Understanding Suicide-Related Vulnerability Through Network Analysis: Mapping the Associations Between Distal and Proximal Risk Domains

BACKGROUND: Suicide risk is increasingly understood to be the result of interacting environmental and psychological vulnerabilities, rather than the effect of isolated risk factors. In this perspective, distal and proximal factors (e.g., early adverse experiences and current emotional-psychopathological functioning) may be associated with suicide-related vulnerability. METHODS: = 35.3 ± 15.1; 55.1% females). RESULTS: Exploratory analyses supported a two-community structure reflecting distal (i.e., early adversities) and proximal factors (i.e., psychological vulnerabilities). Emotional abuse and affective lability showed the highest strength centrality (strength = 1.22). Suicide-relevant mental states also displayed high overall connectedness (strength = 1.05), and the highest bridge expected influence (BEI = 0.30). Among early adversities, only emotional abuse showed a significant direct association with suicide-relevant cognitions and emotions, emerging as the sole interpretable cross-community bridge. Within the psychological vulnerabilities, suicide-relevant mental states were significantly connected to psychopathology, affective lability, detachment, negative affectivity, and psychoticism. CONCLUSIONS: Suicide-relevant cognitive and emotional states are embedded within a tightly interconnected system of environmental and psychological vulnerabilities. Emotional abuse showed the strongest cross-community association with suicide-relevant mental states, suggesting a robust cross-sectional association between developmental adversity and suicide-related vulnerability. Among psychological vulnerabilities, suicide-relevant mental states were closely integrated with emotional-psychopathological functioning and characterized suicide-relevant psychological distress.