Individual differences in affect during suicidal and nonsuicidal states among military personnel and Veterans with posttraumatic stress disorder (PTSD)

Abstract: Objective: This study examined individual differences in affect during nonsuicidal and suicidal states among 116 military personnel and veterans diagnosed with posttraumatic stress disorder. Method: Current affect and suicidal ideation were assessed four times per day for 14 consecutive days via ecological momentary assessment using the Positive and Negative Affect Scale-Short Form and Scale for Suicidal Ideation (SSI) items. Positive and Negative Affect Scale-Short Form items were used to create four affect states based on the circumplex model of core affect: pleasant activation (e.g., excited), activated pleasure (e.g., proud), unpleasant activation (e.g., aroused), and activated displeasure (e.g., anxious). Mixed-effects regression modeling was used to assess variability in mean affect scores across active (SSI Item 4) and passive (SSI Item 5) suicidal states and variability in the correlation between affect and severity of suicidal ideation. Results: Mean pleasant activation, F(2,7) = 4.8, p = .043, and activated pleasure, F(2, 5) = 22.0, p = .003, were significantly lower during active suicidal versus nonsuicidal states. Mean unpleasant activation, F(2, 7) = 19.9, p = .001, and activated displeasure, F(2, 9) = 42.3, p < .001, were higher during active suicidal versus nonsuicidal states. Activated pleasure was less variable, chi(2)(1) = 6.3, p = .012, but unpleasant activation, chi(2)(1) = 8.0, p = .005, and activated displeasure were more variable, chi(2)(2) = 15.7, p < .001, during active suicidal versus nonsuicidal states. Severity of suicidal ideation was significantly correlated with all four affect states; all correlations varied significantly across participants. Conclusion: Reported affect during suicidal states varies across military personnel and veterans with posttraumatic stress disorder, suggesting suicidal states are heterogeneous. Differentiating affective arousal from affective valence can provide more nuanced understandings of suicide risk.

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