Staff Perspective: A Deeper Look at the Connections Between Stress, Trauma, and Suicide in Young Adults: New Research Findings
Suicide is a serious public health concern, especially for young adults who have experienced trauma. While a history of trauma can be a risk factor for suicide, we have a limited understanding of the specific mechanisms through which stress responses might contribute to this heightened risk. In a recent study, my colleagues and I investigated the links between suicidal thoughts and behaviors, and how individuals respond emotionally and physically to stress. Ninety-four undergraduate students (Mage=20.30; 61.7% women) were selected based on their lifetime exposure to at least one DSM-5 defined traumatic event.
The Study’s Approach
To see how participants reacted to stress, they completed two different breathing tasks in a controlled experimental lab setting:
- Voluntary Hyperventilation Challenge: This task involved breathing rapidly for three minutes. It’s designed to bring on physical sensations like fast heart rate or feeling lightheaded, which can sometimes trigger memories of traumatic events.
- Normal Breathing Control Task: This was a comparison task, similar in setup but with a regular calm breathing rate.
Throughout these tasks, we measured:
- Suicidal Thoughts and Behaviors: Participants completed the Suicide Behaviors Questionnaire-Revised at baseline, which asks about four key areas: suicidal thoughts or attempts over their lifetime, suicidal thoughts in the past year, threatening a suicide attempt, and how likely they felt to attempt suicide in the future.
- Self-Reported Psychological and Physiological Reactivity: Participants rated how they felt emotionally (e.g., helplessness, feeling unreal, urge to escape) and physically (e.g., tingling, shaking, chest pain, lightheadedness) using a part of the Panic Attack Questionnaire before and after each breathing task. We created a single "stress score" for each participant by subtracting their symptom change during the normal breathing task from their symptom change during the fast breathing task.
Key Findings
- Emotional Reactions Linked to Suicidal Ideation: Past-year suicidal ideation was significantly and positively associated with self-reported psychological reactivity to stress. This suggests that individuals reporting suicidal thoughts in the past year experienced a greater emotional distress during the stress-inducing task.
- No Clear Link to Physical Reactions: None of the four dimensions of suicidality, including past-year ideation, were associated with self-reported physiological reactivity to stress.
Conclusions
Our findings suggest that more recent suicidal ideation might be uniquely connected to a heightened emotional response to stress. This could be explained by how individuals with current suicidal thoughts interpret or “appraise” stressful events, perhaps seeing them as more threatening or overwhelming. Interestingly, we didn't see a link between suicidal thoughts or behaviors and self-reported physical reactions to stress. One possible explanation for this is a growing body of research on interoceptive deficits, which suggests that people at risk for suicide might have a reduced awareness of their body's internal signals. For example, their heart rate could rise during stress, but they might not consciously notice it as others would. This disconnect between mind and body could be even more pronounced in those who have previously attempted suicide. However, more research is needed, especially using physiological measures to more objectively assess an individual's stress response.
Clinical Takeaway
Understanding these specific patterns of reactivity can aid in developing more focused and effective support programs. This may include prioritizing the assessment of recent suicidal ideation and exploring how individuals interpret everyday stressors. These insights can directly inform treatment planning and guide the selection and development of interventions aimed at improving coping and reducing distress. It also highlights a growing interest in strategies that help people connect with and understand their bodily sensations, especially when they have a reduced awareness of these signals.
Limitations
It’s important to note that this study, like all research, has its limitations. The study's findings are based on self-reported physical reactions, and suicidal thoughts and behaviors were assessed at baseline rather than as a component of the experimental design. The study's population was also limited to trauma-exposed undergraduate students with recent alcohol use (part of a larger project). These characteristics are important to keep in mind when thinking about how broadly these findings apply to other populations.
The opinions in CDP Staff Perspective blogs are solely those of the author and do not necessarily reflect the opinion of the Uniformed Services University of the Health Science or the Department of Defense.
Linda Thompson, Ph.D., is a Postdoctoral Fellow with the Center for Deployment Psychology. Dr. Thompson earned her doctorate in Behavioral Science, Psychology from the University of North Texas and a master’s degree in Psychology from San Diego State University.
Study Reference
Thompson, L. M., Kearns, N. T., Rafiuddin, H. S., Contractor, A. A., & Blumenthal, H. (2025).
Associations of Suicidal Thoughts and Behaviors with Psychological and Physiological
Reactivity to a Hyperventilation Task Among Trauma-Exposed Emerging Adults.
Archives of Suicide Research, 1–16. https://doi.org/10.1080/13811118.2025.2524414
Additional References
Kearns, N. T., Blumenthal, H., Contractor, A. A., Guillot, C. R., & Rafiuddin, H. (2021). Effects of
bodily arousal on desire to drink alcohol among trauma-exposed college students.
Alcohol, 96, 15–25. https://doi.org/10.1016/j.alcohol.2021.07.002
Norton, G. R., Harrison, B., Hauch, J., & Rhodes, L. (1985). Characteristics of people with
infrequent panic attacks. Journal of Abnormal Psychology, 94(2), 216–221.
https://doi.org/10.1037//0021-843x.94.2.216
Osman, A., Bagge, C. L., Gutierrez, P. M., Konick, L. C., Kopper, B. A., & Barrios, F. X. (2001).
