Familial Risk and Resilience Moderate the Association Between Intolerance of Uncertainty and Youth Suicidal Ideation

Intolerance of uncertainty (IU), defined as a trait-like tendency to respond to uncertain situations with negative cognitive, behavioral, and/or physiological reactions, is associated with increased risk for suicidal ideation (SI). Theory and research suggest that family-level risk and resilience factors may shape how vulnerability traits such as IU relate to SI; however, few studies have tested these associations. The current study therefore examined the unique and interactive effects of IU and familial risk and resilience factors on SI severity in youth.

A total of 184 individuals, ages 16-19, at elevated risk for escalation in alcohol use, completed self-report measures of IU and current SI severity. The Family Risk and Protective Factors questionnaire was used to create two composites: familial risk and familial resilience. A series of hierarchical linear regressions were used to test the study hypotheses. Biological sex, trauma exposure, and legal minor status were all included in the models as covariates.

There were main effects of IU, familial risk, and resilience on SI. At high levels of familial risk, but not low levels, greater IU was associated with greater SI severity. Meanwhile at low levels of familial resilience, but not high levels, greater IU was associated with greater SI severity.

Results revealed that the link between IU and SI is particularly robust in the context of low familial resilience and high familial risk. Targeting family-level factors may be one pathway for altering the negative mental health consequences associated with high IU.