Metacognitions about suicidal thoughts

Thomas Forkmann; Anna Knorr; Christiane Gerdes; Björn Vüst; Dennis Hamacher; Tobias Teismann

doi:10.1016/j.jpsychires.2023.03.018

Metacognitions about suicidal thoughts

J Psychiatr Res. 2023 May:161:199-205. doi: 10.1016/j.jpsychires.2023.03.018. Epub 2023 Mar 11.

Authors

Thomas Forkmann¹, Anna Knorr², Christiane Gerdes², Björn Vüst³, Dennis Hamacher³, Tobias Teismann²

Affiliations

¹ Department of Clinical Psychology and Psychotherapy, University of Duisburg-Essen, Germany. Electronic address: thomas.forkman@uni-due.de.
² Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Germany.
³ Department of Clinical Psychology and Psychotherapy, University of Duisburg-Essen, Germany.

PMID: 36933446
DOI: 10.1016/j.jpsychires.2023.03.018

Abstract

Background: Rumination about suicide has recently been identified as a risk factor for suicidal behavior. According to the metacognitive model of emotional disorders, the activation and maintenance of rumination is dependent on specific metacognitive beliefs. On this background, the current study is concerned with the development of a questionnaire to assess suicide-specific positive and negative metacognitive beliefs.

Methods: Factor structure, reliability and validity of the Scales for Suicide-related Metacognitions (SSM) were investigated in two samples comprised of participants suffering from lifetime suicide ideation. Participants of sample 1 (N = 214; 81.8% female; M_age = 24.9, SD_age = 4.0) took part in a single assessment using an online survey. Participants of sample 2 (N = 56; 71.4% female; M_age = 33.2, SD_age = 12.2) took part in two online assessments within a two week time-period. To establish convergent validity questionnaire-based assessments of suicidal ideation, general and suicide specific rumination and depression were used. Furthermore, it was analyzed whether suicide-related metacognitions predict suicide-specific rumination cross-sectionally and prospectively.

Results: Factor analyses revealed a two-factor structure of the SSM. Results indicated good psychometric properties, and provided evidence for construct validity and stability of the subscales. Positive metacognitions predicted concurrent and prospective suicide-specific rumination beyond the effect of suicide ideation and depression and rumination predicted concurrent and prospective negative metacognitions.

Conclusion: Taken together the results provide initial evidence that the SSM is a valid and reliable measure of suicide-related metacognitions. Furthermore, findings are in line with a metacognitive conceptualization of suicidal crises and provide first indications of factors that might be relevant for the activation and maintenance of suicide-specific rumination.

Keywords: Metacognitions; Metacognitive model; Rumination; Suicidal ideation.

MeSH terms

Adult
Child
Child, Preschool
Female
Humans
Male
Metacognition* / physiology
Mood Disorders
Prospective Studies
Reproducibility of Results
Suicidal Ideation*
Young Adult