Psychache and Self-Harming Behaviour Among Men Who Are Homeless: a Test of Shneidman's Model

Abstract

Suicidal ideation among the homeless is 10 times greater than in the general population. Therefore, research helping mental health professionals better predict and potentially prevent suicide within the homeless population is an important societal focus. Various cognitive theories of depression and hopelessness have been proposed to explain suicidality, however, to date, none of these are able to fully explain the phenomenon. More recently, Shneidman has suggested a theory of psychache (i.e., unbearable psychological pain) to explain suicidality. Although this theory has been supported by investigations with university students, there has not been much research exploring psychache with populations at high risk for suicide. The current study attempts to assess Shneidman’s theory with a high risk population, namely the homeless. Ninety-seven men were recruited at homeless shelters and drop-in centres. Participants completed questionnaires assessing criterion measures of suicidality and psychological predictors of depression, hopelessness, life meaning, and psychache. Analyses revealed that psychache was the only variable with statistical predictive ability over and above the other three psychological variables in predicting suicide ideation, motivation, preparation, and attempt history. This finding indicates that psychache is a better predictor of suicidality than depression, hopelessness, and life meaning and supports Shneidman’s model of psychache as the most proximal cause of suicide. Results also indicate the potential use of a scale assessing psychache in mental health settings to predict those who are, and are not, at risk for suicide.