Cited by 775Suicide and Self-Harm StudiesPsychological Treatments and DisordersMental Health and Psychiatry

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Commentary: Suicide as Psychache

SHNEIDMAN, EDWIN S.·1993·The Journal of Nervous and Mental Disease

DOI 10.1097/00005053-199303000-00001

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Italian validation of the Orbach and Mikulincer Mental Pain Scale-8 (OMMP-8)
Landi, G., Boccolini, G., Chinali, G., Grandi, S., & Tossani, E. (2025) · Annals of General Psychiatry · doi:10.1186/s12991-025-00584-8 · Cited by 1
“As originally highlighted by Shneidman [6, 53], mental pain is not only significantly correlated with suicide but is considered its primary driver.”
The Impact of Suicide on Clinical Teams: Exploring the Needs of Mental Health Professionals
Morales-Silva, S. (2025) · Depression and personality · doi:10.1007/978-3-031-96037-6_11
On the Psychodynamics of Suicidal Behaviors
Campos, R. C. (2025) · Depression and personality · doi:10.1007/978-3-031-96037-6_3
References
Eswaran, M. (2025) · Open Book Publishers · doi:10.11647/obp.0477.11
7. Some Adverse Effects of Historical Trauma on Indigenous Communities
Eswaran, M. (2025) · Open Book Publishers · doi:10.11647/obp.0477.07
The Economics of Cultural Loss
Eswaran, M. (2025) · Open Book Publishers · doi:10.11647/obp.0477
5. Indigenous Historical Trauma in the North American Context
Eswaran, M. (2025) · Open Book Publishers · doi:10.11647/obp.0477.05
10. Some Concluding Thoughts
Eswaran, M. (2025) · Open Book Publishers · doi:10.11647/obp.0477.10
Foreword
Trosper, R. L. (2025) · Open Book Publishers · doi:10.11647/obp.0477.00
8. The Consequences for Indigenous Deaths of Despair
Eswaran, M. (2025) · Open Book Publishers · doi:10.11647/obp.0477.08
6. An Economic Model to Capture Effects of Historical Trauma
Eswaran, M. (2025) · Open Book Publishers · doi:10.11647/obp.0477.06
3. Incorporating Cultural Belongingness
Eswaran, M. (2025) · Open Book Publishers · doi:10.11647/obp.0477.03
9. Indigenous Survivance
Eswaran, M. (2025) · Open Book Publishers · doi:10.11647/obp.0477.09
4. The Failure of the Dawes’ Act in America and Canadian Attempts to Privatize Indigenous Reserves
Eswaran, M. (2025) · Open Book Publishers · doi:10.11647/obp.0477.04
Introduction
Eswaran, M. (2025) · Open Book Publishers · doi:10.11647/obp.0477.01
Preface
Eswaran, M. (2025) · Open Book Publishers · doi:10.11647/obp.0477.12
2. A Simple Economic Model of an Indigenous Community
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Comparative Investigation of the Predictive Utility of the Variables of Ideation-to-Action Framework Theories in the Development of Suicidal Ideation Among Iranian Adolescents
Khishe, R., Sardarzehi, R., Vand, H. D. A., Bastami, M., Fayazmanesh, H., & Yaztappeh, J. S. (2025) · international journal high risk behaviors & addiction · doi:10.5812/ijhrba-160948
The unity of depression
Boissard, É. (2025) · Philosophical Psychology · doi:10.1080/09515089.2025.2562056
Examining suicidal ideation through the Three-Step Theory: a focus on pain, hopelessness, and meaning in life in a Malaysian sample
Ng, J. S., Siau, C. S., & Ooi, P. B. (2025) · Counselling Psychology Quarterly · doi:10.1080/09515070.2025.2576009 · Cited by 2
Differential patterns of daily trauma-related avoidance among suicide attempters and non-attempters
Albanese, B. J., Porro, D., Johnson, D., Berry, A., Clausen, B. K., & Schmidt, N. B. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.120554
Psychological Mechanisms and Intervention Strategies of Non-Suicidal Self-Injury Behavior among Junior High School Students in Overseas Chinese Towns
赵, 雨. (2025) · Advances in Psychology · doi:10.12677/ap.2025.1511573
Basic Psychological Needs, Entrapment, Conflict Resolution, and Mental Pain in Young Adults: The Moderating Role of Ego Strength
Heidarisoodjani, A., Khodarahimi, S., Bahadivand, A. H., Bougar, M. R., Sharifi, M., & Moradi, S. (2025) · The Journal of Psychology · doi:10.1080/00223980.2025.2586213
“…of theoretical literature and studies regarding the impact of basic psychological needs, entrapment, conflict resolution, and ego strength on mental pain (Fleming, 2008; Long et al., 2022; Murray, 1938; Ordóñez-Carrasco et al., 2020; Shneidman, 1996, 1993; Vierl et al., 2023; Writer, 2024).”
