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Posttraumatic Stress and Distress Tolerance: Associations With Suicidality in Acute-Care Psychiatric Inpatients

Vujanovic, Anka A. PhD*; Bakhshaie, Jafar MD, MA*; Martin, Colleen MA; Reddy, Madhavi K. PhD; Anestis, Michael D. PhD§

The Journal of Nervous and Mental Disease: July 2017 - Volume 205 - Issue 7 - p 531–541
doi: 10.1097/NMD.0000000000000690
Original Articles

Trauma and posttraumatic stress disorder (PTSD) symptomatology have been associated with suicidality, including ideation and behavior. The current investigation evaluated, in acute-care psychiatric inpatients, the mediating role of perceived (self-reported) distress tolerance in the association between PTSD symptom severity and suicidality, defined as a) suicidal ideation, intent, or behavior leading to current psychiatric hospitalization; b) self-reported severity of suicidal desire; and c) percentage of days of suicidality during current hospitalization. Participants were composed of 105 adults (55.2% women; mean age, 33.9; SD, 10.9) admitted to a public psychiatric acute-care inpatient hospital in a large metropolitan area; 52.3% of the participants were hospitalized for suicidality. Results indicated that PTSD symptom severity (and severity of each PTSD symptom cluster) may exert an indirect effect on suicidality, specifically suicidality as a basis for current hospital admission and self-reported severity of suicidal desire, through perceived distress tolerance. Effects were documented after controlling for theoretically relevant covariates.

*Department of Psychology, University of Houston; †Michael E. DeBakey Veterans Affairs Medical Center; ‡Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center, Houston, Texas; and §Department of Psychology, University of Southern Mississippi, Hattiesburg, Mississippi.

Send reprint requests to Anka A. Vujanovic, PhD, Trauma and Stress Studies Center, Department of Psychology, University of Houston, 126 Heyne Building, 3695 Cullen Boulevard, Houston, TX 77204. E-mail:

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