Was Shneidman Right? The Frustration of a Psychological

Was Shneidman Right? The Frustration of a Psychological

Was Shneidman Right?
The Frustration of a Psychological Need, Psychache and
Suicidal Behaviours
Frdrick Dionne1,2,3, M.Ps., Ph.D. cand.
Correspondance: [email protected] 2University of Quebec at Trois-Rivieres 3F-X-Garneau college

1

Introduction
Introduction
Shneidman is a founder of
modern suicidology. By the end of
his career, he summarized the
kernel of his theory in a few words :
Suicide is caused by psychache
(Shneidman, 1993, p.147). This
means that psychache is for him the
variable most proximal to suicide.
Psychache
designates
a
psychological or mental suffering
defined as the pain of overwhelming
emotions
(Shneidman,
1993).
According to Shneidmans theory,
psychache is engendered when
important psychological needs
are frustrated. For example, these
include the need for comfort,
affiliation, humiliation, nurturance,
defence,
harmavoidance,
etc.
(Murray, 1938 ; Shneidman, 1980).
Among these needs, the need for
affiliation, derived from Henry
Murrays list, is certainly among
crucial needs in explaining suicide
(Shneidman, 1999), particularly in
young
adults
(Erikson,
1980;
Leenaars, 1989). Also, at the
empirical level, loneliness (resulting
in a lack of satisfying social needs)
has been identified as a risk factor
for suicidal behaviours (e.g., Joiner
& Rudd, 1996).
Several studies have supported
portions of Shneidmans theory
and/or the concept of psychache in
various populations (e.g., Bancroft,
Skrimshire & Simkin, 1976; Holden &
DeLisle, 2006; Holden & Kroner,
2003; Holden, Kerr, Mendonca &
Velamoor, 1998; Holden & McLeod,
2000; Holden, Mehta, Cunningham
& Mcleod, 2001; Johns & Holden,
1997; Leenaars, 1988; Mills, Green
& Reddon, 2005). However, few
studies have tested directly
Shneidmans theory by measuring
the frustration of psychological
needs.
To
our
knowledge,
Flaumenbaum and Holden (2007)
recently measured the frustration of
psychological needs and produced
mixed results, and Berlim et al.
(2003)
confirmed
Shneidmans
theory but without measuring
psychache per se.

Aims
Aims of
of study
study
The purpose of the
study was to determine the
mediational
role
of
psychache
between
loneliness and suicidal
behaviour. If psychache
has a mediational role, this
would
support
Shneidmans theory on
suicide.

Method
Method

Discussion
Discussion

Participants
Participants were university students met in their classrooms setting in
September 2003. The sample consisted of 615 young adult university
undergraduates of French-Canadian origin. These were 18 to 30 years of age
(mean of 21.81 years old and standard deviation of 2.38) and comprised 422 women
(68.6%) and 193 men (31.4%). They were asked by an evaluator to complete a
series of questionnaires for a mental health study. The participants were treated in
accordance with the ethical standards.

Instruments
Psychache Scale (Holden et al., 2001): The Psychache Scale is a 13-item
single-factor self-report instrument that serves to measure level of intolerable
psychological suffering in an individual, as defined by Shneidman (1993). The items
are rated on a 5-point Likert scale from 1 (never or strongly disagree) to 5 (always or
strongly agree).
UCLA Loneliness Scale (Russell, Peplau & Cutrona, 1980): The UCLA
Loneliness Scale is a 20-item scale that measures feelings of solitude, disconnection,
and lack of closeness. The scale has adequate psychometrics properties and has
been extensively validated.
Questions regarding suicidal behaviours: The following yes/no questions
drawn from the Quebec Health Survey (Gouvernement du Qubec, 1993) were used
to screen for presence or absence of suicidal behaviours in the past 12 months :
(Q1) In the past 12 months, have you ever seriously thought about attempting
suicide? (Q2) In the past 12 months, have you ever planned of attempted suicide?
(Q3) In the past 12 months, how often have you attempted suicide? Participants
were distributed into two groups : The suicidal group and the non-suicidal group.
To fall into the suicidal group, a participant had to respond affirmatively to questions
Q1, Q2 or Q3?

Results
Results
Among de 615 participants, 42 individuals (6.8% of the overall sample)
reported having had at least serious suicidal thoughts in the past 12 months. Of
these, 36 were women (8.5% of all the women) and 6 were men (3.1%) of all the
men.
First, we wished first to verify whether the two groups could be distinguished
from one another through psychache or loneliness. The relevant data on these two
variables are presented in Table I where we can find descriptive statistics on the
overall sample, the suicidal group and the non-suicidal groups considered separately.
Coefficient Alpha

Psychache*

Non-suicidal
group
(n = 573)

.95

Loneliness*

M

SD

M

SD

19.6

7.2

35.0

12.4

34

.92

Suicidal
group
(n = 42)

8.5

42.2

11.9

The results confirmed Shneidmans
path to suicidal behaviours. In our
sample, psychache was a mediator
between loneliness and suicidal
behaviours. Effectively, the three
conditions held concordant using
partials correlations. The frustration
of the affiliation need (or loneliness)
affected significantly psychache.
Psychache and suicidal behaviours
were associated when loneliness was
in the equation. When psychache
was controlled for, the link between
loneliness and suicidal behaviours
was reduce to non-significance. This
finding is meaningful because it offers
empirical data on Shneidmans
theorizing
and
adds
to
the
understanding of variables and risk
factors
related
with
suicidal
behaviours, particularly in young
adults university students.

