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

## TL;DR

This study explores whether positive mental health and social support protect against suicidal ideation in people with chronic pain.

## Contribution

It is the first to test these factors as moderators of entrapment's impact on suicidal ideation in a longitudinal study of chronic pain patients.

## Key findings

- Positive mental health moderated the relationship between entrapment and suicidal ideation.
- Entrapment remains a key risk factor for suicidal ideation in chronic pain patients.
- The factors did not predict changes in suicidal ideation over four weeks.

## Abstract

The “integrated motivational‐volitional (IMV) model of suicidal behavior” links the development of suicidal ideation (SI) to feelings of defeat and entrapment. Positive mental health and social support appear to be protective in this process. Both were tested as moderating factors between entrapment and SI in the at‐risk group of persons living with chronic pain (PLCP).

N = 285 PLCP participated in an online survey, n = 161 again at a 4‐week follow‐up. Generalized linear models tested whether positive mental health and social support moderated associations between both internal and external entrapment and SI, cross‐sectionally. Further, both entrapment facets, positive mental health, social support and their interactions were tested as predictors of change for SI, longitudinally.

Cross‐sectionally, only positive mental health moderated the relationship between both entrapment facets and SI. Longitudinally, none of the factors or their interaction were able to predict change in SI over 4 weeks.

This study confirmed entrapment as a proximal risk factor for SI in PLCP. It further supports positive mental health buffering the impact of entrapment on SI. However, these factors could not predict change in SI over 4 weeks. This study underlines a need for (micro)longitudinal studies on this topic.