(PS9-B33) Repetitive Negative Thinking as Cognitive Vulnerability to Suicidality Among Depressed and Anxious Adults

Repetitive negative thinking (RNT) is a cognitive process that individuals find distressing and difficult to control or disengage from (Ehring & Watkins, 2008). Examples of RNT include worry and rumination, which represent repetitive and uncontrollable thinking about feared future events or past negative experiences (e.g., causes and meaning of one’s distress), respectively. Both worry and rumination have emerged as cognitive vulnerability to suicidality. Rumination was associated with both suicidal ideation and attempt (e.g., Morrison & O’Connor, 2008). Worry, especially its uncontrollability, has been also linked to suicidal ideation (Gorday et al., 2018). However, there exist several limitations with the current literature. First, few studies have accounted for the potential confounding effect of comorbid affective disorders, which also involve RNT. In addition, most studies operationalized RNT based on distinct types (e.g., worry, rumination) rather than underlying dimensions (e.g., perceived function, temporal orientation) despite the latter approach’s potential to provide more targeted clinical implications. It has also been rarely examined whether RNT is differentially associated with suicidal ideation relative to suicide attempts. These limitations obscure what we know and how we should intervene on the maladaptive cognitive patterns among individuals with varying levels of suicide risk. To address these limitations, the current study recruited anxious and depressed individuals and examined whether and which RNT types and dimensions were uniquely associated with suicidal thoughts and behaviors among those individuals.

196 adults (86.7% female, 67.9% White, M_age=19.40, range=18-53) with affective disorders were recruited from the undergraduate subject pool and the community. Diagnostic status, current suicidal ideation, and lifetime suicide attempt history were assessed via a structured diagnostic interview (MINI; Sheehan et al., 2016), yielding three groups: suicidal ideation with suicide attempt history (n=45), suicidal ideation only (n=64), and no suicidal ideation/attempt history (n=87). Participants completed an online survey assessing worry (Penn State Worry Questionnaire; Meyer et al., 1990), rumination (Ruminative Response Scale; Nolen-Hoeksema & Morrow, 1991), and underlying dimensions of RNT (Perseverative Cognitions Questionnaire; Szkodny & Newman, 2017). Based on one-way ANOVAs, the three groups did not differ on the levels of worry and rumination, ps=.36-.71, ds=.12-.22. Significant group differences emerged for the RNT dimensions of anticipating the worst outcome, p< .001, d=0.60, and experiencing one’s thoughts as ego-dystonic (e.g., bizarre, unacceptable), p=.002, d=0.55. Based on Tukey’s post-hoc tests, participants with suicidal ideation only and those with suicide attempt history scored higher on the dimensions than non-suicidal participants, ps=.001-.011, with no differences between the two suicidal groups, ps=.65-.98. These findings suggest catastrophizing and ego-dystonic thinking as the RNT dimensions that are uniquely associated with suicidality beyond their associations with affective disorders.