Does psychache mediate the relationship between general distress and suicide ideation?
Open accessAbstract
This study evaluated whether psychache (i.e., mental pain) mediates the association between general distress, assessed as the frequency and the intensity of psychological symptoms in the previous week, and suicide ideation in community adults. For a sample of 202 adults, psychache fully mediated the relationship between suicide ideation and the frequency of psychological symptoms, and partially mediated the relationship between suicide ideation and the intensity of psychological symptoms. As such, mental pain fully or partially explains the process linking the frequency and the intensity of general distress to suicide ideation and, thus, mental pain is a target for potential intervention.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Psychological pain mediated the association between frequency of psychological symptoms and suicidal ideation, and partially mediated the relationship between symptom intensity and suicidal ideation in a community sample.
“Campos et al. [18] showed that psychological pain mediated the association between the frequency of psychological symptoms and suicidal ideation, and partially mediated the relationship between symptom intensity and suicidal ideation in a community sample.”
From Targeting Psychological Pain After a Suicide Attempt: Scoping Review and Intervention Protocol (2026) · cites this paper as [18]
Cites
(2013) · Cited by 44,563 · see citing works
Risk factors for suicide in psychiatric outpatients: A 20-year prospective study.
Brown, G. K., Beck, A. T., Steer, R. A., & Grisham, J. R. (2000) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.68.3.371 · Cited by 1,317 · see citing works
Advances in testing the statistical significance of mediation effects.
Mallinckrodt, B. S., Abraham, W. T., Wei, M., & Russell, D. W. (2006) · Journal of Counseling Psychology · doi:10.1037/0022-0167.53.3.372 · Cited by 1,010 · see citing works
Journal of Affective Disorders
Flint, A. J., & Rifat, S. L. (1996) · Journal of Affective Disorders · doi:10.1016/0165-0327(96)00074-2 · Cited by 864 · see citing works
Commentary: Suicide as Psychache
SHNEIDMAN, E. S. (1993) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-199303000-00001 · Cited by 775 · see citing works
IDENTIFICATION OF SUICIDE RISK FACTORS USING EPIDEMIOLOGIC STUDIES
Mościcki, E. K. (1997) · Psychiatric Clinics of North America · doi:10.1016/s0193-953x(05)70327-0 · Cited by 507 · see citing works
Development and preliminary validation of a scale of psychache
Holden, R. R., Mehta, K., Cunningham, E. J., & McLeod, L. D. (2001) · Canadian Journal of Behavioural Science / Revue canadienne des sciences du comportement · doi:10.1037/h0087144 · Cited by 354 · see citing works
Self-citationMental Pain and Suicide: A Systematic Review of the Literature
Verrocchio, M. C., Carrozzino, D., Marchetti, D., Andreasson, K., Fulcheri, M., & Bech, P. (2016) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2016.00108 · Cited by 297 · see citing works
The Harvard Medical School Guide to Suicide Assessment and Intervention
Hughes, D. H. (1999) · Psychiatric Services · doi:10.1176/ps.50.12.1642-a · Cited by 217 · see citing works
Troister, T., & Holden, R. R. (2010) · Personality and Individual Differences · doi:10.1016/j.paid.2010.06.006 · Cited by 175 · see citing works
McAllister, T. W., & Trzepacz, P. T. (1992) · Journal of Neuropsychiatry · doi:10.1176/jnp.4.1.106 · Cited by 119 · see citing works
