The Integrated Motivational‐Volitional Model of Suicidal Behavior

O’Connor, Rory C.; Cleare, Seonaid; Eschle, Sarah; Wetherall, Karen

doi:10.1002/9781118903223.ch13

Cited by 134 publications

(198 citation statements)

References 73 publications

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“…Relatedly, in a recent study using sequence analysis techniques to examine factors leading to self-harm, impulsivity (identified by the item “I did it on impulse without planning’ and which may relate to trait disposition or momentary state) was identified as the only proximal factor immediately preceding the first ever and most recent episode [73]. Support was also found in the present review for the influence of trait impulsivity in the translation of self-harm thoughts into behaviour [52, 53] as theorised by the Integrated Motivational–Volitional model of self-harm/suicidal behaviour [38]. Importantly, discriminating between intention and enaction has been identified as a critical area for self-harm research [72].…”

Section: Discussionmentioning

confidence: 54%

“…Other models of self-harm propose a role for impulsivity. The Integrated Motivational–Volitional (IMV) model [38] sets out a tripartite diathesis-stress framework that charts the relationship from background stressors, the development of ideation and intent, and the translation of thoughts into behaviour. The model proposes that impulsivity acts as a proximal volitional moderator to self-harm, bridging the intention-behaviour gap.…”

Section: Introductionmentioning

confidence: 99%

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Impulsivity and self-harm in adolescence: a systematic review

Lockwood

Daley

Townsend

et al. 2016

Eur Child Adolesc Psychiatry

158

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Research supports an association between impulsivity and self-harm, yet inconsistencies in methodology across studies have complicated understanding of this relationship. This systematic review examines the association between impulsivity and self-harm in community-based adolescents aged 11–25 years and aims to integrate findings according to differing concepts and methods. Electronic searches of EMBASE, MEDLINE, PsychINFO, CINAHL, PubMed and The Cochrane Library, and manual searches of reference lists of relevant reviews identified 4496 articles published up to July 2015, of which 28 met inclusion criteria. Twenty-four of the studies reported an association between broadly specified impulsivity and self-harm. However, findings varied according to the conception and measurement of impulsivity and the precision with which self-harm behaviours were specified. Specifically, lifetime non-suicidal self-injury was most consistently associated with mood-based impulsivity-related traits. However, cognitive facets of impulsivity (relating to difficulties maintaining focus or acting without forethought) differentiated current self-harm from past self-harm. These facets also distinguished those with thoughts of self-harm (ideation) from those who acted on thoughts (enaction). The findings suggested that mood-based impulsivity is related to the initiation of self-harm, while cognitive facets of impulsivity are associated with the maintenance of self-harm. In addition, behavioural impulsivity is most relevant to self-harm under conditions of negative affect. Collectively, the findings indicate that distinct impulsivity facets confer unique risks across the life-course of self-harm. From a clinical perspective, the review suggests that interventions focusing on reducing rash reactivity to emotions or improving self-regulation and decision making may offer most benefit in supporting those who self-harm.

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Section: Discussionmentioning

confidence: 54%

Section: Introductionmentioning

confidence: 99%

Impulsivity and self-harm in adolescence: a systematic review

Lockwood

Daley

Townsend

et al. 2016

Eur Child Adolesc Psychiatry

158

View full text Add to dashboard Cite

show abstract

“…Thus, exploring the predictive effect of entrapment for suicidal ideation may provide additional information for our understanding of suicidality. According to the defeat/humiliation–entrapment–suicidal ideation hypothesis proposed in the Integrated Motivational‐Volitional Model of Suicidal Behaviour (O'Connor, ), suicidal individuals often consider themselves a failure when they are in a defeat and/or humiliating situation where they do not achieve their excessive and unrealistic expectations. When the desire to escape from such defeat and/or humiliating situation is thwarted, feelings of entrapment will be triggered and suicide will then be considered a salient solution to this stressful life circumstance (O'Connor, ).…”

