Distinguishing Patient Profiles of Suicidal Ideation and Behavior: The Influence of Repetitive Negative Thinking, Internal and External Entrapment, and Defeat within the Integrated Motivational-Volitional Model in a Suicide Prevention Program.

This study investigates the cognitive mechanisms that facilitate the transition from suicidal ideation (SI) to suicidal behavior (SB), focusing on the interplay of repetitive negative thinking (RNT), feelings of defeat, and perceptions of entrapment, both internal and external, within the framework of the Integrated Motivational-Volitional (IMV) Model. We aimed to predict group membership and identify predictors between those exhibiting SI (n = 56) and those with SB (n = 37), with particular attention to the aforementioned cognitive variables. An observational, analytical, cross-sectional study was conducted with a clinical sample from a suicide prevention program in Spain, in which patients were assessed during suicidal crises. Results revealed a moderate positive correlation between RNT and both entrapment types, as well as feelings of defeat, across both patient groups, with stronger correlations observed for internal entrapment, particularly in the SB group. The binary logistic regression did not yield conclusive results regarding distinguishing between patient groups in terms of cognitive variables, consistent with existing literature, which may reflect the complexity of the factors influencing suicidal ideation and behavior. Female gender and prior emergency department visits were significant factors distinguishing the SI from the SB group, and female gender was the only variable that proved to be a key predictor of patient type (SI specifically), with an OR = 13.397 (p = 0.005). Our findings highlight the implication of integrating cognitive-behavioral interventions that target repetitive negative thinking, feelings of defeat, and entrapment into specific suicide prevention programs. More specifically, preventive clinical strategies should prioritize high-risk populations such as young women with a history of psychiatric emergencies. To effectively address the needs of this population, protocols could be implemented that include support groups, personalized follow-up systems, and training for mental health professionals on gender-sensitive approaches to enhance their mental well-being.