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. / Thesis (Master, Psychology) -- Queen's University, 2009-09-23 20:46:04.812

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. / Thesis (Master, Psychology) -- Queen's University, 2013-03-20 10:53:20.277

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. / Thesis (Ph.D, Psychology) -- Queen's University, 2007-12-14 17:09:43.918 / Social Sciences and Humanities Research Council

Suicide takes the lives of over 3,500 Canadians each year, making prevention an important public health concern. Identifying psychological predictors of suicide risk is essential because these variables may be amenable to change in treatment, unlike demographic or historical factors. Although past research reveals that both hopelessness and depression are moderately strong predictors of suicidal outcomes, neither one of these constructs alone, or combined, is able to fully account for suicidality. Shneidman postulated that a different psychological construct, termed psychache, is a unique predictor of suicide when controlling for depression and hopelessness, and research has supported this assertion. Although evidence for psychache as a predictor of suicidal outcomes is accumulating, previous research has limitations, namely the use of cross-sectional research and a focus on healthy student populations. In addition, it has been suggested that because scales measuring depression, hopelessness, and psychache correlate highly, they are not distinct constructs, but instead represent a single syndrome. The general purpose of the current studies is to establish the importance of psychache as a predictor of suicidal ideation. In order to address past limitations in the literature on psychache, three related studies were conducted. The first study was cross-sectional and examined a general group of undergraduate students. Factor analysis showed that psychache, depression, and hopelessness are three correlated, but distinct, variables. The second study was a longitudinal study where self-report measures were administered to high-risk undergraduate students. A two-year follow-up revealed that psychache was the only significant predictor of suicidal ideation at follow-up, and that its inclusion rendered the predictive value of depression and hopelessness to nonsignificant levels. The final study involved two groups of undergraduates and was a longitudinal study with a five-month follow-up. One group was a general university sample, and the other was a group of high-risk students. The two groups were analyzed separately, but showed almost identical results, lending support to the generalization of results from university samples to clinical samples. In addition, for each group, psychache was a unique predictor of suicidal ideation and suicide preparation, after controlling for depression and hopelessness. Overall, these studies suggest that psychache is distinct from depression and hopelessness, and is a better predictor of suicidality than depression or hopelessness when studied longitudinally in both general and high-risk undergraduate students. The findings also indicate congruence between low and high-risk samples, highlighting the generalizability of psychache as a predictor. This research has implications for the assessment of suicide risk and treatment for individuals experiencing suicidal ideation. It is hoped that these studies will help bring psychache forward as a pre-eminent risk factor alongside depression and hopelessness. / Thesis (Ph.D, Psychology) -- Queen's University, 2014-04-26 12:13:48.797

Spirituality is a multifaceted construct, and often studied as a one- or two-dimensional variable. Recent work has resulted in the development of the RiTE model of spirituality. While preliminarily supported as a useful approach to measuring spirituality, little is known regarding its associations with other outcomes. Past studies have shown inverse associations between spirituality and psychological distress, which appears to be partially a function of social support derived from spiritual beliefs or practices. As such, the present study tested the relationship between the RiTE dimensions and psychache as mediated by multiple types of social support. Parallel mediation results from an undergraduate sample (N = 1994) showed that all three RiTE dimensions were indirectly associated with psychache via multiple forms of social support. Ritualistic and existential spirituality also displayed direct associations with psychache. Implications of these findings are discussed in the context of past literature, applicable theoretical constructs, and treatment considerations.

Although female inmates are considered to be the population who are at high risk of committing suicide, little attention has been paid to this field, since most of suicide in correctional facilities are typically committed by males. This paper attempted to investigate some psychological factors which may affect female inmates’ suicidal ideation. Specifically, this paper focused on the role of psychache, intense and chronic psychological pain which leads to suicide. The data was collected from 95 female inmates in two Canadian prisons. The results indicated that psychache was the only factor which predicted the participants’ level of suicidal ideation. Therefore, it is suggested that the screening tools which focus on psychache will be useful in examining the inmates’ risk of suicide. Also, it shows that for the successful rehabilitation, providing the treatment which precisely addresses psychache among inmates is important.

