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Evidence suggests that the negative consequences of COVID-19 may extend far beyond its considerable death toll, having a significant impact on psychological well-being. Prior work has highlighted that previous epidemics are linked to elevated suicide rates, however, there is no research to date on the relationship between the COVID-19 pandemic and suicidal thoughts and behaviors. Utilizing an online survey, the current study aimed to better understand the presence, and extent, of the association between COVID-19-related experiences and past-month suicidal thoughts and behaviors among adults in the United States. Results support an association between several COVID-19-related experiences (i.e., general distress, fear of physical harm, effects of social distancing policies) and past-month suicidal ideation and attempts. Further, we found that a significant proportion of those with recent suicidal ideation explicitly link their suicidal thoughts to COVID-19. Exploratory analyses highlight a potential additional link between COVID-19 and suicidal behavior, suggesting that a portion of individuals may be intentionally exposing themselves to the virus with intent to kill themselves. These findings underscore the need for increased suicide risk screening and access to mental health services. Particular attention should be paid to employing public health campaigns to disseminate information on such services in order to reduce the enormity of distress and emotional impairment associated with COVID-19 in the United States.

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Concerns of measurement error often motivate researchers to aggregate item information, using simple heuristics (e.g., sum scores) or latent variable methods, to mitigate unwanted effects such as parameter bias and attenuation. These approaches are often invoked without acknowledging that many scales in practice likely fail to possess the necessary properties for these models to be sufficient (i.e., positive conditional association and vanishing conditional dependence). We argue that measures which are not psychometrically homogeneous likely contain item specific effects particularly when examined in conjunction with external variables. We demonstrate this using a clinical empirical example assessing risk factors for suicidal ideation and show that measures constructed in alignment with principles of psychometric homogeneity are most appropriately modeled at the scale (or subscale) level while other measures should be considered at the item level. As a result, latent variable applications to such instruments are susceptible to interpretational confounding. The effects of interpretational confounding on R2, root mean square error, and model parameters are evaluated in a small simulation study. We conclude that item specific effects are not uncommon in practice and impact both explanatory and predictive research. Our findings suggest that classical approaches to addressing measurement error are insufficient to fully capture the breadth of instruments implemented in practice. Careful consideration of both the scale construction process and roles of scale items in the broader psychological theory are necessary prior to the application of traditional measurement methods.

People with anxiety-related disorders often engage in safety behaviors: overt or covert actions performed to prevent the occurrence of a feared outcome and/or reduce associated distress. Although clinical experience and conceptual models of posttraumatic stress disorder (PTSD) underscore the deleterious long-term effects of such strategies on PTSD symptoms, little empirical research has specifically examined safety behaviors in the context of posttraumatic stress. The current multisite study was designed to identify common posttraumatic safety behaviors and examine their relation to symptom severity. Interview and self-report data were collected from adults residing in the Western United States reporting ongoing distress related to a lifetime traumatic event (n = 89) as well as from adults with a current PTSD diagnosis residing in the Southeastern United States (n = 47). Results showed that posttraumatic safety behaviors were not only common in both groups but also significantly correlated with trauma-related cognitions (rs = .39–.45), self-reported PTSD symptoms (rs = .56–.72), and interviewer-rated PTSD symptoms (rs = .32–.51). Findings point to specific posttraumatic coping strategies that would be important to consider in a clinical context.