Category: Suicide and Self-Injury
Objective: Posttraumatic stress disorder (PTSD) symptoms are associated with increased suicide risk, and both appear to be elevated among firefighters. However, data on malleable factors that account for this link are scarce. Anxiety sensitivity (AS)—the fear of anxiety-related sensations—is both a vulnerability factor for and consequence of PTSD symptoms. AS also predicts suicide risk. To our knowledge, no study has examined whether AS concerns account for the association between PTSD symptoms and suicide risk. This study examined this conjecture in a sample of women firefighters.
Method: A total of 254 women firefighters completed a web-based mental health survey (mean age=37.66y, SD=9.40y, 93.3% White). The PTSD Checklist for DSM-5 (PCL-5), Anxiety Sensitivity Index-3 (ASI-3), and Suicidal Behaviors Questionnaire-Revised (SBQ-R) were utilized to assess PTSD symptoms, AS concerns, and suicide risk, respectively. Bootstrap mediation analyses were conducted, and analyses controlled for depression symptoms.
Results: Global and cognitive AS concerns, but neither physical nor social AS concerns, were statistically significant mediators of the relationship between PTSD symptoms and suicide risk. Alternate mediation models testing PTSD symptoms as a mediator of the relationship between AS concerns and suicide risk were not statistically significant, supporting the specificity of our proposed model.
Conclusions: Anxiety sensitivity concerns—specifically, cognitive AS concerns—account for the link between PTSD symptoms and suicide risk among women firefighters. Among firefighters with elevated PTSD symptoms, interventions that address cognitive AS concerns may thwart the trajectory to suicidal thoughts and behaviors. Additional longitudinal and treatment efficacy research is needed.
Ian Stanley– Doctoral Candidate (Clinical Psychology), Florida State University, Tallahassee, Florida
Melanie Hom– Doctoral Student, Florida State University, Tallahassee, Florida
Sally Spencer-Thomas– Carson J Spencer Foundation
Thomas Joiner– Robert O. Lawton Professor, Florida State University, Tallahassee, Florida
Doctoral Candidate (Clinical Psychology)
Florida State University