The Role of Transdiagnostic Cognitive Behavioural Processes in Suicidal Ideation

Background. Suicidality has most commonly been studied within a psychiatric framework wherein it is conceptualised as a symptom or outcome of mental disorder. However, the majority of people that meet the criteria for a psychiatric diagnosis do not experience suicidality and a significant number of people that do not meet criteria for a diagnosis struggle with thoughts of suicide. Transdiagnostic approaches offer an approach to understanding and intervening with suicidality unhindered by the poor reliability, validity, and lack of specificity associated with psychiatric diagnosis.
Aims. This study first sought to explore differences between people experiencing or not experiencing current suicidality, in terms of engagement in transdiagnostic cognitive and behavioural (TCB) processes. Secondly, the role of TCB processes in relation to suicidality were analysed in terms of their explanatory power when considered simultaneously with established suicide-specific psychological constructs.
Method. A cross-sectional design was employed and a mixed sample was recruited (N = 927) through convenience and purposive sampling via an online survey. Regression analyses were performed to explore the ability of the variables to classify participants as experiencing or not experiencing current suicidality. Structural equation models were constructed to test the indirect effects of TCB processes.
Results. TCB processes were significantly elevated in participants experiencing current suicidality. This elevated engagement persisted in a subsample of participants that had received a psychiatric diagnosis. TCB processes were not significant predictors of suicidality in the final stage of a regression model, but their inclusion improved goodness-of-fit. Finally, TCB processes had a minor but significant negative moderating effect upon 'desire for suicide' in relation to degree of suicidality.
Conclusion. Transdiagnostic psychological constructs and cognitive and behavioural processes offer greater explanatory power for suicidality than does meeting the criteria for a psychiatric diagnosis. TCB processes may act as a means of coping with suicidal desire, however, and may not be indicated as initial targets for intervention.