(PS11-67) Intradaily Dynamics of Rumination and Worry Among Depressed and Anxious Adults: Associations with Suicidal Ideation and Suicide Attempt

Rumination and worry are different forms of repetitive negative thinking, a distressing, persistent, and difficult-to-control cognitive process (Ehring & Watkins, 2008). Both worry and rumination have emerged as cognitive vulnerabilities to suicidality given their associations with suicidal ideation and behaviors (e.g., Morrison & O’Connor, 2008; Gorday et al., 2018). However, there has been limited research examining how those cognitive processes unfold in daily life among suicidal individuals. Existing studies have shown that both momentary rumination and worry were associated with concurrent suicidal ideation (Hallard et al., 2021), and that at higher levels of momentary rumination, negative affective states were more strongly associated with concurrent suicidal ideation in daily life (Rogers et al., 2022). To our best knowledge, no study has yet examined dynamic patterns of momentary rumination and worry in daily life among suicidal individuals. Nonetheless, examining how rumination and worry fluctuate, persist, and increase over time may help to clarify which specific aspects of those cognitive processes are associated with suicide risk. To address this question, the current study used ecological momentary assessment (EMA) to examine dynamic indices of momentary rumination and worry (mean, variability, inertia, and reactivity to a stressor) and their associations with suicidal thoughts and behaviors among anxious and depressed individuals. 

192 adults (87.0% female, 68.8% White, Mage= 19.41, range=18-53) with affective disorders were recruited from the undergraduate subject pool and the community. Diagnostic status, past-month suicidal ideation, and lifetime suicide attempt history were assessed via a structured diagnostic interview (MINI; Sheehan et al., 2016), yielding three groups: suicidal ideation with suicide attempt history (n=45), suicidal ideation only (n=62), and no suicidal ideation/attempt history (n=85). Participants completed 8-day EMA on their momentary rumination and worry 9 times per day. Compliance reached 77%. Dynamic indices were computed for rumination and worry separately and compared between groups.  

Results revealed that participants with suicidal ideation only (M=4.03, SD=1.87) ruminated more on average than non-suicidal participants (M=3.31, SD=1.58), p=.05, d=.42. The suicidal ideation only group (M=4.41, SD=1.95) also worried more on average than non-suicidal participants (M=3.57, SD=1.63), p=.03, d=.47. Similar group difference emerged for worry in the absence of a stressor, p=.04, d=.45. No significant group differences emerged for the other metrics, ps>.05. 

These findings suggest rumination and worry as correlates of suicidal ideation, not suicide attempt. Intradaily average levels of rumination and worry were associated with suicidal ideation beyond their associations with affective disorders whereas variability, inertia, and reactivity were not. Suicidal ideation was also associated with higher baseline worry, or how much individuals worried in the absence of a stressor.