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References
(2025) · Emerald Group Publishing Limited eBooks · doi:10.1108/978-1-83708-380-020251010
Exkurs: Theorien zur Erklärung von Suizid
Michel, K. (2025) · Springer eBooks · doi:10.1007/978-3-662-71653-3_6
Unter hohem emotionalem Stress verlieren wir das Gefühl unserer Identität
Michel, K. (2025) · Springer eBooks · doi:10.1007/978-3-662-71653-3_8
Predicting Suicide Ideation Among College Students in Karnataka Using Machine Learning
Jahan, N. F., Mithun, D. J., & Abhilash, K. (2025) · Lecture notes in networks and systems · doi:10.1007/978-3-032-05545-3_2
EEG Power Spectral Signatures of Looming Vulnerability Style in Individuals with a Recent Suicide Attempt
Bayat, M., Malakouti, K., Rasouli, N., Khosrowabadi, R., Riskind, J. H., Moradkhani, S., & Jafadideh, A. T. (2025) · Archives of Suicide Research · doi:10.1080/13811118.2025.2597354
“We interpret this increase as reflecting heightened motor inhibition demands triggered by perceived looming threats, consistent with LMS theory and the conceptualization of suicide as an escape from overwhelming psychological pain (Schmaal et al., 2020; Shneidman, 1993; Tzur-Bitan et al., 2012).”
Brain Mechanisms of Suicide: Neurocircuits and Inflammatory Triggers
Tripathi, N., & Gupta, G. (2025) · IntechOpen eBooks · doi:10.5772/intechopen.1013720
Perceptions of the decriminalisation of suicidal attempts among mental health service users in Ghana: a qualitative study
Quarshie, C., Daliri, D. B., Dei‐Asamoa, R., et al. (2025) · BMC Psychiatry · doi:10.1186/s12888-025-07720-4
Suicidal behaviours: explanations, current practices and difficulties of health professionals and the impact of a patient suicide
Rothes, I. (2014) · Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) · doi:10.34626/gnvk-wx77
The Relationships Between Affect, Psychache, and Suicidal Ideation: A Network Analysis in 3879 Young Adults
He, Y., Xu, T., Tan, G., Zhang, T., Lu, J., Chen, J., & Guo, Q. (2026) · Psychology Research and Behavior Management · doi:10.2147/prbm.s556389 · Cited by 1
Balancing Unemployment and Psychache: An Individual Cross-Sectional Survey in People with Multi-Comorbidity
Gimelfarb, Y., & Cojocaru, D. (2026) · Societies · doi:10.3390/soc16010035 · Cited by 2
“Based on current theoretical models (e.g., pain and suicidality model [37], the strain theory of suicide [38], social pain model [39]) in social sciences, it is currently well-established that psychache is positively related and is a predictor of suicidal behavior [10,40–44].”
Topological alterations in suicide attempters: exploring the role of the pain network
Chen, Y., Li, H., Hao, Z., Lin, Y., Wen, X., & Wang, X. (2025) · Cerebral Cortex · doi:10.1093/cercor/bhaf347
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
“Shneidman argued that mental pain – which he defined as psychache (Shneidman, 1993) – was a more specific predictor of suicidality than depressive symptoms or hopelessness (Troister et al., 2015; Verrocchio et al., 2016).”
