Stress accounts for the association between ADHD symptoms and suicide ideation when stress-reactive rumination is high.

ADHD symptoms are significantly associated with suicide ideation. However, the variables that explain this association remain unknown. This study tested a theoretical model in which stress was hypothesized to account for the association between ADHD symptoms and suicide ideation among individuals high, but not low, in ruminative responding to stress. We examined this model in a sample of 432 emerging adults, who were predominantly female (72.5%) and Hispanic (70.6%), with a mean age of 19.73 years. Demographic and clinical (ADHD symptoms, stress, stress-reactive rumination, depressive symptoms) information was collected via self-reported rating scales. ADHD symptoms were significantly and positively associated with stress, stress-reactive rumination, and suicide ideation. As hypothesized, the association between ADHD symptoms and suicide ideation was accounted for by stress, and this effect was strongest at high levels of stress-reactive rumination. Conclusions did not change after controlling for depressive symptoms. These findings shed light on one explanation of the elevated levels of suicide ideation seen in emerging adults with elevated ADHD symptoms: heightened levels of stressful events and a tendency to respond to stress by ruminating. Implications for theory development and prevention efforts are discussed.