Psychological pain and suicidal behavior: A review

Abstract

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.

Association of Suicidal Status, Inflammation Markers and Resting State Functional Connectivity in Patients with Major Depressive Disorder

“…Intensity of suicidal ideation and psychological pain (but not depression) were negatively correlated with all rs-fMRI metrics (ALFF, ReHo, and VHMC values) of the pars opercularis of the IFG. Dysfunctions of the pars opercularis have been associated with impaired verbal uency 48 and high levels of psychological pain 49 , two typical features of suicidal patients 50,51 . Moreover, psychological pain has been associated with poor phonemic verbal uency performance in men 52 and with suicidal ideation 30 .…”

Psycho-Neuroendocrinology in the Rehabilitation Field: Focus on the Complex Interplay between Stress and Pain

“…This could be explained by the activation of similar brain areas in both cases. In fact, the brain regions involved in pain pathways, such as the prefrontal cortex, hippocampus, and amygdala, are similar to those involved in mood disorders [85][86][87]. Similarly, other psychological effects related to pain can occur, such as anxiety, anhedonia, sleep disturbances, and suicidal thoughts.…”

Neurogenetics and Epigenetics of Loneliness

“…Similarly, phenomena such as tolerance, withdrawal, and craving, as well as giving up important activities, are observed in the context of broken romantic ties, 54 , 55 along with psychological distress. 56 For example, in the War and Peace novel, the protagonist describes feeling “an electric shock” and experiencing “some fearful pain” that seemed to pierce her heart upon learning about the loss of her brother. The heroine of yet another masterpiece by the same author, Ana Karenina, resorts to the use of morphine to cope with her reactive depression following the rejection by a beloved person.…”