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Emotional Dysregulation and Suicide Risk: If You’ll Leave Me, I’ll Kill Myself!

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Phenomenology of Suicide

Abstract

In this chapter the role of emotional regulatory processes in suicidality is highlighted, not only considering relationship difficulties or breakup as trigger of a sense of helplessness in vulnerable people but also considering the chance that people can use adult relationship context as a regulatory place. In particular, adult relationships are discussed as a possible trigger of risk or resilience to partners’ ability to manage negative emotions that may occur through the life span. Recently, literature suggests that people involved in romantic relationships experience lower suicide rates than single, never-married people and that divorced, separated, and widowed persons have the highest rates. Attachment theory and recent studies on emotion regulation provided a new framework for looking at adult relationships.

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Notes

  1. 1.

    Suicide attempts are considered unsuccessful self-injurious behavior where the intent was to die (Amore et al. 2014).

References

  • Allen JG, Fonagy P (2006) Handbook of mentalization-based treatment. John Wiley, Chichester

    Book  Google Scholar 

  • Amato PR, Anthony CJ (2014) Estimating the effects of parental divorce and death with fixed effects models. J Marriage Fam 76(2):370–386. doi:10.1111/jomf.12100

    Article  PubMed  PubMed Central  Google Scholar 

  • Amore M, Innamorati M, Vittorio CD, Weinberg I, Turecki G, Sher L, Paris J, Girardi P, Pompili M (2014) Suicide attempts in major depressed patients with personality disorder. Suicide Life Threat Behav 44(2):155–166

    Article  PubMed  Google Scholar 

  • Anderson KL (2002) Perpetrator or victim? Relationships between intimate partner violence and well-being. J Marriage Fam 64(4):851–886

    Article  Google Scholar 

  • Anestis MD, Bagge CL, Tull MT, Joiner TE (2011) Clarifying the role of emotion dysregulation in the interpersonal-psychological theory of suicidal behavior in an undergraduate sample. J Psychiatr Res 45(5):603–611. doi:10.1016/jjpsychires201010013

    Article  PubMed  Google Scholar 

  • Archer J (2000) Sex differences in aggression between heterosexual partners: a meta-analytic review. Psychol Bull 126(5):651–680

    Article  CAS  PubMed  Google Scholar 

  • Arria AM, O’Grady KE, Caldeira KM, Vincent KB, Wilcox HC, Wish ED (2009) Suicide ideation among college students: a multivariate analysis. Arch Suicide Res 13:230–246

    Article  PubMed  PubMed Central  Google Scholar 

  • Baca-Gracia E, Parra CP, Perez-Rodriguez MM, Diaz-Sastre C, Reyes Torres R, Saiz-Ruiz J, de Leon J (2007) Psychosocial stressors may be strongly associated with suicide attempts. Stress Health 23:191–198

    Article  Google Scholar 

  • Balzarotti S, Biassoni F, Villani D, Prunas A, Velotti P (2016) Cognitive emotion regulation strategies as predictors of well-being in adults. J Happ Stud 17(1):125–143

    Article  Google Scholar 

  • Berking M, Orth U, Wupperman P, Meier LL, Caspar F (2008) Prospective effects of emotion-regulation skills on emotional adjustment. J Couns Psychol 55:485–494. doi:10.1037/a0013589

    Article  PubMed  Google Scholar 

  • Berscheid E, Reis HT (1998) Attraction and close relationships. In: Gilbert DT, Fiske ST, Lindzey G (eds) The handbook of social psychology, 4th edn. McGraw-Hill, New York, NY, pp 193–281

    Google Scholar 

  • Bowlby J (1969) Attachment and loss, Vol. 1: Attachment. Basic Books, New York, NY

    Google Scholar 

  • Bowlby J (1973) Attachment and loss, Vol. 2: Separation. Basic Books, New York, NY

    Google Scholar 

  • Bowlby J (1979) The making and breaking of affectional bonds. Tavistock, London

    Google Scholar 

  • Bowlby J (1980) Attachment and loss, Vol. 3: Loss, sadness and depression. Basic Books, New York, NY

    Google Scholar 

  • Brown MZ, Comtois KA, Linehan MM (2002) Reasons for suicide attempts and nonsuicidal self-injury in women with borderline personality disorder. J Abnorm Psychol 111(1):198–202

    Article  PubMed  Google Scholar 

  • Campos JJ, Walle E, Dahl A, Main A (2011) Reconceptualizing emotion regulation. Emot Rev 3:26–35

    Article  Google Scholar 

  • Castellano R, Velotti P, Zavattini GC (2013) What makes us together. Attachment theory and couples outcomes. Karnac Books, London

