Interplay of Repetitive Negative Thinking, Defeat, and Entrapment in Patients with Suicidal Ideation versus Suicidal Behavior through the Integrated Motivational-Volitional Model

Abstract Introduction: this study aims to elucidate the cognitive mechanisms underlying the transition from suicidal ideation (SI) to suicidal behavior (SB), exploring the interplay between repetitive negative thinking (RNT), feelings of defeat, and perceptions of entrapment (internal and external) within the framework of the Integrated Motivational-Volitional (IMV) Model. Methods: an observational, analytical, cross-sectional, and prospective study was conducted with 64 patients from a suicide prevention program in Spanish hospital, they were stratified into SI and SB groups. Results: a positive correlation was observed between RNT and both internal and external entrapment, as well as defeat, across both patient groups. These correlations were more robust for internal entrapment and were particularly prominent in the SB group. Discussion: the findings suggest that RNT may serve as a transdiagnostic risk factor for suicide, with its influence being moderated by feelings of defeat and entrapment. This research underscores the critical role of RNT in the context of suicidal risk and supports the IMV model as a valuable framework for understanding the progression from SI to SB. Early identification and targeted therapeutic interventions for RNT, defeat, and entrapment could be pivotal in preventing the escalation to SB. Future studies should explore the causal pathways between these cognitive variables and evaluate the efficacy of interventions aimed at reducing RNT and its associated suicidal outcomes.