Background: Suicidal ideation poses a major public health challenge, especially for at-risk groups. This study primarily explored the link between mentalization and suicidal ideation among women reporting prior suicidal thoughts, with a focus on the mediating role of psychological pain.Methods: This was a cross-sectional correlational study on women with suicidal ideation seeking care at psychology and counseling centers in Karaj, Iran in 2024. From this population, we recruited a convenience sample of 350 participants. For data collection, Mentalization-Based Self-Report Scale (MBSS), Beck Scale for Suicidal Ideation (BSS), and Mental Pain Scale (MPS) were used. For data analysis, we employed structural equation modeling (SEM) in SPSS and AMOS version 27 to evaluate the proposed mediation framework.Results: Our findings revealed a significant negative direct correlation between mentalization and suicidal ideation (β=−0.28, P<0.001), with a mean mentalization score of 52.34 (SD=8.76) and a mean suicidal ideation score of 15.23 (SD=4.89). Psychological pain (mean=26.87, SD=6.23) was found to have a significant mediating effect, fully explaining the correlation between mentalization and suicidal ideation (β=0.19, P<0.001). The proposed structural model showed good fit to the data and confirmed that diminished mentalization exacerbates psychological pain, which in turn increases suicidal ideation.Conclusions: The present study highlighted psychological pain as a critical mediator in the pathway from diminished mentalization to suicidal ideation. Interventions aimed at enhancing mentalization and reducing psychological pain should be a cornerstone of therapeutic and preventative strategies for women at risk of suicide.
Chegini et al. (Wed,) studied this question.