Anxiety and suicide risk: mechanism, timing, and clinical utility

PURPOSE OF REVIEW: Anxiety disorders are associated with suicidal thoughts and behaviors, yet diagnosis and trait measures offer limited clinical utility. We review recent disorder-level and transdiagnostic evidence, focusing on what it adds to explanation, measurement, and prevention. RECENT FINDINGS: Recent studies indicate elevated risk across panic disorder, generalized anxiety disorder, social anxiety disorder, and posttraumatic stress disorder, but estimates differ by disorder and shrink after accounting for depression and other comorbidity. Within-person studies show that anxiety-related affect and rumination covary with suicidal thinking but seldom predict what happens next. Several transdiagnostic anxiety-related processes are modifiable, although durable effects on suicidal outcomes remain unestablished. SUMMARY: Assessment should emphasize processes measured at timescales that match acute risk and interpreted against each person's baseline vulnerability. Mechanism-targeted components should be tested in micro-randomized experiments during periods of acute risk.