019) · Perspectives on Psychological Science · doi:10.1177/1745691619866463 · Cited by 26
“Recently, some temporal models posited evidence that accounts for the fluctuation and severe, abrupt increases in suicide risk by incorporating fluid-vulnerability theory (Rudd, 2006) with dynamical-systems theory perspectives (Bryan & Rudd, 2016) and cusp-catastrophe modeling (Thompson, 1975).”
Background
Affective Instability Prior to and after Thoughts about Self-Injury in Individuals With and At-Risk of Psychosis: A Mobile Phone Based Study
Palmier‐Claus, J. E., Ainsworth, J. D., Machin, M., Dunn, G., Barkus, E., Barrowclough, C., Rogers, A. E., & Lewis, S. W. (2013) · Archives of Suicide Research · doi:10.1080/13811118.2013.805647 · Cited by 27
“Suicidal cognitions are, however, time limited and naturally diminish as the emotional states stabilize (Rudd, 2006).”
Background
A Content Analysis of Reddit Users' Perspectives on Reasons for Not Following Through with a Suicide Attempt
Mason, A., Jang, K., Morley, K. C., Scarf, D., Collings, S. C., & Riordan, B. C. (2021) · Cyberpsychology Behavior and Social Networking · doi:10.1089/cyber.2020.0521 · Cited by 25
“8 Posts within the ‘‘interventions’’ theme describe situations that prevented or stopped possible suicidal actions, which, in turn, either immediately or after a time, allowed the user to reﬂect and appreciate they are still alive.”
Influential
Life course well-being framework for suicide prevention in Canadian Armed Forces Veterans
Thompson, J. M., Heber, A., VanTil, L. D., Simkus, K., Carrese, L., Sareen, J., & Pedlar, D. (2019) · Journal of Military Veteran and Family Health · doi:10.3138/jmvfh.2018-0020 · Cited by 25
Defeat, Entrapment, and Hopelessness: Clarifying Interrelationships between Suicidogenic Constructs
Oakey‐Frost, N., Moscardini, E. H., Russell, K., Rasmussen, S. A., Cramer, R. J., & Tucker, R. P. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph191710518 · Cited by 23
“discussion [3], but the observed results may indeed support the optimally parsimonious operationalization of the suicidal belief system [1,50,52].”
BackgroundResult
Hypomanic symptoms among first‐time suicide attempters predict future multiple attempt status
Bryan, C. J., Johnson, L. G., Rudd, M. D., & Joiner, T. E. (2008) · Journal of Clinical Psychology · doi:10.1002/jclp.20445 · Cited by 24
Self-citation
Anger mediates the relationship between posttraumatic stress disorder and suicidal ideation in veterans
Dillon, K. H., Voorhees, E. E. V., Dennis, P. A., Glenn, J. J., Wilks, C. R., Morland, L. A., Beckham, J. C., & Elbogen, E. B. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.03.053 · Cited by 23
“First, the fluid vulnerability theory (FVT; Rudd, 2006) proposes that risk for suicide fluctuates as function of both chronic and acute risk factors.”
BackgroundResult
Fluid vulnerability theory as a framework for understanding the association between posttraumatic stress disorder and suicide: a narrative review
Rugo‐Cook, K. F., Kerig, P. K., Crowell, S. E., & Bryan, C. J. (2021) · Journal of Traumatic Stress · doi:10.1002/jts.22782 · Cited by 25
Applying ideation-to-action theories to predict suicidal behavior among adolescents
Okado, I., Floyd, F. J., Goebert, D. A., Sugimoto-Matsuda, J. J., & Hayashi, K. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.08.137 · Cited by 26
Suicidal behavior in adolescents under review: fostering hope through action
Fonseca‐Pedrero, E., Departamento de Ciencias de la Educación, U. D. L. R., Pérez‐Albéniz, A., Departamento de Ciencias de la Educación, U. D. L. R., Al‐Halabí, S., & Departamento de Psicología, U. D. O. (2022) · Papeles del Psicólogo - Psychologist Papers · doi:10.23923/pap.psicol.3000 · Cited by 60
“(Joiner, 2005), which has demonstrated its particular usefulness in explaining suicidal behavior in the child and adolescent community and clinical population; b) the integrated motivational-volitional model (IMV) (O’Connor, 2011); c) the three-step theory (3ST) (Klonsky et al., 2021); and d) the fluid vulnerability t…”
Method
Insomnia and risk for suicidal behavior: A test of a mechanistic transdiagnostic model in veterans.
