Comparing two ideation-to-action perspectives on suicide ideation and suicide attempts

Suicide is a leading cause of global death and disability. Yet, despite decades of scientific research, suicide rates have remained largely unchanged, in part because previous empirical and theoretical approaches failed to differentiate explanations for suicide ideation from explanations for suicide attempts. The ideation-to-action framework addresses this limitation and states that distinct risk factors, pathways, and mechanisms are involved in (a) the development of suicide ideation and (b) the progression from suicide ideation to suicide attempts. The present study examined the hypotheses made by two recently developed ideation-to-action perspectives (1) Klonsky and May’s (2015) Three Step Theory (3ST) and (2) Jollant et al.’s (2011) Neurocognitive Model of Suicide Behaviour (NCM) in a large sample (n=1,014) of undergraduate students. Results provide strong support for the hypotheses posited by the 3ST, including the interactive relationship of psychological pain (psychache) and hopelessness to suicide ideation as well as the unique association of practical capability (i.e., knowledge about using and acquiring lethal means) to suicide attempts. In addition, and consistent with the NCM, emotion dysregulation appeared to moderate the relationship of negative affect to suicide ideation. These findings are discussed in the context of the existing literature, along with their clinical implications for reducing suicidal ideation and preventing suicide attempts.