Psychache and Suicide Ideation among Men Who Are Homeless: A Test of Shneidman’s Model
Patterson, A. A., & Holden, R. R. (2012) · Suicide and Life-Threatening Behavior · doi:10.1111/j.1943-278x.2011.00078.x · Cited by 114 · see citing works
Understanding suicide risk: identification of high‐risk groups during high‐risk times
Overholser, J. C., Braden, A. L., & Dieter, L. (2011) · Journal of Clinical Psychology · doi:10.1002/jclp.20859 · Cited by 110 · see citing works
Troister, T., & Holden, R. R. (2012) · Journal of Clinical Psychology · doi:10.1002/jclp.21869 · Cited by 106 · see citing works
An Evaluation of the Psychache Scale on an Offender Population
Mills, J. F., Green, K., & Reddon, J. R. (2005) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.2005.35.5.570 · Cited by 102 · see citing works
Differentiating Between Depression, Hopelessness, and Psychache in University Undergraduates
DeLisle, M. M., & Holden, R. R. (2009) · Measurement and Evaluation in Counseling and Development · doi:10.1177/0748175609333562 · Cited by 100 · see citing works
Identifying correlates of suicide attempts in suicidal ideators: a population-based study
Brezo, J., Paris, J., Tremblay, R. E., Vitaro, F., Hébert, M., & Turecki, G. (2007) · Psychological Medicine · doi:10.1017/s0033291707000803 · Cited by 96 · see citing works
Troister, T., D’Agata, M. T., & Holden, R. R. (2015) · Psychological Assessment · doi:10.1037/pas0000126 · Cited by 95 · see citing works
Troister, T., & Holden, R. R. (2012) · Measurement and Evaluation in Counseling and Development · doi:10.1177/0748175612451744 · Cited by 83 · see citing works
Campos, R. C., Holden, R. R., Laranjeira, P., Troister, T., Oliveira, A. R., Costa, F., Abreu, M., & Fresca, N. (2016) · Death Studies · doi:10.1080/07481187.2016.1150920 · Cited by 41 · see citing works
Testing a Theory-Based Model of Suicidality in a Community Sample
Campos, R. C., & Holden, R. R. (2016) · OMEGA - Journal of Death and Dying · doi:10.1177/0030222815598428 · Cited by 22 · see citing works
Relationship Between Suicidality and Disability When Accounting for Depressive Symptomology
Lund, E. M., Nadorff, M. R., & Seader, K. (2015) · Rehabilitation Counseling Bulletin · doi:10.1177/0034355215586388 · Cited by 16 · see citing works
Erinfolami, A. R., Olagunju, A. T., Oshodi, Y., Akinbode, A. A., Fadipe, B., & Adeyemo, W. L. (2016) · Mental Illness · doi:10.4081/mi.2016.6006 · Cited by 7 · see citing works
Flagged first, then by citations
1 of the 24 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
The three-step theory of suicide: Description, evidence, and some useful points of clarification
Klonsky, E. D., Pachkowski, M. C., Shahnaz, A., & May, A. M. (2021) · Preventive Medicine · doi:10.1016/j.ypmed.2021.106549 · Cited by 256 · see citing works
Montemarano, V., Troister, T., Lambert, C. E., & Holden, R. R. (2018) · Journal of Clinical Psychology · doi:10.1002/jclp.22639 · Cited by 70 · see citing works
A Brief Measure of Unbearable Psychache
Pachkowski, M. C., May, A. M., Tsai, M. V., & Klonsky, E. D. (2019) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12556 · Cited by 60 · see citing works
Pompili, M., Innamorati, M., Sampogna, G., Albert, U., Carmassi, C., Carrà, G., Cirulli, F., Erbuto, D., Luciano, M., Nanni, M. G., et al. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.09.035 · Cited by 47 · see citing works
