The psychological role of dissociation and repetitive negative thinking in the development of suicidal behavior in posttraumatic stress disorder

Cognitive and metacognitive processes, along with dissociative symptoms, play a significant role in the development of suicidal behavior in the context of traumatic experiences and posttraumatic stress disorder. This article reviews theoretical models that conceptualize the transition from suicidal ideation to actions, emphasizing the mechanisms and mediating variables underlying this progression. The discussed models include the interpersonal theory of suicide, the three-step theory, the integrated motivational–volitional model, the perfectionism-based model of suicide risk, the fluid vulnerability theory, the integrated pain-brain evolutionary model, the dual-system model of suicidality, the stage-based theory of antivital behavior, and a dynamic model of antivital and suicidal behavior taking into account the roles of negative social emotions and resilience factors, strength model of self-regulation, the mindsponge-based model of suicide risk simulation, the network analysis model, the cry of pain model, the narrative model of suicidal crisis, the dual-process conceptualization of suicidality, the theory of repetitive negative thinking, suicidal rumination, and others. The cognitive model of trauma memory processing and encoding, along with the model of trauma-induced dissociation and the emergence of hallucinations, helps explain the increasing intrusiveness and uncontrollability of trauma-related experiences. These phenomena are marked by alienation from one’s own physical and psychological suffering and emotional detachment from others. Such mechanisms provide insight into the transition from suicidal ideation to actions as a nonlinear and dynamic process in the development of suicidal behavior.