Approximately 22% of households in the U.S. have at least one child living with a disability. Due, in part, to being overwhelmed by caregiving challenges, parents may report experiencing a deep and unbearable psychological pain (i.e., psychache), characterized by despair, anguish, and hopelessness. Yet, risk for distress may be lessened by seeking and accepting social support (e.g., parenting advice). Spiritual coping (e.g., prayer) may also be beneficial, encouraging meaning-making and better psychological adjustment. Availability of social and religious support may also indirectly affect distress by encouraging self-forgiveness. For example, social feedback and support could minimize self-blame for a child’s diagnosis or self-criticism for perceived parental shortcomings. Through spiritual connections, forgiveness of God may manifest, promoting perception of the child as a “blessing” or opportunity for growth, rather than a punishment (e.g., “why me?”). As such, we examined the potential mediating effect of forgiveness in the association of coping styles and psychache among parents of children with disabilities. At the bivariate level, we hypothesized that coping styles (i.e., social and spiritual support) and types of forgiveness (i.e., of God and self) would be positively related, and that all would be negatively related to psychache. At the multivariate level, we hypothesized that types of forgiveness (included in same model) would mediate the associations of coping styles and psychache, such that higher levels of seeking social or spiritual support would be associated with greater forgiveness of the self and God and, in turn, less psychache. Parents raising children with physical or developmental disabilities (n=253) were recruited from support groups and organizations, and social media websites. Our sample was predominantly mothers (n=203; 80.2%), White (n=186; 73.5%), and married (n=172; 68%). Participants completed self-report measures including: Family Crisis Oriented Personal Scales, Fetzer Multidimensional Measurement of Religiousness/Spirituality, a one-item measure of forgiveness of God, and the Psychache Scale. Bivariate correlations and mediation analyses, per Hayes (2013), were conducted, covarying age, race, and type of guardian (e.g., mother or father). At the bivariate level, hypotheses were supported; all variables were significantly related to one another in the hypothesized directions (p < .05). Multivariate hypotheses were also supported; there was a significant total effect between seeking social support and psychache (t=-3.13, p=.002; 95% CI[-.533, -.121]) and a nonsignificant direct effect (t=-1.35, p=.18; 95% CI[-.302, .057]) when types of forgiveness were added to the model, indicating mediation. Additionally, there was a significant total effect for the association of spiritual coping and psychache (t=-3.24, p=.002; 95% CI[-.813, -.197]), and the direct effect fell out of significance when forgiveness was accounted for (t=-1.13, p=.26; 95% CI[-.448, .121]), indicating mediation. In sum, coping through pursuit of both social and spiritual support was associated with greater self-forgiveness and forgiveness of God and, in turn, to lower risk for psychache. Therapeutic interventions may include community support groups (e.g., health information from providers; connect to other families) or collaborations between psychologists and spiritual leaders. Existential therapy and self-forgiveness activities (e.g., loving-kindness meditation) may also be beneficial for alleviating distress among parents raising children with disabilities.

Studies on forgiveness and its relationship to substance abuse have consistently found salutary associations between the two, yet empirical investigation of variables that may serve as mediating factors in this relationship is in need of more attention. With recent models positing psychological distress as a key component of the forgiveness-substance abuse association, constructs such as psychache, depression, and hopelessness may be likely candidates as mediators of this relationship. As such, cross-sectional, self-report data from 577 undergraduate students was used to perform multiple mediation analyses on the relationship of three dimensions of forgiveness (i.e., of self, of others, of uncontrollable situations) with two substance use outcomes (i.e., problematic alcohol use and problematic drug use), as mediated by psychache, depressive symptoms, and hopelessness. Results indicated that forgiveness of self and forgiveness of uncontrollable situations were associated with lower levels of psychological distress and fewer substance use problems, whereas forgiveness of others was associated with greater levels of psychological distress and more substance use problems. Psychache and depressive symptoms, but not hopelessness, played a role in the forgiveness–substance use problems association. Implications of these findings are discussed, particularly in the context of the self-medication hypothesis.

