Emotion Regulation in Daily Life Among Adults With Suicidal Thoughts

Emotion-regulation difficulties are implicated as a risk factor for suicidal thoughts, yet little is known about how adults with suicidal thoughts regulate emotions in daily life or which deficits are specific to suicidality versus shared across psychopathology. In two ecological-momentary-assessment studies (Study 1: N = 396; Study 2, recruited online: N = 195), we compared adults with current suicidal thoughts with adults with past or no suicidal history (Study 1) and with psychiatric and healthy control participants (Study 2). Participants with current (vs. past) suicidal thoughts reported greater substance use and self-injury to regulate emotions (Study 1). Compared with psychiatric control participants, participants with suicidal thoughts reported higher regulatory effort and substance use, and compared with healthy control participants, they additionally reported greater distraction and rumination and lower regulatory success (Study 2). Self-injury and substance use uniquely predicted momentary suicidal thinking (Study 2). Findings highlight substance use, self-injury, and heightened regulatory effort as potentially distinct emotion-regulation processes associated with suicidal thoughts.