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Cited by 81Suicide and Self-Harm StudiesAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPersonality Disorders and Psychopathology

Entrapment as a mediator of suicide crises

Open access
Li, Shuang, Yaseen, Zimri S., Kim, Hae-Joon, Briggs, Jessica, Duffy, Molly, Frechette-Hagan, Anna, Cohen, Lisa J., Galynker, Igor I.·2018·BMC Psychiatry
DOI 10.1186/s12888-018-1587-0PMC PMC5759206
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Abstract

BACKGROUND: Prior research has validated the construct of a suicide crisis syndrome (SCS), a specific psychological state that precedes and may precipitate suicidal behavior. The feeling of entrapment is a central concept of the SCS as well as of several other recent models of suicide. However, its exact relationship with suicidality is not fully understood. In efforts to clarify the exact role of entrapment in the suicidal process, we have examined if entrapment mediates the relationship of other components of the SCS, including ruminative flooding, panic-dissociation, fear of dying and emotional pain, with suicidal ideation (SI) in recently hospitalized psychiatric inpatients. METHODS: The Suicide Crisis Inventory (SCI) and Beck Scale for Suicidal Ideation (BSS) were administered to 200 high-risk adult psychiatric inpatients hospitalized following SI or suicide attempt, assessing SCS and SI levels at admission, respectively. The possible mediation effects of entrapment on the relationship between the other components of the SCS and SI at admission were evaluated. RESULTS: Entrapment significantly and fully mediated the relationship of ruminative flooding, panic-dissociation, and fear of dying with SI, with no direct relationships between these variables and SI reaching statistical significance. Further, no reverse mediation relationships between these variables and SI were found, indicating that the mediation effects of entrapment were unidirectional. While entrapment did mediate the association between emotional pain and SI, the direct relationship between emotional pain and SI was also significant. Moreover, in reverse mediational analysis, emotional pain was a partial mediator of the relationship between entrapment and SI. CONCLUSION: Entrapment and emotional pain may have a more direct association with SI than the other components of the SCS, including ruminative flooding, panic-dissociation, and fear of dying, the effects of which are mediated by the former. This suggests entrapment and emotional pain may represent key symptomatic targets for intervention in acutely suicidal individuals. Further research is needed to determine the relationship of these constructs to suicidal behavior.

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  • Each SCI subscale had good internal consistency (0.796 < α < 0.946), and there were significant unidirectional mediation effects of entrapment.

    “Good internal consistency for each subscale (0.796 < α < 0.946) Significant, unidirectional mediation effects of entrapment”

    From Suicide Crisis Syndrome: A systematic review (2024) · cites this paper as Li, Yaseen, Kim, Briggs, Duffy, Frechette-Hagan, Cohen, Galynker 2018

    The Methods (Measures) report good-to-excellent internal consistency for all SCI subscales, with α values ranging from 0.796 to 0.946; those endpoints are included, despite the claim’s strict inequalities. The Results (Mediation analyses, Table 11) support unidirectional mediation by entrapment for ruminative flooding, panic-dissociation, and fear of dying, but show a significant reverse mediation effect for emotional pain. No page numbers are available in our copy. (LLM, conf=0.88)

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  • Entrapment fully mediated the relationship between ruminative flooding, panic-dissociation and fear of dying with suicidal ideation in a study of 200 adult psychiatric patients.

    “The authors found that entrapment fully mediated the relationship between ruminative flooding, panic-dissociation and fear of dying with suicidal ideation [73]”

    From The integrated motivational–volitional model of suicidal behaviour (2018) · cites this paper as [73]

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Research works printed but not linked: 1

  1. [6]Galynker I The suicidal crisis: clinical guide to the assessment of imminent suicide risk 2017 New York Oxford University Press

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Authors
Li, S., Yaseen, Z. S., Kim, H.-J., Briggs, J., Duffy, M., Frechette-Hagan, A., Cohen, L. J., & Galynker, I. I.
Affiliations
Mount Sinai Beth Israel (US)
Corresponding author
Galynker, Igor I.
ORCID
Venue
BMC Psychiatry
Publisher
Springer Science and Business Media LLC
Published
2018-01-08
Volume
18
Issue
1
Pages
4-4
ISSN
1471-244X (ISSN-L)
DOI
10.1186/s12888-018-1587-0
PMC
PMC5759206
OpenAlex
W2782923675
Cited by
81
References
60
Citations by year
2026: 10 · 2025: 8 · 2024: 7 · 2023: 11 · 2022: 8 · 2021: 14 · 2020: 8 · 2019: 9 · 2018: 5
FWCI
10.58
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • BMC Psychiatry (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
American Foundation 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 › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Keywords
entrapment, suicide crisis syndrome, suicidal ideation, emotional pain, fear of dying, mediation, psychiatric inpatients, suicide attempts, suicide prevention
MeSH terms
Adolescent, Adult, Aged, Fear, Female, Humans, Internal-External Control, Male, Middle Aged, Stress, Psychological, Suicide, Attempted, Young Adult, Suicidal Ideation

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