The Hierarchical Structure of Antagonism as a Predictor of Suicidal Thoughts and Behaviors

Antagonism is a transdiagnostic dimension of psychopathology associated with interpersonal dysfunction, a central feature of theories of suicide risk. However, little work has evaluated how antagonism or its lower-order components relate to suicidal thoughts and behaviors (STB). We examined the hierarchical structure and external validity of antagonism in 496 adults enrolled in a longitudinal study enriched for personality pathology and suicide risk. Hierarchical factor analysis recovered five lower-order facets—dishonesty, grandiosity, callousness, aggression, and hostile distrust—closely replicating prior structural work. We tested associations of higher-order antagonism and these facets with lifetime and prospective suicide attempts, attempt lethality, and prospective suicidal ideation. Higher-order antagonism was associated with lifetime attempt history but no other outcomes. At the facet level, hostile distrust was associated with lifetime attempt history and greater likelihood and severity of prospective ideation; dishonesty predicted greater attempt lethality, whereascallousness predicted lower lethality. Contrary to expectations, aggression was associated with lower lifetime and prospective attempt risk. Controlling for neuroticism attenuated several associations, including those of higher-order antagonism and hostile distrust with lifetime attempt history. These findings support a reproducible lower-order structure of antagonism and demonstrate that associations between the antagonismdomain and STB are modest, and in some cases, reflective of shared variance with negative emotionality.