Britton, P. C., McKinney, J., Bishop, T., Pigeon, W., & Hirsch, J. K. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.11.044 · Cited by 24
Psychopathy and suicide: The mediating effects of emotional and behavioral dysregulation
Fadoir, N. A., Lutz-Zois, C. J., & Goodnight, J. A. (2019) · Personality and Individual Differences · doi:10.1016/j.paid.2019.01.021 · Cited by 21
“Autopsy studies and other forms of assessment have found mental illness to be the most significant risk factor for suicidal behavior (Bryan & Rudd, 2006; Cavanagh, Carson, Sharpe, & Lawrie, 2003).”
Background
Probable Standards of Care for Suicide Risk Assessment.
Obegi, J. H. (2017) · PubMed · Cited by 21
Veteran Suicide Risk Factors: A National Sample of Nonveteran and Veteran Men Who Died by Suicide
Wood, D. S., Wood, B. M., Watson, A., Sheffield, D., & Hauter, H. (2019) · Health & Social Work · doi:10.1093/hsw/hlz037 · Cited by 25
“Another theory of suicide called fluid vulnerability theory (FVT) proposes that suicide risk is neither linear nor static and that it often spikes rapidly based on shifting psychological and physical aspects of individuals (Rudd, 2006).”
Background
Treating Veterans at Risk for Suicide: An Examination of the Safety, Tolerability, and Outcomes of Cognitive Processing Therapy
Roberge, E. M., Harris, J. A., Weinstein, H. R., & Rozek, D. C. (2021) · Journal of Traumatic Stress · doi:10.1002/jts.22662 · Cited by 21
“…experiencing suicidal thoughts progress to suicidal behaviors (i.e., "ideation-toaction” framework; May & Klonksy, 2014) would all suggest that additional variables should be considered, including one’s capability for suicide (Joiner, 2005) or the presence of an activating event (Rudd, 2006).”
BackgroundMethodInfluential
Suicide Models and Treatment Models Are Separate Entities. What Does It Mean for Clinical Suicide Prevention?
Michel, K. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18105301 · Cited by 24
Neurocognition and the Suicidal Process
Rutter, S., Cipriani, N., Smith, E. C., Ramjas, E., Vaccaro, D. H., Lopez, M. M., Calabrese, W. R., Torres, D., Campos-Abraham, P., Llaguno, M., et al. (2020) · Current topics in behavioral neurosciences · doi:10.1007/7854_2020_162 · Cited by 21
The Association between Parental Attachment and Youth Suicidal Ideation: A Three-Level Meta-analysis
Yang, H., Ran, G., Zhang, Q., & Niu, X. (2021) · Archives of Suicide Research · doi:10.1080/13811118.2021.2020192 · Cited by 26
“This result can also be explained by fluid vulnerability theory (FVT; Rudd, 2006).”
Background
Co-occurring risk factors among U.S. high school students at risk for suicidal thoughts and behaviors
Flores, J. P., Swartz, K., Stuart, E. A., & Wilcox, H. C. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.01.177 · Cited by 20
Correlates of suicidal thoughts and attempts in males engaging in muscle dysmorphia or eating disorder symptoms
Ortiz, S. N., Forrest, L. N., & Smith, A. R. (2020) · Journal of Clinical Psychology · doi:10.1002/jclp.23102 · Cited by 20
Psychological maltreatment, meaning-centered coping, psychological flexibility, and suicide cognitions: A moderated mediation model
Türk, N., Arslan, G., Kaya, A., Güç, E., & Turan, M. E. (2024) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2024.106735 · Cited by 20
Brief Cognitive-Behavioral Therapy for Suicidal Inpatients
Diefenbach, G. J., Rudd, M. D., Merling, L. F., Davies, C. D., Katz, B. W., & Tolin, D. F. (2020) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2020.09.010 · Cited by 22
Self-citation
Translating Interventional Neuroscience to Suicide: It’s About Time
Barredo, J., Bozzay, M. L., Primack, J. M., Schatten, H. T., Armey, M. F., Carpenter, L. L., & Philip, N. S. (2021) · Biological Psychiatry · doi:10.1016/j.biopsych.2021.01.013 · Cited by 21
“, three-step theory (13), interpersonal-psychological theory (14), integrated motivational-volitional model (15), fluid vulnerability theory (FVT) (16)].”
