Prospective association of rumination and hopelessness with onset, remission, and persistence of suicidal ideation among young adults

Abstract

_Objectives: Little is known about risk factors that predict different temporal courses of suicidal ideation (SI) in young adults. The aim of this study is to examine the prospective association of different forms of ruminative thinking and hopelessness on the temporal course of SI—operationalized as no SI, onset of SI, remitted SI, and persistent SI among young adults. We expected that rumination and hopelessness would be independently associated with different SI courses, especially with persistent SI, after adjusting for depressive symptoms. _Methods: Participants comprised 289 young adults (ages 18–34 years; mean ¼ 19.0 years; 74% female) oversampled for baseline SI (40%). Young adults were classified into four SI courses based on the presence/absence of SI in three subsequent assessments over an 18-month follow-up period. Rumination was assessed via the Ruminative Responses Scale (subscales: brooding and reflection) and the Future-Oriented Repetitive Thought Scale (subscales: pessimistic future thinking and goal-oriented repetitive thought). Hopelessness- related cognitions were assessed via the Beck Hopelessness Scale (BHS) and Future Events Questionnaire (to examine depressive-predictive certainty). Depressive symptoms were measured with the Beck Depression Inventory (excluding the SI item). _Results: Rates of SI courses were determined as follows: 1) 52 percent no SI; 2) eight percent onset (i.e., no SI at baseline but SI at follow-up); 3) 24 percent remission (SI at baseline but none at follow-up); and 4) 16 percent persistence (SI at baseline and follow-up). In multinomial regressions, reflection was associated with significantly higher odds of all three SI courses (vs. no SI), brooding was associated with higher odds of remitted and persistent SI, and hopelessness (BHS) was associated with higher odds of persistent SI only (vs. no SI). After adjusting for depressive symptoms, only reflection remained significantly associated with SI courses. _Conclusions: Cognitive variables predicted different courses of SI. Depressive symptoms explained the effect of hopelessness and brooding, but not of reflection, on remitted and persistent SI. Depressive symptoms may be a potential mediator of the association of hopelessness and brooding with SI courses. This possibility aligns with previous findings that depressive symptoms mediated the effect of brooding, but not reflection, on future SI.