Symposia
Suicide and Self-Injury
Gabriela K. Khazanov, Ph.D.
Research Psychologist
Corporal Michael J Crescenz VA Medical Center
Philadelphia, Pennsylvania
Courtney Forbes, M.A., M.Ed.
Clinical Psychology Intern
Emory University School of Medicine
Atlanta, Georgia
Michelle Gordon, MPH
Clinical Research Coordinator
Penn Center for the Prevention of Suicide, University of Pennsylvania, Perelman School of Medicine
Philadelphia, PA
Matthew Tull, PhD
Professor of Psychology
University of Toledo
Toledo, Ohio
Kim L. Gratz, Ph.D.
Professor and Chair, Department of Psychology
University of Toledo
Toledo, Ohio
Michael Thase, MD
Professor of Psychiatry
University of Pennsylvania, Perelman School of Medicine
Philadelphia, PA
James McKay, PhD
Professor of Psychiatry
University of Pennsylvania, Perelman School of Medicine
Philadelphia, PA
Shari Jager-Hyman, Ph.D.
Assistant Professor
University of Pennsylvania
Philadelphia, Pennsylvania
There is limited understanding of modifiable clinical targets that increase risk for suicidal ideation or behavior. Anhedonia, or loss of interest or pleasure in previously rewarding activities, is a key feature of depression and PTSD that may heighten risk of suicide but that can be addressed in treatment. To investigate this possibility, we examined: (1) associations between anhedonia and suicidal outcomes with and without accounting for depression and PTSD in two diverse samples with high levels of traumatic exposure, and (2) potential mechanisms through which anhedonia is related to suicidal outcomes, including suicidal desire (perceived burdensomeness, thwarted belongingness) and suicidal capability
Self-report measures were collected from: (1) Unselected adults (N = 363) recruited through MTurk (Sample 1, or S1) and (2) Veterans (N = 85) with recent (past 6 months) suicidal ideation recruited from the Philadelphia VA (Sample 2, or S2). Participants completed the Positive Valence Systems Scale, a measure of anhedonia, as well as measures of suicidal ideation and behavior (S1: Depressive Symptom Index-Suicidality Subscale and Fine-Grained Suicidal Thoughts and Actions Scale; S2: Columbia-Suicide Severity Rating Scale), depression (S1: Mood and Anxiety Symptoms Questionnaire: Depression Subscale, S2: Patient Health Questionnaire-9), and the PTSD Checklist for DSM-5. S1 also completed the Interpersonal Needs Questionnaire (INQ) and the Acquired Capability for Suicide Scale.
In both samples, anhedonia was significantly associated with suicidal ideation (r’s=.34-.47), depression (r’s = .41-.43), and PTSD (r’s = .19-.34), but not suicidal behavior. Anhedonia remained associated with suicidal ideation over and above depression and PTSD severity (r’s = .16-.33). In S1, anhedonia was significantly associated with perceived burdensomeness and thwarted belongingness on the INQ (r’s = .35-.50) and remained associated with both constructs over and above depression and PTSD severity (r’s = .11-.28). Anhedonia was not associated with acquired capability for suicide.
Findings suggest that interventions addressing anhedonia, a transdiagnostic and modifiable clinical target relevant to depression and PTSD, may improve suicidal ideation but not necessarily suicidal behavior. Anhedonia may impact suicidal outcomes by way of its association with suicidal desire, but not suicidal capability.