Rumination as a within-person indirect pathway between daily negative life events and suicidal ideation in recently hospitalized adults

Abstract

Negative life events are often implicated as a near-term risk factor for suicidal ideation (SI); however ruminative processes may play a critical role in amplifying the distress following experiences of negative life events, ultimately leading to greater suicide risk. In the present work, we examined whether rumination indirectly impacted the association between negative events and SI intensity in a day-level ecological momentary assessment (EMA) study. Participants (N = 107; M_age = 35.9 years, 65% female, 81% white) completed an EMA protocol for 65 days following psychiatric hospitalization. We used dynamic structural equation modeling to test a day-level, within-persons model of direct and indirect effects between negative events, rumination, and SI intensity. After fitting the model across all people, we derived person-specific estimates to examine heterogeneity in the model parameters (i.e., while the indirect effect may be significant in the full sample, effect sizes may vary across individuals). Results indicated that the indirect effect of rumination was significant in the full sample (unstandardized estimate = 0.026) and represented 38.058% of the total effect. Moreover, results for the person-specific examination indicated that the indirect effect was present for nearly all participants who reported SI at any point in their EMA data. Thus, in addition to highlighting the critical role that rumination can play in SI, this study also highlights the value in conducting person-specific research to understand the complexity and heterogeneity of psychological processes involved in suicide risk.