Background
Distress tolerance as a moderator of the dynamic associations between interpersonal needs and suicidal thoughts
Kyron, M. J., Hooke, G. R., Bryan, C. J., & Page, A. C. (2021) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12814 · Cited by 19
Psychological vulnerability, emotional problems, and quality-of-life: Validation of the brief suicide cognitions scale for Turkish college students
Arslan, G., Türk, N., & Kaya, A. (2024) · Current Psychology · doi:10.1007/s12144-024-05913-w · Cited by 19
“One of the approaches to understanding suicide is the fluid vulnerability theory (Rudd, 2006), which builds on Beck’s (1996) cognitive theory and focuses on cognitive issues.”
Influential
Directionality of change in obsessive compulsive disorder (OCD) and suicidal ideation over six years in a naturalistic clinical sample✰
Brown, L. A., Wakschal, E. S., Block, S. R., Boisseau, C. L., Mancebo, M. C., Eisen, J. L., & Rasmussen, S. A. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.11.006 · Cited by 19
“The chronic pain resulting from OCD may operate as a chronic risk factor for suicide according to Rudd's Fluid Vulnerability theory of suicide (Rudd, 2006).”
Background
Nonsuicidal Self‐Injury and Borderline Personality Features as Risk Factors for Suicidal Ideation Among Male Veterans With Posttraumatic Stress Disorder
Cunningham, K. C., Grossmann, J. L., Seay, K., Dennis, P. A., Clancy, C. P., Hertzberg, M. A., Berlin, K. L., Ruffin, R. A., Dedert, E. A., Gratz, K. L., et al. (2019) · Journal of Traumatic Stress · doi:10.1002/jts.22369 · Cited by 19
Interpersonal Trauma, Posttraumatic Stress Disorder Symptoms, and the Interpersonal Theory of Suicide in Women Seeking Shelter from Intimate Partner Violence
Smith, P. N., Kuhlman, S. T. W., Wolford‐Clevenger, C., Faulk, R. D., D’Amato, D., & Granato, S. (2016) · Journal of Aggression Maltreatment & Trauma · doi:10.1080/10926771.2016.1214937 · Cited by 22
“The distinction between the desire and the capability for suicide inherently separates factors that influence proximal or acute risk for suicide, which is dynamic, from baseline risk for suicide, which is more enduring (Rudd, 2006).”
Background
Suicide‐Specific Cognitions, Attentional Fixation, and Worst‐Point Suicidal Ideation
Moscardini, E. H., Aboussouan, A. B., Bryan, C. J., & Tucker, R. P. (2020) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12628 · Cited by 20
Adverse and benevolent childhood experiences among adults in the United Kingdom: a latent class analysis
Cain, S. M., Rooney, E., Cacace, S. C., Post, A., Russell, K., Rasmussen, S. A., Baker, J. C., & Cramer, R. J. (2024) · BMC Public Health · doi:10.1186/s12889-024-19448-z · Cited by 18
“For instance, the fluid vulnerability theory conceptualizes suicide within a diathesis-stress model that suggests suicide is nonlinear, time-bound, and influenced by prior adverse experiences [80].”
Background
Using the stress–vulnerability model to better understand suicide in prison populations
Scott, R. J., Aboud, A., & Smith, T. (2022) · Psychiatry Psychology and Law · doi:10.1080/13218719.2021.2013340 · Cited by 20
“…by whether a prisoner has a mental illness (which may be a vulnerability or a current stressor) but also by vulnerabilities that may be reflected in tendencies to experience more suicidal ideation and to be more impulsive and, therefore, more likely to act on suicidal ideation (Bryan & Rudd, 2006).”
