What is Unbearable Psychological Pain? A Quantitative Exploration

Objectives Unbearable psychological pain (UPP) is emphasized in suicide theory and research, yet the nature of UPP remains unclear. This study examines a wide variety of emotion and cognitive-emotional variables to determine which best explain UPP, individually or in combination.Methods In 1,828 undergraduates we explored how UPP relates to 10 discrete emotions, hopelessness, thwarted belongingness, overall negative and positive emotionality, and the frequency, intensity, persistence, and regulation of negative and positive emotions. We also tested whether UPP could be explained by the combination of high negative emotions with: 1) hopelessness about the future, 2) poor emotion regulation, or 3) low positive emotions. Finally, we evaluated the unique and relative importance of each predictor.Results UPP was most strongly related to sadness (r = .52) and hopelessness (r = .51). Regarding emotion dimensions, UPP more strongly related to negative (r = .46) than positive (r = −.35) emotions, and more strongly related to the frequency of negative emotions (r = .44) than intensity (r = .36), duration (r = .31), or regulation (r = .33). Regarding hypothesized models, UPP was best explained by the interaction of negative emotions with hopelessness (R2=36%). Additionally, sadness interacted with hopelessness to explain 39% of variance in UPP. Sadness, hopelessness, thwarted belongingness, and low happiness each contributed uniquely to UPP.Conclusions UPP is strongly associated with the combination of negative emotions (especially sadness) with hopelessness. Future work should utilize additional methods and samples to further clarify the nature of UPP.