Abstract
Suicidal behaviour remains a critical public health issue due to its high prevalence and significant impacts. Traditional risk assessment methods often fall short of reliably predicting suicidal behaviour, highlighting the need for implicit risk factors. This study explored how interoception - the ability to perceive and respond to internal physiological signals - may serve as an implicit risk factor for suicidal thoughts and behaviours, specifically examining the relationships between poor interoception, psychotic-like experiences, and suicidal thoughts and behaviours.
It was hypothesised that poor interoceptive awareness and the frequency, intrusiveness, and distress of psychotic-like experiences would directly increase an individual’s capability for suicide. This capability for suicide was expected to mediate the relationship between interoceptive awareness and psychotic-like experiences with suicidal behaviour. Additionally, it was hypothesised that interoceptive awareness and psychotic-like experiences would moderate the relationship between suicidal ideation and suicide attempt history through capability for suicide.
The study employed a cross-sectional design, gathering data online from 262 undergraduate students. Participants completed assessments on interoceptive awareness, psychotic-like experiences, suicidal ideation, past suicide attempts, fear of death, and suicide capacity. Data analysis involved correlation, regression, moderation, and mediation analyses to investigate the relationships between these variables.
The findings indicated that lower interoceptive awareness was linked to higher levels of suicidal thoughts and behaviours. Specifically, participants who struggled with managing and utilising bodily sensations for distress regulation reported more suicidal thoughts and behaviours. Increased frequency, intrusiveness, and distress of psychotic-like experiences were associated with higher levels of suicidal thoughts and behaviours. Poorer interoceptive abilities were related to more frequent and distressing psychotic-like experiences. Lower interoceptive awareness was associated with reduced fear of death. Suicide capacity mediated the association between psychotic-like experiences and suicide attempt history.
These findings highlight the complexity of suicidality and challenge existing theoretical models. Future research should focus on the subcomponents of interoception, explore the role of psychotic-like experiences in arousal and interoception, and conduct longitudinal studies to understand these dynamics better to refine theoretical frameworks and clinical practices.