Negative self-appraisals and suicidal behavior among trauma victims experiencing PTSD symptoms: The mediating role of defeat and entrapment

Background A considerable body of literature has shown a strong association between posttraumatic stress disorder (PTSD) and suicidal behavior but only a limited number of studies have investigated the putative psychological mechanisms underlying suicidal behavior in PTSD. Based on a recent theoretical model of suicide, the Schematic Appraisals Model, the current study aimed to examine whether perceptions of defeat and entrapment mediated the effects of three types of negative self-appraisals (emotion coping, problem solving, and social support) on suicidal behavior among individuals experiencing PTSD symptoms in the past month. Methods The sample comprised 56 individuals who had been previously exposed to a traumatic event and reported at least one PTSD symptom in the past month (confirmed through the Posttraumatic Diagnostic Scale). The mediational analyses were conducted using a nonparametric, bootstrapping method. Results The results showed that defeat and entrapment fully mediated the effect of all three types of self-appraisals on suicidal behavior. When controlling for PTSD symptom severity, defeat and entrapment continued to mediate fully the effect of two types of self-appraisals, namely the perceived ability to control negative emotions (emotion coping) and the perceived ability to cope with difficult situations/problems (problem solving) on suicidal behavior. Conclusions The current findings provide support for the Schematic Appraisals Model of Suicide and suggest that both specific types of negative self-appraisals and general perceptions of defeat and entrapment are strongly related to suicidal behavior in those with PTSD. The findings have important clinical implications. © 2012 Wiley Periodicals, Inc.