Skip to main content

01.12.2018 | Research article | Ausgabe 1/2018 Open Access

BMC Psychiatry 1/2018

Entrapment as a mediator of suicide crises

BMC Psychiatry > Ausgabe 1/2018
Shuang Li, Zimri S. Yaseen, Hae-Joon Kim, Jessica Briggs, Molly Duffy, Anna Frechette-Hagan, Lisa J. Cohen, Igor I. Galynker
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1186/​s12888-018-1587-0) contains supplementary material, which is available to authorized users.



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.


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.


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.


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.
Additional file 1: Mediation models controlling for age and depression. Results of mediation analyses controlling for age and depression. (DOC 63 kb)
Additional file 2: Mediation models demonstrating mutual partial mediation of entrapment and emotional pain by depression. Results of mediation analyses demonstrating mutual partial mediation of entrapment and emotional pain by depression. (DOC 57 kb)
Über diesen Artikel

Weitere Artikel der Ausgabe 1/2018

BMC Psychiatry 1/2018 Zur Ausgabe

Neu im Fachgebiet Psychiatrie

Meistgelesene Bücher aus dem Fachgebiet

2017 | Buch

Pocket Guide Psychopharmaka von A bis Z

Im Pocket Guide finden Sie von A bis Z schnell und übersichtlich die "Erste-Hilfe"-Information rund um alle Psychopharmaka, die Sie auf Station und im Praxisalltag brauchen. Das Pocket-Buch passt bestens in die Kitteltasche. Auf eine ausführliche Darstellung der Störungen wurde bewusst verzichtet.

Prof. Dr. med. Otto Benkert, Prof. Dr. med. I.-G. Anghelescu, Prof. Dr. med. G. Gründer, Prof. Dr. med. P. Heiser, Prof. Dr. rer. Nat. C. Hiemke, Prof. Dr. med. H. Himmerich, Prof. Dr. med. F. Kiefer, Prof. Dr. med. C. Lange-Asschenfeldt, Prof. Dr. med., Dr. rer. nat., Dipl.-Psych. M.J. Müller, Dr. med., Dipl.-Kfm. M. Paulzen, Dr. med. F. Regen, Prof. Dr. med. A. Steiger, Prof. Dr. med. F. Weber

2016 | Buch

Klinikmanual Psychiatrie, Psychosomatik und Psychotherapie

Dieses Kitteltaschenbuch enthält übersichtlich und systematisch alle notwendigen Informationen zum schnellen Nachschlagen auf Station, in der Ambulanz oder im Konsildienst: Klare Handlungsanweisungen, Therapieempfehlungen und die notwendigen rechtlichen Hintergründe.

Prof. Dr. Dr. Frank Schneider