An Investigation of the Relationship Between Rumination Styles, Hope, and Suicide Ideation Through the Lens of the Integrated Motivational-Volitional Model of Suicidal Behavior

Examining aspects of psychological flexibility within the integrated motivational-volitional model of suicidal behavior: A prospective investigation

BACKGROUND

According to the integrated motivational-volitional model of suicide, feelings of entrapment are related to the emergence of suicidal ideation (SI). However, this relation can be moderated by certain protective factors.

METHODS

This study examined whether aspects of psychological flexibility (i.e., experiential avoidance, experiential acceptance, harnessing) moderated the relation between aspects of entrapment and SI severity in college students experiencing SI (N = 553) both cross-sectionally and when SI severity was measured 1 week later (N = 247).

RESULTS

At baseline, experiential acceptance, but not experiential avoidance or harnessing, significantly moderated the relation between external entrapment and SI severity and internal entrapment and SI severity. No aspects of psychological flexibility prospectively moderated relations between entrapment and SI severity.

CONCLUSIONS

Aspects of psychological flexibility may influence immediate vulnerability to SI severity among young adults experiencing feelings of entrapment. Implications for clinical interventions influencing changes in psychological flexibility are discussed.

Religion and Suicide in Black Emerging Adults: Examining Pathways Through Hope and Meaning in Life

While suicide persists as a leading cause of death for Black emerging adults in the U.S., few studies identify specific positive psychological mechanisms that can be leveraged to reduce future risk. The current study, therefore, explores whether religion is related to suicidal ideation via hope and meaning in life among a sample of n = 375 Black emerging adults ages 18-25-years-old (M = 20.79, SD = 2.22). Structural equation modeling techniques were used to measure direct and indirect associations. Primary results indicate that non-organizational religiosity (e.g., reading religious texts, listening to religious music, prayer) was positively associated with hope, presence of meaning in life, and search for meaning in life. Presence of meaning in life was the strongest contributor to decreased suicidal ideation. Further, non-organizational religiosity was indirectly associated with less suicidal ideation via hope and presence of meaning in life. Personal forms of religious involvement, and not service attendance, appear to be the most salient aspects of religion to consider when exploring pathways between religion and suicidality during this particular developmental stage.

A systematic review of the studies testing the integrated motivational-volitional model of suicidal behaviour

Despite the influence of the integrated motivational-volitional (IMV)1 model on research and practice, the supporting literature has not been systematically synthesised. This systematic review aims to synthesise the literature testing the IMV model of suicidal behaviour. Using citation and database searching, PsycINFO, EMBASE, PubMed, Web of Science, and Google Scholar were searched for studies referencing the IMV model (last searched on 28th March 2023). Included studies empirically tested the hypotheses of the model. Quality assessment was conducted using the National Institute of Health tool. Findings from 98 records (100 studies, 138,365 participants) were narratively synthesised. Results from studies directly testing the hypothesised pathways of the model supported the defeat-entrapment-suicidal ideation pathway of the IMV model. Case-control studies comparing differences between control, ideation, and enactment groups were consistent with hypotheses in univariate and cross-sectional analyses. However, support for the model was mixed for case-control multivariate and prospective studies. Due to low overlap in variables studied, the role of specific pre-motivational phase variables and stage-specific moderators was inconclusive. The studies received overall good quality ratings. The IMV model presents a promising framework for understanding and preventing suicide. Defeat, entrapment, and key variables may be useful in informing suicide prevention measures.

Entrapment and Defeat Scales: Factor Structure Assessment and Variation by Gender and Sexual Identity among Adults in the United Kingdom

Entrapment and defeat are empirically-supported suicide risk factors. Their measurement is the subject of some debate, however. Also, limited work exists examining sexual and gender minority (SGM) differences in these suicide risk factors despite overall elevated rates of suicidal thoughts and behaviors (STBs) for SGM persons. The present study examined (1) entrapment and defeat differences by sexual orientation and gender identity, (2) factor structure and criterion validity of the Entrapment Scale (E-Scale) and the Defeat Scale (D-Scale), and (3) measurement invariance by sexual orientation (subsamples were too small for gender identity). A sample of 1,027 adults living in the United Kingdom completed a cross-sectional online questionnaire assessing mental health. Analysis of Variance and Kruskal-Wallis testing revealed: (1) all sexual minority (i.e., gay/lesbian, bisexual, and other SM) persons reported higher internal and external entrapment, defeat, and suicidal ideation compared to their heterosexual counterparts, and; (2) gender minority (i.e., transgender and gender diverse) persons reported higher internal and external entrapment, defeat, and suicidal ideation compared to cisgender persons. Supported by suicide theory, confirmatory factor analysis showed modest support for a two-factor E-Scale (internal and external), and a one-factor D-Scale. All entrapment and defeat scores displayed significant moderate positive correlations with suicidal ideation. E- and D-scale scores displayed high intercorrelation, tempering confidence in conclusions regarding the facture structure findings. Item threshold-level responding varied by sexual orientation for the D-Scale but not the E-Scale. Results are discussed with respect to suicide theory and measurement, public health, and clinical practice.

