Suicidal behavior and social cognition: the role of hypomentalizing and fearlessness about death

Background: Suicide attempt (SA) lethality is associated with heightened suicidal desires and social cognition deficits. Fearlessness about death (FAD) and hypomentalizing may play a role in SA and self-harm. Although studies have identified relationships between these constructs, this line of resea...

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Detalhes bibliográficos
Autores: Andreo-Jover, Jorge, Fernández-Jiménez, Eduardo, Bobes, Julio, Cebrià, Ana Isabel, Crespo-Facorro, Benedicto, Torre-Luque, Alejandro de la, Díaz-Marsá, Marina, García-Ramos, Adriana, Grande, Iria, González-Pinto, Ana, Jiménez-Treviño, Luis, Roberto, Natalia, Ruiz-Veguilla, Miguel, Palao-Tarrero, Ángela, Pérez Solà, Víctor
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Recursos:Universitat Pompeu Fabra
Repositorio:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/72420
Acesso em linha:https://hdl.handle.net/10230/72420
http://dx.doi.org/10.7334/psicothema2024.82
Access Level:acceso abierto
Palavra-chave:Suicide attempt lethality
Suicidal ideation
Self-harm
Fearlessness about death
Mentalizing
Social cognition
Descrição
Resumo:Background: Suicide attempt (SA) lethality is associated with heightened suicidal desires and social cognition deficits. Fearlessness about death (FAD) and hypomentalizing may play a role in SA and self-harm. Although studies have identified relationships between these constructs, this line of research is still limited. We aimed to explore the mediating role of FAD and mentalizing between suicidal ideation and both SA lethality and self-harm. Method: 1,371 suicide attempters (70.1% women; M = 40 years) from seven Spanish hospitals participated. We used the Fearlessness About Death (ACSS-FAD) subscale, the Reflective Functioning Questionnaire-8 (RFQ-8), and the Columbia Suicide Severity Rating Scale (CSSRS). We conducted serial multiple mediation analyses with suicidal ideation as exposure; FAD and mentalizing as mediators; SA lethality and self-harm as outcomes. Results: Indirect effects were found of suicidal ideation on self-harm (B = 0.08, CI = 0.03-0.15) and SA lethality mediated by FAD (B = 0.02, CI = 0.001-0.04); indirect effects of suicidal ideation on self-harm through mentalizing (B = 0.10, CI = 0.04-0.167), and total indirect effects between suicidal ideation and self-harm through FAD and mentalizing (B = 0.18, CI = 0.11-0.27). Conclusions: Interventions addressing mentalizing and FAD may help reduce SA lethality and self-harm risk.