Depressive symptoms, suicidal ideation and positive ideation: The mediation effect of unbearable psychache

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Portuguese Journal of Public Health

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Objective: The aim of the present study is to test the relationship between depressive symptoms and high levels of suicidal ideation, as well as low levels of positive ideation (protective ideation against more severe suicidal behaviors). Additionally, the study aims to test the mediating effect of psychache and unbearable psychache. Methods: A sample of 334 young adults, university students from the University of Évora, mostly female (79.6%), aged between 18 and 25 years (M = 20.25; SD = 1.99), mostly undergraduate students (N = 247; 74%), and non-working students (N = 285; 85.3%), participated in the. Participants responded to an online research protocol via the LimeSurvey platform at the end of 2022. Several measures were used: the Depression Anxiety Stress Scales, Psychahce Scale and Positive and Negative suicide Ideation Inventory. A mediation model was tested by path analysis using Structural Equation Modeling (SEM), introducing depressive symptoms as an exogenous independent variable, along with demographic variables that correlated with suicidal ideation or positive ideation as exogenous covariates. The variables psychache and unbearable psychache were included as mediating variables, and suicidal ideation and positive ideation as endogenous dependent variables. Results: The results show a partial mediating effect of the variable unbearable psychache in the relationship between depressive symptoms and both positive ideation and suicidal ideation. The model explains 62% of the variance in positive ideation and 51% of the variance in suicidal ideation. Conclusions: The variable unbearable psychache may help explaining why the presence of depressive symptoms contributes to higher levels of suicidal ideation and, at the same time, lower levels of positive ideation. According to the results, the presence of depressive symptoms increases the experience of unbearable psychache, which in turn leads to higher levels of suicidal ideation and lower levels of protective ideation against more severe suicidal behaviors.

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