Thinking About Suicidal Thinking: Suicide-Related Metacognitions’ Relation to Maladaptive Processing of Suicidal Thoughts

The metacognitive model of suicidality proposes that positive metacognitions about suicide (PMS) activate a cognitive attentional syndrome (CAS), i.e., suicide-specific rumination, attentional fixation, and thought suppression, which in turn activates negative metacognitions about suicide (NMS) and an aggravation of suicidality. Preliminary evidence supports the model assumptions; however, a more comprehensive investigation is missing by now. One hundred eighty-six participants (148 female [79.6%]; age M = 28.3 (SD = 9.8)) with lifetime suicidal ideation filled in self-report measures of suicide ideation/behavior, all CAS-components, and metacognitions about suicide. All elements of the CAS correlated significantly with each other and with concurrent suicidal ideation. PMS predicted suicide-specific rumination and attentional fixation. All CAS-components predicted NMS. Suicide-specific rumination, attentional fixation, and positive and negative metacognitions differentiated between lifetime suicide attempters and non-attempters. Results are in line with the metacognitive model of suicidality and warrant further studies regarding the model assumptions.