Background
Longitudinal Trends in Suicidal Thoughts and Behaviors Among US Military Veterans During the COVID-19 Pandemic
Fischer, I. C., Nichter, B., Na, P. J., Norman, S. B., Krystal, J. H., & Pietrzak, R. H. (2023) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2023.0393 · Cited by 19
Agency is Associated with Decreased Emotional Distress and Suicidal Ideation in Military Personnel
Bryan, C. J., Andreski, S. R., McNaughton-Cassill, M. E., & Osman, A. (2014) · Archives of Suicide Research · doi:10.1080/13811118.2013.824836 · Cited by 18
“Results of the current study, in combination with previous research, are consistent with suicidal mode theory (Rudd, 2006), which posits that an individual’s thoughts, assumptions, and beliefs about themselves contribute to suicide risk when in the presence of a stressful event.”
Result
Individual and environmental contingencies associated with multiple suicide attempts among U.S. military personnel
Bryan, C. J., Rudd, M. D., & Wertenberger, E. G. (2016) · Psychiatry Research · doi:10.1016/j.psychres.2016.05.028 · Cited by 18
“This is consistent with the fluid vulnerability theory of suicide (Rudd, 2006), which posits that multiple attempters have predisposing cognitive, affective, behavioral, and physiological/genetic vulnerabilities that increase their propensity to experience suicidal crises in response to triggering…”
BackgroundResultSelf-citation
Psychache and Suicidal History in Patients with Obsessive-Compulsive Disorder
Demirkol, M. E., Namlı, Z., Davut, Ö. E., Karaytuğ, M. O., Tamam, L., & Yılmaz, H. (2019) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s237369 · Cited by 18
“Based on the Rudd’s Fluid Vulnerability theory of suicide, it can be concluded that chronic pain caused by OCD may be a risk factor for suicide, similar to psychological pain.(26) In this study, we aimed to determine the relationship between psychological pain, previous suicide attempts and obsessions, compulsions, an…”
Background
Suicide among justice-involved veterans: a brief overview of extant research, theoretical conceptualization, and recommendations for future research
Holliday, R., Martin, W. B., Monteith, L. L., Clark, S. C., & LePage, J. P. (2020) · Journal of Social Distress and the Homeless · doi:10.1080/10530789.2019.1711306 · Cited by 14
“In addition, other complementary theories of suicide (e.g. Fluid Vulnerability Theory or Three-Step Theory; Klonsky & May, 2015; Rudd, 2006) may hold merit for this population and provide additional important insight regarding factors that facilitate the transition from suicidal ideation to…”
Background
Examining multiple features of episodic future thinking and episodic memory among suicidal adults
Christine, B. W., Robinaugh, D. J., Schacter, D. L., Altheimer, G., Marx, B. P., Keane, T. M., Kearns, J. C., & Nock, M. K. (2022) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12826 · Cited by 21
“Consistent with prior work (e.g., Rudd, 2006; Wenzel & Beck, 2008), we assume that SI can be distinguished from other maladaptive cognitive processes that may lead to SI and maintain it over time.”
A cross-sectional investigation of divine struggles and suicide risk among men in early recovery from substance use disorders.
