Aliño-Dies María, Sánchez-Reolid Daniel, Monferrer Marta, Montes María J, Fernández-Caballero Antonio, Fernández-Sotos Patricia, Ricarte Jorge J
Department of Psychology, Faculty of Medicine, Universidad de Castilla La Mancha, Albacete, Spain.
Computing Systems Department, Universidad de Castilla-La Mancha, Albacete, Spain.
Psychiatr Q. 2025 Jul 17. doi: 10.1007/s11126-025-10187-x.
This study investigates the cognitive mechanisms that facilitate the transition from suicidal ideation (SI) to suicidal behavior (SB), focusing on the interplay of repetitive negative thinking (RNT), feelings of defeat, and perceptions of entrapment, both internal and external, within the framework of the Integrated Motivational-Volitional (IMV) Model. We aimed to predict group membership and identify predictors between those exhibiting SI (n = 56) and those with SB (n = 37), with particular attention to the aforementioned cognitive variables. An observational, analytical, cross-sectional study was conducted with a clinical sample from a suicide prevention program in Spain, in which patients were assessed during suicidal crises. Results revealed a moderate positive correlation between RNT and both entrapment types, as well as feelings of defeat, across both patient groups, with stronger correlations observed for internal entrapment, particularly in the SB group. The binary logistic regression did not yield conclusive results regarding distinguishing between patient groups in terms of cognitive variables, consistent with existing literature, which may reflect the complexity of the factors influencing suicidal ideation and behavior. Female gender and prior emergency department visits were significant factors distinguishing the SI from the SB group, and female gender was the only variable that proved to be a key predictor of patient type (SI specifically), with an OR = 13.397 (p = 0.005). Our findings highlight the implication of integrating cognitive-behavioral interventions that target repetitive negative thinking, feelings of defeat, and entrapment into specific suicide prevention programs. More specifically, preventive clinical strategies should prioritize high-risk populations such as young women with a history of psychiatric emergencies. To effectively address the needs of this population, protocols could be implemented that include support groups, personalized follow-up systems, and training for mental health professionals on gender-sensitive approaches to enhance their mental well-being.
本研究探讨了促进从自杀意念（SI）转变为自杀行为（SB）的认知机制，重点关注在综合动机 - 意志（IMV）模型框架内，重复消极思维（RNT）、挫败感以及内在和外在被困感之间的相互作用。我们旨在预测组间差异，并确定表现出自杀意念（n = 56）和自杀行为（n = 37）的两组人群之间的预测因素，尤其关注上述认知变量。对来自西班牙一个自杀预防项目的临床样本进行了一项观察性、分析性横断面研究，在自杀危机期间对患者进行评估。结果显示，在两个患者组中，RNT与两种被困类型以及挫败感之间均存在中度正相关，其中内在被困感的相关性更强，尤其是在自杀行为组中。二元逻辑回归在认知变量方面未能得出区分患者组的确切结果，这与现有文献一致，这可能反映了影响自杀意念和行为的因素的复杂性。女性性别和既往急诊就诊史是区分自杀意念组和自杀行为组的重要因素，女性性别是唯一被证明是患者类型（特别是自杀意念组）关键预测因素的变量，其比值比（OR）= 13.397（p = 0.005）。我们的研究结果强调了将针对重复消极思维、挫败感和被困感的认知行为干预纳入特定自杀预防项目的意义。更具体地说，预防性临床策略应优先考虑高风险人群，如患有精神疾病急诊史的年轻女性。为了有效满足这一人群的需求，可以实施包括支持小组、个性化随访系统以及针对心理健康专业人员进行性别敏感方法培训以增强其心理健康的方案。
