OC08 - Suicidal Behaviour in People With Mental Disorders and Substance Abuse
Variability in Momentary Affect During Suicidal States Among Psychiatric Outpatients With Posttraumatic Stress DisorderResearchers have recently argued that suicidal states operate as complex adaptive systems composed of multiple interacting and interdependent components (Bryan, Butner et al., 2020). Consistent with this perspective, research has shown that suicidal states are multidimensional, with different facets of suicidal thinking following different patterns that operate on different timescales (Bryan et al., 2016; Butner et al., 2024; Coppersmith et al., 2022). The cognitive content of suicidal states is also heterogeneous, such that the subjective experience of “being suicidal” can manifest in a variety of idiographic ways (Bryan et al., 2022; Millner et al., 2015; Wastler et al., 2022). The affective features of suicidal states may similarly vary. To examine this possibility, 117 adult U.S. military personnel and veterans completed an ecological momentary assessment protocol assessing momentary affect, measured with the Positive and Negative Affect Scale-Short Form (PANAS-SF), and suicidal ideation, measured with the first five items of the Scale for Suicidal Ideation (SSI), four times per day for 14 consecutive days while receiving outpatient treatment for posttraumatic stress disorder (PTSD). Four affect states were measured using PANAS-SF item scores: pleasant activation (e.g., interested, excited), a high arousal positive affect; activated pleasure (e.g., enthusiastic, proud), a moderate arousal positive affect; unpleasant activation (e.g., nervous, jittery), a high arousal negative affect; and activated displeasure (e.g., upset, irritable), a moderate arousal negative affect. Six suicidal states were measured using SSI item scores: low, moderate, and high levels of active suicidal ideation and passive suicidal ideation. Mixed effects modeling indicated the intensity of pleasant activation and activated pleasure were lower on average whereas unpleasant activation and activated displeasure were higher on average during suicidal states. The variability of all four affect states was greater during suicidal versus nonsuicidal states. The correlation of each affect state with suicidal ideation also varied significantly, indicating suicidal states were characterized by a wide range of affective experiences, not just extreme negative affect.