Currier, J. M., Fadoir, N. A., Carroll, T. D., Kuhlman, S. T. W., Marie, L., Taylor, S. E., Smith, T. L., Isaak, S. L., & Sims, B. M. (2019) · Psychology of Religion and Spirituality · doi:10.1037/rel0000286 · Cited by 18
Finding purpose and happiness after recovery from suicide ideation
Bryan, C. J., Bryan, A. O., & Kopacz, M. S. (2019) · The Journal of Positive Psychology · doi:10.1080/17439760.2019.1676460 · Cited by 17
Symptom trajectories in the months before and after a suicide attempt in individuals with bipolar disorder: A STEP‐BD study
Ballard, E. D., Farmer, C., Shovestul, B. J., Voort, J. V., Machado‐Vieira, R., Park, L., Merikangas, K. R., & Zarate, C. A. (2019) · Bipolar Disorders · doi:10.1111/bdi.12873 · Cited by 17
Psychological autopsy study comparing suicide decedents with and without a history of suicide attempts in a nationwide sample of South Korea
Yook, V., Kim, H., Kim, E. J., Kim, Y., Lee, G., Choi, J. H., Shin, M., & Jeon, H. J. (2021) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12750 · Cited by 20
Examining the Importance of Mental Pain and Physical Dissociation and the Fluid Nature of Suicidality in Young Suicide Attempters
Levinger, S., Holden, R. R., & Ben-Dor, D. H. (2015) · OMEGA - Journal of Death and Dying · doi:10.1177/0030222815575899 · Cited by 17
“Rudd (2000, 2006) describes the suicidal mode as a situation in which four systems are activated (cognitive, affective, behavioral-motivational, and physiological).”
Background
Characterizing self-injurious cognitions: Development and validation of the Suicide Attempt Beliefs Scale (SABS) and the Nonsuicidal Self-Injury Beliefs Scale (NSIBS).
Siddaway, A. P., Wood, A. M., O'Carroll, R. E., & O'Connor, R. C. (2019) · Psychological Assessment · doi:10.1037/pas0000684 · Cited by 16
Suicide ideation severity is associated with severe suicide attempts in a military setting
Shelef, L., Klomek, A. B., Fruchter, E., Kedem, R., Mann, J. J., & Zalsman, G. (2019) · European Psychiatry · doi:10.1016/j.eurpsy.2019.06.005 · Cited by 16
Rethinking Suicide Risk With a New Generation of Suicide Theories
Keefner, T. P., & Stenvig, T. E. (2020) · Research and theory for nursing practice · doi:10.1891/rtnp-d-19-00128 · Cited by 21
Recognizing flawed assumptions in suicide risk assessment research and clinical practice
Rudd, M. D. (2021) · Psychological Medicine · doi:10.1017/s0033291721002750 · Cited by 16
“…suicide for the first time, those making a single attempt, and those with multiple suicide attempts, with converging data over the last several decades indicating that multiple attempters present a profoundly more complex and severe clinical profile across a broad range of variables (Rudd, 2006).”
BackgroundSelf-citation
Polycystic Ovary Syndrome (PCOS) and Non-Suicidal Self-Injury (NSSI): A Community-Based Study
Williams, S., Fido, D., & Sheffield, D. (2022) · Healthcare · doi:10.3390/healthcare10061118 · Cited by 17
“Even though this in no way detracts from the relevance and importance of the findings reported here, it does neglect the potential confounding that one’s risk for attempting suicide fluctuates over time [41].”
Self-Forgiveness and Military Service: Equipping Warriors to Combat Moral Injury
Griffin, B. J., Worthington, E. L., Danish, S. J., Donovan, J. P., Lavelock, C. R., Shaler, L., Dees, R. F., Maguen, S., & Davis, D. E. (2017) · Springer eBooks · doi:10.1007/978-3-319-60573-9_16 · Cited by 19
Those left behind: A scoping review of the effects of suicide exposure on veterans, service members, and military families
Peterson, A. L., Bozzay, M. L., Bender, A. M., Monahan, M. F., & Chen, J. I. (2020) · Death Studies · doi:10.1080/07481187.2020.1802628 · Cited by 17
“One framework which may inform efforts is Fluid Vulnerability Theory, which posits that specific stressors can activate cognitive, affective, and motivational responses that increase suicide risk (Rudd, 2006).”
Background
First- and Second-Generation Psychological Theories of Suicidal Behaviour
Yöyen, E., & Keleş, M. (2024) · Behavioral Sciences · doi:10.3390/bs14080710 · Cited by 17
“These distortions, called the ‘suicide belief system’, consist of two different predispositions, ‘cognitive rigidity’ and ‘emotion dysregulation’, and one of them is not less important than the other [32,41].”
