Latent profiles of dissociation, pain vigilance, interoception, and mentalization in university students: Associations with suicide-related outcomes

Introduction: Suicide is a leading cause of death among young people. Altered pain processing, dissociation, and interoceptive dysfunction have all been implicated in suicide risk, with evidence suggesting both pain hypo- and hypersensitivity pathways. Mentalization, as an embodied capacity integrating internal states, may further modulate these processes. This study aimed to identify distinct profiles of dissociation, pain, interoception, and mentalization in young adults and examine their associations with suicide-related outcomes. Methods: University students aged 18-29 completed an online survey assessing suicide-related outcomes, dissociation, interoceptive awareness, subjective pain-related experiences, and mentalization. A latent profile analysis was conducted on these dimensions and the resulting profiles entered into logistic regressions to examine associations with lifetime and current suicidal ideation, lifetime suicidal planning, non-suicidal self-injury, and suicide attempts. Results: Latent profile analysis identified four meaningful profiles: 1) low-risk, 2) hypervigilant, 3) dissociative-hypovigilant, and 4) dissociative-hypervigilant. Logistic regressions showed that dissociative profiles, particularly the dissociative-hypervigilant group, had substantially higher odds of current suicidal ideation and lifetime suicidal planning, non-suicidal self-injury, and suicide attempts compared to the low-risk profile. All associations for both dissociative profiles remained significant after adjusting for age, gender, current psychopharmacological medication, current medical condition, and lifetime psychiatric/neuropsychiatric diagnosis. Conclusion: Suicide risk in our sample reflected distinct profiles rather than uniform distress. Two dissociative subtypes emerged: a hypovigilant profile marked by detachment and disengagement, and a hypervigilant profile combining detachment with heightened pain monitoring, the latter conferring greatest risk. These findings highlight dissociation-interoception interactions as key targets for assessment and prevention.