4 - (SYM 2) Heterogeneity in Momentary Affective Experiences Related to Suicidal States in a Non-clinical Sample of Adult Handgun Owners and Non-owners Recruited from the Community

Background: Although suicide risk is complex and heterogeneous, most suicide theories assume that suicidal states occur primarily in the context of extreme emotional distress. Newer models of suicide based on complex systems theory propose greater heterogeneity in suicidal states across individuals and groups, such that some, but not all, suicidal states are associated with extreme negative affect. We assessed positive and negative affect with varying levels of arousal, using a circumplex model of affect. We hypothesized that (1) affect scores would significantly vary during suicidal states, (2) the association of affect with suicidal ideation (SI) would significantly vary, and (3) the association of affect with SI would significantly differ between handgun owners and non-owners.

Method: Participants were 138 adults recruited from the community; 81 (59.1%) owned handguns. Participants reported their current affect and SI 6 times/day for 28 days via ecological momentary assessment. Mixed effects regression models used (1) different affective scores as outcomes, and fixed and random effects for SI; (2) SI as an outcome, and fixed and random effects for different affective scores representing varying degrees of valence and arousal (High arousal: pleasant activation, unpleasant activation; Moderate Arousal: activated pleasure, activated displeasure); and (3) incorporated separate and interactive fixed effects of handgun ownership group.

Results: Nonsuicidal vs. suicidal states were characterized by more intense positive affect combined with less intense and less variable negative affect. Activated displeasure showed the relative strongest average association with SI severity and varied more than the other affective states. This pattern that was more pronounced for non-owners vs. handgun owners. The association of unpleasant activation with SI significantly varied among handgun owners but not non-owners.

Discussion: Suicidal states are characterized by high affective heterogeneity. That effects were much larger in the moderate (versus high) arousal state suggests that SI is related differentially to levels of negatively valenced arousal and underscore the importance of considering multiple dimensions of affect in characterizing suicide risk states. Our findings also suggest that suicidal states may vary within clinically relevant subgroups. Collectively, our results support complexity-based models that allow for heterogeneity in suicidal states and the possible existence of multiple trajectories to suicide.