Hostname: page-component-8448b6f56d-tj2md Total loading time: 0 Render date: 2024-04-15T09:48:50.405Z Has data issue: false hasContentIssue false
  • English
  • Français

Emotional Regulation of Mental Pain as Moderator of Suicidal Ideation in Military Settings

Published online by Cambridge University Press:  29 June 2015

L. Shelef ,
E. Fruchter ,
A. Hassidim  and
G. Zalsman
L. Shelef
Affiliation:
Mental Health Unit, Medical Corps-Israel Defense Forces, Israel
E. Fruchter
Affiliation:
Mental Health Unit, Medical Corps-Israel Defense Forces, Israel
A. Hassidim
Affiliation:
Medical Corps-Israel Defense Forces, Israel
G. Zalsman*
Affiliation:
Child and Adolescent Division, Geha Mental Health Center, Petah Tikva, Israel Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Molecular Imaging and Neuropathology Division, Psychiatry Department, Columbia University, New York, NY, USA
*
*Corresponding author. Child and Adolescent Psychiatry, Geha Mental Health Center, Tel Aviv University, PO Box 102, Petach Tiqwa 49100, Israel. Tel.: +972 3 92 58 205; fax: +972 3 92 41 041. E-mail address: zalsman@post.tau.ac.il (G. Zalsman).
Get access

Abstract

Background

In the Israel Defense Forces (IDF) as well as in most armies throughout the world, the leading cause of death during peace-time is suicide. This study examines emotional regulation of mental pain as a contributor to suicidal ideation in soldiers.

Methods

One hundred sixty-eight IDF soldiers (aged 18–21 years, 59% males) completed the following self-report questionnaires: Scale for Suicide Ideation (SSI); Orbach & Mikulincer Mental Pain Scale (OMMP); and Emotional Regulation of Mental Pain questionnaire. Participants were divided into 3 groups: soldiers who attempted suicide (AS group, n = 58), soldiers under treatment by a mental health professional and reporting no suicidal behavior (PT group, n = 58), and controls (C group, n = 50).

Results

Suicide ideation, mental pain, and low emotional regulation were significantly higher in the suicidal group as compared to the two other groups (P < 0.001). Mental pain was significantly related to more suicide ideation in soldiers with low ability to regulate mental pain (P < .001 for the interaction).

Conclusion

Emotional regulation of mental pain moderates the link between mental pain and suicide ideation. Soldiers with high mental pain and low regulation of mental pain exhibited higher suicidal ideation. These findings may assist in planning prevention programs in the army and similar settings.

Keywords

Suicide attemptArmyMilitaryMental painDisruptive mood dysregulation disorderSuicide ideation
Type
Original article
Information
European Psychiatry , Volume 30 , Issue 6 , September 2015 , pp. 765 - 769
Copyright
Copyright © Elsevier Masson SAS 2015

