| “Every psychological event depends upon the state of the person and at the same time on the environment, although their relative importance is different in different cases.” — Kurt Lewin |
How we think, feel and respond to distress is shaped, at least in part, by the social and cultural contexts in which we live. Suicidal thinking is unlikely to be an exception.
The Integrated Motivational–Volitional model (IMV) reflects this broader view, recognising that suicidal thoughts develop in the context of biological and psychological vulnerabilities, social circumstances, environmental influences and life events. That raises a further question: do the factors linked to suicidal thinking look the same across countries, or does context make a difference?
We explored this question in our recent study involving 2,018 adults from Italy, South Korea, the United Kingdom and the United States. We looked at suicidal ideation alongside defeat and entrapment, perceived burdensomeness and thwarted belongingness, social comparison, relative deprivation, and reasons for living. Using network analysis, we examined how these experiences were connected rather than looking at each factor in isolation.
What seemed to be shared?
Several patterns stood out across countries.
Defeat and internal entrapment were strongly connected: people who felt defeated also tended to feel trapped within their thoughts and feelings. Defeat was also the most central factor in the broader network of connections, consistent with the importance given to defeat and entrapment in the IMV model.
Perceived burdensomeness — feeling that one is a burden to others — stood out in a different way. It was more directly associated with suicidal ideation and was particularly important in explaining suicidal thoughts. This points to an interesting distinction: what is central in the broader network is not necessarily what is most directly related to suicidal thoughts.
Across countries, defeat remained relatively prominent and perceived burdensomeness consistently showed high importance, suggesting that some psychological processes may matter across quite different national settings.
And what differed?
Other connections varied more from one country to another, particularly those involving social comparison, relative deprivation and reasons for living. In South Korea, comparing one’s abilities or achievements with those of others was more strongly connected with defeat than in the other countries. While speculative, one possibility is that in a social context where competition is strong and people tend to define themselves more in relation to others, ability and achievement comparisons may have a stronger impact on how people see themselves, making unfavourable comparisons more closely tied to feelings of defeat. A recent review suggests that collectivistic societies can be highly competitive and that people may be more likely to judge themselves against common standards rather than goals they define for themselves. In the UK and Italy, survival and coping beliefs — one aspect of people’s reasons for living — were more clearly associated with lower suicidal ideation. The association between defeat and suicidal ideation was also weaker in the US than in South Korea and Italy.
These findings suggest that even when similar psychological factors are relevant across countries, the ways in which they connect may differ.
But a country is not the same thing as a culture. We compared countries, but did not directly measure cultural values or broader structural conditions. The differences may therefore reflect influences beyond the individual factors examined here.
Looking at the bigger picture
Suicide research is increasingly recognising the importance of the wider social conditions in which psychological and interpersonal risk processes unfold. Recent evidence has highlighted the wide range of social factors associated with suicide-related outcomes, and called for prevention efforts to look beyond clinical and psychiatric risk factors alone.
Our study speaks to a different, more immediate part of this broader picture. We looked at experiences such as social comparison and relative deprivation alongside established psychological processes related to suicidal thinking. These factors were not the ones most directly connected with suicidal ideation; instead, they were linked with other processes, particularly defeat.
This suggests that social context may matter not only through broader social conditions, but also through how people experience and make sense of those conditions in relation to themselves and others.
Looking across countries offered one way to examine whether these connections remain relatively consistent across settings or vary more with context. Our findings suggest that both may be true: some processes appear broadly relevant, while other connections — particularly those involving social comparison, relative deprivation and reasons for living — may be more context-sensitive.
For suicide research and prevention, the question may therefore be not only which factors matter, but also how they are connected — and how those connections vary across social contexts.
Paper link