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Type: Theses
Title: Suicide vulnerability and risk: fragmented sense of self and psychache
Author: Prysak, Margaret Alicja
Issue Date: 2018
School/Discipline: School of Psychology
Abstract: Suicidality research has largely focused on psycho-social or demographic suicide risk factors, with less emphasis generally being directed towards understanding individual vulnerability factors. Moreover, although previous research has indicated that suicidality is underscored by the inner workings of personhood, suitable phenomenological approaches appear to have been infrequently applied. Accordingly, this thesis aimed to explore suicidal tendencies as predicted by low sense of self-cohesion, low self-esteem, psychological pain, distress, and emotions that underlie those psychological states. The selection of theoretically derived psychological factors was guided by the theories of Edwin S. Shneidman (psychache), and Heinz Kohut (self and self-cohesion). The cross-sectional nonexperimental design involved a survey of university students and staff, and volunteers from the South Australian community (N = 359, 72% females, 28% males, aged 18-67 years [M = 28.72; SD = 12.29]). Participants completed a battery of psychometric instruments, assessing self-cohesion, psychache, self-esteem, and psychological distress: 1) The Psychological Pain Assessment Scale (PPAS); 2) The Orbach and Mikulincer Mental Pain scale (OMMP); 3) The Psychache Scale (PS); 4) The Adelaide Self-Cohesion Scale (ASCS); 5) The Depression Anxiety Stress Scales 21 (DASS 21); 6) The Beck Self-Esteem scale (BSE); and 7) recent suicidality (from The Psychiatric Symptom Frequency Scale), lifetime attempts, and current suicidality indices. The thesis involved five studies, with results from each informing subsequent studies. Study 1 examined the psychometric properties of ASCS. Its three-factorial structure was replicated, confirming its validity for assessing a sense of self-cohesion. Study 2 tested relationships between self-cohesion, self-esteem, psychache, depression, anxiety, and stress. Exploratory factor analysis, followed by a Schmid-Leiman solution, found near-equivalence between the psychache measures OMMP and PS. Self-cohesion, self-esteem, psychache, depression, anxiety, and stress emerged as distinct but inter-related constructs, all strongly loading on a general factor of psychological frailty. Studies 3 and 4 explored relationships between these psychological factors and recent suicidal ideation/action, and history of suicide attempts. The utility of ASCS for assessing suicidality was also examined. The strongest contributor to recent suicidal ideation/action was depression, followed by self-esteem (part of self-cohesion) and psychache. The strongest contributor to lifelong suicide attempts was anxiety, followed by unmet childhood needs (part of self-cohesion). Study 5 clarified the nature of psychache in relation to three suicidality indices (recent suicidal ideation/action, lifetime attempts, and current suicidality). Two negative emotions underscored intense psychache across the three suicidality measures: self-hate and worthlessness. Additionally, “lure of death” was associated with lifetime suicide attempts only. Sadness, betrayal, and anger had negative associations with suicidality indices; hopelessness was associated with recent/current ideation, but not suicidal actions. It was concluded that suicide vulnerability is characterised by anxiety and a diminished sense of self, originating in early developmental frustrations resultant from unmet psychological needs. Further, tendencies for suicidal ideation/behaviours may partially be attributed to heightened levels of depression and psychache, and lowered self-esteem. As a clinical implication of the findings, it was proposed that a personal capacity for self-empathy may counter limitations of the self, help mollify deleterious effects of psychache and depression, reducing potential for suicide.
Advisor: Nettelbeck, Theodore John
Chamberlain, Peter
Delfabbro, Paul Howard
Dissertation Note: Thesis (Combined MPsych (Clin) & Ph.D.) -- University of Adelaide, School of Psychology, 2018
Keywords: Psychological pain
psychological distress
Provenance: This electronic version is made publicly available by the University of Adelaide in accordance with its open access policy for student theses. Copyright in this thesis remains with the author. This thesis may incorporate third party material which has been used by the author pursuant to Fair Dealing exceptions. If you are the owner of any included third party copyright material you wish to be removed from this electronic version, please complete the take down form located at
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