Are Positive Mental Health and Social Support Protective Factors in the Development of Suicidal Ideation in Chronic Pain? A Longitudinal Study.

Entrapment was confirmed as a proximal risk factor for suicidal ideation in persons living with chronic pain.

• Both internal and external entrapment facets were examined as predictors of suicidal ideation.
• The study used generalized linear models to test associations between entrapment and suicidal ideation.
• N = 285 persons living with chronic pain (PLCP) participated in the cross-sectional portion of the online survey.
• The finding aligns with the integrated motivational-volitional (IMV) model of suicidal behavior, which links suicidal ideation to feelings of defeat and entrapment.

Positive mental health moderated the relationship between both internal and external entrapment and suicidal ideation cross-sectionally.

• Cross-sectional analyses showed only positive mental health (not social support) significantly moderated the entrapment–suicidal ideation relationship.
• The moderation was observed for both internal and external entrapment facets.
• Social support did not moderate the association between either entrapment facet and suicidal ideation in cross-sectional analyses.
• Generalized linear models were used for the cross-sectional moderation analyses.

Neither positive mental health, social support, entrapment facets, nor their interactions predicted change in suicidal ideation over 4 weeks longitudinally.

• n = 161 participants completed the follow-up assessment 4 weeks after baseline.
• Both entrapment facets, positive mental health, social support, and their interactions were tested as predictors of change in suicidal ideation.
• None of the tested factors or interaction terms were significant predictors of change in suicidal ideation over the 4-week period.
• The longitudinal dropout from n = 285 to n = 161 represents a retention rate of approximately 57% at follow-up.

The study identified a need for microlongitudinal studies on suicidal ideation in persons living with chronic pain.

• The 4-week follow-up interval may have been insufficient to capture meaningful change in suicidal ideation.
• Authors explicitly state the study 'underlines a need for (micro)longitudinal studies on this topic.'
• The failure of longitudinal predictors to reach significance was interpreted in the context of the study's temporal resolution rather than as a refutation of the cross-sectional findings.
• Persons living with chronic pain are described as an 'at-risk group' for suicidal ideation, motivating the call for more fine-grained longitudinal designs.

The study used an online survey design with an adult sample of persons living with chronic pain to test the IMV model's moderating factors.

• N = 285 persons living with chronic pain participated in the baseline online survey.
• n = 161 participated again at a 4-week follow-up.
• The integrated motivational-volitional (IMV) model of suicidal behavior provided the theoretical framework.
• Positive mental health and social support were operationalized as candidate moderating factors between entrapment and suicidal ideation.