    Google Scholar 

  • Cheng AT, Chen TH, Chen CC, Jenkins R (2000) Psychosocial and psychiatric risk factors for suicide case-control psychological autopsy study. Br J Psychiatry 177:360–365

    Article  CAS  PubMed  Google Scholar 

  • Cooper J, Appleby L, Amos T (2002) Life events preceding suicide by young people. Soc Psychiatry Psychiatr Epidemiol 37(6):271–275

    Article  CAS  PubMed  Google Scholar 

  • Davis TS, Mauss IB, Lumian D, Troy AS, Shallcross AJ, Zarolia P, McRae K (2014) Emotional reactivity and emotion regulation among adults with a history of self-harm: laboratory self-report and functional MRI evidence. J Abnorm Psychol 123(3):499–509

    Article  PubMed  PubMed Central  Google Scholar 

  • Diamond LM, Hicks AM (2005) Attachment style, current relationship security, and negative emotions: the mediating role of physiological regulation. J Soc Pers Relat 22:499–518

    Article  Google Scholar 

  • Doherty T, DeVilder J (2016) Identifying risk for suicide. Health Soc Work. doi:10.1093/hsw/hlw033

  • Dutton DG (2011) Attachment and violence: an anger born of fear. In: Shaver PR, Mikulincer M (eds) Human aggression and violence: causes, manifestations, and consequences. American Psychological Association, Washington, DC, pp 259–276

    Chapter  Google Scholar 

  • Ellsberg M, Jansen HA, Heise L, Watts CH, Garcia-Moreno C (2008) Intimate partner violence and women’s physical and mental health in the WHO multi-country study on women's health and domestic violence: an observational study. Lancet 371:1165–1172

    Article  PubMed  Google Scholar 

  • Elison J, Garofalo C, Velotti P (2014) Shame and aggression: theoretical considerations. Aggress Violent Behav 19:447–453. doi:10.1016/javb201405002

    Article  Google Scholar 

  • Feeney JA (2008) Adult romantic attachment: developments in the study of couple relationships. In: Cassidy J, Shaver PR (eds) Handbook of attachment: theory, research, and clinical applications, 2nd edn. Guilford, New York, NY, pp 456–481

    Google Scholar 

  • Feeney JA, Noller P, Hanrahan M (1994) Assessing adult attachment. In: Sperling MB, Berman WH (eds) Attachment in adults: clinical and developmental perspectives. Guilford, New York, NY, pp 122–158

    Google Scholar 

  • Feeney BC, Monin JK (2008) An attachment-theoretical perspective on divorce. In: Cassidy J, Shaver PR (eds) Handbook of attachment: theory, research, and clinical applications, 2nd edn. Guilford Press, New York, NY

    Google Scholar 

  • Gottman JM, Levenson RW (2003) Risk factors for and functions of deliberate self-harm: an empirical and conceptual review. Fam Process 38(3):287–292

    Google Scholar 

  • Gratz KL (2003) Risk factors for and functions of deliberate self-harm: an empirical and conceptual review. Clin Psychol Sci Pract 10:192–205

    Article  Google Scholar 

  • Gratz KL (2006) Risk factors for deliberate self-harm among female college students: the role and interaction of childhood maltreatment emotional inexpressivity and affect intensity/reactivity. Am J Orthopsychiatry 76:238–250

    Article  PubMed  Google Scholar 

  • Gratz KL, Roemer L (2008) The relationship between emotion dysregulation and deliberate self-harm among female undergraduate students at an Urban Commuter University. Cogn Behav Ther 37(1):14–25. doi:10.1080/16506070701819524

  • Greenberg LS (2000) Emociones: una guía interna. Desclée De Brouwer, Bilbao

    Google Scholar 

  • Gross JJ (1998) Antecedent- and response-focused emotion regulation: divergent consequences for experience, expression, and physiology. J Pers Soc Psychol 74:224–237

    Article  CAS  PubMed  Google Scholar 

  • Gross J, Thompson RA (2007) Emotion regulation: conceptual foundations. In: Gross JJ (ed) Handbook of emotion regulation. Guilford Press, New York, NY, pp 3–24

    Google Scholar 

  • Houston K, Hawton K, Sheppard R (2001) Suicide in young people 15-24: a psychological autopsy study. J Affect Disord 63:159–170

    Article  CAS  PubMed  Google Scholar 

  • Kappas A (2011) Emotion and regulation are one! Emot Rev 3:17–25

    Article  Google Scholar 

  • Hank K, Wagner M (2013) Parenthood, marital status, and well-being in later life: evidence from share. Soc Indicat Res 114(2):639–653. doi:10.1007/s11205-012-0166-x

