Conceptual and Empirical Scrutiny of Covarying Depression Out of Suicidal Ideation.

Depression and suicidal ideation are highly intertwined constructs. A common practice in suicide research is to control for depression when predicting suicidal ideation, yet implications of this practice have not been subjected to sufficient empirical scrutiny. We explore what, precisely, is represented in a suicidal ideation variable with depression covaried out. In an adult psychiatric outpatient sample ( N = 354), we computed two variables-depression with suicidal ideation covaried out, and suicidal ideation with depression covaried out-and examined correlations between these residuals, three factors comprising a variegated collection of psychological correlates of suicidal ideation, psychiatric diagnoses, and past suicidal behavior. Findings indicated that suicidal ideation with depression covaried out appears to be characterized by fearlessness about death, self-sacrifice, and externalizing pathology. We propose that suicidal ideation may comprise two distinct components: desire for death (passive ideation and depressive cognitions) and will (self-sacrifice, fearlessness, externalizing behavior). Implications, limitations, and future directions are discussed.