Pain and Suicidal Behavior in Primary Care Patients: Mediating Role of Interpersonal Needs

Pain, Social Distress and Suicide in Primary Care
  • Jameson K. Hirsch
  • Kelly C. Cukrowicz
  • Kristin L. Walker


Individuals experiencing chronic pain are at greater risk for suicidal behavior. The mechanism of action for this association is unexplored, but may involve the influence of pain on interpersonal functioning. We examined the mediating role of unsatisfied interpersonal needs on the relation between pain severity and interference, and suicidal behavior. Low income, uninsured participants completed self-report measures of pain severity and interference, thwarted interpersonal needs and suicidal behavior. Our hypotheses were partially supported; in simple mediation models, an indirect only effect existed for both thwarted belongingness and perceived burdensomeness in the relation between pain severity and pain interference and suicidal behavior. These effects did not persist in multiple mediation analyses. Our findings suggest that, for patients experiencing pain, assessment and improvement of the quantity and quality of interpersonal relationships may reduce risk for suicide ideation and attempts.


Suicidal behavior Pain severity Pain interference Thwarted interpersonal needs 


Compliance with Ethical Standards

Participant Rights

Our study was approved by the East Tennessee State University Institutional Review Board, and participants provided signed informed consent prior to study enrollment.

Animal Use

No animals were used in this study.

Funding Sources

There are no funding sources to report.

Conflict of Interest

Jameson K. Hirsch, Kelly C. Cukrowicz and Kristin L. Walker declare that they have no conflict of interest to report.


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Jameson K. Hirsch
    • 1
  • Kelly C. Cukrowicz
    • 2
  • Kristin L. Walker
    • 3
  1. 1.Department of PsychologyEast Tennessee State UniversityJohnson CityUSA
  2. 2.Department of PsychologyTexas Tech UniversityLubbockUSA
  3. 3.Semel Institute for Neuroscience and Human BehaviorUniversity of California, Los AngelesLos AngelesUSA

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