When the Pain Becomes Unbearable: Case-Control Study of Mental Pain Characteristics Among Medically Serious Suicide Attempters

Arch Suicide Res. Jul-Sep 2018;22(3):380-393. doi: 10.1080/13811118.2017.1355288. Epub 2017 Sep 7.


The unbearable mental pain experience is recognized as a key antecedent of suicidal behavior. We aimed to examine the precise nature of the mental pain among medically serious suicide attempters (MSSAs), a population closely resembling those who died by suicide. We evaluated various factors of mental pain from the Orbach and Mikulincer Mental Pain Scale, as well as medical lethality and suicide intent. MSSAs were higher than non-MSSAs and psychiatric controls for Irreversibility of pain. Moreover, Emptiness predicted medical lethality, while Cognitive Confusion negatively predicted suicide intent level, controlling for hopelessness and depression. high sense of Irreversibility of pain as well as high Emptiness and low Cognitive Confusion are important risk factors for more severe suicidal behavior. Implications for identification of at-risk groups for suicide as well as for suicide prevention and treatment of suicidal individuals are discussed.

Keywords: MSSA; irreversibility; medical lethality; mental pain; serious suicide attempts; suicide intent.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Case-Control Studies
  • Cognition
  • Confusion / psychology
  • Female
  • Humans
  • Intention*
  • Male
  • Middle Aged
  • Pain / psychology*
  • Stress, Psychological / psychology*
  • Suicide, Attempted / psychology*
  • Young Adult