Perceived Chronic Social Adversity and Suicidal Ideation Among Chinese College Students: The Moderating Role of Hope

This study aimed to investigate the relations among perceived chronic social adversity, hope and suicidal ideation among Chinese college students. 535 college students completed the Perceived Chronic Social Adversity Questionnaire (PCSAQ), the Suicidal Ideation Scale (SIS), and the Revised Adult Dispositional Hope Scale (RADHS). The results showed that perceived chronic social adversity was positively associated with suicidal ideation, and hope was negatively associated with suicidal ideation. The results also confirmed that hope negatively moderated the relationship between perceived chronic social adversity and suicidal ideation. Further study showed that there was a significant positive relation between perceived chronic social adversity and suicidal ideation under the low hope level, however, there was a non-significant relation between perceived chronic social adversity and suicidal ideation under the high hope level.

Hope for the future protects against suicidal ideation among adolescents and young adults affected by perinatal HIV

Hope for the future has been found protective against suicidal ideation (SI) in adolescents and young adults (AYA) yet has not been examined in AYA with perinatal HIV-infection (PHIV) or AYA who were perinatally HIV-exposed but uninfected (PHEU), who are at higher risk for SI than general populations. Using data from a New York City-based longitudinal study of AYAPHIV and AYAPHEU enrolled when 9-16 years old, we examined associations between hope for the future, psychiatric disorders, and SI over time using validated measures. Generalized estimating equations were used to estimate differences in mean hope for the future scores by PHIV-status and to estimate adjusted odds ratios for associations between hope for the future and SI. AYA reported high hope for the future scores and low SI across visits, irrespective of PHIV-status. Higher hope for the future scores were associated with lower odds of SI (AOR = 0.48, 95% CI: 0.23, 0.996). Mood disorder was associated with increased odds of SI (AOR = 13.57, 95% CI: 5.11, 36.05) in a model including age, sex, follow-up, PHIV-status, mood disorder, and hope for the future. Understanding how hope can be cultivated and how it protects against SI can help to inform preventive interventions for HIV-affected AYA.

A qualitative assessment and short-term mediation analysis of defeat, entrapment, and suicide

OBJECTIVES

The Integrated Motivational-Volitional Model (IMV) of Suicide is growing in empirical support. The present study advances IMV research through two aims: (1) to qualitatively probe the subjective experiences of defeat, internal entrapment, and external entrapment, and (2) conducting a 3-month prospective mediation analysis using quantitative and qualitative metrics of defeat and entrapment.

METHODS

The study featured an online two-point survey separated by 3 months. Participants were 255 adults living in the United Kingdom.

RESULTS

Persons endorsing qualitative defeat and internal entrapment in their narratives also showed higher quantitative scores on corresponding IMV and suicide-related self-report scales. Internal entrapment mediated the effect of baseline defeat on 3-month suicidal ideation, whereas external entrapment mediated the association of baseline defeat on 3-month suicide attempt likelihood. Quantitative assessment of entrapment was more significantly associated with suicide attempts and ideation within mediation tests compared to corresponding qualitative variables.

CONCLUSIONS

IMV model principles are largely supported by findings. Mediation results support further consideration of entrapment and defeat within clinical practice and public health-focused suicide research. Understanding the complexity of entrapment narratives represents an important next step for conducting qualitative IMV-focused research with minoritized and high-risk suicide populations.

Hope and suicidal ideation and behaviour

Understanding the factors that protect against suicidal ideation and behaviour may strengthen our ability to identify and support those at risk of death by suicide, above and beyond that which is possible by focusing solely on risk factors. A factor that may confer protection against the development of suicidal ideation and behaviour is hope, a future orientated construct that features within recent theories of suicide. Here, we provide an overview of the literature examining the role of hope in moderating and mediating the relationship between suicide risk factors and suicide ideation and behaviour. Evidence suggests that hope may be important in buffering against suicide ideation and behaviour across different population. Limitations and recommendation for future research are also discussed.

Role of rumination and hope on negative life events and suicidal ideation under the background of normalization of pandemic prevention and control: A moderated mediation model

Introduction

The study aimed to investigate the impact and mechanism of negative life events on college students' suicidal ideation during the COVID-19 pandemic and the buffering effect of hope under the background of normalization of pandemic.

Methods

A total of 5211 participants took part in this study. Self-reported negative life events, rumination, hope and suicide ideation were measured using a range of questions and scales. Our research demonstrated that the incidence of suicidal ideation among college freshmen in the past week was higher during the COVID-19 pandemic than that before the pandemic. In this study, conditional process model 15 was used to verify the hypothetical model of rumination as a potential mediator and hope as a moderator.

