Psychological Medicine: Interpersonal and Targeted Rejection Life Stressors Are Proximal Risk Factors for Suicidal Ideation and Behavior

Life stressors are known risk factors for suicide, but the specific stressor types that most strongly precipitate suicidal outcomes, and on what timescale, remain poorly understood. Social rejection may be an especially potent interpersonal stressor because it threatens to interrupt the maintenance of social bonds and stimulates a cascade of affective, cognitive, and biological changes that promote depression and suicidal ideation. Specifically, targeted rejection (social rejection that is intentional, has isolated impact, and involves social demotion) may be especially pernicious. 

While some research has shown that targeted rejection is related to changes in inflammatory biology that have been implicated in depression and suicide, no research has examined whether targeted rejection is a proximal risk factor for subsequent acute increases in suicidal ideation or behavior over short time frames.

Lori Scott, PhD (Associate Professor of Psychiatry), is lead author of a recent study in Psychological Medicine investigating whether objectively rated interpersonal stressors, especially social and targeted rejection stressors, are proximally associated with increased likelihood of suicidal ideation and behavior. Dr. Scott and a team of investigators examined associations between various types of life stressors and suicidal ideation/behavior retrospectively using timeline follow-back and objective life stress interview methods in young adults. They found that daily within-person increases in interpersonal stressor severity were related to higher odds of same-day (but not next-day) suicidal ideation. Additionally, greater increases in targeted rejection severity were uniquely related to increased likelihood of both same-day and next-day suicidal behavior after controlling for prior-day suicidal behavior and other types of stressors.

“These findings suggest that clinicians should ask about recent experiences of targeted rejection when assessing acute risk for suicidal behavior, as this may be an especially important warning sign,” said Dr. Scott.

Interpersonal and targeted rejection life stressors are proximal risk factors for suicidal ideation and behavior
Scott LN, Malcolm IB, Brown SL, Hernandez Valencia EM, Krafty RT, Slavich GM.
Psychological Medicine. 2025;55:e271. doi:10.1017/S0033291725101414