Suicidal Cognitions and Suicidal Ideation Severity: The Moderating Effect of Psychological Inflexibility About Suicidal Ideation

OBJECTIVE: Most self-report measures of suicidal ideation (SI) index thoughts or behaviors but broadly fail to contextualize the degree to which SI is perceived to impair quality of life. Theories of suicide propose that psychological inflexibility (i.e., metacognitive distress) about SI may compound suicidal cognitions and impact suicide risk. This study tested whether suicidal cognitions and psychological inflexibility about SI interact to amplify SI severity. METHODS: = 87) with current SI at a health care system in the Southeast United States. The sample primarily identified as male (70%) and White/Caucasian (45.6%). A moderation model tested main and interactive effects of suicidal cognitions and psychological inflexibility about SI on SI severity. RESULTS: There was a significant interaction between suicidal cognitions and psychological inflexibility about SI, such that the statistically significant relationship between suicidal cognitions and SI severity increased at each level (-1 SD, mean, and +1 SD) of psychological inflexibility about SI. CONCLUSIONS: Psychological inflexibility about SI may amplify SI severity, which has theoretical implications for ideation-to-action frameworks of suicide. In addition to treating underlying suicidal cognitions, patients may benefit from addressing concerns about the meaning and impact of SI itself.