Childhood adversity and youth suicide risk: The mediating role of intolerance of uncertainty

Exposure to adverse childhood experiences (ACEs) is a well-established risk factor for suicidality in adolescence and young adulthood. However, the specific mechanisms underlying this relationship remain unclear. Existing research and theoretical frameworks suggest alterations in cognitive and affective processes may account for this association. Intolerance of uncertainty (IU) exacerbates negative affect and arousal states and may contribute to sustained distress. It is therefore plausible that ACEs may be associated with high IU, and in turn, high IU may be associated with increased suicide risk. The present study directly tests this hypothesis in a cohort of youth (18-19 years) with varying ACE exposure. Participants with and without a history of trauma (N = 107) completed a battery of self-report questionnaires to assess ACEs, IU, and suicide risk. Results revealed ACEs were significantly associated with both IU and suicide risk. IU and suicide risk were also correlated. Importantly, findings demonstrated a significant indirect effect of ACEs on suicide risk through IU. Findings converge with broader literature on the relationship between childhood adversity and suicidality and extend previous research by highlighting IU as a mediator of this relationship, positing IU as a potentially viable target for suicide prevention among those with a history of ACEs.