The suicide crisis syndrome: A network analysis.
Abstract
Recent studies introduced the suicide crisis syndrome (SCS), a condition associated with imminent suicidal behavior and characterized by (a) a pervasive feeling of entrapment in which the escape from an unbearable life situation is perceived as both urgent and impossible (Criterion A) and (b) affective disturbance, loss of cognitive control, hyperarousal, and social withdrawal (Criterion B). The goal of the present study was to use some of the analytic tools provided by network analyses to further the understanding of the psychological, emotional, cognitive, behavioral, and physiological processes involved in the SCS by testing (a) whether the different symptoms of the proposed syndrome are related to each other, (b) whether symptoms form meaningful clusters, and (c) whether certain symptoms are more central than others. The study included 500 outpatient and 223 inpatient participants. A network analysis of the participants' scores on the various symptoms of the SCS was conducted. The network analysis suggested that most SCS symptoms are linked by strong connections and that entrapment and ruminative flooding are highly correlated with the other SCS symptoms. Three clusters of symptoms were identified, suggesting the existence of several interdependent psychological processes potentially involved in SCS phenomenology. Our findings support both the suggested symptoms of the SCS and the central role of entrapment in the proposed criteria for the syndrome. Emotional pain appears…
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Cohen et al. (2021) found both the Suicide Narrative and the SCS to mediate each other's effect on suicidal ideation and behavior 4-8 weeks later.
“In line with their analysis of concurrent suicidal ideation and behavior (see above), Cohen et al. (2021) found both the Suicide Narrative as well as the SCS to mediate each other's effect on suicidal ideation and behavior 4-8 weeks later (see also Bloch-Elkouby, Gorman, Schuck, et al., 2020).”
From Suicide Crisis Syndrome: A systematic review (2024) · cites this paper as Bloch-Elkouby, Gorman, Schuck, et al., 2020
Differentiation between SCS and posttraumatic stress disorder might be of special importance due to possible symptom overlap: hypervigilance is both a criterion of the SCS and PTSD, the SCS loss of cognitive control cluster might overlap with intrusion symptoms in PTSD, and the SCS affective disturbance cluster might overlap with negative alterations in cognitions and mood seen in PTSD.
“With regard to the latter the differentiation between SCS and posttraumatic stress disorder (PTSD) might be of special importance due to possible symptom overlap (Bloch-Elkouby, Gorman, Schuck, et al., 2020): hypervigilance is both a criterion of the SCS and PTSD, the SCS loss of cognitive control cluster might overlap with intrusion symptoms in PTSD, and the SCS affective disturbance cluster”
From Suicide Crisis Syndrome: A systematic review (2024) · cites this paper as Bloch-Elkouby, Gorman, Schuck, et al., 2020
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Self-citation
- Authors
- Bloch-Elkouby, S., Gorman, B., Schuck, A., Barzilay, S., Calati, R., Cohen, L. J., Begum, F., & Galynker, I.
- Affiliations
- Adelphi University (US)
- Icahn School of Medicine at Mount Sinai (US)
- ORCID
- Venue
- Journal of Counseling Psychology
- Published
- 2020-10
- Volume
- 67
- Issue
- 5
- Pages
- 595-607
- ISSN
- 0022-0167 (ISSN-L)
- 1939-2168
- OpenAlex
- W3017067583
- Cited by
- 79
- References
- 0
- Citations by year
- 2026: 9 · 2025: 15 · 2024: 12 · 2023: 16 · 2022: 11 · 2021: 11 · 2020: 4
- FWCI
- 4.17
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Counseling Psychology (publishedVersion)
- PubMed (publishedVersion)
- BOA (University of Milano-Bicocca) (submittedVersion)
- Funders
- Association for Suicide Prevention (RFA-1-015-14)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- suicide crisis syndrome, suicidal behavior, entrapment, emotional pain, symptom networks, symptom clusters, hyperarousal, social withdrawal, cognitive control, mood disorders, suicide risk
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Mental Disorders, Female, Humans, Male, Middle Aged, Motivation, Psychometrics, Suicide, Suicide, Attempted, Syndrome, Young Adult, Self Report, Suicidal Ideation
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