Murray State Theses and Dissertations

Abstract

Chronic pain is a burdensome condition that has been found to be associated with increased suicide risk, yet the mechanisms underlying this relationship remain unclear (Domenichiello & Ramsden, 2019). The present study aimed to examine the role of pain interference and psychological inflexibility in predicting past two-week suicidal thoughts among individuals with chronic pain, with psychological inflexibility explored as a potential moderator. This study also sought to replicate and extend McCracken et al. (2018) and enhance the understanding of suicidality in chronic pain populations by using the Multidimensional Psychological Flexibility Inventory (Rolffs et al., 2018b), a more psychometrically sound measure of psychological flexibility and inflexibility. Results from 155 participants with chronic pain supported Hypothesis 1, indicating that pain interference significantly predicted suicidal ideation, replicating prior work by McCracken and colleagues (2018). Hypothesis 2 was partially supported, as while the overall model of psychological inflexibility predicted suicidal ideation, only the subcomponent of lack of contact with the present moment emerged as a significant individual predictor. This finding extends previous work by identifying present-moment awareness as a key contributor to suicidality in this population. Contrary to Hypothesis 3, psychological inflexibility did not significantly moderate the relationship between pain interference and suicidal ideation. Instead, both factors were significant conditional predictors. These findings deepen the understanding of the psychological mechanisms underlying suicidality in chronic pain populations and highlight the potential value of interventions targeting psychological flexibility, such as ACT and mindfulness-based interventions, as a means to mitigate suicide risk.

Year manuscript completed

2025

Year degree awarded

2025

Author's Keywords

Psychological Flexibility, Chronic Pain, Suicidality, Suicidal Ideation, Pain, Psychology

Degree Awarded

Master of Science

Department

Psychology

College/School

College of Humanities and Fine Arts

Thesis Advisor

Michael Bordieri

Committee Chair

Michael Bordieri

Committee Member

Angie Trezpacz

Committee Member

Jana Hackathorn

Committee Member

Laura Liljequist

Document Type

Thesis

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