Results

The hypothesized moderated mediation model was verified significant (β = -0.047, 95% CI = [-0.061, -0.035]), and hope was found to moderate the direct effect of negative life events on suicidal ideation (β = -0.039, t = -2.937, 95% CI = [-0.065, -0.013]) as well as the indirect effect of through the mediator rumination (β = -0.134, t = -10.850, 95% CI = [-0.158, -0.110]).

Discussion

We found that rumination partially mediated the effect of negative life events on suicidal ideation, and hope buffered the direct and indirect effect of negative life events on suicidal ideation. The implications of the findings for clinical interventions are discussed, including the importance of hope arousal as a protective factor and rumination as a cognitive mechanism for emotion regulation under the background of normalization of pandemic.

Future-Oriented Group Training for suicidal individuals: A randomized controlled trial

INTRODUCTION

Suicide is a serious public health concern worldwide. Current psychological interventions targeting suicidal ideation and behavior are, however, limited and often lack convincing empirical support. Future-Oriented Group Training (FOGT) targets crucial aspects of the suicidal process, thus possibly offering a promising intervention for suicidal ideation. This study aimed at investigating the short-term and long-term effects of FOGT on suicidal thoughts and related variables.

METHODS

A randomized controlled trial was conducted, comparing the intervention group (FOGT + treatment as usual (TAU)) to a control group (TAU) at pre and posttreatment and at a 12-week follow-up. Suicidal ideation was the primary outcome, while depressive symptoms, hopelessness, defeat, entrapment, worrying, and the ability for future-oriented thinking were secondary outcomes.

RESULTS

When compared to the control group, the intervention group showed significant decreases in worrying at posttreatment and significant increases in future-oriented thinking at follow-up. Pre-post analyses within the intervention group showed significant small-to-medium effects for primary as well as most secondary outcomes. Changes in suicidal ideation, depression, hopelessness, and future-oriented thinking remained significant at follow-up.

CONCLUSION

This study provides promising empirical evidence for the use of FOGT for individuals with suicidal ideation.

The Relationship of Family Functioning and Suicidal Ideation among Adolescents: The Mediating Role of Defeat and the Moderating Role of Meaning in Life

OBJECTIVE

To investigate the relationship between family functioning and suicidal ideation among adolescents.

METHOD

A total of 4515 junior and senior high school students were assessed using the Family APGAR, the Depressive Symptom Index-Suicidality Subscale, the Defeat Scale, and the Chinese Meaning in Life Questionnaire.

RESULTS

This study found pairwise correlations between suicidal ideation, family functioning, defeat, and meaning in life. Specifically, family functioning was an influencing factor of adolescent suicidal ideation, and defeat was a mediator of the relationship between family functioning and adolescent suicidal ideation; meaning in life was found to be a moderator of the first half of the mediation process by defeat, that is, it moderated the influence of family functioning on adolescent defeat.

CONCLUSIONS

This study demonstrated that the relationship between family functioning and adolescent suicidal ideation, as well as the influence of defeat and meaning in life on this relationship, constituted a moderated intermediary model. This finding has both theoretical and practical value for the implementation of a psychosocial model of adolescent suicide prevention and intervention.

The Relationship between Depressive Symptoms, Rumination, and Suicide Ideation in Patients with Depression

The relationship between suicide and rumination in depression is a recent topic of attention in mental health. The purpose of this study was to investigate the relationship between demographic variables, depressive symptoms, rumination, and suicide ideation in patients with depression, as well as the predictors of suicide ideation.

RESEARCH DESIGN

A cross-sectional study of 95 subjects with depression recruited intentionally from the psychiatric ward of Tzu Chi Hospital. The questionnaire included demographic data, the Beck Depression Inventory-II, the Ruminative Response Scale, and the Beck Scale for Suicide Ideation. Independent sample t-test, Pearson product difference correlation, and the stepwise regression test were adopted for data analysis.

RESULTS

Age (r = -0.41, p < 0.01), age at diagnosis (r = -0.34, p < 0.01), and sleep duration (r = -0.25, p < 0.05) were negatively correlated with rumination-reflection. The depressive symptoms (r = 0.72, p < 0.01) were positively correlated with rumination, whereas rumination (r = 0.57, p < 0.01) and suicide ideation were positively correlated. Depressive symptoms and rumination could predict suicide ideation, and the effective explanatory power reached 60%.

CONCLUSIONS

If the patient with depression was younger or the patient was diagnosed at a younger age, the depressive symptoms of the reflection subscale of rumination thinking and suicide ideation were more serious. Our results indicate that clinicians who care for patients with depression should be aware of rumination and its impact on suicide ideation, specifically in younger patients.

Predicting suicidal ideation in a nationally representative sample of young adults: a 12-month prospective study

BACKGROUND

Evidence-based theoretical models outlining the pathways to the development of suicidal ideation may inform treatment. The current research draws from the Interpersonal Theory of Suicide (IPT) and the Integrated Motivational-Volitional (IMV) Model of suicidal behaviour and aims to test the interaction between perceived burdensomeness and thwarted belongingness as proposed by the IPT model, and the defeat-entrapment pathway as proposed by the IMV model, in the prediction of suicidal ideation at 12-month follow-up.

