The Importance of Mental Pain and Physical Dissociation in Youth Suicidality

Abstract

This study examines the importance of two suicide risk factors, mental pain and physical dissociation, among young people. Participants were 42 suicidal inpatients, 36 nonsuicidal inpatients, and 45 nonclinical participants. Overall, suicide attempters reported a stronger intensity of and lower tolerance for mental pain and more physical dissociation compared to the other two groups. Suicide attempters with a low tolerance for mental pain showed a higher level of dissociation from pain and insensitivity to bodily cues compared to nonsuicidal inpatients with similar levels of tolerance for mental pain. Physical dissociation contributed significantly to the likelihood of suicidality beyond the contribution of mental pain. Our results accentuate the importance of the combination of mental pain and physical dissociation in suicidality. Further research on the applicability of our findings to self-injurious behavior is warranted.

Reliability and validity study of the Turkish Version of the Psychache Scale

“…5,25 İntihar girişimin-de bulunan kişilerin, yüksek düzeyde psikolojik acı çektikleri ve bu acıyı tolere edemedikleri, ayrıca psikolojik acının intihar davranışı için depresyondan bağımsız bir risk etkeni olduğu belirtilmiştir. 26 Psikolojik acı ile intihar davranışı arasındaki ilişki göz önüne alındığında, psikolojik acı varlığını ve şiddetini değerlendiren ölçeklerin kullanılması psikolojik acı varlığını belirlemek dışında, intihar öngördücülüğünü/riskini belirlemeyi, hastaların antidepresan tedaviye yanıtını, hastalığın gidişini belirleme konusunda da yardımcı olabilir. 17 Bu çalışmada PAÖ'nün Türk-çe Formunun geçerlilik ve güvenilirliği çalışılmış-tır.…”

Self-Injury and Suicidality: The Impact of Trauma and Dissociation

“…Intolerance of mental pain may be conceptualized as a form of emotion dysregulation, consistent with the dialectical behavior therapy core construct of distress intolerance (Harned, Jackson, Comtois, & Linehan, 2010). Moreover, physical dissociation also was found to be associated with SA over and above the effect of mental pain (Levinger et al, 2015). Patients with past suicide attempts reported higher levels of general dissociation and insensitivity to bodily cues compared to the two other groups.…”

“…Regarding the former, it is important to let the research on various forms of self-harm inform standards of screening and assessment. The articles in this special issue have captured some of the complexity within NSSI, SA, and their many predictors, such as dissociation (Franzke et al, 2015;Karpel & Jerram, 2015;Levinger et al, 2015), emotion regulation (Chaplo et al, 2015), PTSD, and depression (Franzke et al, 2015). Screening and assessment that tap into these constructs and distinguish among specific forms of exposure to psychological trauma across the lifespan may facilitate the early identification and treatment of persons at risk for NSSI and SA.…”

“…The fourth study in this special issue addresses the role of dissociation in self-harm involving SA (Levinger, Somer, & Holden, 2015). In a sample of youth and young adults in inpatient psychiatric treatment and nonclinical adult control participants, the inpatients who had past suicide attempts had a higher intensity of and lower tolerance for mental pain than the group of inpatients without past SA and the nonclinical, community control group.…”

Acceptance and Commitment Therapy for the Management of Suicidal Patients: A Randomized Controlled Trial

“…Secondly, ACT seeks to increase psychological flexibility [4], leading to the ability to choose valued actions in the presence of unpleasant psychological events. This may be of particular relevance to suicidal patients who are prone to suffering from a higher level and/or lower tolerance of psychological pain [39]. Our results on subjective program experience further suggest that ACT may impact neuropsychological features of suicidal risk: altered decision-making [40], reduced cognitive flexibility [41], and poor problem-solving ability [42].…”