Date of Award

2026

Document Type

Dissertation

Degree Name

Doctor of Philosophy in Clinical Psychology

Department

Psychology

Committee Chair and Members

Nicholas Papouchis

Cory Chen

John R Keefe

Keywords

Attachment, Emotion regulation, Interpersonal Theory of Suicide (IPTS), Suicidal ideation, Suicide, Suicide risk

Abstract

Despite decades of research, suicide rates remain high, suggesting that risk-factor approaches have not captured the complexity of suicidality (Cai, Chang, & Yip, 2020; Hjelmeland, 2016; Milner, Robinaugh, & Nock, 2020). Contemporary theories have emphasized understanding suicidal ideation (SI) as part of a developmental process (Joiner, 2010; Klonsky & May, 2015). Emerging research has suggested that, for some, SI serves an emotion regulation function, but individual differences in this remain underexplored (Coppersmith et al., 2018; Kleiman et al., 2018). This study examined SI as a regulation strategy by integrating the Interpersonal Theory of Suicide, attachment theory, and models of emotion regulation (Joiner, 2010; Mikulincer & Shaver, 2008). Participants (N = 348) completed self-report measures of SI severity, comfort from SI, emotion regulation, attachment style, acquired capability, and suicide risk. It was hypothesized that difficulties in emotion regulation would predict comfort from SI, mediated by SI severity and moderated by attachment, and that comfort would contribute to suicide risk through acquired capability. Results supported SI as an emotion regulation process for some, including relief and perceived control over distress. Emotion regulation difficulties were associated with greater comfort, with significant indirect effects through SI severity. Attachment avoidance moderated this, suggesting a deactivating regulatory process. SI severity predicted greater suicide risk both directly and indirectly through comfort from SI. Findings extended existing models by identifying SI as a heterogeneous regulatory process. Additional analyses were explored and implications were discussed.

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