METHODS

The Scottish Wellbeing Study is a nationally representative prospective study of young people aged 18-34 years (n = 3508) from across Scotland, who completed a baseline interview and a 12-month follow-up (n = 2420). The core factors from both the IPT (perceived burdensomeness and thwarted belongingness) and the IMV model (defeat, internal and external entrapment) were measured alongside demographics, depressive symptoms and suicidal ideation at baseline. At 12-month follow-up, suicidal ideation was assessed again.

RESULTS

In multiple regression analysis perceived burdensomeness and internal entrapment, with baseline suicidal ideation, predicted 12-month suicidal ideation. No support for the interaction between perceived burdensomeness and thwarted belongingness in predicting 12-month suicidal ideation was found. However, there was evidence that internal, but not external, entrapment mediated the relationship between defeat and 12-month suicidal ideation, but no support was found for the moderation of burdensomeness and belongingness on the entrapment to suicidal ideation pathway.

CONCLUSIONS

The current findings highlight the importance of targeting perceived burdensomeness and internal entrapment to reduce the likelihood that suicidal ideation emerges in at risk individuals.

Defeat and Entrapment Mediate the Relationship Between Insomnia Symptoms and Suicidal Ideation in Young Adults

AIM

In recent years, there has been a growing interest in understanding the relationship between sleep disturbance and suicide. The current study aimed to advance understanding of the psychological processes driving these relationships by examining whether insomnia symptoms are related to suicidal ideation via perceptions of defeat and entrapment.

METHODS

Young adults (n = 259; 202 students [78.0%], 45 employed [17.4%], 12 unemployed [4.6%]) completed an anonymous self-report survey that was advertised via social media, university participant pools, and fliers. The survey was described as being related to sleep and mood/mental health. Validated measures were used to assess insomnia symptoms, chronotype, defeat, entrapment, suicidal ideation, and affective covariates.

RESULTS

Bivariate associations found insomnia severity to be related to poorer affective outcomes including severity of suicidal ideation. Insomnia and depression were significant independent variables in multiple linear regression with suidical ideation as the dependent variable. The relationship between insomnia and suicidal ideation was mediated by perceptions of defeat and entrapment.

CONCLUSION

Taken together, these findings shed light on the psychological mechanisms linking sleep disturbance and suicidal ideation by highlighting the role of defeat and entrapment. These findings have the potential to improve suicide risk assessment and prevention in young adults experiencing difficulties initiating or maintaining sleep.HighlightsDefeat and entrapment mediate relationship between insomnia and suicidal ideationEvidence for Integrated Motivational-Volitional Model of Suicidal Behavior in community sampleUses validated multi-item suicide measure.

Desire for control and the integrated motivational-volitional model of suicidal behavior: Results from a pilot investigation of adults in the United Kingdom

BACKGROUND

Suicidal behavior remains a pressing problem in the United Kingdom. Continued theory development is a critical step toward designing effective prevention.

AIMS

The present study tested a novel element to suicide theory, the Desire for Control, for its direct and moderating roles within the Integrated Motivational-Volitional (IMV) Model of Suicidal Behavior.

METHOD

An online-administered cross-sectional suicide risk survey study (n = 116) was conducted among adults living in the United Kingdom.

RESULTS

Mean suicidal ideation scores were in the non-clinical range. DOC Leadership and Destiny Control were associated with good mental health. DOC Decision Avoidance was associated with poor mental health. DOC Decision Avoidance also acted as a motivational moderator in which the entrapment-suicidal thinking link was worse among those high in decisional avoidance.

CONCLUSION

DOC represents a novel, valuable addition to suicide theory and may inform suicide-specific psychotherapeutic intervention. Additional research is needed to full understand the role of DOC and its factor structures in the IMV.

Examining the protective function of perceptions of post-traumatic growth against entrapment and suicidal ideation

BACKGROUND

Recent evidence has found that reporting post-traumatic growth (PTG) from a past stressful life event is associated with lower reports of suicidal ideation. Perceptions of PTG measure the extent to which an individual reports positive changes in their identity, relationships, and worldviews after a stressful event. However, little is known about how perceptions of PTG interact with feelings of defeat and entrapment to influence suicidal ideation. The current study examined this question through the Integrated Motivational-Volitional (IMV) Model of Suicidal Behavior.

METHODS

521 adult participants (315 females with age range of 18-82, M = 30.4 years, SD = 13.6) completed an online cross-sectional questionnaire with defeat, entrapment, suicidal ideation, PTG, depression and anxiety measures. Hypotheses and data analysis plans were pre-registered prior to data collection.

RESULTS

PTG negatively correlated with defeat, entrapment and suicidal ideation. PTG predicted lower suicidal ideation when controlling for entrapment, depression and anxiety. PTG did not moderate the relationship between defeat on entrapment or the relationship between entrapment on suicidal ideation.

