Thinking for healing: The role of mentalization deficits as moderator in the link between complicated grief and suicide ideation among suicide-loss survivors
Abstract
Suicide-loss survivors are an at-risk population for complicated grief and suicide ideation. This study examined mentalization deficits as a possible moderator of the association between complicated grief and suicide ideation. Suicide-loss survivors (N = 152) completed questionnaires on complicated grief, suicide ideation, and mentalization deficits. Mentalization deficits facilitated suicide ideation, beyond the contribution of complicated grief. Complicated grief and suicide ideation were more strongly associated at higher mentalization deficit levels. Limitations include the non-representative cross-sectional nature of the sample and the use of a single item for suicide ideation. The findings highlight the critical link between complicated grief and suicide ideation among suicide-loss survivors and mentalization deficits’ role as its possible facilitator.
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The study had adequate statistical power based on an a priori power analysis.
“A priori power analysis [19], conducted using G*Power (version 3.1.9.4) [20], ensured that the statistical power was adequate to obtain statistically significant results.”
Cites
Statistical Power Analysis for the Behavioral Sciences
Muller, K. E., & Cohen, J. (1989) · Technometrics · doi:10.2307/1270020 · Cited by 99,588 · see citing works
Baron, R. M., & Kenny, D. A. (1986) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.51.6.1173 · Cited by 91,532 · see citing works
(2013) · Cited by 44,563 · see citing works
Affect Regulation, Mentalization, and the Development of the Self
Fonagy, P., Gergely, G., Jurist, E. L., & Target, M. (2018) · doi:10.4324/9780429471643 · Cited by 3,886 · see citing works
Applied Multiple Regression/Correlation Analysis for the Behavioral Sciences
Cohen (2013) · doi:10.4324/9780203774441 · Cited by 3,228 · see citing works
Suicide and suicidal behaviour
Turecki, G., & Brent, D. A. (2016) · The Lancet · doi:10.1016/s0140-6736(15)00234-2 · Cited by 2,338 · see citing works
Osman, A., Bagge, C. L., Gutierrez, P. M., Konick, L. C., Kopper, B. A., & Barrios, F. X. (2001) · Assessment · doi:10.1177/107319110100800409 · Cited by 2,276 · see citing works
Inventory of complicated grief: a scale to measure maladaptive symptoms of loss.
Prigerson, H. G., Maciejewski, P. K., Reynolds, C. F., Bierhals, A. J., Newsom, J. T., Fasiczka, A., Frank, E., Doman, J., & Miller, M. (1995) · Psychiatry Research · doi:10.1016/0165-1781(95)02757-2 · Cited by 1,582 · see citing works
Psychotherapy for Borderline Personality Disorder: Mentalization-based treatment
Bateman, A., & Fonagy, P. (2004) · doi:10.1093/med:psych/9780198527664.001.0001 · Cited by 1,460 · see citing works
Mentalizing in Clinical Practice
Allen, J. G., Fonagy, P., & Bateman, A. W. (2008) · doi:10.1176/appi.books.9781615370887 · Cited by 944 · see citing works
Kleiman, E. M., Turner, B. J., Fedor, S., Beale, E. E., Huffman, J. C., & Nock, M. K. (2017) · Journal of Abnormal Psychology · doi:10.1037/abn0000273 · Cited by 831 · see citing works
Fonagy, P., Luyten, P., Moulton-Perkins, A., Lee, Y.-W., Warren, F., Howard, S., Ghinai, R., Fearon, P., & Lowyck, B. (2016) · PLOS ONE · doi:10.1371/journal.pone.0158678 · Cited by 754 · cited 3× · see citing works
“The items were rescored based on a non-linear recoding of the scale responses (to 0–3 values), as described by Fonagy et al. (2016).”