Psychache Predicts Suicide Attempter Status Change in Students Starting University
Lambert, C. E., Troister, T., Ramadan, Z., Montemarano, V., Fekken, G. C., & Holden, R. R. (2020) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12624 · Cited by 43 · see citing works
Erbuto, D., Innamorati, M., Lamis, D. A., Berardelli, I., Forte, A., De Pisa, E., Migliorati, M., Serafini, G., Gonda, X., Rihmer, Z., et al. (2018) · Psychiatry · doi:10.1080/00332747.2018.1480251 · Cited by 32 · see citing works
Bao, J., Li, H., Song, W., & Jiang, S. (2020) · Children and Youth Services Review · doi:10.1016/j.childyouth.2020.104744 · Cited by 33 · see citing works
Psychache, unmet interpersonal needs, childhood trauma and suicide ideation in young adults
Spínola, J., Campos, R. C., Marques, D., & Holden, R. R. (2020) · Death Studies · doi:10.1080/07481187.2020.1788670 · Cited by 24 · see citing works
Holden, R. R., Lambert, C. E., Rochelle, M. L., Billet, M. I., & Fekken, G. C. (2020) · Journal of Clinical Psychology · doi:10.1002/jclp.23052 · Cited by 27 · see citing works
Holden, R. R., Patterson, A. A., & Fekken, G. C. (2021) · Personality and Individual Differences · doi:10.1016/j.paid.2021.111414 · Cited by 22 · see citing works
Uğur, K., Demirkol, M. E., & Tamam, L. (2020) · Archives of Suicide Research · doi:10.1080/13811118.2020.1740124 · Cited by 21 · see citing works
Peterson, A. L., Bender, A. M., Sullivan, B., & Karver, M. S. (2021) · Archives of Sexual Behavior · doi:10.1007/s10508-020-01888-4 · Cited by 21 · see citing works
Psychological pain in depressive disorder: A concept analysis
Chen, S., Cheng, Y., Zhao, W., & Zhang, Y. (2022) · Journal of Clinical Nursing · doi:10.1111/jocn.16543 · Cited by 19 · see citing works
Granieri, A., Casale, S., Sauta, M. D., & Franzoi, I. G. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19106167 · Cited by 19 · see citing works
Psychache and Suicidal History in Patients with Obsessive-Compulsive Disorder
Demirkol, M. E., Namlı, Z., Davut, Ö. E., Karaytuğ, M. O., Tamam, L., & Yılmaz, H. (2019) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s237369 · Cited by 18 · see citing works
Preventing comorbidity between distress and suicidality: a network analysis
Junus, A., & YIP, P. S. F. (2023) · npj Mental Health Research · doi:10.1038/s44184-023-00022-1 · Cited by 17 · see citing works
Campos, R. C., Holden, R. R., & Santos, S. (2017) · Journal of Clinical Psychology · doi:10.1002/jclp.22518 · Cited by 13 · see citing works
Faure, M. I., Urquidi, C., Bustamante, F., Florenzano, R. U., Ampuero, K., Terán, L., Figueroa, M. I., Farías, M., Rueda, M. L., & Giacaman, E. (2018) · Revista chilena de pediatría · doi:10.4067/s0370-41062018005000103 · Cited by 12 · see citing works
Martins, L. C., Campos, R. C., & Morujão, I. S. (2021) · British Journal of Clinical Psychology · doi:10.1111/bjc.12338 · Cited by 13 · see citing works
Bao, J., Wan, J., Li, H., & Sun, F. (2024) · Acta Psychologica · doi:10.1016/j.actpsy.2024.104271 · Cited by 10 · see citing works
Yeşiloğlu, C., Tamam, L., Demirkol, M. E., Namlı, Z., & Karaytuğ, M. O. (2023) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s430139 · Cited by 10 · see citing works
Validity and Reliability Study of the Turkish Version of the Unbearable Psychache Scale
Namlı, Z., Demirkol, M. E., Tamam, L., Karaytuğ, M. O., & Yeşiloğlu, C. (2022) · ALPHA PSYCHIATRY · doi:10.5152/alphapsychiatry.2022.21604 · Cited by 9 · see citing works
Psychological pain: A moderating factor between personality psychopathology and self-harm