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Anestis, M.D., Bagge, C.L., Tull, M.T., Joiner, T.E.Clarifying the role of emotion dysregulation in the interpersonal-psychological theory of suicidal behavior in an undergraduate sample. J Psychiatr Res 2011;45:603–611.CrossRefGoogle Scholar
Apter, A., Bleich, A., King, R.A., Kron, S., Fluch, A., Kotler, M.J., et al.Death without warning? A clinical postmortem study of suicide of 43 Israeli adolescent males. Arch Gen Psychiatry 1993;50:138–142.CrossRefGoogle Scholar
Baumeister, R.F.Suicide as escape from self. Psychol Rev 1990;97:90–113.CrossRefGoogle ScholarPubMed
Baumeister, R.F., DeWall, C.N., Ciarocco, N.J., Twenge, J.M.Social exclusion impairs self-regulation. J Pers Soc Psychol 2005;88:589–604.CrossRefGoogle ScholarPubMed
Beautrais, A.L.Suicides and serious suicide attempts in youth: A multiple-group Comparison study. Am J Psychiatry 2003;160:1093–1099.CrossRefGoogle ScholarPubMed
Beck, A.T., Steer, R.A., Ranieri, W.F.Scale for suicide ideation: psychometric properties of a self-report version. J Clin Psychol 1988;44:499–505.3.0.CO;2-6>CrossRefGoogle ScholarPubMed
Bodner, E., Ben-Artz, E., Kaplan, Z.Soldier who kill themselves: the contribution of dispositional and situational factors. Arch Suicide Res 2006;10:29–43.CrossRefGoogle ScholarPubMed
Bradley, B., DeFife, J.A., Guarnaccia, C., Phifer, J., Fani, N., Ressler, K.J., et al.Emotion dysregulation and negative affect: association with psychiatric symptoms. J Clin Psychiatry 2011;72(5):685–691.CrossRefGoogle ScholarPubMed
Brotman, M.A., Schmajuk, M., Rich, B.A.Prevalence, clinical correlates, and longitudinal course of severe mood dysregulation in children. Biol Psychiatry 2006;60:991–997.CrossRefGoogle ScholarPubMed
Brown, M.Z.Linehan's theory of suicidal behavior: theory, research, and dialectical behavior therapy. In: Ellis, T.E. editors. Cognition and Suicide, Theory, Research, and Therapy. Washington DC: American Psychological Association; 2006. 91–117.CrossRefGoogle Scholar
Carver, C.S., Scheier, M.F., Weintraub, J.K.Assessing Coping Strategies: A Theoretically Based Approach. J Pers Soc Psychol 1989;56:267–283.CrossRefGoogle ScholarPubMed
Centers for Disease Control Prevention Web-based injury Statistics Query and Reporting System (WISQARS). 2005 Available from http://www.cdc.gov/ncipc/wisqars/default.htm.Google Scholar
Eaton, D.K., Kann, L., Kinchen, S., Shanklin, S., Ross, J., Hawkins, J., et al.Youth risk behavior surveillance-United States, 2007. MMWR Surveill Summ 2008;57:1–131.Google ScholarPubMed
Friedman, M.J.Suicide Risk Among Soldiers Early Findings From Army Study to Assess Risk and Resilience in Service members (Army STARRS). JAMA Psychiatry 2014;3. [Published online March].Google Scholar
Gal, R.A portrait of the Israeli soldier. Greenwood Press: New York, NY; 1986.Google Scholar
Gordana, D.J., Milivoje, P.Suicide prevention program in the army of Serbia and Montenegro. Mil Med 2007;172:551–555.CrossRefGoogle Scholar
Gratz, K.L., Roemer, L.Multidimensional assessment of emotion regulation and dysregulation: development, factor structure, and initial validation of the difficulties in emotion regulation scale. J Psychopathol Behav Assess 2004;26:41–54.CrossRefGoogle Scholar
Gratz, K.L., Roemer, L.The relationship between emotion dysregulation and deliberate self-harm among female undergraduate students at an urban commuter university. Cogn Behav Ther 2008;37:14–25.CrossRefGoogle ScholarPubMed
Hoge, C.W., Castro, C.A.Preventing suicides in US Service members and veterans, concerns after a decade of War. J Am Med Assoc 2012;308:671–672.CrossRefGoogle Scholar
Holtmann, M., Buchmann, A.F., Esser, G., Schmidt, M.H., Banaschewski, T., Laucht, M.The Child Behavior Checklist-Dysregulation Profile predicts substance use, suicidality, and functional impairment: a longitudinal analysis. J Child Psychol Psychiatry 2011;52:139–147.CrossRefGoogle ScholarPubMed
Shneidman's contributions to the understanding of suicidal thinking. Jobes, D.A., Nelson, K.N., Ellis, T.E.Cognition and Suicide, Theory, Research, and Therapy. Washington DC: American Psychological Association; 2006. 29–49.CrossRefGoogle Scholar
Joiner, T.E., Pettit, J.W., Perez, M., Burns, A.B., Gencoz, T., Gencoz, F., et al.Can positive emotion influence problem-solving attitudes among suicidal adults?. Prof Psychol Res Prac 2001;32:507–512.CrossRefGoogle Scholar
Kessler, R.C., Heeringa, S.G., Stein, M.B., Colpe, L.J., Fullerton, C.S., Hwang, I., et al.Thirty-Day Prevalence of DSM-IV Mental Disorders among non-deployed soldiers in the US army. Results from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). JAMA Psychiatry 2014 10.1001/jamapsychiatry.2014.28Published online March 3.CrossRefGoogle Scholar
