The interaction of dissociation, pain tolerance, and suicidal ideation in predicting suicide attempts

Pain tolerance and dissociation have individually been shown to be risk factors for suicidal behaviors. The aim of the current study was to investigate how dissociation and physiological pain tolerance influence the relation between suicidal thoughts and behaviors. The sample consisted of 70 undergraduate college students who completed self-report measures of suicidality and dissociation and an electrical stimulation task to measure physiological pain tolerance. Results showed that dissociation and suicidal ideation, but not pain tolerance, were independently associated with increased suicide attempts. A three-way interaction of suicidal ideation, physiological pain tolerance, and dissociation statistically predicted number of suicide attempts, with an increased number of suicide attempts associated with high suicidal ideation and dissociation, regardless of pain tolerance. These results suggest that dissociation plays a significant role in predicting suicide attempts, perhaps by engendering a state of disconnect from one's body.