Attachment, loneliness, and social connection as prospective predictors of suicidal ideation during the COVID-19 pandemic: a relational diathesis-stress experience sampling study

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Introduction. Concerns about the impact of the COVID-19 pandemic on mental health have led to efforts to understand how pandemic-specific factors, such as decreased social contact during periods of social distancing, may relate to suicide risk. The present study evaluated personality-based risk factors and frequency of social contact as prospective predictors of suicidal ideation (SI) during the pandemic. Methods. We tested a relational diathesis-stress model of suicide focusing on insecure attachment, trait loneliness, and social contact as predictors of SI, using twice-weekly survey data collected via smartphone from a community sample (n=184) over eight weeks. Results. Multilevel modeling showed that both trait loneliness and anxious attachment predicted the prospective development of SI during the study period. Reduced in-person contact, but not remote contact, was proximally associated with increased SI. Participants with low attachment anxiety, high attachment avoidance, and high trait loneliness were more likely to develop SI in the context of reduced daily in-person contact compared to participants without these traits. Conclusion. Findings support a relational diathesis-stress model of suicide risk during the pandemic, showing that dispositional traits related to emotional connection with others predicted the relative salience of reduced social contact as a proximal risk factor for SI.

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