Defeat, entrapment, and suicidal ideation: Twelve‐month trajectories

Abstract

Background: Defeat and entrapment have been highlighted in the development of suicidal ideation within the Integrated Motivational-Volitional model of suicidal behavior. Research suggests that entrapment has to be differentiated into internal and external entrapment. The aim of this study was to investigate the associations between defeat, internal, external entrapment, and suicidal ideation within and prospectively over measurements. Methods: A sample of 308 psychiatric inpatients (53% female) aged 18 to 81 years (M = 36.92, SD = 14.30) was assessed for the four constructs after admission to a psychiatric ward and six, nine, and twelve months later. Multilevel analyses were conducted to examine associations. Results: Defeat was associated with (a change in) internal and external entrapment. Defeat predicted a change in internal entrapment over time. Defeat and internal, but not external, entrapment were associated with (a change in) suicidal ideation. Internal entrapment was able to predict suicidal ideation. Internal entrapment and defeat predicted a change in suicidal ideation over time. Conclusion: Results highlight the importance to distinguish between internal and external entrapment, and their specific association with suicidal ideation. Perceptions of internal entrapment are of central relevance when experiencing suicidal ideation and should be considered in clinical practice.

Internal entrapment and fearlessness about death as precipitants of suicidal thoughts and planning in the context of post‐traumatic stress disorder

“…PTSD and its associated symptoms may serve as persistent risk factors for the emergence of SI when the individual endeavors to “escape from the aversive psychological states that characterize PTSD” (Bryan, 2016, p. 2). Indeed, both Höller et al (2021) and Rasmussen et al (2010) demonstrate the mechanistic properties of IE and not EE in predicting SI in the context of defeat and suggest that the deleterious effects of IE may be more resistant to intrapersonal change whereas changes in EE are subject to greater intrapersonal locus of control.…”

Were self-described introverts "immune" to increased drug use and entrapment during the pandemic?

“…We asked our respondents—all of whom reported having used alcohol, opioids, or psychostimulants in the previous six months—about introversion, changes in drug use during the pandemic, and changes in their sense of entrapment . Entrapment is a feeling of being unable to escape internal and/or external stressors and has been linked to depression and suicidal behavior ( Carvalho et al, 2021 ; Gilbert & Allan, 1998 ; Höller et al, 2021 ; Stenzel et al, 2020 ). Increased entrapment seems likely to result from a mismatch between social preferences and social circumstances—and might plausibly cause more drug use.…”

Trapped in my inner prison—Cross-sectional examination of internal and external entrapment, hopelessness and suicidal ideation

“…The explained variance in suicidal ideation through internal entrapment is smaller, which emphasizes the role of internal entrapment especially for the development of hopelessness and not to such a large amount of suicidal ideation, which is in line with the high correlations we found for hopelessness and internal entrapment. Earlier studies [ 12 , 13 ] finding effects for associations between internal entrapment and suicidal ideation did not consider hopelessness, which might explain these effects.…”

“…This study aimed at examining the differential relation between internal and external entrapment and suicidal ideation and investigated whether this relation is (partially) mediated by hopelessness. Prior studies showed that internal entrapment might be more important than external entrapment in the development of suicidal ideation [ 12 , 13 ]. However, it has not yet been examined why this might be the case.…”

“…Only internal but not external entrapment mediated the relationship between defeat and suicidal ideation in a sample of 80 adults with bipolar disorder. Höller, Rath [ 13 ] showed in a prospective study with a sample at high-risk of suicide that only internal entrapment could predict suicidal ideation but not external entrapment. O’Connor and Portzky [ 9 ] and Rasmussen, Fraser [ 8 ] stated that internal entrapment might be more difficult to modify deliberately for an individual than external entrapment, which then could lead in turn to more intense feelings of hopelessness which then entail heightened suicidal ideation.…”