Suicide-specific rumination as a predictor of suicide planning and intent

Suicide-specific rumination (SSR), that is repetitive negative thinking about suicide, has been proposed as a risk factor for suicidal behavior. Yet, few studies have investigated associations between SSR and suicide intent and planning in a longitudinal study design. The purpose of the present study was to investigate the association between SSR, suicide intent, suicide planning and suicide attempts in a sample of adult outpatients undergoing psychotherapy.

Data from N = 637 patients (58.4% female, 41.6% male; M_age = 35.81, SD_age = 13.50, range: 18-79 years) who started therapy at an outpatient clinic were collected. A subsample of n = 335 patients (n = 335; 56,4% female, 43,6% male; M_age = 35.4, SD_age = 13.1, range: 18-73 years) also took part in a post-treatment assessment after twelve therapy sessions.

SSR differentiated lifetime suicide attempters from suicide ideators. Furthermore, SSR was associated with lifetime suicide attempt status above age, sex, suicide ideation, depression, anxiety, and stress. Finally, SSR served as a prospective predictor of both suicide planning and suicide intent.

The results emphasize the key role of SSR in understanding the suicidal process.