O'Connor DB, Branley-Bell D, Green JA, et al. - For suicide, one of the potential risk factor is dysregulated hypothalamic-pituitary-adrenal (HPA) axis activity, as measured by cortisol levels. Researchers, for the first time, demonstrated that trait resilience, social support, socially prescribed perfectionism, trait worry and trait impulsivity are linked with smaller total cortisol awakening responses (CARs) in individuals vulnerable to suicide over a 7-day study period.

• Recruited were 142 participants with a history of suicidal attempt or ideation (suicide vulnerability group; n = 95) and with no suicide risk history (control group; n = 47).

• The suicide vulnerability group described higher worry, socially prescribed perfectionism and impulsivity, lower resilience and social support.

• Significantly lower total CAR was observed in correlation with lower levels of resilience, higher levels of socially prescribed perfectionism, worry and impulsivity.

• Via trait worry, an indirect effect was also identified on total CAR in individuals with suicide group membership.

• Elucidation of the precise causal mechanisms correlating these traits, CAR and suicide risk would allow development of interventions to help build resilience in vulnerable populations.