(PS8-48) Exploring the Link Between Physical Pain Tolerance and Psychological Pain as Moderated by Current Suicidal Ideation and Suicide Attempt Histories

Numerous studies have explored the connection between physical and psychological pain, suggesting that both types of pain may elicit similar psychological responses, or utilize similar pathways in the brain. Connections between psychological (via the three-step theory of suicide) and physical pain tolerance (via ideation-to-action theories) and suicide-related outcomes have been previously investigated, with evidence indicating a relationship between higher levels of psychological/physical pain and increased risk for suicide-related outcomes. However, the influence of current suicidal ideation and a history of suicide attempts on the relationship between psychological pain and physical pain tolerance remains largely unexamined. The current study investigated the relationship between psychological and physical pain and examined whether this relationship was moderated by the presence of current suicidal ideation/lifetime suicide attempts in a sample of 245 undergraduate students (73.7% cisgender women, 72.% White/European  American; M_age = 19.27 years, SD = 2.81) with lifetime suicidal ideation. Participants completed several self-report measures, including the Psychache Scale (PAS) and the Beck Scale for Suicide Ideation (BSS), in addition to four pain tolerance tasks (algometer, heat, shock, and cold pressor) and a clinical interview. The bivariate correlation between psychological pain and pain tolerance assessed by the pressure algometer (r = .07, p = .303), cold pressor (r = .10, p = .124), shock machine (r = .01, p = .848), and heat machine (r = .12, p = .073) revealed no significant relationship. Likewise, a series of moderation analyses using the PROCESS macro indicated that neither current suicidal ideation nor a lifetime suicide attempt history moderated the relationship between algometer-assessed pain tolerance and psychological pain (B = .00, SE = .00, p = .571 and B = .00, SE = .00, p = .692, respectively), cold pressor-assessed tolerance and psychological pain (B = .00, SE = .001, p = .988 and B = .001, SE = .00, p = .451, respectively), shock-assessed tolerance and psychological pain (B = -.00, SE = .00, p = .819 and B = .00, SE = .00, p = .255, respectively), and heat-assessed tolerance and psychological pain (B = .004, SE = .02, p = .838 and B = .03, SE = .02, p = .272, respectively). Consistent with theory, the main effects of suicidal ideation (B = .33, SE = .05, p < .001) and suicide attempt histories (B = .24, SE = .07, p < .001) and psychological pain were significant. In sum, these findings imply that suicidal ideation and past suicide attempts may have an important relationship with psychological pain, but that physical and psychological pain may not. Future research should analyze the distinct characteristics of psychache and physical pain and determine why there is a lack of evidence to support a relationship between the two.