BackgroundMethodInfluentialHandbook of Mentalization‐Based Treatment
(2006) · doi:10.1002/9780470712986 · Cited by 631 · see citing works
Simon, G. E., Rutter, C. M., Peterson, D., Oliver, M., Whiteside, U., Operskalski, B., & Ludman, E. J. (2013) · Psychiatric Services · doi:10.1176/appi.ps.201200587 · Cited by 575 · see citing works
A Current Perspective of Suicide and Attempted Suicide
Mann, J. J. (2002) · Annals of Internal Medicine · doi:10.7326/0003-4819-136-4-200202190-00010 · Cited by 568 · see citing works
Shear, M. K. (2015) · New England Journal of Medicine · doi:10.1056/nejmcp1315618 · Cited by 533 · see citing works
Mechanisms of change in mentalization‐based treatment of BPD
Fonagy, P., & BATEMAN, A. W. (2006) · Journal of Clinical Psychology · doi:10.1002/jclp.20241 · Cited by 448 · see citing works
Latham, A. E., & Prigerson, H. G. (2004) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.34.4.350.53737 · Cited by 448 · see citing works
How Many People Are Exposed to Suicide? Not Six
Cerel, J., Brown, M. M., Maple, M., Singleton, M., van de Venne, J., Moore, M., & Flaherty, C. (2019) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12450 · Cited by 445 · see citing works
Suicide survivors’ mental health and grief reactions: A systematic review of controlled studies
Sveen, C., & Walby, F. A. (2008) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.2008.38.1.13 · Cited by 343 · cited 2× · see citing works
“Adverse reactions may include shame, guilt, stigma, and loneliness (Corrigan et al., 2018; Jordan, 2008; Young et al., 2012), as well as suicide ideation (Sveen & Walby, 2008; Levi-Belz & Aisenberg, 2021).”
BackgroundSuicide bereavement and complicated grief
Tal Young, I., Iglewicz, A., Glorioso, D., Lanouette, N., Seay, K., Ilapakurti, M., & Zisook, S. (2012) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2012.14.2/iyoung · Cited by 291 · see citing works
Batterham, P. J., Ftanou, M., Pirkis, J., Brewer, J. L., Mackinnon, A. J., Beautrais, A., Fairweather-Schmidt, A. K., & Christensen, H. (2015) · Psychological Assessment · doi:10.1037/pas0000053 · Cited by 264 · see citing works
Mentalizing about emotion and its relationship to empathy
Hooker, C. I., Verosky, S. C., Germine, L. T., Knight, R. T., & D’Esposito, M. (2008) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nsn019 · Cited by 239 · see citing works
Ensink, K., Normandin, L., Target, M., Fonagy, P., Sabourin, S., & Berthelot, N. (2015) · British Journal of Developmental Psychology · doi:10.1111/bjdp.12074 · Cited by 238 · see citing works
Murphy, S. A., Johnson, L. C., & Lohan, J. A. (2003) · Death Studies · doi:10.1080/07481180302879 · Cited by 198 · see citing works
The Internal Struggle Between the Wish to Die and the Wish to Live: A Risk Factor for Suicide
Brown, G. K., Steer, R. A., Henriques, G. R., & Beck, A. T. (2005) · American Journal of Psychiatry · doi:10.1176/appi.ajp.162.10.1977 · Cited by 196 · see citing works
Estimating the population of survivors of suicide: Seeking an evidence base
Berman, A. L. (2011) · Suicide and Life-Threatening Behavior · doi:10.1111/j.1943-278x.2010.00009.x · Cited by 190 · cited 1× · see citing works
“Each of these tragic deaths profoundly impacts more than 60 people, defined as suicide-loss survivors (Berman, 2011; Cerel et al., 2019; Feigelman et al., 2018).”
BackgroundComplicated grief and suicidal ideation in adult survivors of suicide.
Mitchell, A. M., Kim, Y., Prigerson, H. G., & Mortimer, M. K. (2005) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.2005.35.5.498 · Cited by 171 · see citing works
Parents Bereaved by Offspring Suicide: A Population-Based Longitudinal Case-Control Study
Bolton, J. M., Au, W., Leslie, W. D., Martens, P. J., Enns, M. W., Roos, L. L., Katz, L. Y., Wilcox, H. C., Erlangsen, A., Chateau, D., et al. (2013) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2013.275 · Cited by 164 · see citing works
Physiological correlates of bereavement and the impact of bereavement interventions
Buckley, T., Sunari, D., Marshall, A., Bartrop, R., McKinley, S., & Tofler, G. (2012) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2012.14.2/tbuckley · Cited by 160 · see citing works
Badoud, D., Luyten, P., Fonseca‐Pedrero, E., D, S. E. M., Fonagy, P., & Debbané, M. (2015) · PLoS ONE · doi:10.1371/journal.pone.0145892 · Cited by 142 · see citing works
Jordan, J. R. (2008) · Psychiatric Annals · doi:10.3928/00485713-20081001-05 · Cited by 127 · see citing works
