Thinking Too Much: Rumination as a Catalyst of the Real-Time Associations Between Affective States and Suicidal Ideation

Objective: Affective states and rumination have each been linked to suicidal ideation; however, to our knowledge, no studies have examined their interactive effect in predicting suicidal ideation in the short term. The present study examined the concurrent and short-term prospective relationships between affective states, rumination, and suicidal ideation using ecological momentary assessment (EMA). Method: A sample of 237 community-based adults at high risk for suicide (Mage = 27.12 years, 61.6% cisgender women) responded to six EMA prompts each day for 2 weeks that assessed their momentary affective states (depression, anxiety, happiness, hopelessness, agitation, irritability), rumination, and suicidal ideation. Results: Rumination moderated the relationship between concurrent affective states and suicidal ideation, at both the within-person and between-person levels. Specifically, the relations between affective states and suicidal ideation were stronger at higher levels of rumination. These interaction effects were not found when examining short-term prospective associations. Conclusions: Affective states and rumination may each confer risk for suicidal ideation in the short term, and rumination may serve as a catalyst of the link between affective states and suicidal ideation when examined concurrently. Clinical implications, limitations, and future research directions are discussed. What is the public health significance of this article? This study highlights rumination as an important moderating feature influencing of the relationship between emotions and suicidal ideation. Individuals who ruminate more, both in general and from moment to moment, have a stronger relationship between these affective states and suicidal ideation.