Future Directions for Mathematical, Computational, & Digital Methods in Suicide Research
Wang, S. B., Behbehani, L. M., Hamm, S., & Hart, F. G. (2026) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2026.2617212
“These include relatively simple theories of suicide as an escape from aversive self-awareness or psychological pain (Baumeister, 1990; Shneidman, 1993), to more complicated theories proposing interactions between multiple social, cognitive, emotional, and biological factors (Joiner, 2005; Klonsky &…”
Mathematical and Computational Modeling of Suicide as a Complex Dynamical SystemPreprint
Wang, S. B., Robinaugh, D. J., Millner, A. J., Fortgang, R. G., Hamm, S., Barrow, C., & Nock, M. K. (2026) · PsyArXiv (OSF Preprints) · doi:10.31234/osf.io/b29cs_v2
Psychological pain as existential grief in midlife: a constructivist grounded theoryPreprint
Hakimnia, M., Borjali, A., Rafezi, Z., Isamorad, A., & Moatamedy, A. (2026) · Research Square · doi:10.21203/rs.3.rs-8698936/v1
Negative Problem Orientation, Future Orientation, and Pessimism Matter for Multigroup Latinx Adults Living in the US: Identifying Robust Expectancy Predictors of Depressive Symptoms and Psychological Pain Among the Invisible
Chang, E. C., Meyers, C., Polanco-Roman, L. A., Jeglic, E. L., & Hirsch, J. K. (2026) · Cognitive Therapy and Research · doi:10.1007/s10608-025-10699-7
Effect of Logotherapy on Depressive Symptoms, Psychological Pain, and Meaning of Life Among Individuals With Depression
UĞURYOL, M., & Engin, E. (2026) · Journal of Psychosocial Nursing and Mental Health Services · doi:10.3928/02793695-20260312-04
The Lived Experience of Suffering among Transitional Age Youth with Mental Disorders: A Phenomenological Thematic Analysis
Kozlowitz, S., Ben-Shaool, E., Sibéoni, J., & Chevance, A. (2026) · Psychopathology · doi:10.1159/000551658
Douleur psychologique et exclusion sociale dans les conduites suicidaires
Olié, É. (2014) · theses.fr (ABES) · doi:10.70675/657d26f9zdfd9z495ez8d2az0095d5ba2816
Article 1. Analyse des écrits en post-mortem : autopsie psychologique sur une observation.
Koumou, R. D., Mouanga, A. M., er, T. S. A. O., et al. (2026) · Psy Cause · doi:10.3917/psca.094.0006
“I had no safe space.” Painful childhood experiences in the lives of men who are suicidal: A qualitative thematic analysis
Bennett, S., Robb, K. A., Zortea, T. C., & O’Connor, R. C. (2026) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2026.108024 · Cited by 1
“According to leading psychological theories of suicide, unbearable psychological pain is a central driver of suicide (Shneidman, 1993, 1998; Gunn, 2017; Joiner, 2005; O ’ Connor, 2011).”
Évaluation écologique des marqueurs périphériques de stress à l'aide de biocapteurs en population psychiatrique
Conejero, I. (2020) · theses.fr (ABES) · doi:10.70675/e0cb59ecz80a8z4338za3ddz2ea8e8d0334d
Concevoir l'humeur dépressive pour comprendre la dépression : psychiatrie et philosophie des états affectifs
Boissard, É. (2023) · theses.fr (ABES) · doi:10.70675/95d775e5z6b0ez44c6z8f63z6473f8f6f430
Impact du profil d’attachement sur les effets des traumatismes infantiles : déterminants cognitifs et mécanismes sous-jacents
Ihme, H. (2023) · theses.fr (ABES) · doi:10.70675/48a456c3z9e47z480ezbae2z40c7011bef72
Differences in gender, race, and sexual orientation across latent classes of suicide ideation and related behaviour
Martin, L. W., Yeo, S. N., & Stewart, J. G. (2026) · Psychiatry Research Communications · doi:10.1016/j.psycom.2026.100252
Suicidal ideation and its determinants among Palestinian university students
Ahmead, M., & Lail, S. A. (2026) · Scientific Reports · doi:10.1038/s41598-026-49039-4
“According to Edwin Shneidman (1993), the major cause of suicide is anxiety.”
Mental Pain Management’s Role in the Relationship Between Dispositional Mindfulness and Adolescent NSSI: A Cross-Lagged Network Perspective
Liu, Y., Zeng, J. Z., & Gong, J. (2026) · Mindfulness · doi:10.1007/s12671-026-02833-7
“Shneidman (1993) introduced the concept of “psychache,” defining it as psychological pain stemming from intense shame, guilt, humiliation, loneliness, fear, angst, or related emotions.”