Leibenluft, E., Blair, R.J., Charney, D.S., Pine, D.S.Irritability in pediatric mania and other childhood psychopathology. Ann N Y Acad Sci 2003;1008:201–218.CrossRefGoogle ScholarPubMed
Leibenluft, E., Charney, D.S., Towbin, K.E., et al.Defining clinical phenotypes of juvenile mania. Am J Psychiatry 2003;160:430–437.CrossRefGoogle ScholarPubMed
Leibenluft, E., Cohen, P., Gorrindo, T.Chronic versus episodic irritability in youth: a community-based, longitudinal study of clinical and diagnostic associations. J Child Adolesc Psychopharmacol 2006;16:456–466.CrossRefGoogle ScholarPubMed
Levi, Y., Horesh, N., Fischel, T., Treves, I., Or, E., Apter, A.Mental pain and its communication in medically serious suicide attempts: an “impossible situation”. J Affect Disord 2008;111:244–250.CrossRefGoogle Scholar
Lubin, G., Werbeloff, N., Halperin, D., Shmushkevitch, M., Weiser, M., Knobler, H.Y.Decrease in suicide rates after a change of policy reducing access to firearms in adolescents: a naturalistic epidemiological study. Suicide Life Treat Behav 2010;40:421–424.CrossRefGoogle ScholarPubMed
Nock, M.K., Banaji, M.R.Prediction of suicide ideation and attempts among adolescents using a brief performance-based test. J Consult Clin Psychol 2007;75:707–715.CrossRefGoogle ScholarPubMed
Nock, M.K., Hwang, I., Sampson, N.A., Kessler, R.C.Mental disorders, comorbidity and suicidal behavior: results from the National Comorbidity Survey Replication. Mol Psychiatry 2010;15(8):868–876.CrossRefGoogle ScholarPubMed
Nock, M.K., Stein, M.B., Heeringa, S.G., Ursano, R.J., Colpe, L.J., Fullerton, C.S., et al.Prevalence and correlates of suicidal behavior among soldiers. Results from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). JAMA Psychiatry 2014. 10.1001/jamapsychiatry.2014.30[Published online March 3].CrossRefGoogle Scholar
Orbach, I.Mental pain suicide. Israel J Psychiatry Relat Sci 2003;40:191–201.Google ScholarPubMed
Orbach, I., Mikulincer, M.Mental pain: conceptualization and operationalization. [Unpublished manuscript]. .Ramat-Gan, Israel: Bar-Ilan University; 2000.Google Scholar
Orbach, I., Gilboa-Schechtman, E., Johan, M., Mikulincer, M.Tolerance – for Mental Pain Scale. [Unpublished manuscript]. Ramat-Gan, Israel: Department of psychology, Bar-Ilan University; 2004.Google Scholar
Orbach, I., Blomenson, R., Mikulincer, M., Gilboa-Schechtman, E., Rogolsky, M., Retzoni, G.Perceiving a problem-solving task as a threat and suicidal behavior in adolescents. J Soc Clin Psychol 2007;26:1010–1034.CrossRefGoogle Scholar
Posner, K., Brown, G.K., Stanley, B., Brent, D.A., Yershova, K.V., Oquendo, M.A., et al.The Columbia-Suicide Severity Rating Scale: initial validity and internal consistency findings from three multisite studies with adolescents and adults. Am J Psychiatry 2011;168:1266–1277.CrossRefGoogle ScholarPubMed
Salovy, P., Bedell, B.T., Mayer, J.D.Current direction in emotional intelligence research. In: Lewis, M., Haviland-Jones, J.M. editors. Handbook of Emotion. 2rd ed.New York: Guilford Press; 2000. 504–520.Google Scholar
Shneidman, E.Autopsy of a Suicidal Mind. New York: Oxford University Press; 2004.Google Scholar
Shoval, G., Feld-Olspanger, J., Nahshoni, E., Gothelf, D., Misgav, S., Manor, I., et al.Suicidal behavior and related traits among inpatient adolescents with first-episode schizophrenia. Compr Psychiatry 2011;52(6):596–599.CrossRefGoogle ScholarPubMed
Wintagate, L.R., Burns, A.B., Gordon, K.H., Perez, M., Walker, R.L., Williams, F.M., et al.Suicide and Positive cognitions: positive psychology and treatment of suicidal behavior. In: Ellis, T.E. editors. Cognition and Suicide, Theory, Research, and Therapy. Washington DC: American Psychological Association; 2006. 261–283.CrossRefGoogle Scholar
Witte, T.K., Merrill, K.A., Stellrecht, N.E., Bernert, R.A., Hollar, D.L., Schatschneider, C., et al.“Impulsive” youth suicide attempters are not necessarily all that impulsive. J Affect Disord 2008;107:107–116.CrossRefGoogle Scholar
Yacobi, A., Fruchter, E., Mann, J.J., Shelef, L.Differentiating army suicide attempters from psychologically treated and untreated soldiers: a demographic, psychological and stress-reaction characterization. J Affect Disord 2013;150:300–305.CrossRefGoogle ScholarPubMed
Zlotnick, C., Donaldson, D., Spirito, A., Pearlstein, T.Affect regulation and suicide attempts in adolescent inpatients. J Am Acad Child Adolesc Psychiatry 1997;36:793–798.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.