Perfectionism and Prospective Near-Term Suicidal Thoughts and Behaviors: The Mediation of Fear of Humiliation and Suicide Crisis Syndrome.


Journal

International journal of environmental research and public health
ISSN: 1660-4601
Titre abrégé: Int J Environ Res Public Health
Pays: Switzerland
ID NLM: 101238455

Informations de publication

Date de publication:
22 02 2020
Historique:
received: 07 02 2020
revised: 07 02 2020
accepted: 18 02 2020
entrez: 27 2 2020
pubmed: 27 2 2020
medline: 6 10 2020
Statut: epublish

Résumé

Perfectionism has been linked to suicide. According to the Narrative-Crisis Model of suicide, individuals with trait vulnerabilities are prone to develop a certain mindset, known as a Suicidal Narrative, which may precipitate the Suicide Crisis Syndrome (SCS), culminating in suicide. The purpose of this study was to investigate the association between perfectionism (trait vulnerability), fear of humiliation (component of the Suicidal Narrative), SCS, and prospective near-term suicidal thoughts and behaviors (STB). Adult psychiatric outpatient participants (N = 336) were assessed at baseline with the Suicidal Narrative Inventory for perfectionism and fear of humiliation. The questions used to assess perfectionism were adapted from the Multidimensional Perfectionism Scale. The severity of the SCS was calculated using the Suicide Crisis Inventory. STB were assessed at baseline and after one month using the Columbia Suicide Severity Rating Scale. Serial mediation analyses were conducted using PROCESS version 3.3 in SPSS. While the direct effect of perfectionism on prospective STB was not significant (b = 0.01, p = 0.19), the indirect effect of perfectionism on STB, through serial mediation by fear of humiliation and the SCS, was significant (indirect effect p = 0.007, 95% CI [0.003,0.013]). The indirect effect was not significant for models that did not include both mediators. Variables were assessed at one time only. Perfectionism did not directly modulate STB. Perfectionism may be related to suicidal behavior through fear of humiliation, leading to the SCS. These results support the Narrative-Crisis Model of suicide and clarify the role of perfectionism in the etiology of suicide.

Sections du résumé

BACKGROUND
Perfectionism has been linked to suicide. According to the Narrative-Crisis Model of suicide, individuals with trait vulnerabilities are prone to develop a certain mindset, known as a Suicidal Narrative, which may precipitate the Suicide Crisis Syndrome (SCS), culminating in suicide. The purpose of this study was to investigate the association between perfectionism (trait vulnerability), fear of humiliation (component of the Suicidal Narrative), SCS, and prospective near-term suicidal thoughts and behaviors (STB).
METHODS
Adult psychiatric outpatient participants (N = 336) were assessed at baseline with the Suicidal Narrative Inventory for perfectionism and fear of humiliation. The questions used to assess perfectionism were adapted from the Multidimensional Perfectionism Scale. The severity of the SCS was calculated using the Suicide Crisis Inventory. STB were assessed at baseline and after one month using the Columbia Suicide Severity Rating Scale. Serial mediation analyses were conducted using PROCESS version 3.3 in SPSS.
RESULTS
While the direct effect of perfectionism on prospective STB was not significant (b = 0.01, p = 0.19), the indirect effect of perfectionism on STB, through serial mediation by fear of humiliation and the SCS, was significant (indirect effect p = 0.007, 95% CI [0.003,0.013]). The indirect effect was not significant for models that did not include both mediators.
LIMITATIONS
Variables were assessed at one time only.
CONCLUSION
Perfectionism did not directly modulate STB. Perfectionism may be related to suicidal behavior through fear of humiliation, leading to the SCS. These results support the Narrative-Crisis Model of suicide and clarify the role of perfectionism in the etiology of suicide.

Identifiants

pubmed: 32098414
pii: ijerph17041424
doi: 10.3390/ijerph17041424
pmc: PMC7068323
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Déclaration de conflit d'intérêts

The authors declare no conflict of interest.

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Auteurs

Tyler Pia (T)

Department of Psychiatry, Mount Sinai Beth Israel, New York, NY 10003, USA.

Igor Galynker (I)

Department of Psychiatry, Mount Sinai Beth Israel, New York, NY 10003, USA.
Icahn School of Medicine at Mount Sinai, New York, NY 10029-6574, USA.

Allison Schuck (A)

Department of Psychiatry, Mount Sinai Beth Israel, New York, NY 10003, USA.

Courtney Sinclair (C)

Department of Psychiatry, Mount Sinai Beth Israel, New York, NY 10003, USA.

Gelan Ying (G)

Department of Psychiatry, Mount Sinai Beth Israel, New York, NY 10003, USA.

Raffaella Calati (R)

Department of Psychiatry, Mount Sinai Beth Israel, New York, NY 10003, USA.
Icahn School of Medicine at Mount Sinai, New York, NY 10029-6574, USA.
Department of Psychology, University of Milan-Bicocca, 20126 Milan, Italy.
Department of Adult Psychiatry, Nîmes University Hospital, 30029 Nîmes, France.

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Classifications MeSH