Background: Obsessive compulsive disorder (OCD) is associated with elevated suicide risk, but the directionality of the association between OCD severity and suicidal ideation has not been established, which was the goal of this study. Methods: Participants (n = 325) were adults with either a current or past diagnosis of Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) OCD who were assessed annually for suicidal ideation and OCD symptom severity for six years. Cross-lagged panel analyses statistically compared unidirectional and bidirectional models over time. Serious suiciderelated adverse events were reported. Results: The best-fitting and most parsimonious model included paths predicting suicidal ideation from OCD symptom severity, but not vice versa. These results were confirmed by comparing a model with cross-lagged paths constrained equal to a freely estimated model. Higher OCD symptom severity in a given year was associated with a higher suicidal ideation severity in the subsequent year. Five suicide-related adverse events were reported throughout the duration of the study, including two suicide deaths and three suicide attempts.
Individuals with borderline and avoidant personality disorders show interpersonal dysfunction that includes maladaptive responses to rejection and reduced emotional benefits from acceptance. To identify the attributional styles that may underlie these difficulties, we examined causal attributions for rejection and acceptance among undergraduates high in features of each disorder and a healthy comparison group. In Study 1, participants rated how likely they were to attribute hypothetical rejection and acceptance experiences to positive and negative qualities of the self and others, as well as external circumstances. In Study 2, we examined these same attributions in daily diary assessments of real rejection and acceptance experiences. Although the two studies showed some differences in results, they both linked borderline personality features with suspicious, selfbolstering responses and avoidant personality features with perceived inferiority. Distinct attributional styles may contribute to the distinct interpersonal problems characteristic of these conditions.
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