Suicide attempts among adults denying active suicidal ideation: An examination of the relationship between suicidal thought content and suicidal behavior

The purpose of the current study was to examine the possibility that there are multiple pathways to suicidal behavior by conducting a fine-grained investigation of the relationship between suicidal thought content and suicidal behavior.Six thousand two hundred US adults completed self-report measures of suicidal thoughts and behaviors. Descriptive statistics and logistic regression were used to examine the relationship between suicidal thoughts and behaviors.About 36.0% of participants with a lifetime suicide attempt denied ever experiencing any active suicidal thoughts and 11.0% denied ever experiencing any suicidal thoughts; 53.8% of recent attempters denied recent active suicidal thoughts and 22.6% denied any recent suicidal thoughts. Additionally, the sole presence of passive suicidal ideation was associated with increased odds of lifetime and past-month suicide attempts.These findings suggest that there are likely multiple pathways to suicide, some of which do not involve progressively worsening suicidal thoughts.