New Risk Factors Predict Suicidal Behaviors

This cross-sectional study using secondary data of military personnel from various branches is the first to look at interoception* in a military context and its relation to suicidal behavior. Researchers examined associations between interoceptive deficits** and suicidal thoughts, attempts, and related psychopathology. This is the first study to replicate previous findings associating interoceptive deficits and suicidal ideation and behavior in a military sample and the first to find an association between interoceptive deficit and lethality of suicide attempts in any sample. Key research findings are the following:

  • Service members with a history of suicide attempt showed significantly greater interoceptive deficits than those with suicidal ideation but no history of attempt. Those with suicidal ideation but no history of attempt showed significantly greater interoceptive deficits than those with no history of either suicidal ideation or attempts1
  • In addition, greater interoceptive deficits were more strongly associated with higher suicidal ideation, more suicide attempts, more non-suicidal self-injuries (NSSI), and greater lethality of suicide attempts than with other risk factors including age, gender, PTSD symptoms, and hopelessness1.

These takeaways may inform future research and implications for clinical practice. While there is currently no guidance for implementation, clinicians might consider assessing for interoceptive deficits as part of suicide assessment or increasing interoception as a means of reducing suicide risk. However, further longitudinal research is needed as is evidence that changing interoceptive deficits will lead to decreased suicidal ideation and behavior in military settings. 

*Interoception is defined as one’s ability to accurately perceive and interpret sensations of the physical body (ie: touch, temperature, pain, emotions, etc.)

**Interoceptive deficits refer to a disconnection from the physical body. Such deficits can cause challenges in understanding one’s own body.



  1. Smith, A. R., Dodd, D. R., Ortiz, S., Forrest, L. N. & Witte, T. K. Interoceptive deficits differentiate suicide groups and associate with self-injurious thoughts and behaviors in a military sample. Suicide Life. Threat. Behav. 50, 472–489 (2020).*
  2. Dodd, D. R. et al. Interoceptive Deficits, Nonsuicidal Self-Injury, and Suicide Attempts Among Women with Eating Disorders. Suicide Life. Threat. Behav. 48, 438–448 (2018).
  3. Hielscher, E., Whitford, T. J., Scott, J. G. & Zopf, R. When the body is the target—Representations of one’s own body and bodily sensations in self-harm: A systematic review. Neurosci. Biobehav. Rev. 101, 85–112 (2019).