An investigation of persistence through pain and distress as an amplifier of the relationship between suicidal ideation and suicidal behavior

- Persistence through pain and distress may facilitate suicidal behavior.
- Prior research has not behaviorally considered this model.
- Ideation more strongly related to suicidal behavior among those who persist.

Recent research has emphasized the importance of examining factors that strengthen the association between suicidal ideation and suicidal behavior, thereby aiding in the transition from thought to action. Theoretical and empirical work has demonstrated that suicidal desire is more strongly associated with suicidal behavior among individuals better able to tolerate distressing sensations, consistent with the notion that suicidal behavior is difficult and aversive and requires a capability to overcome otherwise daunting obstacles. Participants were 100 adults, recruited from the community, in part based upon their prior history of suicidal behavior. Each participant took part in a behavioral task during which both emotional distress and physical pain were induced. Participants were told that persistence through the end of the task would result in the ability to opt out of all but five minutes of the remaining protocol, whereas early cessation of the task would result in the administration of the entire protocol. Results indicated the relationship between current suicidal thoughts and lifetime attempts was significant only at mean and high levels of task persistence. Our results provide novel behavioral support for the importance of persistence through pain and distress in suicidal behavior.