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Cited by 76Suicide and Self-Harm StudiesMental Health Research TopicsMental Health via Writing

Highly variable suicidal ideation: a phenotypic marker for stress induced suicide risk

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Oquendo, Maria A., Galfalvy, Hanga C., Choo, Tse-Hwei, Kandlur, Raksha, Burke, Ainsley K., Sublette, M. Elizabeth, Miller, Jeffrey M., Mann, J. John +1 more·2021·Molecular Psychiatry
DOI 10.1038/s41380-020-0819-0PMC PMC7755748
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Abstract

Suicidal behavior (SB) can be impulsive or methodical; violent or not; follow a stressor or no obvious precipitant. This study tested whether childhood trauma, affective lability, and aggressive and impulsive traits predicted greater SI variability. We also assessed whether affective lability, aggressive or impulsive traits explain childhood trauma's effects on SI variability and whether those with highly variable SI respond to stressful events with increases in SI. Finally, we assessed variable SI's trajectory over 2 years. Depressed participants (n = 51) had ecological momentary assessments (EMA) over 7 days at baseline, 3, 6, 12, 18, and 24 months. SI variability was assessed using the square Root of the Mean Square of Successive Deviations. Mixed Effects Models were fit as appropriate. Childhood trauma was associated with subsequent aggression. Physical abuse predicted both aggression and affective lability as well as SI variability, but not impulsivity. In two-predictor models, physical abuse's effect on SI variability was no longer significant, when controlling for the effect of higher aggression and impulsivity. Those with high SI variability exhibited greater increases in SI after stressors compared with those with less variability. We did not find that SI variability changed over time, suggesting it might be trait-like, at least over 2 years. Variable SI predisposes to marked SI increases after stressful events and may be a trait increasing risk for impulsive SB, at least over 2 years.

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  • Newer theories suggest a subtype of individuals with highly variable SI may be at particular risk for suicidal behavior in times of stress.

    “newer theories of suicide risk suggest that a subtype of individuals who report highly variable SI may be at particular risk for suicidal behavior in times of stress (Oquendo et al., 2021).”

    From Clinical indicators of the suicide crisis and response to ketamine (2025) · cites this paper as Oquendo et al., 2021

  • Pseudo-random sampling schedules were most frequently used (57%, n = 13), followed by fixed sampling (26%, n = 6), and combined fixed and pseudo-random sampling (13%, n = 3).

    “(pseudo)random sampling schedules were most frequently used [57%, n = 13 (42, 47, 51, 58, 61, 65, 69, 71, 79, 83, 85, 86, 88)], followed by fixed sampling [26%, n = 6 (45, 66, 67, 72, 80, 82)], and protocols that combined both fixed and (pseudo)random sampling [13%, n = 3 (47, 56, 60)].”

    From Don't Miss the Moment: A Systematic Review of Ecological Momentary Assessment in Suicide Research (2022) · cites this paper as [65]

  • Those with higher mean suicidal ideation across the EMA period experienced more variability.

    “Those with higher mean ideation (per person, across EMA period) experienced more variability (47, 65, 66).”

    From Don't Miss the Moment: A Systematic Review of Ecological Momentary Assessment in Suicide Research (2022) · cites this paper as [65]

  • The test-retest reliability of EMA-assessed within-person suicidal ideation variability (RMSSD) was high across 24 months.

    “The test-retest reliability of EMA-assessed within-person suicidal ideation variability (as estimated by the Root Mean Square of the Successive Differences, RMSSD) was high across 24 months (65).”

    From Don't Miss the Moment: A Systematic Review of Ecological Momentary Assessment in Suicide Research (2022) · cites this paper as [65]

  • Compliance rates were not significantly related to suicide history or current depressive symptom or suicidal ideation severity.

    “Compliance rates were not significantly related to suicide history or current depressive symptom or suicidal ideation severity (65, 66, 71, 85, 88).”

    From Don't Miss the Moment: A Systematic Review of Ecological Momentary Assessment in Suicide Research (2022) · cites this paper as [65]

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Authors
Oquendo, M. A., Galfalvy, H. C., Choo, T.-H., Kandlur, R., Burke, A. K., Sublette, M. E., Miller, J. M., Mann, J. J., & Stanley, B. H.
Affiliations
  • Columbia University (US)
  • New York State Psychiatric Institute (US)
ORCID
Venue
Molecular Psychiatry
Publisher
Springer Science and Business Media LLC
Published
2020-06-23
Volume
26
Issue
9
Pages
5079-5086
ISSN
  • 1359-4184 (ISSN-L)
  • 1476-5578
DOI
10.1038/s41380-020-0819-0
PMC
PMC7755748
OpenAlex
W3035825417
Cited by
76
References
30
Citations by year
2026: 10 · 2025: 18 · 2024: 14 · 2023: 5 · 2022: 19 · 2021: 8 · 2020: 2
FWCI
3.40
Type
journal article
Language
en
Open access
Licence
Locations
  • Molecular Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
U.S. Department of Health & Human Services | NIH | National Institute of Mental Health (MH090964)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
  • Social Sciences › Psychology › Social Psychology › Mental Health via Writing
Keywords
suicidal ideation, childhood trauma, physical abuse, emotional lability, aggression, impulsivity, depression, phenotypic markers, trait stability
MeSH terms
Aggression, Humans, Impulsive Behavior, Risk Factors, Suicide, Suicide, Attempted, Biomarkers, Suicidal Ideation

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