Identity Pathology and Emptiness as Novel Predictors of Suicidal Ideation

Emptiness and identity pathology are understudied clinical constructs that overlap, co-occur, and predict suicidal ideation (SI). However, specific risk pathways have yet to be formally tested. Aim: We examined whether identity pathology was indirectly associated with future SI via emptiness, and tested impulsivity and emotion dysregulation as moderators. Methods: Participants (N = 251) completed baseline questionnaires assessing SI, borderline personality disorder symptoms, emotion dysregulation, and impulsivity, and SI 2 months later. Results: Identity pathology was indirectly associated with future SI via emptiness, controlling for baseline SI (beta = 0.15, Bootstrap 95% CI = [0.06, 0.24]). There was a two-way interaction between emptiness and both poor use of emotion regulation strategies (beta = 0.06, p < 0.001) and impulsive lack of premeditation (beta = 0.09, p = 0.03) predicting SI. Conclusion: Those with greater identity pathology were more likely to experience emptiness, which was in turn associated with future SI. Participants who felt empty were also more likely to experience SI when they also reported an inability to use emotion regulation strategies and a tendency to act without considering the consequences. We provide preliminary support for an untested risk pathway for SI, highlighting the need to further study these important experiences.