PTSD Symptom Severity and Emotion Regulation in Acute-Care Psychiatric Inpatients: Associations with Suicidality
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Trauma and posttraumatic stress disorder (PTSD) have been positively associated with both suicidality (suicidal ideation and attempts) and difficulties with emotion regulation in various samples (e.g., sexual assault victims, combat veterans, college students, community samples). The association between PTSD and suicidality in a psychiatric inpatient setting has a limited research base of approximately 5 studies, and no study to date has examined the role of emotion regulation difficulties in the association of PTSD and suicidality. The present study aimed to address these gaps in the extant literature by examining the main and interactive effects of PTSD symptom severity and emotion regulation in regard to suicidality among trauma-exposed acute-care psychiatric inpatients. It is hypothesized that 1) PTSD will be significantly related to greater levels of suicidality, 2) greater difficulties in emotion regulation will be significantly related to greater levels of suicidality, and 3) the interaction of PTSD and emotion regulation difficulties will be significantly related to greater levels of suicidality. Participants were comprised of 120 adults in a psychiatric inpatient setting. Hierarchical linear and logistic regression analyses were used to examine the main and interactive effects of PTSD and emotion regulation difficulties with four outcomes of suicidality. PTSD symptom severity (ß = .30, p = .02) had a main effect on self-reported suicidal ideation. Difficulties in emotion regulation (p = .01) and number of traumatic life events (p = .002) had significant main effects in predicting suicide as the reason for current admission. An interactive effect of PTSD symptom severity and difficulties in emotion regulation existed for self-reported suicidal ideation (ß = .24, p < .001) in that high levels of both of these variables resulted in the highest level of self-reported suicidal ideation. For individuals with heightened emotion regulation difficulties, the association between PTSD symptom severity and self-reported suicidal ideation was significant whereas with less emotion regulation difficulties it was non-significant. Limitations (e.g., measurement) and future directions (e.g., implementing causal and longitudinal designs) are discussed.