Abby Adler Mandel

Objectives: Primal world beliefs (primals) are fundamental assumptions about the world that may serve as suicide risk factors. This study examined relationships between primals and suicidal thoughts and behaviors in three samples of adults with recent suicidal ideation (SI). Method: Study 1 analyzed cross‐sectional data ( N = 304 undergraduates; N = 390 Prolific participants) involving measures of primals, SI, wish to live (WTL), wish to die (WTD), and coping self‐efficacy. Study 2 included Prolific participants ( N = 174) who completed measures of primals and SI at baseline and 1‐month follow‐up. Cross‐lagged panel analyses examined temporal relationships between primals and SI. Results: Positive primals were associated with lower SI, greater WTL, lower WTD, and higher suicidal coping self‐efficacy. Believing the world is meaningful, needs me, and good at baseline predicted lower SI at 1‐month follow up, whereas SI at baseline did not predict primals at follow up. Primals were inconsistently related to past suicide attempts. Conclusion: Findings support a relationship between primals and SI both cross‐sectionally and over time. Positive primals may play a protective role against SI over time and may serve as a promising treatment target for adapting existing interventions.

Introduction: The Collaborative Assessment of Suicidality (CAMS) is an effective clinical framework to treat suicidal thoughts and behaviours. CAMS employs the Suicide Status Form (SSF) to monitor suicide risk factors across sessions. The first six items (termed the SSF Core Assessment) include psychological pain, stress, agitation, hopelessness, self‐hate and self‐reported overall behavioural risk for suicide. The first five are theoretically derived risk factors. While CAMS employs session‐by‐session tracking, no research has investigated how the five risk factors vary together and concurrently and prospectively predict self‐perceived suicide risk when assessed via ambulatory assessment. Methods: Undergraduates ( n = 52) with past‐2‐week suicidal ideation completed 5 ambulatory assessment surveys of the SSF Core Assessment variables daily over 10 days. Descriptive and variability statistics were used to describe the core assessment constructs. Multilevel models were used to examine how the first five items predicted overall behavioural risk of suicide. Results: Each of the SSF Core Assessment variables demonstrated variability over the study period, with stress exhibiting the greatest and overall risk the lowest variability. Self‐hate and hopelessness concurrently predicted self‐reported overall risk for suicide within the same model. Only self‐hate and agitation were significantly prospectively predictive of overall behavioural risk, even after controlling for suicidal ideation. Conclusions: This is the first study to provide insight into the short‐term variability and predictive capabilities of the SSF Core Assessment constructs. Each construct varies considerably over short time scales, suggesting that more frequent monitoring of these constructs may be an important consideration within future CAMS treatment research.

Social problem solving (SPS) is a multistep, cognitive-behavioral process to tackle life’s challenges. Those with a history of suicidal thoughts and behaviors have demonstrated deficits in this process. Problem solving therapy has been shown to improve SPS abilities and reduce suicidal ideation, hopelessness, and other suicide-related risk factors. This brief review of the literature was written to provide scholarly references for undergraduate or graduate students new to the field.

According to SAMHSA (2023), approximately 16,600,000 American adults and teens reported having serious thoughts of suicide in 2022. While suicide prevention has primarily focused on suicide deaths and attempts, we contend that suicidal ideation (SI) deserves more in-depth investigation and should be an essential intervention target on its own. In support of this point, we provide three examples of ways to improve specificity in understanding of SI through the study of controllability of SI, the language used to assess SI, and measuring SI in real time. We also consider qualitative work on the content of SI, its treatment, and definitional considerations. We thus call for an increased general focus on SI within research, clinical care, and policy.