Research has long documented beneficial associations between forgiveness and numerous health outcomes; however, its relationship to suicidal behavior has been relatively neglected. Both cynicism, and psychache, or agonizing psychological pain, have displayed deleterious associations with suicidal behavior, but have rarely been incorporated into more comprehensive models of suicidal behavior. Recent work has resulted in the development of a theoretical model of the forgiveness-suicidal behavior association, which can incorporate several mediator variables including cynicism and psychache. The present study used an undergraduate sample of college students (N = 312) to test a serial mediation model of the cross-sectional associations between forgiveness, cynicism, psychache, and suicidal behavior. Forgiveness of self and of uncontrollable situations were indirectly associated with suicidal behavior via psychache, while forgiveness of others was indirectly associated via cynicism and psychache in serial fashion. Implications in the context of previous literature and treatment, particularly acceptance-based interventions, are discussed.

Les conduites suicidaires (CS) sont considérées comme des entités pathologiques à part entière avec une neurobiologie propre, abordées selon un modèle stress-vulnérabilité et pouvant bénéficier de la recherche de biomarqueurs. Nous proposons l'ébauche d'un modèle clinico-biologique de la vulnérabilité aux CS en considérant la douleur au coeur du processus suicidaire. Les stress psychosociaux sont sources de douleur psychologique. Leur maintien ou leur émergence perpétuerait ou majorerait la douleur psychologique via un dysfonctionnement du système vasopressinergique et des régions cérébrales impliqués dans les cognitions sociales. Nos données suggèrent une modification du seuil douloureux chez les sujets vulnérables pour le suicide qui percevraient une douleur psychologique accrue, associée aux idées suicidaires. Aussi les difficultés interpersonnelles sont associées une altération de prise de décision sous tendue par un dysfonctionnement du cortex préfrontal, associé à la vulnérabilité suicidaire. Ceci entrainerait le sujet à favoriser un choix (suicide) associé à une récompense immédiate (sédation de la douleur), même s'il est associé à les conséquences délétères (mort). Ainsi la douleur psychologique serait centrale dans les CS en tant que conséquence immédiate des stress psychosociaux, et en influençant les facteurs de vulnérabilité, qui favorisent sa perception et augmentent la sensibilité à certains événements sociaux via des processus neuroanatomiques et biochimiques. Nos travaux ouvrent de nouvelles voies de compréhension physiopathologiques et permettent d'envisager la douleur psychologique comme une potentielle cible thérapeutique de prévention suicidaire. / Current knowledge suggests that suicidal behavior: 1) are pathological entities per se, with a specific neurobiology, 2) may be studied according to a stress-diathesis model, 3) may be better characterized by identifying biomarkers. Emphasizing that pain is the core of the suicidal process, we propose an outline of a model of suicide based on clinical neuropsychological and neuroimaging data. Psychosocial stressors cause psychological pain. Through dysfunctional vasopressinergic system and cerebral regions involved in social cognitions, psychosocial stress would be maintained or give rise to new stresses, perpetuating or increasing psychache. We suggest a modification of pain thresholds in vulnerable subjects for suicide leading to an increased perception of psychache, which is associated with suicidal ideation. Then, interpersonal difficulties are associated with impaired decision-making underpinned by prefrontal dysfunction that has been associated with suicidal vulnerability. This would cause the subject to promote a choice (suicide) associated with immediate reward (pain relief), although it is associated with deleterious consequences (death). Thus, psychological pain is central to suicidal behavior as an immediate consequence of psychosocial stressors, and influencing the suicidal vulnerability favoring pain perception and increasing susceptibility to social events, based on neuroanatomical and biochemical bases. Finally the hypothesis that a change of pain perception is involved in the suicidal process would open new avenues for understanding suicidal pathophysiology. It allows considering the psychological pain as a potential therapeutic target to prevent suicide