Variables associated with reductions in insomnia severity among acutely suicidal patients receiving brief cognitive behavioral therapy for suicide prevention
Roberge, E. M., Bryan, C. J., Peterson, A. L., & Rudd, M. D. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.04.045 · Cited by 15
Self-citation
Moderation Effects of Coping Flexibility on the Association Between Depressive Symptoms and Suicidal Risk
Kato, T. (2021) · Crisis · doi:10.1027/0227-5910/a000800 · Cited by 15
Reevaluating Suicidal Behaviors: Comparing Assessment Methods to Improve Risk Evaluations
Harris, K. M., Lello, O. D., & Willcox, C. H. (2016) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-016-9566-6 · Cited by 18
Understanding the emergence of suicidal thoughts and behaviors in adolescence from a brain and behavioral developmental perspective
Lewis, C. P., Klimes‐Dougan, B., Croarkin, P. E., & Cullen, K. R. (2025) · Neuropsychopharmacology · doi:10.1038/s41386-025-02168-2 · Cited by 25
Public Health Perspectives on Depressive Disorders
Cohen, N. L. (2017) · Johns Hopkins University Press eBooks · doi:10.1353/book.52762 · Cited by 15
Evaluating Suicide Risk Using the Reasons for Dying-Reasons for Living (RFD-RFL) Index in a Military Psychiatric Inpatient Setting
Fox, A. M., LaCroix, J. M., Bond, A. E., Perera, K. U., Luk, J. W., Goldston, D. B., Weaver, J. J., Soumoff, A. A., & Ghahramanlou‐Holloway, M. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.113576 · Cited by 16
Does Hopelessness Accurately Predict How Bad You Will Feel in the Future? Initial Evidence of Affective Forecasting Errors in Individuals with Elevated Suicide Risk
Bauer, B. W., Hom, M. A., Karnick, A. T., Charpentier, C. J., Keefer, L. A., Capron, D. W., Rudd, M. D., & Bryan, C. J. (2022) · Cognitive Therapy and Research · doi:10.1007/s10608-021-10285-7 · Cited by 14
“Suicide attempts often occur during a suicidal crisis (short periods of elevated acute suicide risk), which consists of a sudden and rapid increase in severe negative emotional experiences (Rogers et al., 2017) and is often preceded by a life-stressor (e.g., job loss) or with a life-stressor looming in the future (Dem…”
ResultInfluentialSelf-citation
Psychotic experiences, emotion regulation, and suicidal ideation among Chilean adolescents in the general population
Wastler, H. M., & Núñez, D. E. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.983250 · Cited by 13
Use of Tobacco Products and Suicide Attempts Among Elementary School–Aged Children
Lee, P. H., Tervo-Clemmens, B., Liu, R. T., Gersten, M., Jung, J.-Y., Janes, A. C., & Gilman, J. M. (2024) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.0376 · Cited by 16
Suicidal Ideation in Adolescents and Young Adults: The Role of Defeat, Entrapment, and Depressive Symptoms—From a Systematic Review to a Tentative Theoretical Model
Arco, A. H.-D., Izquierdo-Sotorrío, E., Carrasco, M. Á., Caro‐Cañizares, I., & Tello, F. P. H. (2024) · Behavioral Sciences · doi:10.3390/bs14121145 · Cited by 14
Occupational Stressors, Burnout, and Predictors of Suicide Ideation Among U.S. Air Force Remote Warriors
Bryan, C. J., Goodman, T. M., Chappelle, W. L., Thompson, W. T., & Prince, L. (2017) · Military Behavioral Health · doi:10.1080/21635781.2017.1325803 · Cited by 22
“The fluid vulnerability theory of suicide (Rudd, 2006) posits that suicidal thoughts and behaviors emerge as a”
Background
Psychometric properties of the Spanish version of the 12-item Interpersonal Needs Questionnaire in fibromyalgia syndrome patients
Ordóñez-Carrasco, J. L., Salgueiro, M., Sayans‐Jiménez, P., Blanc, A., Garcia‐Leiva, J. M., Calandre, E. P., & Tejada, A. J. R. (2018) · Anales de Psicología · doi:10.6018/analesps.34.2.293101 · Cited by 13
“Later, other theories (three-step theory [Klonsky & May, 2015], integrated motiva- tional-volitional model [O'Connor, 2011], fluid vulnerability theory [Rudd, 2006]) have been developed in consonance with the interpersonal theory of suicide.”
