RESUMO
Introduction: The behavioral addiction model posits that repetitive suicidal behaviors can serve as maladaptive strategies for managing stress and negative emotional states, akin to substance addiction. Both behaviors involve negative emotions, offer temporary psychological relief, and persist, indicating shared neurobiological mechanisms. This study explored psychometric differences among major repeaters, occasional attempters, and non-suicidal prisoners. Methods: A multi-centre cross-sectional survey of 363 inmates across four prisons assessed depression, cognitive-emotional regulation, impulsivity, perceived stress, lifetime non-suicidal self-injury and suicide attempts. Results: Mild depression, moderate suicidal ideation, and moderate impulsivity were common, with nearly half of the participants having attempted suicide at least once. Hierarchical multiple regression analyses revealed that repeated suicidal behavior in the past increases susceptibility to future suicidal thoughts, with suicide attempts serving as a maladaptive emotion regulation strategy among repeated attempters. Discussion: The results reveal differences in emotional dysregulation, impulsivity, and stress coping strategies among the studied groups, reinforcing the idea of suicidality as a form of behavioral addiction. The addiction approach helps explain the sensitivity to later suicidal thoughts in former attempters and self-harmers, offering valuable insights for tailored interventions within correctional settings.
RESUMO
INTRODUCTION: Suicide attempts and their consequences have been the leading causes of death among prisoners. Meta-analyses suggest that the main risk factors are current suicidal ideation, the presence of a mental disorder, high perceived stress levels, previous suicidal attempts or self-harm, and institutional and criminogenic variables. Empirical evidence is consistent with the integrated motivational-volitional model of suicidality, which also emphasizes the role of impulsivity in suicidal behaviour. The main objectives of our research are: (a) factor analysis of the Barratt Impulsiveness Scale-Brief-8 (BIS-R-8); (b) examination of the mental health status of prisoners, and the suicidal risk factors in our sample; (c) modeling the effect of mindfulness skills on the main risk factors. METHODS: In our cross-sectional survey, we matched a sample of inmates to a convenience sample according to gender and age (N=378). Based on our hypotheses, we examined the factor structure and reliability of the BIS-R-8. An independent sample t-test was used for comparison, and a two-step linear regression and mediation modeling were used to examine the risk of suicide. RESULTS: Based on factor analysis, the BIS-R-8 can be used as a unidimensional scale. A two-factor structure with cognitive and behavioral impulsivity subscales has also been confirmed. However, the internal and external reliability of the one-factor structure proved to be better. Depression, hopelessness, perceived stress and impulsivity turned out to be of higher level in the prisoner sample; lower levels of coping skills, self-esteem, mindfulness skills and well-being were also confirmed. Depression and perceived stress level seems to be the main modifiable risk factors for suicidal thoughts in the total and prisoner's sample. Previous suicide attempts and non-suicidal self-harm are the main unmodifiable risk factors of suicidal thoughts. Low level of mindfulness skills directly and indirectly via perceived stress explains 50% of the heterogeneity in depression. DISCUSSION: In correctional institutions BIS-8-R can be a suitable screening tool for measuring impulsivity as a suicide risk factor. Mindfulness-based interventions seem promising for improving the mental health status of prisoners and reducing the risk of suicide.