Public health researchers have raised the concern that both the 2019 coronavirus disease (COVID-19) pandemic and the ensuing public health response will increase interpersonal stressors associated with suicide risk. The Acceptance and Commitment Therapy (ACT) framework conceptualizes psychological flexibility as an important way to reduce the impact of painful and even catastrophic events on psychological suffering. The current study examines psychological flexibility as a potential moderator of the prevailing interpersonal model of suicide risk. METHODS: A sample of 1003 parents (73% female, 82% Caucasian 86% in romantic relationships) were recruited as part of a larger study on the COVID-19 pandemic and family functioning from Mach 27th to the end of April 2020, the height of the United States’ “first wave.” Participants completed measures of psychological flexibility (the Multidimensional Psychological Flexibility inventory; MPFI), interpersonal constructs (perceived burdensomeness and thwarted belongingness), desire for death, COVID-19 related stressors (resource strain and loss due to COVID-19). RESULTS: Moderated-mediation path models highlighted a significant indirect association between COVID-19 stressors and desire for death mediated by perceived burdensomeness to others. This indirect pathway was moderated by psychological inflexibility such that links were strongest at high levels of inflexibility and weak or non-significant at low levels of inflexibility. Results were generally consistent across five of the six facets of inflexibility. DISCUSSION: The findings highlight the value of targeting psychological inflexibility as an important strategy to reduce suicide risk during the COVID-19 pandemic. Implications of patterns of results across different facets for treatment approach are discussed.

公共卫生研究人员提出了一种担忧，即2019年冠状病毒病（COVID-19）大流行和随之而来的公共卫生应对措施都会增加与自杀风险相关的人际压力源。接受和承诺治疗（ACT）框架将心理灵活性概念化，认为是减轻痛苦甚至灾难性事件对心理痛苦的影响的重要方法。当前的研究检验了心理灵活性作为潜在的自杀风险人际关系模型的潜在调节者。方法：招募了1003位父母（73％的女性，82％的白种人，86％的恋爱关系）作为一项关于COVID-19大流行和家庭功能的更大研究的一部分，该研究从2020年4月27日至年底进行，美国的“第一波”。参与者完成了心理灵活性的测量（多维心理灵活性清单； MPFI），人际交往结构（感知的负担和挫败的归属感），对死亡的渴望，与COVID-19相关的压力源（由于COVID-19而造成的资源紧张和损失）。结果：中介调节路径模型突显了COVID-19压力源与对他人的负担造成的死亡愿望之间的显着间接联系。这种间接途径被心理上的僵化所调节，这样，在僵化程度高的时候，链接最强，而在僵化程度低的时候，联系最弱或不重要。在僵硬的六个方面中，五个方面的结果通常是一致的。讨论：这些发现凸显了针对心理僵化的价值，将其作为降低COVID-19大流行期间自杀风险的重要策略。讨论了治疗方法跨不同方面的结果模式的含义。