    Article  Google Scholar 

  • Kazan D, Calear AL, Batterham PJ (2016) The impact of intimate partner relationships on suicidal thoughts and behaviours: a systematic review. J Affect Disord 190:585–598

    Article  PubMed  Google Scholar 

  • Kobak R, Hazan C, Ruckdeschel K (1994) From symptom to signal: an attachment view of emotion in marital therapy In: Greenberg JL (eds). Emotions in marital therapy. Brunner/Mazel, New York, NY, pp 46–71

    Google Scholar 

  • Kobak R, Madsen SD (2008) The emotional dynamics of disruptions in attachment relationships: implications for theory, research, and clinical intervention. In: Cassidy J, Shaver PR (eds) Handbook of attachment, 2nd edn. Guilford Press, New York, NY, pp 23–47

    Google Scholar 

  • Kõlves K, Ide N, De Leo D (2010) Suicidal ideation and behaviour in the aftermath of marital separation: gender differences. J Affect Disord 120:48–53

    Article  PubMed  Google Scholar 

  • Kõlves K, Kõlves KE, De Leo D (2013) Natural disasters and suicidal behaviours: a systematic literature review. J Affect Disord 146(1):1–14. doi:10.1016/j.jad.2012.07.037

    Article  PubMed  Google Scholar 

  • Kõlves K, Värnik A, Schneider B, Fritze J, Allik J (2006) Recent life events and suicide: a case-control study in Tallinn and Frankfurt. Soc Sci Med 62:2887–2896

    Article  PubMed  Google Scholar 

  • Koole SL (2009) The psychology of emotion regulation: an integrative review. Cognit Emot 23(1):4–41

    Article  Google Scholar 

  • Kposowa AJ (2000) Marital status and suicide in the National Longitudinal Mortality Study. J Epidemiol Community Health 54:254–261

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Kranzler A, Fehling KB, Anestis MD, Selby EA (2016) Emotional dysregulation, internalizing symptoms, and self-injurious and suicidal behavior: structural equation modeling analysis. Death Stud 40(6):358–366. doi:10.1080/07481187.2016.1145156

    Article  PubMed  Google Scholar 

  • Kring AM, Sloan DS (2010) Emotion regulation and psychopathology. Guilford Press, New York, NY

    Google Scholar 

  • Law KC, Khazem LR, Anestis MD (2015) The role of emotion dysregulation in suicide as considered through the ideation to action framework. Curr Opin Psychol 3:30–35

    Article  Google Scholar 

  • Laye-Gindhu A, Schonert-Reichl KA (2005) Nonsuicidal self-harm among community adolescents: understanding the “whats” and “whys” of self-harm. J Youth Adolesc 34(5):447–457. doi:10.1007/s10964-005-7262-z

    Article  Google Scholar 

  • Levitt JT, Brown TA, Orsillo SM, Barlow DH (2004) The effects of acceptance versus suppression of emotion on subjective and psychophysiological response to carbon dioxide challenge in patients with panic disorder. Behav Ther 35:747–766

    Article  Google Scholar 

  • Luoma JB, Martin CE, Pearson JL (2002) Contact with mental health and primary care providers before suicide: a review of the evidence. Am J Psychiatry 159(6):909–916

    Article  PubMed  PubMed Central  Google Scholar 

  • Lynch TR, Cheavens JS, Morse JQ, Rosenthal MZ (2004) A model predicting suicidal ideation and hopelessness in depressed older adults: the impact of emotion inhibition and affect intensity. Aging Ment Health 8:486–497

    Article  CAS  PubMed  Google Scholar 

  • Maltsberger JT, Hendin H, Haas AP, Lipschitz A (2003) Determination of precipitating events in the suicide of psychiatric patients. Suicide Life Threat Behav 33(2):111–119

    Article  PubMed  Google Scholar 

  • Mikulincer M, Shaver PR (2008) Adult attachment and affect regulation. In: Cassidy J, Shaver PR (eds) Handbook of attachment: theory, research, and clinical applications, 2nd edn. Guilford, New York, NY, pp 503–531

    Google Scholar 

  • Mikulincer M, Shaver PR, Gillath O, Nitzberg RA (2005) Attachment, caregiving, and altruism: boosting attachment security increases compassion and helping. J Pers Soc Psychol 89(5):817–839

    Article  PubMed  Google Scholar 

  • Nock MK, Wedig MM, Holmberg EB, Hooley JM (2008) The emotion reactivity scale: development evaluation and relation to self-injurious thoughts and behaviors. Behav Ther 39:107–116

