Understanding the Relationship between Depression, Hopelessness, Psychache and Suicide Risk

Abstract

Two studies were undertaken to examine the relationship between suicidality and three key psychological predictors of suicide risk, namely, depression, hopelessness, and psychache. Study 1 determined the degree to which these suicide risk predictors are distinct using a sample of undergraduate students (N = 587). Because typical measures of depression, hopelessness, and psychache differ in terms of their scale format, results were compared using original items, dichotomized items, parcels of original items, and parcels of dichotomized items. Exploratory and confirmatory factor analyses indicated that depression, hopelessness, and psychache comprise three separate, but correlated factors. Psychache accounted for a greater proportion of variance in depression and hopelessness than vice versa, and psychache was also more strongly associated with a wider range of suicide criteria than depression and hopelessness, though all three predictors made unique contributions to suicidality. In order to ascertain whether suicide risk predictors interact with stress to predict suicidality, study 2 compared diathesis-stress models of depression, hopelessness, and psychache in a 4-month longitudinal study using an independent sample of university undergraduates (N = 301). When initial levels of all variables were controlled, hopelessness and psychache, but not depression, were significantly associated with suicide risk. Furthermore, negative cognitions about oneself, the world, and the future served as a common diathesis that interacted with major negative life events to precipitate increases in both hopelessness and psychache. Simple slopes analyses further indicated that among individuals with a low level of cognitive diathesis, the frequency of major life stressors was positively associated with both hopelessness and psychache. However, among individuals with a high level of cognitive diathesis, the frequency of major life stressors was negatively associated with hopelessness and unrelated to psychache. Together, the results of the research presented in this dissertation have important implications for understanding the unique roles of depression, hopelessness, and psychache in the prediction of suicide risk.