Transdiagnostic risk factors

The term “multifinality” means that the same risk process might impact multiple, distinct outcomes. Given my research focus on comorbidity and multivariate approaches, it is probably not surprising that I also have interest in identifying transdiagnostic risk factors for psychopathology.

Much of my work in this area has studied interoceptive impairment in relation to suicide. Interoception is the perception of the physiological condition of the body. Interoception is what allows people to sense their emotions, their heartbeats, and their hunger and fullness, for example. Interoceptive impairment has long been noted among people with eating disorders. Interoceptive impairment may exacerbate eating disorder symptoms because being out of touch with one’s body and sensations might promote—and/or reduce a barrier to—behaviors that damage the body.

This logic seemed like it may also apply to suicidal behavior, and I therefore led the first study, and numerous follow-up studies, on interoceptive impairment in suicide. Overall, this line of work determined that reduced interoceptive abilities may be a novel correlate of self-injurious thoughts and behaviors.

Example questions I tackle within this area include:

1. How does impaired interoception relate to suicidal thoughts and behaviors?
2. How does interoception become impaired?
3. How can interoception be improved, and does improving interocpetion result in less suicidal thoughts and behaviors and/or less eating disorder symptoms?

Example papers in this content area include, but are not limited to:

*indicates mentee

Gioia, A. N.*, Forrest, L. N., & Smith, A. R. (2022). Diminished body trust uniquely predicts suicidal ideation and nonsuicidal self-injury among people with recent self-injurious thoughts and behaviors. Suicide and Life-Threatening Behaviors, 52, 1205–1216.

Forrest, L. N., & Smith, A. R. (2021). A multi-measure investigation of interoception in people with recent nonsuicidal self-injury. Suicide and Life-Threatening Behaviors, 51, 492–503.

Smith, A. R., Dodd, D. R., Ortiz, S. N., Forrest, L. N., & Witte, T. K. (2020). Interoceptive deficits differentiate groups and associate with self-injurious thoughts and behaviors in a military sample. Suicide and Life-Threatening Behaviors, 50, 472–489.

Forrest, L. N., Smith, A. R., White, R. D., & Joiner, T. E. (2015). (Dis)connected: An examination of interoception in individuals with suicidality. Journal of Abnormal Psychology, 124, 754–763.