Davis, K. C., & Anderson, J. L. (2021) · Journal of American College Health · doi:10.1080/07448481.2021.1928677 · Cited by 8 · see citing works
Chen, S.-Y., Bian, C., Cheng, Y., Zhao, W.-W., Yan, S.-R., & Zhang, Y.-H. (2023) · BMC Nursing · doi:10.1186/s12912-023-01252-6 · Cited by 6 · see citing works
Sun, G., Liu, Z., Ma, Z., Lew, B., & Jia, C.-X. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.928666 · Cited by 7 · see citing works
Junus, A., & YIP, P. S. F. (2023) · Journal of Affective Disorders · doi:10.1016/j.jad.2023.11.060 · Cited by 7 · see citing works
Jin, T., Lei, Z., Zhang, L., & Wu, Y. (2021) · OMEGA - Journal of Death and Dying · doi:10.1177/00302228211048960 · Cited by 6 · see citing works
Xue, S., Lu, A., Zhu, K., Chen, J., Li, X., Wang, X., & Liang, Y. (2025) · Journal of Adolescence · doi:10.1002/jad.70002 · Cited by 5 · see citing works
Suicide Ideation, Distress, and Peer Perceptions as Predictors of Substance Use
O’Loughlin, C. M., Park, Y., & Ammerman, B. A. (2023) · Substance Use & Misuse · doi:10.1080/10826084.2023.2177964 · Cited by 5 · see citing works
Mo, Y., Lei, Z., Chen, M., Deng, H., Liang, R., Yu, M., & Huang, H. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1287891 · Cited by 5 · see citing works
Mental health utilization among veterans at risk for suicide: Data from a post-deployment clinic.
Miller, S. N., Monahan, C. J., Phillips, K. M., Agliata, D., & Gironda, R. J. (2018) · Psychological Services · doi:10.1037/ser0000311 · Cited by 5 · see citing works
Innamorati, M., Erbuto, D., Rogante, E., Sarubbi, S., Trocchia, M. A., Cifrodelli, M., Migliorati, M., Comparelli, A., Berardelli, I., & Pompili, M. (2025) · BMC Psychiatry · doi:10.1186/s12888-025-06482-3 · Cited by 5 · see citing works
Boye, C. M., Botor, N. J. B., Tuliao, A. P., & Webb, J. R. (2024) · Journal of Ethnicity in Substance Abuse · doi:10.1080/15332640.2024.2366965 · Cited by 5 · see citing works
Ohenewa, E., & Meyer‐Weitz, A. (2024) · Advances in Mental Health · doi:10.1080/18387357.2024.2389296 · Cited by 4 · see citing works
Keshky, M. E. S. E., & Alghanami, B. H. (2025) · Psychology in the Schools · doi:10.1002/pits.23408 · Cited by 5 · see citing works
Liang, M., Xu, H., Jiang, Q., & Liu, T. (2025) · BMC Psychiatry · doi:10.1186/s12888-025-07130-6 · Cited by 3 · see citing works
Risk and protective factors for suicidal ideation among Saudi adolescents: A network analysis
Keshky, M. E. S. E. (2024) · International Journal of Social Psychiatry · doi:10.1177/00207640241277164 · Cited by 3 · see citing works
Targeting Psychological Pain After a Suicide Attempt: Scoping Review and Intervention Protocol
Comendador, L., Palao, D. J., Sanz, A., Andreo-Jover, J., Baca-García, E., Barrigón, M. L., Bobes-Bascarán, M. T., Botí, M. Á., Diaz-Marsá, M., Elices, M., et al. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15083124 · Cited by 2 · see citing works
Suicide as a By-Product of “Pain and Brain”
Soper, C. A. (2018) · Evolutionary psychology · doi:10.1007/978-3-319-77300-1_3 · Cited by 2 · see citing works
Campos, R. C., Holden, R. R., & PEREIRA, A. M. (2021) · Minerva Psychiatry · doi:10.23736/s2724-6612.21.02147-6 · Cited by 2 · see citing works
Estudos de Validação da Tolerance for Mental Pain Scale-10 (TMPS-10) para a População Portuguesa
Campos, R. C., Martins, L. C., & Passos, B. (2023) · Revista Iberoamericana de Diagnóstico y Evaluación - e Avaliação Psicológica · doi:10.21865/ridep68.2.07 · Cited by 1 · see citing works
