Acute stress experiences as markers of temporal risk for near-term suicidal ideation: Examining the roles of tonic and phasic impulsivity and emotion dysregulation.

Abstract

Stressful experiences are a well-established risk factor for suicidal ideation. Yet, it is imperative to develop a granular understanding of when acute stressors increase risk and which person-level markers exacerbate this risk relationship. The current study evaluated the joint moderating effects of impulsivity and emotion dysregulation on the relationship between the frequency of acute stressful experiences throughout the day and momentary concurrent and prospective suicidal ideation (i.e., 3-way interaction). Impulsivity and emotion dysregulation were evaluated as both tonic (trait) and phasic (state) measures. A community sample of 103 adult participants with a recent (i.e., past 6 months) and repeated history of suicidal ideation completed a virtual baseline session and 30-day ecological momentary assessment period (Mage = 33, SD = 11.7; 63.1% female, 15.5% non-binary, 15.5% transgender; 20.4% racial minority; 62.1% sexual minority). Findings indicated a significant two-way interaction between the frequency of acute stressful experiences and phasic impulsivity, after controlling for momentary stress intensity: stressful experiences were associated with concurrent momentary suicidal ideation when an individual's phasic impulsivity was higher-than-usual (i.e., within-person above average). No other 3-way or 2-way interactions emerged. Also, main effects of tonic emotion dysregulation and phasic emotion dysregulation emerged as risk factors for concurrent and prospective momentary suicidal ideation. These findings highlight that moment-to-moment fluctuations, not stable dispositions, are most relevant for understanding how stressful experiences translate into immediate risk for suicidal ideation. This study has the potential to inform the development of effective just-in-time interventions.