LIMITATIONS

The findings were based on cross-sectional data where participants recalled experiences of defeat, entrapment and suicidal ideation from the past year. The sample was a large community (non-clinical) sample, and most of the participants identified as white (85%).

CONCLUSION

Although PTG did not function as a moderator within the IMV model of suicidality, it predicted lower suicidal ideation while controlling for other known predictors of suicidal ideation. Future research could explore the function of PTG in appraisal-based models of suicidality.

Entrapment and suicidal ideation: The protective roles of presence of life meaning and reasons for living

OBJECTIVE

The integrated motivational-volitional model of suicide proposes that feelings of entrapment play a key role in the development of suicidal ideation. The model also posits a set of motivational moderators which either facilitate or hinder the development of suicidal thinking when entrapment is present. These motivational moderators include factors such as attitudes, future goals, thwarted belongingness, and social support. Two previously studied protective factors against suicide, reasons for living and life meaning, have received support in suicidology and might serve as motivational moderators in this model.

METHODS

The current cross-sectional study included college students (N=195) oversampled for recent suicidal ideation who took a series of self-report questionnaires online.

RESULTS

Our findings demonstrated that both reasons for living and life meaning are protective against the relation between entrapment and suicidal ideation, especially when presence of life meaning and reasons for living of high. Search for life meaning was found demonstrated a less protective relation with SI severity, particularly when reasons for living were low.

CONCLUSION

Both motivational moderators demonstrated protective relationships with suicidal ideation and may be relevant to suicide prevention strategies. Limitations and future directions are discussed.

Being certain that negative events will happen or that positive events will not happen: Depressive predictive certainty and change in suicide ideation over time

INTRODUCTION

Relatively little research has examined the precise components of hopelessness that increase vulnerability to suicidal thinking. We examined whether certainty about an absence of positive future outcomes (Certainty-AP) would more strongly predict suicide ideation over time than certainty about negative future outcomes (Certainty-N).

METHOD

Young adults (N = 208), ages 18-34 (M = 19.08, SD = 2.22), with either recent suicide ideation, suicide attempt history, or past-year psychiatric diagnosis were assessed four times over 18 months.

RESULTS

We used multilevel modeling to assess within-participant differences in suicide ideation over time. Both Certainty-AP and Certainty-N predicted later suicide ideation above and beyond generalized hopelessness and depressive symptoms, when examined in separate models. However, Certainty-AP emerged as a stronger predictor of suicide ideation than Certainty-N when examined in the same model.

DISCUSSION

These findings suggest that certainty about an absence of positive future outcomes may have a more unique prospective relationship to SI than certainty about the presence of negative future outcomes. We discuss clinical and theoretical implications of these findings.

Suicide in African American Adolescents: Understanding Risk by Studying Resilience

Historically, suicide rates for African American adolescents have been low,relative to rates for youth of other racial-ethnic backgrounds. Since 2001, however, suicide rates among African American adolescents have escalated: Suicide is now the third leading cause of death for African American adolescents. This disturbing trend warrants focused research on suicide etiology and manifestation in African American adolescents, along with culturally sensitive and effective prevention efforts. First, we revisit leading suicide theories and their relevance for African American adolescents. Next, we discuss health promotive and protective factors within the context of African American youth development. We also critique the current status of suicide risk assessment and prevention for African American adolescents. Then, we present a heuristic model of suicide risk and resilience for African American adolescents that considers their development within a hegemonic society. Finally, we recommend future directions for African American adolescent suicidology. Expected final online publication date for the Annual Review of Clinical Psychology, Volume 18 is May 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Evaluating the validity and reliability of the Chinese entrapment scale and the relationship to depression among men who have sex with men in Shanghai, China

BACKGROUND

Perception of entrapment can emerge when someone feels trapped in an aversive situation and incapable of escape. Depression is closely related to the construct of entrapment. In China, men who have sex with men (MSM) have a high prevalence of depression; therefore, a tool to evaluate entrapment in this population is needed. We evaluated the validity and reliability of the Chinese version of the entrapment scale (ES) and the relationship to depression among MSM in Shanghai, China.

METHODS

We recruited 304 MSM from four districts in Shanghai, China. Participants completed health behavior questionnaires that included baseline information and psychological measurements such as the ES and Patient Health Questionnaire (PHQ-9). The sample was randomly divided into two groups for exploratory factor analysis (n = 143) and confirmatory factor analysis (n = 161). Criterion validity was tested to explore the correlation between the ES and PHQ-9 scores. The reliability of the ES was evaluated with internal consistency reliability (Cronbach's α coefficient) and split-half reliability (Spearman-Brown coefficient). We performed hierarchical regression analysis to determine the variance explained of entrapment to predicting depressive symptoms after adjusting for sociodemographic factors. Finally, receiver operator characteristic curve analysis was performed to measure the optimal ES cut-off value for predicting depression.

