Academic journal article Advances in Mental Health

Longitudinal Analysis of the Emotion Self-Confidence Model of Suicidal Ideation in Adolescents

Academic journal article Advances in Mental Health

Longitudinal Analysis of the Emotion Self-Confidence Model of Suicidal Ideation in Adolescents

Article excerpt

Suicidal ideation is a defining feature of sui- cidality (Bryan & Rudd, 2006); interventions to prevent and reduce suicidal ideation there- fore have a role in suicide prevention. Despite much research into associated factors (see Evans, Hawton, & Rodham, 2004) the processes in the evolution of suicidal ideation within an individ- ual have yet to be explained fully. We developed a cognitive behavioral model based on stress-coping principles (e.g., Lazarus & Folkman, 1984, 1987) to help explain the processes involved. The emo- tion self-confidence model of suicidal ideation (ESC-SI Model; see Deeley & Love, 2012a) is an emotion-focused coping model describing one possible pathway to suicidal ideation in the con- text of overwhelming negative emotionality.

Distressing negative emotionality is central to many theories of suicide. Baumeister (1990, 1993) hypothesized that suicide is motivated by a desire to escape the aversive experience of nega- tive emotionality. Beck has focused on the role of depression (see Beck, 1967; Beck & Alford, 2009). Moreover, according to Shneidman (1993), the fundamental process involved in suicide is psychache (meaning 'intolerable psy- chological pain' p. 51), implying a high level of emotional distress (Shneidman, 2001). Other researchers have directly observed negative emo- tionality as a dominant feature of experiences involving suicidal ideation (e.g., Everall, Bostik, & Paulson, 2006).

Still, not all negative emotionality is associ- ated with suicidal ideation. The ESC-SI Model aims to explain why some negative emotional experiences involve suicidal ideation whilst others do not. Recognizing that many suicide theorists believe that suicide is often motivated by a desire to escape internal turmoil associated with distressing emotionality (see, for example, Baumeister, 1990, 1993; Wenzel & Beck, 2008; Williams, Crane, Barnhofer, & Duggan, 2005), we conceptualized negative emotionality as a stressor, and suicidal ideation as a coping response that would emerge depending on how the negative emotionality is appraised. In particular, we speculated that apprais- als concerning expectations for managing the pre- vailing negative emotionality would be important.

The perceived inability to regulate emotions has been associated with depression (Catanzaro, 1997; Catanzaro & Mearns, 1990) as well as suicidal ideation (e.g., Rajappa, Gallagher, & Miranda, 2011; Weinberg & Klonsky, 2009). We hypothesized that two types of appraisals relevant to the onset of suicidal ideation would be expectations for coping with (tolerating) the experience of negative emotionality and expecta- tions of the ability to change the experience into one more pleasant. We reasoned that low expected ability to tolerate the internal experience of nega- tive emotionality would likely heighten distress. Moreover, low expectations in relation to chang- ing this experience into one more tolerable may prompt consideration of suicide as a way to escape the distress. This latter appraisal would be linked to elevated hopelessness levels (general pessimism regarding the future) which have been observed in conjunction with suicidal ideation (e.g., Beck, Steer, Beck, & Newman, 1993; Smith, Alloy, & Abramson, 2006). We have termed expectations of the ability to cope with/tolerate or to change negative emotionality into a more pleasant experi- ence emotion self-confidence.

The ESC-SI Model proposes that low emotion self-confidence would predispose toward suicidal thinking, whereas high emotion self-confidence would result in more positive ways of coping. The model describes a specific sequential process of the form: (a) negative emotionality as a stressor; (b) emotion self-confidence appraisals; (c) sui- cidal ideation as a coping response. In reality, stress-coping processes are interactive and recur- sive in nature (Lazarus, 1999, 2006; Lazarus & Folkman, 1984). However, description at a lin- ear level is conceptually useful and research can be conducted through snapshots of relationships between variables at a particular point in time (Folkman & Lazarus, 1985). …

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