Posttraumatic Stress Disorder and Suicidal Ideation, Plans, and Impulses: The Mediating Role of Anxiety Sensitivity Cognitive Concerns Among Veterans

Amanda M. Raines, Southeast Louisiana Veterans Healthcare System
Daniel W. Capron, University of Southern Mississippi
Lauren A. Stentz, Florida State University
Jessica L. Walton, Southeast Louisiana Veterans Healthcare System
Nicholas P. Allan, Ohio University
Eliza S. McManus, Southeast Louisiana Veterans Healthcare System
Madeline Uddo, Southeast Louisiana Veterans Healthcare System
Gala True, Southeast Louisiana Veterans Healthcare System
C. Laurel Franklin, Southeast Louisiana Veterans Healthcare System


Background: Although the relationship between posttraumatic stress disorder (PTSD) and suicide has been firmly established, research on underlying mechanisms has been disproportionately low. The cognitive concerns sub scale of anxiety sensitivity (AS), which reflects fears of cognitive dyscontrol, has been linked to both PTSD and suicide and thus may serve as an explanatory mechanism between these constructs.

Methods: The sample consisted of 60 male veterans presenting to an outpatient Veteran Affairs (VA) clinic for psychological services. Upon intake, veterans completed a diagnostic interview and brief battery of self-report questionnaires to assist with differential diagnosis and treatment planning.

Results: Results revealed a significant association between PTSD symptom severity and higher suicidality (i.e., ideation, plans, and impulses), even after accounting for relevant demographic and psychological constructs. Moreover, AS cognitive concerns mediated this association.

Limitations: Limitations include the small sample size and cross-sectional nature of the current study.

Conclusions: These findings add considerably to a growing body of literature examining underlying mechanisms that may help to explain the robust associations between PTSD and suicide. Considering the malleable nature of AS cognitive concerns, research is needed to determine the extent to which reductions in this cognitive risk factor are associated with reductions in suicide among at risk samples, such as those included in the present investigation.