Psicothema was founded in Asturias (northern Spain) in 1989, and is published jointly by the Psychology Faculty of the University of Oviedo and the Psychological Association of the Principality of Asturias (Colegio Oficial de Psicología del Principado de Asturias).
We currently publish four issues per year, which accounts for some 100 articles annually. We admit work from both the basic and applied research fields, and from all areas of Psychology, all manuscripts being anonymously reviewed prior to publication.
Jorge Andreo-Jover1,2, Eduardo Fernández-Jiménez1,3, Julio Bobes4,5, Ana Isabel Cebria6,7, Benedicto Crespo-Facorro8,9, Alejandro De la Torre-Luque10,11, Marina Díaz-Marsá12, Adriana García-Ramos10, Iria Grande13,14, Ana González-Pinto15,16, Luis Jiménez-Treviño4,5, Natalia Roberto13,14, Miguel Ruiz-Veguilla8,9, Ángela Palao-Tarrero1,2 and Víctor Pérez-Sola17,18
Background: Suicide attempt (SA) lethality is associated with heightened suicidal desires and social cognition deficits. Fearlessness about death (FAD) and hypomentalizing may play a role in SA and self-harm. Although studies have identified relationships between these constructs, this line of research is still limited. We aimed to explore the mediating role of FAD and mentalizing between suicidal ideation and both SA lethality and self-harm. Method: 1,371 suicide attempters (70.1% women; M = 40 years) from seven Spanish hospitals participated. We used the Fearlessness About Death (ACSS-FAD) subscale, the Reflective Functioning Questionnaire-8 (RFQ-8), and the Columbia Suicide Severity Rating Scale (CSSRS). We conducted serial multiple mediation analyses with suicidal ideation as exposure; FAD and mentalizing as mediators; SA lethality and self-harm as outcomes. Results: Indirect effects were found of suicidal ideation on self-harm (B = 0.08, CI = 0.03-0.15) and SA lethality mediated by FAD (B = 0.02, CI = 0.001-0.04); indirect effects of suicidal ideation on self-harm through mentalizing (B = 0.10, CI = 0.04-0.167), and total indirect effects between suicidal ideation and self-harm through FAD and mentalizing (B = 0.18, CI = 0.11-0.27). Conclusions: Interventions addressing mentalizing and FAD may help reduce SA lethality and self-harm risk.
Antecedentes: La letalidad del intento suicida (IS) se asocia con deseo suicida incrementado y cognición social deficitaria. La temeridad ante la muerte (FAD) e hipomentalización podrían desempeñar un papel en IS y autolesiones. Aunque la investigación ha identificado una relación entre estos constructos, ésta es limitada. Este estudio examina el papel mediador de FAD y mentalización entre ideación suicida y letalidad del IS y autolesiones. Método: Participaron 1.371 pacientes tras un IS (70,1% mujeres; M = 40 años), de siete hospitales españoles. Empleamos la subescala Temeridad Ante la Muerte (ACSS-FAD), Cuestionario de Funcionamiento Reflexivo-8 (RFQ-8) y Escala de Gravedad del Suicidio Columbia (CSSRS). Analizamos mediación serial múltiple con ideación suicida como exposición; FAD y mentalización como mediadores; letalidad del IS y autolesiones como resultados. Resultados: Se obtuvieron efectos indirectos entre ideación suicida (B = 0,08; CI = 0,03-0,15), autolesiones y letalidad del IS, mediados por FAD (B = 0,02; CI = 0,001-0,04); entre ideación suicida y autolesiones, mediadas por mentalización (B = 0,10; CI = 0,04-0,17), y efectos indirectos totales entre ideación suicida y autolesiones mediante FAD y mentalización (B = 0,18; CI = 0,11-0,27). Conclusiones: Intervenciones en mentalización y FAD pueden disminuir la letalidad del IS y riesgo autolesivo.
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ENGLISH
https://doi.org/10.7334/psicothema2024.82