A network perspective on suicidal behavior: understanding suicidality as a complex system
Open accessAbstract
BACKGROUND: Suicidal behavior is the result of complex interactions between many different factors that change over time. A network perspective may improve our understanding of these complex dynamics. Within the network perspective, psychopathology is considered to be a consequence of symptoms that directly interact with one another in a network structure. To view suicidal behavior as the result of such a complex system is a good starting point to facilitate moving away from traditional linear thinking. OBJECTIVE: To review the existing paradigms and theories and their application to suicidal behavior. METHODS: In the first part of this paper, we introduce the relevant concepts within network analysis such as network density and centrality. Where possible, we refer to studies that have applied these concepts within the field of suicide prevention. In the second part, we move one step further, by understanding the network perspective as an initial step toward complex system theory. The latter is a branch of science that models interacting variables in order to understand the dynamics of complex systems, such as tipping points and hysteresis. RESULTS: Few studies have applied network analysis to study suicidal behavior. The studies that do highlight the complexity of suicidality. Complexity science offers potential useful concepts such as alternative stable states and resilience to study psychopathology and suicidal behavior, as demonstrated within the field of depression. To date, one innovative study has applied concepts from complexity science to better understand suicidal behavior. Complexity science and its application to human behavior are in its infancy, and it requires more collaboration between complexity scientists and behavioral scientists. CONCLUSIONS: Clinicians and scientists are increasingly conceptualizing suicidal behavior as the result of the complex interaction between many different biological, social, and psychological risk and protective factors. Novel statistical techniques such as network analysis can help the field to better understand this complexity. The application of concepts from complexity science to the field of psychopathology and suicide research offers exciting and promising possibilities for our understanding and prevention of suicide.
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In the case of prolonged stress and suicidal thoughts, even minor mood changes may be sufficient to activate a more intensive preoccupation with suicidal desires.
“in the case of prolonged stress and suicidal thoughts, even minor mood changes may be sufficient to activate a more intensive preoccupation with suicidal desires (12, 29, 30).”
From Ambivalence model of suicidality [ABS-model]: an orientation model for the treatment of suicidal individuals (2024) · cites this paper as [29]
In Part Two’s “Cusp catastrophe model” section (page unavailable), the paper hypothesizes that rising stress can erode resilience so that a small perturbation produces a large increase in suicide risk. It also describes fluctuating mood and feedback loops that can intensify suicidal ideation, but does not specifically say that minor mood changes during prolonged stress and existing suicidal thoughts trigger more intensive preoccupation with suicidal desires. (LLM, conf=0.84)
Experimental — accuracy not yet measuredWhether and when suicidal individuals enter the transition phase cannot be predicted.
“Whether and when suicidal individuals enter the transition phase cannot be predicted; some authors speak of a “mental accident” in which behavioral control over suicidal impulses (suddenly) fails (56), others speak of coincidence (57) and within dynamic systems approaches (29) the term tipping points is used to characterize the sudden shift into a state of acute suicidality.”
From Ambivalence model of suicidality [ABS-model]: an orientation model for the treatment of suicidal individuals (2024) · cites this paper as [29]
Suicidal behavior occurs in complex ways.
“In general, it must be kept in mind that suicidal behavior occurs in complex ways (de Beurs et al., 2021;Huang et al., 2019)”
From Suicide Crisis Syndrome: A systematic review (2024) · cites this paper as de Beurs et al., 2021
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- O’Connor, R. C., & Kirtley, O. J. (2018b). The integrated motivational–volitional model of suicidal behaviour. Philosophical Transactions of the Royal Society B: Biological Sciences, 373(1754), 20170268. 10.1098/rstb.2017.0268 PMC6053985 30012735 · DOI · Paper page
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Self-citation
- Authors
- de Beurs, D., Bockting, C., Kerkhof, A., Scheepers, F., O’Connor, R., Penninx, B., & van de Leemput, I.
- Affiliations
- Trimbos Institute (Netherlands Institute of Mental Health) Utrecht The Netherlands
- Amsterdam UMC Location University of Amsterdam (NL)
- Amsterdam Public Health (NL)
- University Medical Center Utrecht (NL)
- University of Glasgow (GB)
- Department of Aquatic Ecology and Water Quality Management Wageningen University Wageningen The Netherlands
- Venue
- Suicide and Life-Threatening Behavior
- Publisher
- Wiley
- Published
- 2021-02
- Volume
- 51
- Issue
- 1
- Pages
- 115-126
- ISSN
- 0363-0234 (ISSN-L)
- 1943-278X
- PMC
- PMC7986393
- OpenAlex
- W3036727385
- Cited by
- 119
- References
- 56
- Citations by year
- 2026: 30 · 2025: 25 · 2024: 27 · 2023: 17 · 2022: 15 · 2021: 5
- FWCI
- 15.46
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Suicide and Life-Threatening Behavior (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- VU Research Portal (publishedVersion, other-oa)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion, cc-by-sa)
- Socio-Environmental Systems Modeling (submittedVersion, cc-by)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
- Pure Amsterdam UMC (submittedVersion, other-oa)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, cc-by)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- suicidal behavior, suicidality, network analysis, complexity theory, network density, network centrality, suicide prevention, tipping points, hysteresis, alternative stable states, resilience, depression, psychopathology, risk and protective factors
- MeSH terms
- Suicide Prevention, Humans, Psychopathology, Risk Factors, Suicidal Ideation
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