Hopelessness as a Mechanism of the Relationship between Physical Pain and Thoughts of Suicide: Results from Two Smartphone-Based Real-Time Monitoring Samples

Although there is research establishing that physical pain is a risk factor for suicidal ideation, there is limited understanding of how physical pain confers risk. The current study uses ecological momentary assessment to explore hopelessness as a potential mechanism of physical pain’s effect on suicidal ideation in two distinct samples: an undergraduate population reporting elevated levels of suicidal ideation and an outpatient population with borderline personality disorder receiving comprehensive dialectical behavior therapy. Our results demonstrated that hopelessness significantly mediated the relationship between physical pain and suicidal ideation in both samples. This implies that physical pain might increase hopelessness, which may in turn increase suicidal ideation. Our study adds to a growing body of research of risk factors for suicide, and future research should explore this relationship between physical pain and hopelessness with suicidal behavior.