Negative self-appraisals and suicidal behavior among trauma victims experiencing PTSD symptoms: the mediating role of defeat and entrapment

Depress Anxiety. 2012 Mar;29(3):187-94. doi: 10.1002/da.21917. Epub 2012 Mar 16.

Abstract

Background: A considerable body of literature has shown a strong association between posttraumatic stress disorder (PTSD) and suicidal behavior but only a limited number of studies have investigated the putative psychological mechanisms underlying suicidal behavior in PTSD. Based on a recent theoretical model of suicide, the Schematic Appraisals Model, the current study aimed to examine whether perceptions of defeat and entrapment mediated the effects of three types of negative self-appraisals (emotion coping, problem solving, and social support) on suicidal behavior among individuals experiencing PTSD symptoms in the past month.

Methods: The sample comprised 56 individuals who had been previously exposed to a traumatic event and reported at least one PTSD symptom in the past month (confirmed through the Posttraumatic Diagnostic Scale). The mediational analyses were conducted using a nonparametric, bootstrapping method.

Results: The results showed that defeat and entrapment fully mediated the effect of all three types of self-appraisals on suicidal behavior. When controlling for PTSD symptom severity, defeat and entrapment continued to mediate fully the effect of two types of self-appraisals, namely the perceived ability to control negative emotions (emotion coping) and the perceived ability to cope with difficult situations/problems (problem solving) on suicidal behavior.

Conclusions: The current findings provide support for the Schematic Appraisals Model of Suicide and suggest that both specific types of negative self-appraisals and general perceptions of defeat and entrapment are strongly related to suicidal behavior in those with PTSD. The findings have important clinical implications.

MeSH terms

  • Adaptation, Psychological / physiology
  • Adolescent
  • Adult
  • Diagnostic Self Evaluation*
  • Effect Modifier, Epidemiologic
  • Emotions / physiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Problem Solving / physiology
  • Psychiatric Status Rating Scales
  • Severity of Illness Index
  • Social Support
  • Stress Disorders, Post-Traumatic / complications
  • Stress Disorders, Post-Traumatic / epidemiology
  • Stress Disorders, Post-Traumatic / psychology*
  • Suicidal Ideation*
  • Young Adult