Emotion Regulation in Daily Life among Adults with Suicidal Thoughts

Emotion regulation difficulties are implicated as a risk factor for suicidal thoughts, yet little is known about how adults with suicidal thoughts regulate emotions in daily life or which deficits are specific to suicidality versus shared across psychopathology. In two Ecological Momentary Assessment studies (N1=396; N2=195, recruited online), we compared adults with current suicidal thoughts to those with past or no suicidal history (Study 1) and to psychiatric and healthy controls (Study 2). Participants with current (vs. past) suicidal thoughts reported greater substance-use and self-injury to regulate emotions (Study 1). Compared to psychiatric controls, participants with suicidal thoughts reported higher regulatory effort and substance-use, while compared to healthy controls, they additionally reported greater distraction, rumination, and lower regulatory success (Study 2). Self-injury and substance-use uniquely predicted momentary suicidal thinking (Study 2). Findings highlight substance-use, self-injury, and heightened regulatory effort as potentially distinct emotion regulation processes associated with suicidal thoughts.