Background
The psychological scars of suicide: Accounting for how risk for suicidal behavior is heightened by its past occurrence
Liu, R. T. (2019) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2019.01.024 · Cited by 17
“Consistent with this view, the fluid vulnerability theory (Bryan et al., 2014; Rudd, 2006; Wolfe-Clark and Bryan, 2017) posits that individual variation in baseline risk for suicidal behavior exists.”
Background
Suicide Cognitions Scale: Psychometric Support in a Community Sample Using Bifactor Modeling and Altered Item Content
Moscardini, E. H., Pardue-Bourgeois, S., Oakey‐Frost, N., Powers, J. T., Bryan, C. J., & Tucker, R. P. (2021) · Assessment · doi:10.1177/10731911211050894 · Cited by 12
“This finding supports the key tenants of the FVT (Rudd, 2006), which posits that a host of dispositional risk factors, which can include the suicidal belief system, are related to fluctuations in the severity of STBs.”
BackgroundResultInfluential
Suicidal ideation and suicidal beliefs as prospective indicators of suicidal behavior among primary care patients
Bryan, C. J., & Rudd, M. D. (2023) · Psychiatry Research Communications · doi:10.1016/j.psycom.2023.100107 · Cited by 14
Self-citation
Trajectories to Suicide Following Intimate Partner Violence Victimization: Using Structural Equation Modelling to Examine Suicide and PTSD in Female Emergency Department Users
Rasmussen, V., Spangaro, J., Steel, Z., Briggs, N., & Torok, M. H. (2023) · Journal of Family Violence · doi:10.1007/s10896-023-00640-5 · Cited by 16
“…IPV and suicide, and the mediating role of PTSD, are consistent with prominent theoretical frameworks in suicidology, which conceptualise risk as resulting from an interplay of environmental stressors and predisposing factors (FVT; Rudd, 2006) or individual’s cognitions (IPTS; Joiner, 2005).”
A dynamical systems analysis of change in PTSD symptoms, depression symptoms, and suicidal ideation among military personnel during treatment for PTSD
Bryan, C. J., Butner, J., Tabares, J. V., Brown, L. A., Young‐McCaughan, S., Hale, W. J., Litz, B. T., Yarvis, J. S., Fina, B. A., Foa, E. B., et al. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.01.107 · Cited by 12
Suicidal ideation among adults with a recent sexual assault: Prescription opioid use and prior sexual assault
Gilmore, A. K., Hahn, C. K., Jaffe, A. E., Walsh, K., Moreland, A. D., & Ward-Ciesielski, E. F. (2018) · Addictive Behaviors · doi:10.1016/j.addbeh.2018.05.028 · Cited by 12
“Re-victimization may increase risk for suicidal behaviors by contributing to an underlying vulnerability (Bryan et al., 2013; Rudd, 2006).”
Background
Suicide Risk and Restricted Emotions in Women: The Diverging Effects of Masculine Gender Norms and Suicide Capability
Fadoir, N. A., Kuhlman, S. T. W., & Smith, P. N. (2019) · Archives of Suicide Research · doi:10.1080/13811118.2019.1599480 · Cited by 14
Examining the Interrelationships Among Suicide Cognitions, Suicidal Ideation, and Theoretically Derived Protective Factors
Oakey‐Frost, N., Cowan, T., Moscardini, E. H., Pardue-Bourgeois, S., Beurs, D. P. D., Cohen, A., Bryan, C. J., & Tucker, R. P. (2022) · Archives of Suicide Research · doi:10.1080/13811118.2022.2096521 · Cited by 14
Clinical decision making regarding suicide risk: Effect of patient and clinician age
Berman, N. C., Tung, E. S., Matheny, N. L., Cohen, I. G., & Wilhelm, S. (2015) · Death Studies · doi:10.1080/07481187.2015.1128498 · Cited by 12
“%) and those who attempt suicide (2.7%; Nock et al., 2008), along with the high false positive rates for self-report suicide measures (Bryan & Rudd, 2006), leads to inaccurate assessments of suicide risk.”