Internalized stigma and psychache in individuals with mental disorders: a cross-sectional comparative study
Kaplan, V., Kaçkın, Ö., & Günerigök, M. (2026) · BMC Psychiatry · doi:10.1186/s12888-026-08090-1
“Psychological pain was first conceptualized as psychache by Shneidman (1993) [15], and various studies indicated that individuals who have any mental disorders may have felt psychache intensively [16–21].”
Influential
The bidirectional relationship between cumulative risk and psychological pain in Chinese early adolescents: The mediating role of future expectations
Jing, K., Wang, J., Ye, B., 但颖丽, Wang, A., & Gao, X. (2026) · Acta Psychologica · doi:10.1016/j.actpsy.2026.107073
Psychological pain and decision-making in schizophrenia: associations with lifetime suicide attempt history and suicidal ideation
Aslan, M., & Beştepe, E. E. (2026) · Cognitive Neuropsychiatry · doi:10.1080/13546805.2026.2678597
“Originally conceptualised by Shneidman, psychache refers to intense and intolerable subjective mental pain, including feelings such as guilt, shame, fear, loneliness, and inner distress (Shneidman, 1993).”
Problems with Suicide and Self-Harming Behaviors by Individuals Living with Serious Mental Illness
McKeegan, G. F. (2026) · Evidence-based practices in behavioral health · doi:10.1007/978-3-032-18372-9_17
Harsh parenting and suicidal ideation of undergraduates: The mediating role of psychache and the moderating role of resilience
Peng, J.-X., Bai, L.-F., Xue, T., & Tian, J.-Q. (2026) · World Journal of Psychiatry · doi:10.5498/wjp.120630
Post-pandemic shocks and non-suicidal self-injury risk in working-age adults: differential pathways via psychological distress and social support
Yang, X., Qiang, Z., Luo, H., & 袁满地 (2026) · BMC Public Health · doi:10.1186/s12889-026-28021-9
“Psychological distress, characterized by a combination of negative emotions such as anxiety and depression, often serves as a precursor to self-injurious behavior [78].”
Associations between psychiatric diagnoses, comorbidity, and psychological pain across suicide-related presentations: A comparative study in clinical populations
Aschenbrenner, L. M., Baumgartner, A., Sedlinská, M.-A., Frei, A., Walther, S., Adorjan, K., & Gysin-Maillart, A. (2026) · Journal of Affective Disorders · doi:10.1016/j.jad.2026.122157
The divergent pathways from child abuse to suicidal ideation and suicidal attempt: A longitudinal sequential mediation study of psychache and nonsuicidal self-injury among Chinese adolescents
Kang, N., Xie, R., Sun, H., Wu, R., Chen, D., Lai, W., & You, J. (2026) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2026.108210
Zapobieganie zachowaniom suicydalnym wśród klientów pomocy społecznej w świetle standardów dla pracowników socjalnych
Lenart‐Kłoś, K. (2026) · Praca Socjalna · doi:10.71358/ps.2896
Protest in Flames: The Symbolic and Political Power of Self-Immolation, 1963-2024
Dungan, S. (2026) · The Interdependent Journal of Undergraduate Research in Global Studies · doi:10.33682/x3sf-mj1b
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Bader, N. (2026) · Asia Pacific Journal of Education and Society · doi:10.20897/apjes/18997
“Emotional suffering : Shneidman (1993) presented the concept of unbearable "psychache" as a direct cause of suicidal behavior, referring to a general emotional condition that differs from a general negative feeling.”
Suggestibility, Psychic Pain, and Body Dysmorphic Disorder Symptoms: The Mediating Role of Defense Mechanisms
Abdi, M., & Khodarahimi, S. (2026) · The Journal of Psychology · doi:10.1080/00223980.2026.2709403
Douleur psychosociale
Olié, É. (2025) · Elsevier eBooks · doi:10.1016/b978-2-294-78794-2.00030-0
Modèles psychologiques
Alacreu‐Crespo, A. (2025) · Elsevier eBooks · doi:10.1016/b978-2-294-78794-2.00008-7
Which youth with suicidal ideation will go on to make a suicide attempt? A systematic review
Dobin, D., & Brent, D. A. (2026) · Neurotherapeutics · doi:10.1016/j.neurot.2026.e01034
“Another theory of suicidal behavior was advanced by Edwin Shneidman, termed “ Psychache, ” based on the view that suicidal behavior ensures when the suicidal person is faced with unbearable psychological pain [88].”
