A Prospective Study of Psychache and its Relationship to Suicidality

Abstract

Identifying psychological factors that can predict suicide risk is essential for reducing suicide rates. Shneidman (1993) postulated that psychache (or psychological pain) is a unique predictor of suicide when controlling for other relevant factors such as depression and hopelessness. Previous cross-sectional research has established a relationship between psychache and suicidality, leaving the question of whether or not feelings of psychache actually precede suicidal behaviours unanswered. Two studies were undertaken to increase knowledge on the relationship of depression, hopelessness, and psychache to suicidality. Psychological variables were examined prospectively to allow inferences to be drawn on their causal implications for suicidality. In Study 1, students (n = 1475) completed the Beck Depression Inventory, Beck Hopelessness Scale, Psychache Scale, Beck Scale for Suicide Ideation and provided information about prior suicidal behaviour. Regression analyses revealed that psychache was most strongly associated with suicidality, but that depression and hopelessness still contributed unique variance in the prediction of some suicidal outcomes. In Study 2, a subset of suicide ideators and attempters completed identical materials 10 weeks later (n = 90) and then another 10 weeks after that (n = 56). Again, regression analyses revealed that psychache was most strongly associated with suicidality. When looking at changes over time, dropping one predictor at a time could not overcome problems of multicollinearity, as most models were significant, but with no individual prediction from the factors. Results from models with significant regression coefficients revealed that psychache, hopelessness, and depression may be causes for suicide ideation. Theoretical and practical implications for the statistical prediction of suicide risk are discussed.