BackgroundInfluential
Prevalence of Suicidal Ideation and Its Association with Positive Affect in Working Women: A Day Reconstruction Study
Tian, L., Yang, Y., Yang, H., & Huebner, E. S. (2017) · Frontiers in Psychology · doi:10.3389/fpsyg.2017.00285 · Cited by 12
“Similarly, in a 6-month prospective study of hospitalized adolescents, lower frequencies of positive affect were associated with shorter intervals in manifesting suicidal ideation, whereas negative affect was unrelated to manifesting suicidal ideation (Yen et al., 2013).”
Background
Randomized controlled trial investigating web-based, therapist delivered eye movement desensitization and reprocessing for adults with suicidal ideation
Burback, L., Yap, S., Purdon, S. E., Abba‐Aji, A., O’Shea, K., Brémault‐Phillips, S., Greenshaw, A. J., & Winkler, O. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1361086 · Cited by 12
Choosing Death Over Survival: A Need to Identify Evolutionary Mechanisms Underlying Human Suicide
Chatterjee, D., & Rai, R. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.689022 · Cited by 10
“Few other psychological theories of suicide, namely, the Fluid Vulnerability Theory (Rudd, 2006), the Integrated Motivational Model of suicidal behavior (O’Connor, 2011; O’Connor and Kirtley, 2018), and the 3-step “ideation to activation” framework (Klonsky and May, 2015), have attempted to…”
Background
Using ordinal regression for advancing the understanding of distinct suicide outcomes
Jacobucci, R., Ammerman, B. A., & Li, X. (2021) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12669 · Cited by 10
Understanding Patterns of Adolescent Suicide Ideation: Implications for Risk Assessment
Miranda, R., Ortin‐Peralta, A., Rosario‐Williams, B., Kelly, T. F., Macrynikola, N., & Sullivan, S. R. (2021) · Springer eBooks · doi:10.1007/978-3-030-82465-5_9 · Cited by 13
Catalytic Reaction Model of Suicide
McPherson, P., Sall, S., Santos, A., Thompson, W., & Dwyer, D. S. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.817224 · Cited by 14
Cognition and Suicide: Two Decades of Progress
Ellis, T. E., & Rutherford, B. J. (2008) · International Journal of Cognitive Therapy · doi:10.1680/ijct.2008.1.1.47 · Cited by 11
Toward objective characterizations of suicide risk: A narrative review of laboratory-based cognitive and behavioral tasks
Lamontagne, S. J., Zabala, P. K., Zarate, C. A., & Ballard, E. D. (2023) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2023.105361 · Cited by 12
The end of ambivalence. A narrative perspective on ambivalence in the suicidal process
Galasiński, D., & Ziółkowska, J. (2024) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.13101 · Cited by 10
The Role of the Lateral Habenula in Suicide: A Call for Further Exploration
Marks, R. B., Wee, J. Y., Jacobson, S. V., Hashimoto, K., O’Connell, K. L., Golden, S. A., Baker, P. M., & Law, K. C. (2022) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2022.812952 · Cited by 10
“In the Fluid Vulnerability Theory of suicide, eCB levels in the LHb could then play a crucial role in understanding biological predispositions to suicide risk, which then could be compounded by chronic stress (Authement et al., 2018).”
Background
Differences in Guilt, Shame, Self-Anger, and Suicide Cognitions Based on Recent Suicide Ideation and Lifetime Suicide Attempt History
Szeto, E. H., Ammendola, E., Starkey, A. G., Hay, J. M., McClung, J. G., & Bryan, C. J. (2022) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000001592 · Cited by 10
“From the perspective of the FVT, differences between SI and suicidal action can be most usefully understood by explicitly considering temporality.”
BackgroundInfluential

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
DOI: 10.1037/11377-016
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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Fluid vulnerability theory: a cognitive approach to understanding the process of acute and chronic suicide risk

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