The mediating role of tolerance for psychological pain in the relationship of childhood trauma to suicidal ideation in individuals with a substance use disorder

Abstract

Objectives. The association between childhood trauma and suicidal ideation has been well documented in several populations, including individuals with a substance use disorder (SUD). However, a gap still exists in the literature regarding the mechanisms by which childhood trauma later impacts suicide risk. This cross-sectional study tested the effect of childhood trauma on suicidal ideation, as well as the mediating effect of tolerance for psychological pain (managing the pain and enduring the pain) in that relationship, controlling for the effect of depressive symptoms, in individuals with a SUD. Methods. A sample of 102 adults with a SUD participated in the study. Path analysis by structural equation modelling tested a mediation model. Results. Depressive symptoms and lower levels of managing the pain were found to fully mediate the association between childhood trauma and suicidal ideation. Conclusions. Our results suggest that depressive symptoms and a lack of ability to manage psychological pain contribute towards explaining why traumatic childhood experiences may result in suicidal cognitions in individuals with SUDs. Moreover, they have relevant implications for prevention and clinical interventions regarding suicidal ideation in this population.