RESULTS

Factor analysis showed the ES had one principal component, and one-dimensional scale had more acceptable model fit indices than two-dimensional model. The correlation coefficient between the ES and PHQ-9 scores was 0.756 (P < 0.01). The Cronbach's α coefficient was 0.970 and the Spearman-Brown coefficient was 0.976. ES scores significantly predicted an additional 45.1% of depressive symptoms after controlling for sociodemographic characteristics in the MSM population (β = 0.689, P < 0.001). The optimum cut-off value was 23, which had a sensitivity of 70% and a specificity of 85.4%.

CONCLUSIONS

The Chinese version of the ES has good validity and reliability in the MSM population in Shanghai, and can be used to evaluate perception of entrapment among MSM. The findings confirmed an association between entrapment and depression.

Testing the Integrated Motivational-Volitional Model of Suicidal Behavior in Chinese Adolescents

The integrated motivational-volitional model of suicidal behavior (IMV; O'Connor & Kirtley, 2018) integrates some key factors of suicidal behavior (e.g., defeat and entrapment) to explain the development of suicidal ideation and suicidal attempts. This study aimed to empirically test this model in a sample of Chinese adolescents. A number of 1,239 Chinese adolescents (679 girls; M_age = 14.07, SD = 1.54) completed self-report questionnaires. Results showed that defeat was associated with entrapment, which, in turn, was related to suicidal ideation and suicidal attempts. In addition, the relationship between entrapment and suicidal ideation was significant at high levels of thwarted belongingness and perceived burdensomeness, and low levels of resilience. These findings support the application of the IMV model in Chinese adolescents, and might help mental health organizations and educational agencies formulate effective suicidal prevention programs geared toward Chinese adolescents.

Predicting self-injurious thoughts in daily life using ambulatory assessment of state cognition

Self-injurious thoughts (SITs) fluctuate considerably from moment to moment. As such, "static" and temporally stable predictors (e.g., demographic variables, prior history) are suboptimal in predicting imminent SITs. This concern is particularly true for "online" cognitive abilities, which are important for understanding SITs, but are typically measured using tests selected for temporal stability. Advances in ambulatory assessments (i.e., real-time assessment in a naturalistic environment) allow for measuring cognition with improved temporal resolution. The present study measured relationships between "state" cognitive performance, measured using an ambulatory-based Trail Making Test, and SITs. Self-reported state hope and social connectedness was also measured. Data were collected using a specially designed mobile application (administered 4x/week up to 28 days) in substance use inpatients (N = 99). Consistent with prior literature, state hope and social connectedness was significantly associated with state SITs. Importantly, poorer state cognitive performance also significantly predicted state SITs, independent of hallmark static and state self-report risk variables. These findings highlight the potential importance of "online" cognition to predict SITs. Ambulatory recording reflects an efficient, sensitive, and ecological valid methodology for evaluating subjective and objectives predictors of imminent SITs.

Suicidal Ideation Profiles in Patients with Fibromyalgia Using Transdiagnostic Psychological and Fibromyalgia-Associated Variables

Several studies have emphasized the heterogeneity of fibromyalgia patients. Furthermore, fibromyalgia patients are considered a high-risk suicide group. The ideation-to-action framework proposes a set of transdiagnostic psychological factors involved in the development of suicidal ideation. The present study aims to explore the existence of different subgroups according to their vulnerability to suicidal ideation through these transdiagnostic psychological variables and a set of variables typically associated with fibromyalgia. In this cross-sectional study, 151 fibromyalgia patients were assessed through the Revised Fibromyalgia Impact Questionnaire, Beck Depression Inventory-II, Plutchik Suicide Risk Scale, Interpersonal Needs Questionnaire, Defeat Scale, Entrapment Scale, Psychache Scale, and Beck Hopelessness Scale. A K-means cluster analysis identified two clusters, one (45.70%) according to a low vulnerability, and a second (54.30%) with a high vulnerability to suicidal ideation. These clusters showed statistically significant differences in suicidal ideation and suicide risk. However, no differences were observed in most socio-demographic variables. In conclusion, fibromyalgia patients who present a clinical condition characterized by a moderate-high degree of physical dysfunction, overall disease impact and intensity of fibromyalgia-associated symptoms, along with a high degree of perceived burdensomeness, thwarted belongingness, defeat, entrapment, psychological pain and hopelessness, form a homogeneous group at high risk for suicidal ideation.

The Common Factors of Grit, Hope, and Optimism Differentially Influence Suicide Resilience

No study to date has simultaneously examined the commonalities and unique aspects of positive psychological factors and whether these factors uniquely account for a reduction in suicide risk. Using a factor analytic approach, the current study examined the relationships between grit, hope, optimism, and their unique and overlapping relationships in predicting suicide ideation. Results of principle axis factor analysis demonstrated close relationships between these variables at both the construct and item level. Item-level analyses supported a five-factor solution (Stick-to-Itiveness, Poor Future, Consistency of Interest, Positive Future, and Poor Pathways). Four of the five factors (excluding Stick-to-Itiveness) were associated with suicide ideation. Additionally, results of a multiple regression analysis indicated that two of the five factors (Consistency of Interest and Positive Future) negatively predicted suicide ideation while Poor Future positively predicted suicide ideation. Implications regarding the interrelationships between grit, hope, and optimism with suicide ideation are discussed.

