Manifestations of overarousal account for the association between cognitive anxiety sensitivity and suicidal ideation

• We examine mechanisms of the ASCC-suicidal ideation association.
• Study 1: Agitation/insomnia are explanatory links between ASCC-suicidal ideation.
• Study 2: Agitation/anger account for the ASCC-suicidal ideation association.
• Study 2: Insomnia/nightmares do not explain this relationship.

BackgroundRecent evidence suggests an association between cognitive anxiety sensitivity and suicidal ideation. Cognitive anxiety sensitivity has also been implicated as a precursor to various forms of overarousal. These manifestations of overarousal (i.e., agitation, insomnia, nightmares, and anger) may account for the association between cognitive anxiety sensitivity and suicidal ideation.MethodsIn Study 1, undergraduate students selectively sampled for recent suicidal ideation completed all measures online. In Study 2, clinical outpatients completed all measures prior to their initial intake appointments at a psychology clinic.ResultsStudy 1 demonstrated that agitation and insomnia individually and jointly accounted for the association between cognitive anxiety sensitivity and suicidal ideation, controlling for general anxiety and demographic variables. Study 2 replicated and extended these findings, such that, controlling for demographics, general anxiety, and physical and social anxiety sensitivity, agitation and anger each independently and together accounted for the association between cognitive anxiety sensitivity and suicidal ideation, whereas insomnia and nightmares did not.LimitationsThis study utilized a cross-sectional design and self-report measures in both samples as well as a sample of undergraduate students in Study 1.ConclusionsTogether, these findings suggest that agitation and anger may explain the previously established relationship between cognitive anxiety sensitivity and suicidal ideation. Targeting cognitive anxiety sensitivity in treatment may in turn reduce these forms of overarousal and thereby suicide risk.