Reductions in suicide ideation via PTSD symptoms following an anxiety sensitivity intervention: Evidence for chained mediation

J Affect Disord. 2026 Mar 5:121581. doi: 10.1016/j.jad.2026.121581. Online ahead of print.

ABSTRACT

OBJECTIVES: Suicide is a leading cause of death in the United States each year. Posttraumatic stress disorder (PTSD) is one disorder that confers risk for suicide, though specific reasons for this are not well understood. Emerging evidence suggests that suicidality and PTSD share a common, malleable vulnerability factor in anxiety sensitivity (AS). This study sought to test these relationships by investigating the pathways through which an AS intervention may reduce suicidal ideation (SI) among a trauma-exposed sample.

METHODS: Clinical outpatients (N = 97) participating in a randomized clinical trial of a computerized AS intervention provided measures of AS at baseline and after the third intervention session; and PTSD and SI symptoms at baseline and follow-ups (1- and 3-months post intervention, respectively).

RESULTS: A chained mediation effect was observed, such that SI at month-three follow-up was lower among the active condition, following condition-specific reductions in AS at session three and PTSD symptoms at one-month follow-up. Reductions in the AS cognitive concerns dimension appeared to be the primary driver of this effect.

CONCLUSIONS: Findings suggest that AS and PTSD symptoms influence SI trajectories and are mechanisms through which SI can be mitigated in at risk samples. Scalable digital interventions that target AS cognitive concerns could be successfully leveraged to remediate both PTSD symptoms and suicide risk.

PMID:41794148 | DOI:10.1016/j.jad.2026.121581