(PS2-B44) Influences of Pain Tolerance on the Association Between Emotion Dysregulation and Acquired Capability for Suicide

Suicide is a leading cause of death in the U.S. and a global public health concern (CDC, 2020; WHO 2021). Emotion dysregulation, while conducive to suicidal ideation, is a likely obstacle to the acquired capability for suicide; however, emotionally dysregulated individuals, through repeated engagement in painful behaviors (i.e., non-suicidal self-injury), may be increasing their pain tolerance and consequently their capability for suicide (Law et al., 2015). While promising, this model has not been empirically validated, particularly using objective indicators. Prior studies have found Respiratory Sinus Arrythmia (RSA) to be a reliable indicator of emotion regulation (Beauchaine, 2015). Furthermore, low resting RSA and poor RSA recovery significantly predicted prior suicide attempts and adolescent engagement in self-injurious thoughts and behaviors (Tsypes et al., 2017; Wielgus et al., 2016). Using subjective and objective measures (i.e. resting and recovery RSA), we aim to examine whether pain tolerance moderates the association between emotion dysregulation and acquired capability. We hypothesize that high self-reported emotion dysregulation and low resting and recovery RSA in the presence of low pain tolerance will predict lower acquired capability but will predict higher acquired capability amidst increased pain tolerance. Contrastingly, higher emotion regulation will contribute to acquired capability, especially at higher levels of pain tolerance.

Participants who completed the study (N = 47; M_Age = 20.66, SD = 3.79, 74.5% Female, 59.6% White) were recruited using an undergraduate recruitment system. Participants completed the Difficulties with Emotion Regulation Scale (DERS; Gratz & Roemer, 2004) and the Acquired Capability for Suicide Scale (ACSS; Van Orden et al., 2008) to assess baseline emotion dysregulation and acquired capability, with higher scores indicating greater dysregulation and greater capability, respectively. The Cold Pressor Task (CPT) was used to identify baseline pain tolerance. Respiratory Sinus Arrhythmia (RSA) was acquired using an electrocardiogram, analyzed via AcqKnowledge Software, and measured at baseline and following the CPT to assess resting and recovery RSA.

We will use R to conduct hierarchical regression analyses to examine the effects of baseline emotion dysregulation (DERS), baseline RSA, and recovery RSA as moderated by pain tolerance on subjects’ baseline ACSS scores. In block 1, we will assess the main effect of emotion dysregulation on ACSS. In block 2, we will assess the main effects of both baseline RSA and recovery RSA on ACSS. In block 3, we will assess the interactive effects of pain tolerance on emotion dysregulation, baseline RSA, and recovery RSA. If our hypotheses are supported, this will provide support for the necessity of pain tolerance in contributing to greater acquired capability for suicide, particularly for those with greater emotion dysregulation. Additionally, this will expand further upon past studies finding support for the effects of both emotion dysregulation and pain tolerance on acquired capability for suicide, while integrating physiological biomarkers to differentiate those with lower or greater acquired capability for suicide.