Evidence map›Paper›PMID 42039025›Full record

ArticleFrontiers in psychology2026

Mapping interpersonal-to-cognitive pathways with suicidal ideation: unforgiveness-based moderators within the interpersonal theory of suicide framework.

Andy Po Sze Cheung, Sylvia Yuk Ching Lai Kwok, Minmin Gu, Yu Huang

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Article in Frontiers in psychology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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4 authors.

Andy Po Sze CheungDepartment of Social and Behavioral Sciences, City University of Hong Kong, Kowloon, Hong Kong SAR, China.
Sylvia Yuk Ching Lai KwokDepartment of Social and Behavioral Sciences, City University of Hong Kong, Kowloon, Hong Kong SAR, China.
Minmin GuResearch Institute of Social Development, Southwestern University of Finance and Economics, Chengdu, China.
Yu HuangDepartment of Social and Behavioral Sciences, City University of Hong Kong, Kowloon, Hong Kong SAR, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Suicidal ideation among young adults is a significant public health concern. While the Interpersonal Theory of Suicide (ITS) provides a robust framework, the role of unforgiveness-based coping responses to interpersonal transgressions remains under-specified. Specifically, how strategies like avoidance, self-dysfunction, and revenge relate to the strength of ITS associations requires clarification. We examined cross-sectional associations among thwarted belongingness (TB), perceived burdensomeness (PB), hopelessness (HL), and suicidal ideation (SI), and whether these associations varied by unforgiveness-related coping (avoidance, self-dysfunction, revenge) within a moderated serial mediation framework. Methods: Standardized questionnaires were completed by 205 university-affiliated participants in Hong Kong. Given the cross-sectional design and zero-inflated outcome data, SI was modeled with Bayesian hurdle lognormal regression. Competing structural specifications were compared using WAIC/LOOIC to evaluate model plausibility. Results: Model comparisons favored a serial specification over a common-cause model. PB was robustly associated with both the presence and severity of SI. Moderator analyses indicated that avoidance and self-dysfunction were associated with a stronger link between TB and PB. Revenge motivation showed a complex pattern: it was associated with heightened hopelessness but reduced likelihood of reporting SI. In this non-clinical university sample, this pattern may reflect a form of emotional externalization, temporarily deflecting internalizing distress outward rather than conferring stable protection; this interpretation remains conditional on the cross-sectional design and sample characteristics. Discussion: Unforgiveness-based coping strategies appear to be associated with distinct points in the interpersonal-to-cognitive sequence. The "deflection" effect observed with revenge motivation should be interpreted with caution, likely representing an unstable externalization response rather than adaptive protection. Conversely, avoidance and self-dysfunction are linked to entrenched interpersonal distress. Integrating unforgiveness-based coping into suicide risk assessment offers a more granular understanding of risk. These findings highlight the value of assessing coping styles in youth-serving settings, suggesting that brief screening and low-intensity supports targeting specific coping mechanisms may be valuable for suicide prevention.

Indexed as

avoidanceBayesian SEMhopelessnessperceived burdensomenessrevengeself-dysfunctionsuicidal ideationthwarted belongingness

Identifiers

PMID42039025
PMCPMC13102621

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.