(PS13-51) The Relationship Between Emotion Reactivity and Uncontrollability of Suicidal Thoughts in a Psychiatric Inpatient Population

Emotional reactivity (ER) is defined as the tendency to experience frequent and intense emotional arousal. Research suggests that increased ER may interfere with cognitive and behavioral inhibitory control, which could then prompt suicidal thoughts or urges to escape the unbearable emotional state. ER may be important in populations at elevated risk for suicide because it may explain why or how maladaptive behaviors are maintained. Perceived controllability of suicidal thoughts has also been shown to be associated with current and lifetime suicidal thoughts and behaviors (STBs), possibly through impaired inhibitory control of maladaptive cognitions and emotions. Despite the shared characteristics between these concepts, no studies have examined the relationship between perceived controllability and ER. It’s possible that perceptions of uncontrollability lead to heightened ER; similarly, having heightened ER may heighten the experience of uncontrollability of suicidal ideation. The present study is assessing the bidirectional relationship between ER and perceived controllability of STBs two months after baseline in an acute psychiatric inpatient sample by 1) analyzing if higher baseline ER could predict future perceived controllability of SI and 2) analyzing if increased uncontrollability of SI could predict future ER. 

Participants were 59 adult psychiatric inpatients who endorsed suicidal ideation (SI) or a suicide attempt within a month prior to hospitalization. Participants completed the Columbia Suicide Severity Scale (C-SSRS) to assess severity of SI and lifetime suicidal behaviors (SB) and the Emotion Reactivity Scale (ERS) to assess individuals’ experiences of emotional reactivity. Linear regression analyses were used to examine whether baseline ER predicted controllability of SI two months after baseline assessments, controlling for baseline controllability. ER at baseline did not significantly predict controllability at the 2-month follow-up. However, baseline controllability predicted future ER, after controlling for baseline ER. The overall model was significant, p=.004, and accounted for 13.6% of the variance in ER. Greater perceived uncontrollability of SI significantly predicted increased ER 2-months after baseline. 

The results indicate that baseline ER did not predict future uncontrollability of SI while baseline controllability did significantly predict future ER, even after controlling for baseline ER. This suggests that perceived difficulty to control one's STBs significantly predicted future intensity and persistence of one’s emotional experiences. This one-way directionality suggests that perhaps feeling like one cannot control their suicidal thoughts leads to being more emotionally reactive but not the other way around. Understanding the directionality of traits such as emotion reactivity at baseline is important to determine what to assess in an inpatient setting when considering intervention targets. Due to the relationship between uncontrollability and ER, further research should elucidate the directionality between uncontrollability and emotional processes and its relation to future suicide risk and outcomes.