The Role of Emotion Dysregulation in Suicidal Ideation Intensity and Suicide Attempts in Crisis Hotline Callers

OBJECTIVE: There is a need to better understand, among people experiencing suicidal ideation (SI), who is at greatest risk of transitioning to suicide attempts. The present study assessed the moderating role of emotion dysregulation in the association of SI intensity and suicide attempts among participants experiencing distress. METHOD: Linear, logistic, and hurdle negative binomial models tested associations in a high-risk sample of crisis hotline callers cross-sectionally and longitudinally over a two-week follow-up. Both the likelihood of attempting suicide and the number of suicide attempts were examined. RESULTS: Emotion dysregulation did not moderate the association of SI intensity with the likelihood of ever attempting suicide. However, higher SI intensity was cross-sectionally associated with more suicide attempts at lower levels of emotion dysregulation. Higher SI intensity prospectively predicted higher odds of a suicide attempt at the two-week follow-up. CONCLUSIONS: Individuals with more intense SI are more likely to attempt suicide. However, among those with intense SI and a history of attempting, better emotion regulation was unexpectedly associated with more attempts. Further research is needed to disentangle the complex interrelations between SI intensity, suicide attempts, and emotion dysregulation.