Suicide and Self-Injury
A network analysis of the impact of COVID-19 pandemic on suicidality: moderating effect of economic hardship
Inna Goncearenco, None
Graduate Student
Teachers College, Columbia University
Jersey City, New Jersey
Megan L. Rogers, Ph.D.
Postdoctoral Research Fellow
Mount Sinai Beth Israel, Department of Psychiatry
New York, New York
Igor Galynker, M.D., Ph.D.
Professor of Psychiatry
Icahn School of Medicine at Mount Sinai
New York, New York
Background: COVID-19, one of the world’s deadliest pandemics, has had an unprecedented impact on mental health. Additionally, public health regulations aimed to control the spread of the virus led to economic hardship for many individuals, which has been linked to increased suicide risk. In particular, the effects of COVID-related isolation, disconnection, entrapment, and hopelessness may be related to the Suicide Crisis Syndrome (SCS), which includes symptoms like a persistent feeling of entrapment, affective disturbance, loss of cognitive control, hyperarousal, and social withdrawal; the SCS may in turn relate to increased suicide risk. Moreover, those with economic hardship may have been disproportionately impacted by these symptoms. The present study explored the complex interplay between COVID-related factors, SCS symptoms, and suicide-related outcomes, as moderated by economic hardship.
Methods: We applied network analysis to online survey data from a nationwide community sample of 1,970 U.S. adults collected during the COVID pandemic between June 2020 and January 2021. Participants completed an assessment of SCS symptoms, past-month suicidal ideation, lifetime suicide attempts, as well as COVID-related cognitions and emotions, such as the ability to acquire emotional support, perceived connectedness with others, feelings of isolation, loneliness, entrapment, increased stress, and hopelessness.
Results: Symptoms formed a sparse network, with edges emerging in expected directions. There were eight edges moderated by the economic hardship variable. Participants with recent economic hardship had stronger relationships between (1) COVID-related connectedness to others and SCS hyperarousal; (2) SCS entrapment and suicidal ideation; and (3) SCS loss of cognitive control and suicidal ideation. However, participants without recent economic hardship had stronger relationships between (1) COVID-related feelings of being trapped and suicidal ideation; (2) COVID-related hopelessness and suicidal ideation; (3) SCS affective disturbance and suicidal ideation; (4) SCS hyperarousal and suicidal ideation; and (5) suicidal ideation and lifetime suicide attempts.
Discussion: Overall, the network analysis has shown that recent economic hardship, such as financial crisis or job loss, tends to affect the strength of several of the relationships between COVID-related cognitive and emotional factors, SCS symptoms, and suicide-related outcomes (especially suicidal ideation), but not in any consistent or predictable way. Future research should explore whether household demographics (e.g., having dependents), gender, ethnicity, and socioeconomic background change the magnitude of the association between economic hardship and individuals’ mental health. Additionally, cross-national studies may be warranted investigating how government economic relief measures might have affected the economic impact of the COVID on individuals’ mental health.