Limitations
However, they were some limits that
reduced the generalization of the
research. Giving our experimental
design, it would be necessary to
conduct a longitudinal study to test
the model and conclude in a causeand-effect relationship. Additionally,
other measures might be considered
like depression and hopelessness
to find variables that covariate with
loneliness and psychache. Also,
utilizing a sample drawn from a
general population reduces the
score range and limits the statistical
potential of the measure scales. The
results are encouraging, but it will be
essential to conduct research on
clinical populations (e.g., mooddisordered
individuals,
suicide
attempters) in order to gain a finer
appreciation of Shneidmans theory
of suicide.

References
References
Bancroft, J. H. J., Skrimshire, A. M. & Simkin, S. (1976). The reasons people give
for taking overdoses. British Journal of Psychiatry, 128, 538-548.
Baron, R.B., & Kenny, D.A. (1986). The moderator-mediator variable distinction in
social psychological research : conceptual, strategic, and statistical
considerations. Journal of Personality and Social Psychology, 51, 11731182.

Table 1. Means and standard deviations for suicidal group and non-suicidal group
* p < .001 Berlim, M.T., Mattevi, B.S., Pavanello, D.P., Caldieraro, M.A., Fleck, P.A., Wingate, L.R., & Joiner, T.E. (2003). Psychache and suicidality in adults mood disordered outpatients in Brazil. Suicide and Life-Threatening Behavior, 33, 8-17. Second, three conditions must hold to confirm the hypothesis (Baron & Kenny, 1986). Partial correlations were used. Erikson, E. (1980). Identity and the life cycle. New-York : W.W. Norton. 1) Variations of the frustration of the affiliation need (or loneliness) significantly account for variation in the mediator (psychache) (r = .54; r2 = .29; p < .001). Holden, R.R., Kerr, P.S., Mendonca, J.D., & Velamoor, V.R. (1998). Are some motives more linked to suicide proneness than others? Journal of Clinical Psychology, 54, 569-576. 2) Variations in the mediator (psychache) significantly account for variations in the dependant variable (suicidal behaviours) (r = .40; r2 = .16; p < .001). Holden, R.R., & Kroner, D.G. (2003). Differentiating suicidal motivations and manifestations in a forensic sample. Canadian Journal of Behavioural Science, 35, 35-44. 3) When the mediators path is control for (psychache), a previously significant relation between the independent variable (loneliness) and the dependant variable (suicidal behaviours) is no longer significant. (r = -.25; p = ns). Flaumenbaum, R., & Holden, R.R. (2007). Psychache as a mediator in the relationship between perfectionnism and suicidality. Journal of Consulting Psychology, 54, 51-61. Holden, R.R., & DeLisle, M.M., (2006). Factor structure of the Reasons for attempting suicide questionnaire (RASQ) with suicide attempters. Journal of Psychopathology and Behavioural Assessment, 28, 1-8. Holden R.R., & McLeod, D.G. (2000). The structure of the Reasons for attempting suicide questionnaire (RASQ) in a nonclinical adult population. Personality and Individual Differences, 29, 621-628. Holden, R.R., Mehta, K., Cunningham, J., & Mcleod, L.D. (2001). Development and preliminary validation of a Scale of Psychache. Canadian Journal of Behavioural Science, 33, 224-232. Johns, D., & Holden, R.R. (1997). Differentiating suicidal motivations and manifestations in a nonclinical population. Canadian Journal of Behavioral Science, 29, 266-274. Joiner, T.E. & Rudd, D. (1996). Disentangling the interrelations between hopelessness, loneliness, and suicide ideation. Suicide and Life-Threatening Behavior, 26, 19-26. Leenaars, A. A. (1988). Suicide notes : Predictive clues and patterns. New York : Human Sciences Press. 1 Loneliness (r 54 . = ; . < p 00 1 ). Psychache 3 (r = -.25; p = ns). 2 (r = Leenaars, A. A. (1989). Are young adults suicides psychologically different from those of other adults? (The Shneidman Lecture). Suicide and LifeThreatening Behavior, 19, 249-263. .40 ; Mills, J.F., Green, K., & Reddon, J.R. (2005). An evaluation of the psychache scale on an offender population. Suicide and Life-Threatening Behavior, 35, 570580. p< .00 1 ). Suicidal behaviours Murray, H. A. (1938). Explorations in personality. New-York : Oxford University Press. Russel, D., Peplau, L.A., & Cutrona, C.C. (1980). The revised UCLA lonliness scale : concurent and discriminant validity evidence. Journal of Social Psychology, 39, 472-480. Shneidman, E. S. (1980a). A possible classification of suicidal acts based on Murrays need system. Suicide and Life-Threatening Behaviour, 10(3), 175181. Shneidman, E. S. (1992). A conspectus of the suicidal scenario. Dans R. W. Maris, A. L. Berman, J. T. Maltsberger, & R. I. Yufit (ds), Assessment and prediction of suicide (pp. 50-64). New-York : Guilford. Shneidman, E. S. (1993). Suicide as psychache. Journal of Nervous and Mental Disease, 181, 147-149. Figure 1. Mediational model. Perfect mediation of psychache between loneliness and suicidal behaviours. Shneidman, E.S. (1999). Le temprament suicidaire : Risques, souffrances et thrapies. Bruxelles : De Boeck et Berlin.

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