The meaning of being suicidal - a reflective lifeworld research
Eriksson, T., Sellin, T., Fogelkvist, M., & Lindstedt, K. (2026) · International Journal of Qualitative Studies on Health and Well-Being · doi:10.1080/17482631.2026.2720834
“In their isolation, participants experienced a continuum of self-contempt and failure that functioned as an unavoidable force drawing them into the darkness of negative thoughts, strong affects and anhedonia—closely aligned with psychache (Shneidman, 1993).”
Suicide Risk Screening: A New Method to Identify At-Risk Students from General College Populations
Liu, Q., Zhang, H., Hu, Y., Zhang, J., & Luo, F. (2026) · Behavioral Sciences · doi:10.3390/bs16091576
Impact of LIFE training on educational staff’s suicide prevention skills and confidence levels
Chiu, J., Chitty, T. M., Ray, M. K., Lombardo, C., & Ray, M. K. (2026) · The Journal of Mental Health Training Education and Practice · doi:10.1108/jmhtep-04-2024-0043
Dark Tetrad Traits and Suicidal Ideation in Psychiatric Patients: The Role of Depression, Anxiety, and Stress
Mamić, M., Farčić, N., Barać, I., Mudri, Ž., Barišić, M., Bukvić, B. K., Mamić, I., Puharić, Z., & Vukoja, I. (2026) · Behavioral Sciences · doi:10.3390/bs16091606
“This interpretation also accords with broader conceptualizations of suicide risk that emphasize the interaction between enduring vulnerability and fluctuating states of acute distress, including the concepts of psychache and fluid vulnerability (Bryan et al., 2020; Shneidman, 1993).”
Risk factors and warning signs of suicidal behavior: A literature review
Jovčić, I., & Sredić, D. (2026) · Medicinska rec · doi:10.5937/medrec2601024j
The Influence of Suggestibility, Positive Expectancy, and Identification on Resilience (INSPIRE) Model
Lewis, R., Niederkrotenthaler, T., Robinson, J., Sala, L. L., Mitchell, R. H. B., & Sinyor, M. (2026) · Crisis · doi:10.1027/0227-5910/a001073
Relative Deprivation and Suicidal Ideation Among Chinese College Students: The Mediating Role of Psychological Pain and the Moderating Role of Social Support
Lyu, C., Lin, J., Zhang, K., Wang, S., Hu, Y., Wei, J.-M., & Chang, B. (2026) · Behavioral Sciences · doi:10.3390/bs16101836
“Psychological pain represents a form of psychological strain (Zhang, 2019) and refers to an extreme, aversive emotional state that is chronic and intolerable (Baryshnikov & Isometsä, 2022; Shneidman, 1993; Troister & Holden, 2013).”
Influential

Authors: SHNEIDMAN, E. S.
Affiliations: University of California, Los Angeles (US)
Corresponding author: SHNEIDMAN, EDWIN S.
Venue: The Journal of Nervous and Mental Disease
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 1993-03
Volume: 181
Issue: 3
Pages: 145-147
ISSN: 0022-3018 (ISSN-L)
DOI: 10.1097/00005053-199303000-00001
OpenAlex: W2224716391
Cited by: 775
References: 0
Citations by year: 2026: 39 · 2025: 84 · 2024: 58 · 2023: 43 · 2022: 50 · 2021: 49 · 2020: 59 · 2019: 42 · 2018: 32 · 2017: 38 · 2016: 34 · 2015: 25 · 2014: 31 · 2013: 22 · 2012: 20
Type: journal article
Language: en
Open access: closed
Locations: The Journal of Nervous and Mental Disease (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Disorders
Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
Keywords: suicide, emotional pain, psychological suffering
MeSH terms: Depressive Disorder, Frustration, Happiness, Humans, Models, Psychological, Pain, Personality, Q-Sort, Stress, Psychological, Suicide

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Commentary: Suicide as Psychache

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