Feigelman, W. T., Cerel, J., McIntosh, J. L., Brent, D. A., & Gutin, N. J. (2017) · Journal of Affective Disorders · doi:10.1016/j.jad.2017.09.056 · Cited by 120 · see citing works
Teismann, T., Forkmann, T., Brailovskaia, J., Siegmann, P., Glaesmer, H., & Margraf, J. (2018) · International Journal of Clinical and Health Psychology · doi:10.1016/j.ijchp.2017.08.001 · Cited by 120 · see citing works
Parents’ Experiences of Suicide-Bereavement: A Qualitative Study at 6 and 12 Months after Loss
Ross, V. L., Kõlves, K., Kunde, L., & Leo, D. D. (2018) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph15040618 · Cited by 89 · see citing works
Taubner, S., & Curth, C. (2013) · Psihologija · doi:10.2298/psi1302177t · Cited by 79 · see citing works
Revealing, Organizing, and Reorganizing the Self in Response to Stress and Emotion
Pennebaker, J. W., & Keough, K. A. (1999) · doi:10.1093/oso/9780195127300.003.0005 · Cited by 68 · see citing works
Mentalization and depressive symptoms in a clinical sample of adolescents and young adults
Murri, M. B., Ferrigno, G., Penati, S., Muzio, C., Piccinini, G., Innamorati, M., Ricci, F., Pompili, M., & Amore, M. (2016) · Child and Adolescent Mental Health · doi:10.1111/camh.12195 · Cited by 63 · see citing works
Levi‐Belz, Y., & Zerach, G. (2018) · Psychiatry Research · doi:10.1016/j.psychres.2018.08.105 · Cited by 55 · see citing works
Self-citationMentalizing Self and Other and Affect Regulation Patterns in Anorexia and Depression
Rothschild‐Yakar, L., Stein, D. J., Goshen, D., Shoval, G., Yacobi, A., Eger, G., Kartin, B., & Gur, E. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.02223 · Cited by 50 · see citing works
Levi‐Belz, Y., & Ari, L. L. (2019) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000000940 · Cited by 45 · see citing works
Self-citationEmotional distress among suicide survivors: the moderating role of self-forgiveness.
Levi-Belz, Y., & Gilo, T. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.00341 · Cited by 44 · see citing works
Self-citationLevi‐Belz, Y., & Aisenberg-Shafran, D. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.01.006 · Cited by 44 · see citing works
Self-citationGergely, G., & Unoka, Z. (2008) · Oxford University Press eBooks · doi:10.1093/med/9780198569183.003.0011 · Cited by 43 · see citing works
Levi‐Belz, Y., & Ari, L. L. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16193740 · Cited by 41 · see citing works
Self-citationCorrigan, P. W., Sheehan, L. L., Al‐Khouja, M., Lewy, S. A., Major, D. R., Mead, J., Redmon, M., Rubey, C. T., & Weber, S. (2016) · Archives of Suicide Research · doi:10.1080/13811118.2016.1275993 · Cited by 30 · see citing works
Deficits in Mentalization Predict Suicide Risk Among Psychiatric Inpatients
Pompili, M., Innamorati, M., Erbuto, D., et al. (2017) · European Psychiatry · doi:10.1016/j.eurpsy.2017.02.080 · Cited by 9 · see citing works
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Lenzo, V., Sardella, A., Musetti, A., Petralia, M. C., Grado, I., & Quattropani, M. C. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph191911930 · Cited by 10 · see citing works
“A priori power analysis [19], conducted using G*Power (version 3.”
MethodThe relationship between bereavement-related guilt and suicide ideation in Turkish bereaved adults
Keser, E., Çakmakçı, E., Gökmen, F., Şahin, N. E., Akyalçın, R., & Zeybek, S. G. (2025) · Death Studies · doi:10.1080/07481187.2024.2390891 · Cited by 1 · see citing works
- Authors
- Levi-Belz, Y., & Lev-Ari, L.
- Affiliations
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel
- Venue
- Death Studies
- Publisher
- Informa UK Limited
- Published
- 2022-04-21
- Volume
- 47
- Issue
- 3
- Pages
- 360-369
- ISSN
- 0748-1187 (ISSN-L)
- 1091-7683
- OpenAlex
- W4224221950
- Cited by
- 9
- References
- 47
- Citations by year
- 2025: 2 · 2024: 3 · 2023: 1 · 2022: 3
- FWCI
- 2.05
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Death Studies (publishedVersion)
- PubMed (publishedVersion)
- Funders
- American Foundation for Suicide Prevention (PRG-2-083-14)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Social Psychology › Death Anxiety and Social Exclusion
- Keywords
- complicated grief, suicidal ideation, suicide loss survivors, bereavement, moderator effects
- MeSH terms
- Mentalization, Cross-Sectional Studies, Grief, Humans, Survivors, Suicidal Ideation
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