Negative cognitive styles synergistically predict suicidal ideation in bipolar spectrum disorders: A 3-year prospective study

Jonathan P. Stange, Jessica L. Hamilton, Taylor A. Burke, Evan M. Kleiman, Jared K. O'Garro-Moore, Nicole D. Seligman, Lyn Y. Abramson, Lauren B. Alloy

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


Rates of suicidal ideation and behavior are extremely high in bipolar spectrum disorders (BSDs). However, relatively little work has evaluated potentially synergistic relationships between cognitive and emotion-regulatory processes proposed by theoretical models of suicidality in BSDs. The present study evaluated whether negative cognitive style and subtypes of rumination would exacerbate the impact of self-criticism on suicidal ideation in a prospective study of individuals with BSDs. Seventy-two young adults with BSDs (bipolar II, bipolar NOS, or cyclothymia) completed diagnostic interviews and trait measures of self-criticism, negative cognitive style, and brooding and reflective rumination at a baseline assessment. The occurrence of suicidal ideation was assessed as part of diagnostic interviews completed every 4 months for an average of 3 years of follow-up. Negative cognitive style and reflective rumination strengthened the association between self-criticism and the prospective occurrence of suicidal ideation across follow-up. Individuals with high levels of self-criticism in conjunction with negative cognitive style or reflective rumination were most likely to experience the onset of suicidal ideation. Self-criticism may work synergistically with negative cognitive style and rumination to confer risk for suicidal ideation in bipolar spectrum disorders. These results support theoretical models of suicidality in BSDs and indicate that evaluating and understanding negative cognitive styles may help to identify individuals who are at risk of suicide.

Original languageEnglish (US)
Pages (from-to)162-168
Number of pages7
JournalPsychiatry Research
Issue number1
StatePublished - Mar 30 2015

All Science Journal Classification (ASJC) codes

  • Psychiatry and Mental health
  • Biological Psychiatry


  • Bipolar disorder
  • Bipolar spectrum
  • Cognitive styles
  • Rumination
  • Self-criticism
  • Suicidal ideation
  • Suicide


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