Suicide is the second leading cause of death worldwide for adolescents and emerging adults. Despite knowledge of distal risk factors for suicide (i.e., childhood maltreatment), there is a dearth of developmentally informed psychobiological theories of suicide that test potentially modifiable proximal risk factors. Utilizing a multi-method design, this study integrates cognitive and biological risk factors into a model of suicide risk following maltreatment. Undergraduates completed a screener assessing medical history, trait reward and threat sensitivities, history of suicidal thoughts and behaviors (STBs), and childhood maltreatment. Participants without a history of autoimmune disease completed a reward and threat-salient acute stress task with pre- and post-task blood draws to measure peripheral inflammatory biomarkers. Utilizing ecological momentary assessment, a subset of participants with a history of suicidal ideation completed daily measures (three per day) of STBs and state reward and threat sensitivities for two-weeks before completing follow-up measures of STBs. Mediation models found that inflammatory reactivity to acute stress did not explain the relationship between maltreatment and ideation across the two-week follow-up, but those participants with greater TNF-α reactivity to an acute stress task reported more severe ideation at the study visit. Moderated mediation models showed that the association between inflammatory reactivity and suicidality was not significantly amplified by reward or threat sensitivity. But, at trait and state levels, those with histories of maltreatment who were less sensitive to rewards and more aware of potential threats experienced the most severe ideation. This investigation aimed to understand the processes that immediately precede STBs to inform future prevention and intervention efforts. / Psychology

Previous research provided preliminary support of a potential reinforcing effect of suicidal ideation demonstrating reduced negative affect and increased positive affect after thinking about suicide. The present study therefore sought to investigate the role of mood and affect as a proximal risk factor of suicidal ideation in a high-risk sample. Seventy-four psychiatric inpatients (72% female) with unipolar depression and current and/or lifetime suicidal ideation aged 18 to 85 years (M = 37.6, SD = 14.3) took part in an ecological momentary assessment (EMA) over 6 days. Multilevel analyses were calculated. Analyses revealed negative valence of mood and low positive affect to be predictors of subsequent intensity of suicidal ideation (active, passive) as well as predictors of change in suicidal ideation (active, passive) since the last measurement. High negative affect only predicted intensity of passive suicidal ideation. Suicidal ideation (active, passive) was prospectively associated with subsequent negative valence of mood and lower positive affect as well as with higher intensity of negative affect. Suicidal ideation (active, passive) also predicted the change in valence of mood, positive affect and negative affect since the last measurement. Mood and affect should be taken into account as important proximal risk factors of active and passive suicidal ideation. The results do not support the idea of a reinforcing effect of suicidal ideation. In fact, they show a pattern of reduced subsequent positive affect, negative valence of mood and increased negative affect. Replication studies with larger samples and longer EMA follow-ups are needed