Holden, R. R., D’Agata, M. T., & Peter, E. L. (2024) · Psychological Reports · doi:10.1177/00332941241308498 · Cited by 1 · see citing works
Bungaro, N., Dattilo, L., Innamorati, M., Balsamo, M., Blandizzi, C., Alessio, C., Vincenzo, F. D., Quinto, R. M., Genova, F., Contardi, A., et al. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1676675 · Cited by 1 · see citing works
Hong, X., Ma, Y., Xue, L., & Chen, L. (2026) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.70073 · Cited by 1 · see citing works
Mental Pain in People With Bipolar Disorder Hospitalized in a Psychiatric Hospital in Tehran, Iran
Alvandi, S., Mardani‐Hamooleh, M., Ghasemi, F., Esmaeeli, N., & Haghani, S. (2022) · Iran Journal of Nursing · doi:10.32598/ijn.35.2.764.28 · Cited by 1 · see citing works
Suicide in Younger and Older Adults : A Comparison of Two Theoretical Models for Suicide
Gunn, & John, F. N. (2019)
Cubela, B., Hansson, T., & Rydergård, T. (2008) · Gothenburg University Publications Electronic Archive (Gothenburg University)
Cheng, X., Bu, H., & Duan, W. (2020) · doi:10.21203/rs.3.rs-15815/v1
Cheng, X., Bu, H., & Duan, W. (2020) · doi:10.21203/rs.3.rs-18833/v1
زيد, أ. م. ج. ا. أ. (2023) · مجلة الإرشاد النفسی · doi:10.21608/cpc.2023.316493
Wu, C., Bai, X., Peng, X., Huang, T., & Zhu, X. (2023) · OMEGA - Journal of Death and Dying · doi:10.1177/00302228231221844
Gimelfarb, Y., & Cojocaru, D. (2024) · Educatia 21 · doi:10.24193/ed21.2024.28.34
Mental Pain and Psychological Correlates in Individuals With Gender Dysphoria
Faldi, M., Tarchi, L., Cassioli, E., Rossi, E., Ristori, J., Fisher, A. D., Stanghellini, G., Ricca, V., & Castellini, G. (2026) · International Journal of Social Psychiatry · doi:10.1177/00207640251409842
Peng, J.-X., Bai, L.-F., Xue, T., & Tian, J.-Q. (2026) · World Journal of Psychiatry · doi:10.5498/wjp.120630
Risk and protective factors of psychological pain using machine learning
Yıldırım, M., Öztekin, G. G., Başaran, E., Çağış, Z. G., & Gómez-Salgado, J. C. (2026) · Acta Psychologica · doi:10.1016/j.actpsy.2026.107812
- Authors
- Campos, R. C., Gomes, M., Holden, R. R., Piteira, M., & Rainha, A.
- Affiliations
- University of Évora (PT)
- Queen's University (CA)
- Corresponding author
- Campos, Rui C.
- Venue
- Death Studies
- Publisher
- Informa UK Limited
- Published
- 2016-11-08
- Volume
- 41
- Issue
- 4
- Pages
- 241-245
- ISSN
- 0748-1187 (ISSN-L)
- 1091-7683
- OpenAlex
- W2551266856
- Cited by
- 55
- References
- 24
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 6 · 2023: 9 · 2022: 5 · 2021: 8 · 2020: 7 · 2019: 3 · 2018: 5 · 2017: 1
- FWCI
- 4.01
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- other-oa
- Locations
- Death Studies (publishedVersion)
- PubMed (publishedVersion)
- Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion, other-oa)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Social Psychology › Death Anxiety and Social Exclusion
- Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
- Keywords
- emotional pain, psychological suffering, suicidal ideation, general distress, psychological symptoms, symptom frequency, symptom intensity, mediation, community-dwelling adults
- MeSH terms
- Suicide Prevention, Adolescent, Adult, Aged, Female, Humans, Male, Middle Aged, Models, Psychological, Pain, Surveys and Questionnaires, Risk Factors, Stress, Psychological, Suicide, Young Adult, Suicidal Ideation
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