    Article  PubMed  Google Scholar 

  • Orbach I, Blomenson R, Mikulincer M, Gilboa-Schechtman E, Rogolsky M, Retzoni G (2007) Perceiving a problem-solving task as a threat and suicidal behavior in adolescents. J Soc Clin Psychol 26:1010–1034

    Article  Google Scholar 

  • Palmier-Claus JE, Taylor PJ, Gooding P, Dunn G, Lewis SW (2011) Affective variability predicts suicidal ideation in individuals at ultra-high risk of developing psychosis: an experience sampling study. Br J Clin Psychol 51:72–83

    Article  PubMed  Google Scholar 

  • Pico-Alfonso MA, Garcia-Linares I, Celda-Navarro N, Blasco-Ros C, Echeburúa E, Martinez M (2006) The impact of physical, psychological, and sexual intimate male partner violence on women’s mental health: depressive symptoms, posttraumatic stress disorder, state anxiety, and suicide. J Womens Health 15(5):599–611

    Article  Google Scholar 

  • Rajappa K, Gallagher M, Miranda R (2012) Emotion dysregulation and vulnerability to suicidal ideation and attempts. Cogn Ther Res 36(6):833–839. doi:10.1007/s10608-011-9419-2

    Article  Google Scholar 

  • Ryff CD, Singer B, Wing E, Love GD (2001) Elective affinities and uninvited agonies: mapping emotion with significant others onto health. In: Ryff CD, Singer B (eds) Emotion, social relationships and health. Oxford University Press, New York, NY

    Chapter  Google Scholar 

  • Ronningstam E, Weinberg I, Maltsberger JT (2008) Eleven deaths of Mr K: contributing factors to suicide in narcissistic personalities. Psychiatry 71(2):169–182

    Article  PubMed  Google Scholar 

  • Sandberg-Thoma SE, Kamp Dush CMK (2014) Casual sexual relationships and mental health in adolescence and emerging adulthood. J Sex Res 51:121–130

    Article  PubMed  Google Scholar 

  • Schore AN (2003) Affect dysregulation and disorders of the self. Norton, New York, NY

    Google Scholar 

  • Schulze L, Lischke A, Greif J, Herpertz SC, Heinrichs M, Domes G (2011) Oxytocin increases recognition of masked emotional faces. Psychoneuroendocrinology 36:1378–1382

    Article  CAS  PubMed  Google Scholar 

  • Scoliers G, Portzky G, van Heeringen K, Audenaert K (2009) Sociodemographic and psychopathological risk factors for repetition of attempted suicide: a 5-year follow-up study. Arch Suicide Res 13(3):201–213

    Article  PubMed  Google Scholar 

  • Scott LN, Stepp SD, Pilkonis PA (2014) Prospective associations between features of borderline personality disorder, emotion dysregulation, and aggression. Person Disord 5:278–288

    Article  Google Scholar 

  • Selby EA, Anestis MD, Bender TW, Joiner TE (2009) An Exploration of the emotional cascade model in borderline personality disorder. J Abnorm Psychol 118:375–387

    Article  PubMed  PubMed Central  Google Scholar 

  • Shiner M, Scourfield J, Fincham B, Langer S (2009) When things fall apart: gender and suicide across the life-course. Soc Sci Med 69:738–746

    Article  PubMed  Google Scholar 

  • Siegel DJ (1999) The developing mind: toward a neurobiology of interpersonal experience. Guilford, New York, NY

    Google Scholar 

  • Silk J, Steinberg L, Morris A (2003) Adolescents’ emotion regulation in daily life: links to depressive symptoms and problem behavior. Emotion dysregulation in suicide. Child Dev 74:1869–1880

    Article  PubMed  Google Scholar 

  • Simon NM, Pollack MH, Ostacher MJ, Zalta AK, Chow CW, Fischmann D, Demopulous CM, Nierenberg AA, Otto MW (2007) Understanding the link between anxiety symptoms and suicidal ideation and behavior in out patients with bipolar disorder. J Affect Disord 97:91–99

    Article  PubMed  Google Scholar 

  • Skerrett DM, Kõlves K, De Leo D (2015) Are LGBT populations at a higher risk for suicidal behaviors in Australia? Research findings and implications. J Homosex 62(7):883–901. doi:10.1080/00918369.2014.1003009

    Article  PubMed  Google Scholar 

  • Stack S, Scourfield JB (2013) Recency of divorce, depression, and suicide risk. J Fam Issues 36(6):695–715

    Article  Google Scholar 

  • Stets JE, Straus MA (1989) The marriage license as a hitting license: a comparison of assaults in dating, cohabiting, and married couples. J Fam Violence 4(2):161–180

