Baryshnikov Ilya, Isometsä Erkki
Department of Psychiatry, Helsinki University Hospital, Helsinki, Finland.
Department of Psychiatry, University of Helsinki, Helsinki, Finland.
Front Psychiatry. 2022 Aug 22;13:981353. doi: 10.3389/fpsyt.2022.981353. eCollection 2022.
Despite accumulation of clinical research on risk factors for suicidal process, understanding of the mechanisms and pathways underlying the emergence of suicidal thoughts and their progression to acts is insufficient. The suicidal process has been conceptualized in multiple psychological theories that have aimed to shed light on the interplay of contributing factors. One of the central concepts included in both the cubic model of suicide and the three-step theory of suicide is psychological pain (mental pain or psychache). Over the two last decades, interest in psychological pain has increased considerably, particularly since the discovery of the complex link between the pain processing system and the neurobiology of suicide, and the putative antisuicidal effect of buprenorphine. Growing evidence supports the association between experiencing psychological pain and suicidal ideation and acts in both clinical and non-clinical samples. However, many questions related to the concept of psychological pain and its role in prediction of suicidal behavior remain to be answered in future research. In this narrative review, we have outlined the history of the concept, the definition of psychological pain, and the tools developed for its measurement, summarized the empirical research on psychological pain in relation to suicidal behavior, and suggested future directions for clinical research on psychological pain and suicidal behavior.
尽管关于自杀过程风险因素的临床研究不断积累，但对于自杀念头产生及其发展为自杀行为背后的机制和途径仍了解不足。自杀过程已在多种心理学理论中得到概念化阐释，这些理论旨在揭示各种促成因素之间的相互作用。自杀立方模型和自杀三步理论中都包含的核心概念之一是心理痛苦（精神痛苦或心理疼痛）。在过去二十年中，对心理痛苦的关注显著增加，特别是自发现疼痛处理系统与自杀神经生物学之间的复杂联系以及丁丙诺啡的假定抗自杀作用以来。越来越多的证据支持在临床和非临床样本中，经历心理痛苦与自杀意念及行为之间存在关联。然而，许多与心理痛苦概念及其在自杀行为预测中的作用相关的问题仍有待未来研究解答。在这篇叙述性综述中，我们概述了该概念的历史、心理痛苦的定义及其测量工具，总结了与自杀行为相关的心理痛苦实证研究，并提出了心理痛苦与自杀行为临床研究的未来方向。
