Elsevier

Journal of Psychiatric Research

Volume 92, September 2017, Pages 31-37
Journal of Psychiatric Research

Overarousal as a mechanism of the relation between rumination and suicidality

https://doi.org/10.1016/j.jpsychires.2017.03.024Get rights and content

Abstract

Rumination, particularly brooding, is associated with suicidal ideation and attempts; however, mechanisms of these associations have not been identified. The present study examined manifestations of overarousal—agitation, insomnia, and nightmares—that have been linked to both rumination and suicide as indirect indicators of the link between brooding and suicidal ideation/attempts. A sample of 492 psychiatric outpatients (64.2% female), aged 17–65 years (M = 26.75, SD = 10.32), completed self-report measures before their intake appointments with a therapist. Results indicated that agitation and nightmares, but not insomnia, each significantly explained the association between brooding and suicidal ideation and between brooding and the presence of a past suicide attempt. Overall, these findings provide evidence that certain types of overarousal may serve as a mechanism of the association between brooding and suicidal ideation and attempts. Clinical implications, limitations, and future research directions are discussed.

Section snippets

Participants and procedures

Participants were 492 psychiatric outpatients (64.2% female), aged 17–65 years (M = 26.75, SD = 10.32), who were seeking services at a university-based psychological clinic located in the southeastern United States. The clinic serves the surrounding community in addition to university students and staff, and due to the clinic's inexpensive sliding scale fees, patients tend to be of lower socioeconomic status. Exclusionary criteria are also minimal; individuals are only referred elsewhere if

Results

Means, standard deviations, ranges, and bivariate correlations of all study variables can be found in Table 1. Nightmares and suicidal ideation were positively skewed and leptokurtic; these variables were log-transformed to correct for non-normality, resulting in diminished skewness and kurtosis (<1) in both cases. As expected, all variables were significantly positively correlated. Overall, 248 participants (50.4%) reported current suicidal ideation, and 122 (24.8%) reported at least one past

Discussion

The present study investigated the relationship between rumination, manifestations of overarousal (agitation, insomnia, nightmares), and suicidal ideation and attempts in a psychiatric outpatient sample. Previous research has demonstrated the importance of both rumination (Miranda and Nolen-Hoeksema, 2007, Rogers and Joiner, 2017, Tucker et al., 2016b) and various types of overarousal (Pigeon et al., 2012, Ribeiro et al., 2015b, Ribeiro et al., 2014, Rogers et al., 2016a) in determining risk

Funding

This article was supported, in part, by a grant awarded to Florida State University (W81XWH-10-2-0181) by the Department of Defense. The Department of Defense had no further role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication. The content of this paper is solely the responsibility of the authors, and the views and opinions expressed do not necessarily represent those of the

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