Lack of Emotional Awareness is Associated with Thwarted Belongingness and Acquired Capability for Suicide in a Military Psychiatric Inpatient Sample

Abstract

Objective To examine potential links between facets of impulsivity and emotion dysregulation to components of the Interpersonal‐Psychological Theory of Suicide (thwarted belongingness, perceived burdensomeness, and acquired capability) among U.S. military personnel. Method The current study performed secondary data analysis from a randomized control trial testing the efficacy of a cognitive therapy for 134 service members (71.64% male, 68.66% Caucasian; mean age: 30.14) admitted to a psychiatric inpatient unit for a suicide‐related crisis. We utilized the Difficulties in Emotion Regulation Scale, the Barratt Impulsivity Scale, the Acquired Capability for Suicide Scale, and the Interpersonal Needs Questionnaire. Results All emotion dysregulation dimensions and one impulsivity facet (attentional) were positively correlated with perceived burdensomeness and thwarted belongingness. Lack of emotional awareness was positively associated with acquired capability. After controlling for depression, hopelessness, and demographic covariates, lack of emotional awareness was significantly associated with both thwarted belongingness and acquired capability, but not perceived burdensomeness, and impulsivity dimensions did not link to any variable of interest. Conclusions Findings imply that individuals with reduced emotional awareness may have difficulty cultivating interpersonal bonds and be more vulnerable to elevated acquired capability. Lack of emotional awareness may be a potential contributor to both suicidal desire and capability.

Neural responses to emotional stimuli across the dissociative spectrum: Common and specific mechanisms

“…110,111 Therefore, the involvement of dACC among conditions included in the DS could support the hypothesis that: (i) they are characterized by implicit and rigid evaluations of external and internal emotionally relevant situations as threatening and/or noxious for own mental and physical integrity; (ii) they experience emotions associated with painful sensations, which could reflect a correspondence between physical and psychological pain 112 ; and (iii) difficulties with the management of real or perceived threatening situations reported by individuals included in the DS might be linked to altered emotional awareness and conflict monitoring processes. 113,114 Limitations Despite the evidence provided in the previous sections, some limitations must be discussed. First, the brain network of patients with BPD who had high levels of dissociation were based on a limited number of independent studies (n = 5).…”

The momentary and the macro in action control: A motor control analysis of impulse control difficulties.

“…Emotional impulsivity was assessed with the impulse control difficulties scale of the Difficulties in Emotion Regulation questionnaire, which was designed to assess individual differences in various forms of emotion dysregulation (Gratz & Roemer, 2004). The impulse control difficulties scale squarely focuses on losses of control in emotional contexts (e.g., "When I'm upset, I become out of control"; 1 = almost never, 5 = almost always) and this scale, in particular, has been linked to drinking problems (Dvorak et al, 2014), binge eating problems (Racine & Wildes, 2013), nonsuicidal self-injury (Baer et al, 2018), and the like. This manner of assessing emotional impulsivity was favored over using an urgency scale (Whiteside & Lynam, 2001) because many urgency items do not reference emotional triggers (e.g., "I often get involved in things I later wish I could get out of," which could occur for nonemotional reasons).…”

Monitoring problems in suicide action

“…Higher negative emotions, anger and guilt, worthlessness are associated with having suicidal ideation [44]. Lack of emotional awareness may be a potential contributor to both suicidal desire and capability [45].…”

“…Consequently, its positive, constructive [60] and even suicide preventive functions can be discussed [61]. Nevertheless, awareness in regard to suicide is often identifi ed as distorted or suicidal people are described as lacking emotional awareness [45]. Awareness as awareness of the suicide risks in others has also been addressed [62,63].…”