Suicide is my only way: The longitudinal reciprocal relations of experiential avoidance, cognitive fusion, and suicidal ideation among adolescents

Experiential avoidance and cognitive fusion, the two interrelated processes central to psychological inflexibility according to Acceptance and Commitment Therapy, were theoretically and empirically related to adolescent suicidal ideation. However, the longitudinal interaction among experiential avoidance, cognitive fusion, and adolescent suicidal ideation has yet to be empirically examined. As such, our study aims to examine the longitudinal reciprocal relationships among these variables using the cross-lagged panel model (CLPM) and random intercept cross-lagged panel model (RI-CLPM). A total of 1720 Chinese adolescents (54.6% females; M age = 14.44, SD age = 1.35) completed self-reported questionnaires regarding experiential avoidance, cognitive fusion, and suicidal ideation on three occasions, using 6-month intervals. The results showed that in CLPM, experiential avoidance, cognitive fusion, and suicidal ideation positively predicted each other. However, RI-CLPM only provided support for the longitudinal interaction between experiential avoidance and cognitive fusion as well as the role of suicidal ideation in exacerbating experiential avoidance and cognitive fusion. The findings highlight that suicidal ideation may lead to increased levels of experiential avoidance and cognitive fusion in adolescents and the need to distinguish between within-person and between-person effects when studying the relationship between psychological inflexibility and adolescent suicidal ideation.