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Cited by 17Suicide and Self-Harm StudiesTreatment of Major DepressionElectroconvulsive Therapy Studies

Prospective association of psychological pain and hopelessness with suicidal thoughts

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Ballard, Elizabeth D., Farmer, Cristan A., Gerner, Jessica, Bloomfield-Clagett, Bartholt, Park, Lawrence T., Zarate, Carlos A.·2022·Journal of Affective Disorders
DOI 10.1016/j.jad.2022.04.033PMC PMC9133160
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Abstract

Background Early markers preceding suicide ideation (SI) may provide valuable information for both assessment and treatment. The glutamatergic modulator ketamine has rapid, transient effects on SI, creating an opportunity to observe potential antecedents of the re-emergence of SI. This analysis evaluated whether the interaction between two suicide risk factors-psychological pain and hopelessness-were prospectively associated with SI post-ketamine administration. Methods Data were drawn from three ketamine clinical trials of participants with treatment-resistant major depressive disorder or bipolar disorder (n = 108) with short- and/or long-term follow-up (three or 11 days). A random intercept cross-lagged panel model evaluated the longitudinal relationship between the correlated concepts, specifically whether the interaction between hopelessness and psychological pain was associated with future SI. Results Psychological pain and hopelessness were not prospectively associated with SI in short-term or long-term analyses; rather, long-term analyses found that SI was associated with later psychological pain and hopelessness. Similarly, no relationship was observed for other suicide risk factors, including anhedonia, depressed mood, and impaired sleep. Limitations Secondary analysis of clinical trial data not collected for this purpose; hopelessness and psychological pain were assessed via proxy measures from existing depression rating scales; the small sample size required a restricted statistical model. Conclusions Psychological pain and hopelessness were not associated with the re-emergence of SI post-ketamine. These results may be due to limited variability in the data. The re-emergence of SI post-ketamine may also not follow patterns typically seen in non-pharmacologic contexts. Individuals with a history of SI warrant careful monitoring post-ketamine administration.

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  • Psychological pain and hopelessness prospectively predicted suicidal thoughts.

    “Ballard et al. [17] found that psychological pain and hopelessness prospectively predicted suicidal thoughts”

    From Targeting Psychological Pain After a Suicide Attempt: Scoping Review and Intervention Protocol (2026) · cites this paper as [17]

    The Abstract’s Results state the opposite: psychological pain and hopelessness were not prospectively associated with suicidal ideation in either short- or long-term analyses. The Discussion likewise says their interaction was not prospectively associated with next-day suicidal ideation after ketamine. (LLM, conf=0.95)

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Research works printed but not linked: 2

  1. Hallensleben N, Spangenberg L, Forkmann T, Rath D, Hegerl U, Kersting A, Kallert TW, Glaesmer H, 2018. Investigating the dynamics of suicidal ideation. Crisis 39, 65– 69. 28468557
  2. Shneidman ES, 1993. Suicide as psychache. J Nerv Ment Dis 181, 145– 147. 8445372

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Authors
Ballard, E. D., Farmer, C. A., Gerner, J., Bloomfield-Clagett, B., Park, L. T., & Zarate, C. A.
Affiliations
National Institutes of Health (US)
Corresponding author
Ballard, Elizabeth D.
ORCID
Venue
Journal of Affective Disorders
Publisher
Elsevier BV
Published
2022-07
Volume
308
Pages
243-248
ISSN
0165-0327 (ISSN-L)
DOI
10.1016/j.jad.2022.04.033
PMC
PMC9133160
OpenAlex
W4223901669
Cited by
16
References
36
Citations by year
2026: 1 · 2025: 5 · 2024: 1 · 2023: 7 · 2022: 2
FWCI
3.19
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Affective Disorders (acceptedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
Keywords
suicidal ideation, psychological suffering, hopelessness, ketamine, treatment-resistant depression, bipolar disorder, suicide risk factors, anhedonia, depressive mood
MeSH terms
Major Depressive Disorder, Humans, Ketamine, Pain, Suicidal Ideation, Depressive Disorder, Treatment-Resistant

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