Psychological and Cognitive Correlates of Suicidal Ideation Following Traumatic Brain Injury

Objective: While psychiatric disorders (e.g., depression, anxiety) are well-established predictors of suicidal ideation in individuals with traumatic brain injury (TBI), the roles of other psychological and cognitive factors remain underexplored. This study examined associations between suicidal ideation and emotional-processing difficulties, coping strategies, resilience, and cognitive functioning in individuals with moderate-severe TBI.Method: Data from 106 individuals with moderate-severe TBI were analyzed. Suicidal ideation and emotional distress were assessed using the Inventory of Depression and Anxiety Symptoms and Hospital Anxiety and Depression Scale (HADS), respectively. Participants also completed measures of emotional lability and detachment (Comprehensive Assessment of Traits Relevant to Personality Disorders [CAT-PD]), coping (Coping Scale for Adults), resilience (Connor-Davidson Resilience Scale), and cognitive functioning, including subjective (CAT-PD, Brief Rating of Executive Function) and objective measures (Brief Test of Adult Cognition by Telephone). Spearman’s correlations and structural equation modeling were used to examine psychological and cognitive correlates of suicidal ideation.Results: Suicidal ideation was positively associated with emotional lability, emotional detachment, non-productive coping, and self-reported cognitive problems, and negatively associated with resilience. Structural equation models indicated that emotional distress accounted for 76–100% of these associations. Conversely, suicidal ideation was not significantly associated with adaptive coping or objective cognitive performance.Conclusions: Emotional processing, non-productive coping strategies, low resilience, and self-reported cognitive problems are linked to suicidal ideation in individuals with moderate-severe TBI, primarily through their associations with emotional distress. Findings underscore the importance of addressing emotional distress, including depression and anxiety, and its underlying contributors in suicide prevention for this population.