An examination of the Entrapment Scale: Factor structure, correlates, and implications for suicide prevention

Entrapment is an emerging theoretical and empirical factor associated with suicide. The current study expanded our understanding of entrapment by examining the Entrapment Scale factor structure, demographic correlates, and association with suicidal thoughts and behaviors (STBs). Data from an online cross-national study of suicide were analyzed from two samples of young adults aged 18-34 (United Kingdom [U.K.] sample N = 418; United States [U.S.] N = 414). Primary findings included: (1) factor-analytic support for a two factor (i.e., internal and external) Entrapment Scale structure; (2) variation in external entrapment subscale factor loadings by sample; (3) significant demographic correlates of elevated entrapment of younger age, female gender, and U.S. sample; (4) significant convergent positive associations for both entrapment types with cognitive (e.g., perceived burdensomeness), mental health (e.g., anxiety), and STB correlates; and (5) significant, robust associations of internal entrapment and perceived burdensomeness with STBs in the U.K. sample. Implications are reviewed for suicide prevention theory, research and practice.

Entrapment, positive psychological functioning and suicide ideation: A moderation analysis

The Integrated Motivational-Volitional (IMV) Model of suicide posits that the association between perceptions of entrapment and suicide ideation is buffered by so-called motivational moderators. The present study investigated, whether positive mental health as well as different facets of psychological well-being qualify as motivational moderators. Possible moderator effects were investigated in an online sample (N = 301). Results demonstrated that positive mental health and psychological well-being moderate the association between entrapment and suicide ideation. These findings underscore the importance of entrapment and positive psychological functioning in understanding pathways to suicide ideation.

The Effectiveness of Group Hope Therapy in Labor Pain and Mental Health of Pregnant Women

In the present study, the effect of group hope therapy on labor pain and mental health of pregnant women was investigated, in consideration of the Iranian health policy’s emphasis on encouraging women to have a healthy delivery. The research plan was a semiexperimental pretest–posttest design with a control group. A total of 36 pregnant women were assigned to the treatment and control group using a random procedure. General Health Questionnaire and a Visual Analog Scale were used to collect data about dependent variables. For the analysis of hypotheses, independent samples t test and covariance analysis were used. The findings showed that hope therapy had a significant effect on labor pain (t = 5.17; P < 0.001) and mental health (F = 28.21; P < 0.001). In general, the findings of the present study confirm the application of group hope therapy in relieving labor pain and increasing the mental health of pregnant women. This therapeutic approach can simultaneously reduce the labor pain, generate positive emotions in women, and turn the experience of delivery into a pleasant one.

The integrated motivational-volitional model of suicidal behaviour

Suicide is a major public health concern accounting for 800 000 deaths globally each year. Although there have been many advances in understanding suicide risk in recent decades, our ability to predict suicide is no better now than it was 50 years ago. There are many potential explanations for this lack of progress, but the absence, until recently, of comprehensive theoretical models that predict the emergence of suicidal ideation distinct from the transition between suicidal ideation and suicide attempts/suicide is key to this lack of progress. The current article presents the integrated motivational-volitional (IMV) model of suicidal behaviour, one such theoretical model. We propose that defeat and entrapment drive the emergence of suicidal ideation and that a group of factors, entitled volitional moderators (VMs), govern the transition from suicidal ideation to suicidal behaviour. According to the IMV model, VMs include access to the means of suicide, exposure to suicidal behaviour, capability for suicide (fearlessness about death and increased physical pain tolerance), planning, impulsivity, mental imagery and past suicidal behaviour. In this article, we describe the theoretical origins of the IMV model, the key premises underpinning the model, empirical tests of the model and future research directions.This article is part of the theme issue 'Evolutionary thanatology: impacts of the dead on the living in humans and other animals'.

Rumination in relation to suicide risk, ideation, and attempts: Exacerbation by poor sleep quality?

BACKGROUND

Rumination, particularly brooding rumination, is associated with suicide risk, ideation and attempts; however, findings are inconsistent with respect to reflective rumination. Recent research suggests reflective rumination might be associated with increased suicide risk specifically among vulnerable individuals. Poor sleep quality is related to both suicide risk and rumination, yet no research has examined whether reflective rumination and sleep quality interact in relation to suicidal risk. This study, therefore, examined whether sleep quality moderates the link between ruminative subtypes and (a) suicide risk overall, and (b) suicidal ideation and (c) history of suicide attempts, specifically.