The Suicidal Behaviors Questionnaire-Revised (SBQ-R): Validation with clinical and
nonclinical samples. Assessment, 8(4), 443–454.
https://doi.org/10.1177/107319110100800409
Suicide is a serious public health concern, especially for young adults who have experienced trauma. While a history of trauma can be a risk factor for suicide, we have a limited understanding of the specific mechanisms through which stress responses might contribute to this heightened risk. In a recent study, my colleagues and I investigated the links between suicidal thoughts and behaviors, and how individuals respond emotionally and physically to stress. Ninety-four undergraduate students (Mage=20.30; 61.7% women) were selected based on their lifetime exposure to at least one DSM-5 defined traumatic event.
The Study’s Approach
To see how participants reacted to stress, they completed two different breathing tasks in a controlled experimental lab setting:
- Voluntary Hyperventilation Challenge: This task involved breathing rapidly for three minutes. It’s designed to bring on physical sensations like fast heart rate or feeling lightheaded, which can sometimes trigger memories of traumatic events.
- Normal Breathing Control Task: This was a comparison task, similar in setup but with a regular calm breathing rate.
Throughout these tasks, we measured:
- Suicidal Thoughts and Behaviors: Participants completed the Suicide Behaviors Questionnaire-Revised at baseline, which asks about four key areas: suicidal thoughts or attempts over their lifetime, suicidal thoughts in the past year, threatening a suicide attempt, and how likely they felt to attempt suicide in the future.
- Self-Reported Psychological and Physiological Reactivity: Participants rated how they felt emotionally (e.g., helplessness, feeling unreal, urge to escape) and physically (e.g., tingling, shaking, chest pain, lightheadedness) using a part of the Panic Attack Questionnaire before and after each breathing task. We created a single "stress score" for each participant by subtracting their symptom change during the normal breathing task from their symptom change during the fast breathing task.
Key Findings
- Emotional Reactions Linked to Suicidal Ideation: Past-year suicidal ideation was significantly and positively associated with self-reported psychological reactivity to stress. This suggests that individuals reporting suicidal thoughts in the past year experienced a greater emotional distress during the stress-inducing task.
- No Clear Link to Physical Reactions: None of the four dimensions of suicidality, including past-year ideation, were associated with self-reported physiological reactivity to stress.
Conclusions
Our findings suggest that more recent suicidal ideation might be uniquely connected to a heightened emotional response to stress. This could be explained by how individuals with current suicidal thoughts interpret or “appraise” stressful events, perhaps seeing them as more threatening or overwhelming. Interestingly, we didn't see a link between suicidal thoughts or behaviors and self-reported physical reactions to stress. One possible explanation for this is a growing body of research on interoceptive deficits, which suggests that people at risk for suicide might have a reduced awareness of their body's internal signals. For example, their heart rate could rise during stress, but they might not consciously notice it as others would. This disconnect between mind and body could be even more pronounced in those who have previously attempted suicide. However, more research is needed, especially using physiological measures to more objectively assess an individual's stress response.
Clinical Takeaway
Understanding these specific patterns of reactivity can aid in developing more focused and effective support programs. This may include prioritizing the assessment of recent suicidal ideation and exploring how individuals interpret everyday stressors. These insights can directly inform treatment planning and guide the selection and development of interventions aimed at improving coping and reducing distress. It also highlights a growing interest in strategies that help people connect with and understand their bodily sensations, especially when they have a reduced awareness of these signals.
Limitations
It’s important to note that this study, like all research, has its limitations. The study's findings are based on self-reported physical reactions, and suicidal thoughts and behaviors were assessed at baseline rather than as a component of the experimental design. The study's population was also limited to trauma-exposed undergraduate students with recent alcohol use (part of a larger project). These characteristics are important to keep in mind when thinking about how broadly these findings apply to other populations.
The opinions in CDP Staff Perspective blogs are solely those of the author and do not necessarily reflect the opinion of the Uniformed Services University of the Health Science or the Department of Defense.
Linda Thompson, Ph.D., is a Postdoctoral Fellow with the Center for Deployment Psychology. Dr. Thompson earned her doctorate in Behavioral Science, Psychology from the University of North Texas and a master’s degree in Psychology from San Diego State University.
Study Reference
Thompson, L. M., Kearns, N. T., Rafiuddin, H. S., Contractor, A. A., & Blumenthal, H. (2025).
Associations of Suicidal Thoughts and Behaviors with Psychological and Physiological
Reactivity to a Hyperventilation Task Among Trauma-Exposed Emerging Adults.
Archives of Suicide Research, 1–16. https://doi.org/10.1080/13811118.2025.2524414
Additional References
Kearns, N. T., Blumenthal, H., Contractor, A. A., Guillot, C. R., & Rafiuddin, H. (2021). Effects of
bodily arousal on desire to drink alcohol among trauma-exposed college students.
Alcohol, 96, 15–25. https://doi.org/10.1016/j.alcohol.2021.07.002
Norton, G. R., Harrison, B., Hauch, J., & Rhodes, L. (1985). Characteristics of people with
infrequent panic attacks. Journal of Abnormal Psychology, 94(2), 216–221.
https://doi.org/10.1037//0021-843x.94.2.216
Osman, A., Bagge, C. L., Gutierrez, P. M., Konick, L. C., Kopper, B. A., & Barrios, F. X. (2001).
The Suicidal Behaviors Questionnaire-Revised (SBQ-R): Validation with clinical and
nonclinical samples. Assessment, 8(4), 443–454.
https://doi.org/10.1177/107319110100800409