The role of emotion dysregulation in suicide as considered through the ideation to action framework

• Emotion dysregulation is positively associated with suicidal ideation.
• Emotion dysregulation may serve as an obstacle to the capacity for suicide.
• Emotion dysregulation facilitates suicidal behavior through use of painful behaviors.

Research supports a model in which emotionally dysregulated individuals are more likely to think about suicide and experience proximal risk factors for suicidal ideation (e.g., thwarted belongingness, perceived burdensomeness). The drive to escape aversive affective sensations inherent in emotion dysregulation, however, serves as an obstacle to the capability for suicide. As such, although emotionally dysregulated individuals die by suicide at an elevated rate, the transition from ideation to attempt appears better explained by the tendency of emotionally dysregulated individuals to engage in painful and/or provocative behaviors (e.g., NSSI) capable of elevating the capability for suicide. The relationship between emotion dysregulation and suicide is thus robust but nuanced.