METHODS

Participants were 1696 college students (ages 18-29 years; 65% female) who completed measures assessing rumination, sleep, and suicidal ideation and behavior. Hierarchical linear and logistic regressions were performed regressing overall suicide risk (linear), suicidal ideation (linear) and history of attempts (logistic) on ruminative subtypes controlling for demographics. Sleep quality was examined as a moderator of the rumination-suicide risk/ideation/attempts link.

RESULTS

Brooding rumination was significantly associated with increased suicide risk, ideation, and attempts but these associations were not moderated by sleep quality. Sleep quality exacerbated the association of reflective rumination with overall suicide risk and suicidal ideation specifically. Reflective rumination was not itself, or in interaction with sleep quality, significantly associated with a history of suicide attempts.

LIMITATIONS

The study is cross-sectional and utilizes a college student sample.

CONCLUSIONS

This study adds to the literature that suggests reflective rumination is associated with suicide risk and ideation in certain cases, such as in individuals with lower sleep quality. In addition, the study adds continued support for an association between brooding rumination and suicidal behaviors. More studies that examine the relations between ruminative subtypes and attempts are needed. Interventions that target sleep problems and rumination may be beneficial for suicide prevention and intervention.

Insomnia and Nightmares as Markers of Risk for Suicidal Ideation in Young People: Investigating the Role of Defeat and Entrapment

STUDY OBJECTIVES

Although converging evidence has identified sleep problems as robust predictors of suicidal ideation in young people, the psychological processes driving these associations are not yet known. The current study aimed to test predictions, informed by the Integrated Motivational-Volitional (IMV) Model of Suicidal Behavior, concerning the role of feelings of defeat and entrapment within the sleep-suicide relationship.

METHODS

Volunteers aged 15 to 17 years (n = 1,045) from Scottish secondary schools completed an anonymous self-report survey assessing insomnia symptoms, nightmares, suicidal ideation, depressive symptomology, and feelings of defeat and entrapment.

RESULTS

Both insomnia symptoms and nightmares were associated with an increased likelihood of reporting suicidal ideation (independent of depression). Perceptions of both defeat and entrapment were elevated in young people who reported clinically salient insomnia and/or nightmares, relative to those who did not. The relationship between insomnia and suicidal ideation was fully mediated by perceptions of defeat and entrapment, whereas nightmares were indirectly associated with suicidal ideation through perceptions of defeat and entrapment.

CONCLUSIONS

Taken together, these findings provide novel insights into the psychological mechanisms linking sleep disturbance and suicidality by highlighting the role of defeat and entrapment. Clinically, these findings have the potential to improve suicide risk assessment and prevention in young people experiencing difficulties with their sleep.

Repetitive negative thinking and suicide: a burgeoning literature with need for further exploration

Extant research has found a significant overlap between various repetitive negative thinking (RNT) patterns, such as rumination and worry, across different affective disorders implicating that the process of repetitive negative thinking is likely trans-diagnostic. Furthermore, RNT patterns at the core of psychiatric disorders associated with suicide (e.g., rumination and worry) have been found to be associated with suicide even after accounting for the disorder. A synthesis of existing literature on repetitive negative thoughts suggest that following negative emotional experiences, RNTs may lead to a sense of entrapment and hopelessness that may contribute to the onset of suicidal ideation and then facilitate the transition from thinking about suicide to making a suicide attempt by increasing an individual's capability for suicide through repetitive exposure to violent thoughts and imagery associated with suicide.

The relationship between entrapment and suicidal behavior through the lens of the integrated motivational-volitional model of suicidal behavior

Suicide and suicidal behavior are major public health concerns. As a result, a number of psychological models have been developed to better understand the emergence of suicidal ideation and suicide attempts. One such model is the integrated motivational-volitional model, a tri-partite model of suicidal behavior, which posits that entrapment is central to the final common pathway to suicide. In this review, we summarize the extant research evidence for the relationship between entrapment and suicidal ideation and behavior. Although there is robust evidence for the relationship between entrapment and suicidal ideation and behavior, there are gaps in our knowledge. We discuss the clinical implications and suggest key directions for future research.

Rumination's effect on suicide ideation through grit and gratitude: A path analysis study

The current study documents the relationship between suicide ideation, grit and gratitude, and rumination subtypes of brooding and reflection. The relationship between rumination and suicide ideation has been well documented and previous research has demonstrated that grit and gratitude are protective factors against suicide. We hypothesized that both subtypes of rumination would have an indirect effect on suicide ideation through levels of grit and gratitude. Results of a conditional indirect effects path analysis indicated that brooding was indirectly related to suicide ideation through gratitude. Brooding interacted with grit such that it only predicted suicide ideation at low levels of grit. Reflection interacted with gratitude to predict levels of grit. Results suggest that brooding may impact suicide risk and resilience through its effect on gratitude, indicating important cognitive-behavioral targets for suicide prevention strategies. These results extend the literature about the relationship between well known risk factors for suicide and protective factors.