Abstract
OBJECTIVE: Individuals with a history of suicidality may be especially vulnerable to the adverse impact of COVID-related stressors, but this vulnerability has not been demonstrated. This study examined the longitudinal effects of suicidality history (ideation only or attempt vs. none) and interactions with COVID-related stressors (e.g., work interruptions, childcare challenges, and financial stress) on anxiety symptoms, depressive symptoms, and problematic drinking. METHODS: Longitudinal data from 517 participants were drawn from the National Institute on Alcohol Abuse and Alcoholism Natural History Protocol and COVID-19 Pandemic Impact on Alcohol Study. Lifetime history of suicidality was assessed using the clinician administered Columbia-Suicide Severity Rating Scale. Multiple regressions tested the interaction between suicidality history and COVID-related stressors on clinical outcomes. RESULTS: Compared to individuals without any history of suicidality (79.9%; n = 413), individuals with a history of suicide ideation only (14.5%; n = 75) and suicide attempt (5.6%; n = 29) had higher anxiety symptoms, depressive symptoms, and problematic drinking during the pandemic. Significant interaction effects showed the associations between COVID-related stressors and mental disorder symptoms were stronger among individuals with suicide attempt history than individuals without suicidality history. CONCLUSIONS: History of suicide attempt in combination with high COVID-related stressors put individuals at the greatest risk for pandemic mental disorder symptoms. Individuals with suicide attempt history may have lower coping resources to handle COVID-related stressors. Suicide risk assessment and intervention to increase cognitive flexibility and emotional regulation skills may help these individuals manage emotional distress experienced during the COVID-19 pandemic and beyond.