    Article  Google Scholar 

  • Sugarman DB, Hotaling GT (1989) Dating violence: prevalence, context, and risk markers. In: Pirog-Good AA, Stets JE (eds) Violence in dating relationships: emerging social issues. Praeger, New York, NY, pp 3–31

    Google Scholar 

  • Tangney JP, Dearing R (2002) Shame and guilt. Guilford, New York, NY

    Book  Google Scholar 

  • Thomas HV, Crawford M, Meltzer H, Lewis G (2002) Thinking life is not worth living - a population survey of Great Britain. Soc Psychiatry Psychiatr Epidemiol 37:351–356

    Article  CAS  PubMed  Google Scholar 

  • Thompson RA (1994) Emotion regulation: a theme in search of definition. Monogr Soc Res Child Dev 59(2–3):25–52

    Article  CAS  PubMed  Google Scholar 

  • Tsypes MR, Gallagher M, Rajappa K (2013) Rumination and hopelessness as mediators of the relation between perceived emotion dysregulation and suicidal ideation. Cogn Ther Res 37:786–795

    Article  Google Scholar 

  • Uchino BN, Cacioppo JT, Kiecolt-Glaser JK (1996) The relationship between social support and physiological processes: a review with emphasis on underlying mechanisms and implications for health. Psychol Bull 119:488–531

    Article  CAS  PubMed  Google Scholar 

  • Velotti P, Balzarotti S, Tagliabue S, Zavattini GC, Gross J (2015) Emotional suppression in early marriage: actor, partner and similarity effects on marital quality. J Soc Per Relat 33(3):277–302

    Article  Google Scholar 

  • Velotti P, Garofalo C (2015) Personality styles in a non-clinical sample: the role of emotion dysregulation and impulsivity. Personal Individ Differ 79:44–49. doi:10.1016/j.paid.2015.01.046

    Article  Google Scholar 

  • Velotti P, Garofalo C, Petrocchi C, Cavallo F, Popolo R, Dimaggio G (2016) Alexithymia emotion dysregulation impulsivity and aggression: a multiple mediation model. Psychiatry Res 237:296–303

    Article  PubMed  Google Scholar 

  • Velotti P, Garofalo C, Zavattini GC (2013) The study of the emotion regulation: future directions. Giornale Italiano di Psicologia 2:247–262. doi:10.1421/74555

    Google Scholar 

  • Webb TL, Schweiger Gallo I, Miles E, Gollwitzer PM, Sheeran P (2012) Effective regulation of affect: an action control perspective on emotion regulation. Eur Rev Soc Psychol 23(1):143–186

    Article  Google Scholar 

  • Weiss RS (1977) Marital separation. Basic Books, New York, NY

    Google Scholar 

  • Wiklander M, Samuelsson M, Jokinen J, Nilsonne A, Wilczek A, Rylander G, Åsberg M (2012) Shame-proneness in attempted suicide patients. BMC Psychiatry 12:50

    Article  PubMed  PubMed Central  Google Scholar 

  • Wyder M, Ward P, De Leo D (2009) Separation as a suicide risk factor. J Affect Disord 116:208–213

    Article  PubMed  Google Scholar 

  • Yen S, Shea WT, Sanislow CA, Grilo CM, Skodol AE, Gunderson JG, McGlashan TH, Zanarini MC, Morey LC (2004) Borderline personality disorder criteria associated with prospectively observed suicidal behavior. Am J Psychiatry 161:1296–1298

    Article  PubMed  Google Scholar 

  • Yen S, Pagano ME, Shea MT, Grilo CM, Gunderson JG, Skodol AE, McGlashan TH, Sanislow CA, Bender DS, Zanarini MC (2005) Recent life events preceding suicide attempts in a personality disorder sample: findings from the collaborative longitudinal personality disorders study. J Consult Clin Psychol 73(1):99–105

    Article  PubMed  PubMed Central  Google Scholar 

  • Yip PSF, Yousuf S, Chan CH, Yung T, Wu KCC (2015) The roles of culture and gender in the relationship between divorce and suicide risk: a meta-analysis. Soc Sci Med 128:87–94

    Article  PubMed  Google Scholar 

  • Zavattini GC (2010) Psicoterapia di coppia: la prospettiva psicoanalitica e dell’attaccamento. Quaderni CPD 9:7–20

    Google Scholar 

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Velotti, P., Zavattini, G.C. (2018). Emotional Dysregulation and Suicide Risk: If You’ll Leave Me, I’ll Kill Myself!. In: Pompili, M. (eds) Phenomenology of Suicide. Springer, Cham. https://doi.org/10.1007/978-3-319-47976-7_8

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