Section: The Roles Of Low Self‐esteem and Entrapment In Predicting Sumentioning

confidence: 99%

Low self‐esteem, entrapment, and reason for living: A moderated mediation model of suicidal ideation

et al. 2018

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Adolescent suicidal ideation has become a top public health concern. It is thus significant to explore both risk and protective factors of adolescent suicidal ideation. The present study tested a moderated mediation model of suicidal ideation in a sample of Chinese adolescents. Chinese adolescents of 1074 (54.2% females, aged between 11 and 18 years) completed questionnaires assessing self‐esteem, entrapment, reason for living, and suicidal ideation. We found that entrapment mediated the association between low self‐esteem and suicidal ideation. The association between entrapment and suicidal ideation was moderated by reason for living. Findings of this study may expand our understanding of the development of suicidal ideation, and facilitate future research exploring the interplay of risk and protective factors of suicidality. Clinical implications of these findings were also discussed.

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“…Contemporary theories emphasise psychological mechanisms such as the coping and emotion regulation functions associated with self-harm 10. Other theories acknowledge the complex interplay of psychological, biological and social factors involved and the ‘escape’ function of the behaviour 11. Indeed, self-reported motives from young people reveal that wanting to escape or get relief from unbearable feelings or an unbearable state of mind/situation are commonly reported motives for self-harm with some young people wishing to die as a result of their act 3 12.…”

Section: Why Do Young People Self-harm?mentioning

confidence: 99%

“…Indeed, self-reported motives from young people reveal that wanting to escape or get relief from unbearable feelings or an unbearable state of mind/situation are commonly reported motives for self-harm with some young people wishing to die as a result of their act 3 12. A greater understanding of the psychological mechanisms associated with self-harm, such as self-esteem, impulsivity, hopelessness, depression and entrapment are important when determining vulnerability to self-harm across all ages,3 12 13 with currently influential theories emphasising the importance of the stress-diathesis between key risk factors 11…”

Section: Why Do Young People Self-harm?mentioning

confidence: 99%

Self-harm in young people

Townsend

2014

Evid Based Mental Health

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Self-harm is a common problem among young people with many presenting to clinical services via general hospitals, but many more do not come to the attention of clinical services at all. Self-harm is strongly associated with completed suicide so it is extremely important that patients are assessed and treated for this problem effectively. Despite the scale of the problem in young people, there is a very limited evidence base on what interventions may help them to recover from self-harm. The evidence is discussed here and some recommendations are made about how to engage clinically with young people who self-harm from assessment to therapeutic intervention. WHAT IS SELF-HARM AND WHAT IS THE SCALE OF THE PROBLEM IN YOUNG PEOPLE?Self-harm (self-poisoning or self-injury regardless of the motivation or intent associated with the act) is common in young people.1 Here, 'young people' refers to anyone from age 11 up to the age of 25 years, since psychologists and neuroscientists now suggest this as the most appropriate cut-off for late-adolescence. Hospital-based data demonstrate that self-harm is most common in 15-24-year-olds, with females presenting more frequently than males.2 However, hospital-based statistics are likely to be the 'tip of the iceberg', with many more episodes occurring in the community that do not come to medical attention; community-based studies estimate that around 10% of young people have self-harmed. Self-harm is often repeated; in young people presenting to hospital for self-harm around half will have a history of prior harm and 18% will repeat the behaviour within a year (and present to hospital) again. Self-harm is strongly linked to completed suicide with 40-60% of those who die by suicide having self-harmed in the past, making it the strongest predictor of eventual suicide. 4 In one consecutive case series study, 80% of young people who died by suicide had self-harmed in the preceding year. 5As Owens et al 4 put it, 'suicide risk among self-harm patients is hundreds of times higher than the general population'. Suicide is the second commonest cause of death in young people globally. 6 Importantly, and of significant clinical relevance, is the recent research demonstrating that self-cutting in young people who self-harm is a significant risk factor for completed suicide as is being male, having previously self-harmed and having received psychiatric treatment.7 Given these associations, it is vitally important that young people seen by a clinician (in any setting) for self-harm are taken seriously and are cared for competently and compassionately.

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The Integrated Motivational‐Volitional Model of Suicidal Behavior

Cited by 134 publications

References 73 publications

Impulsivity and self-harm in adolescence: a systematic review

Impulsivity and self-harm in adolescence: a systematic review

Low self‐esteem, entrapment, and reason for living: A moderated mediation model of suicidal ideation

Self-harm in young people

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