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In the present investigation, we used structural equation modeling with 251 adolescents to reveal, through path analyses, the degree to which somatization might mediate the relationships between body image and self-harming behaviors. After controlling for the effects of (a) age, (b) gender, and (c) having previously visited a psychologist, we observed that somatization fully mediated both the relationship between body image and self-harming behaviors and the relationship between gender and self-harming behaviors. These results suggest that having a less satisfied relationship with the body or a more negative body image is closely related to a somatic experience of greater psychological suffering, which could lead, in turn, to a more active expression of this suffering through self-harming behaviors., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Suicide notes are an important warning sign for suicidal behaviors. The aim of this exploratory research is (a) to contribute to understanding the place of suicide notes in the spectrum of suicidal behaviors in Portugal, and (b) to analyze the content remembered by individuals regarding a suicide note. Two complementary studies were carried out. In the first, a quantitative investigation, the statistical relationship of writing a suicide note: To the occurrence of lifetime suicide attempts, to lifetime self-harming behaviors, and to suicidal ideation in the two weeks prior to the assessment was evaluated. In the second study, a qualitative investigation, the content recalled by individuals regarding a suicide note was analyzed. In the quantitative study, 841 adults aged between 18 and 65 years, and 1,012 young adults participated. In the qualitative study, 18 young adults participated. Findings of the quantitative study reveal that writing a suicide note significantly related to the lifetime presence of a suicide attempt and to self-harming behaviors and to suicidal ideation in the two weeks prior to the assessment. Findings of the qualitative study suggest that individuals who have written suicide notes exhibit a significant self-oriented focus, yet they also demonstrate a strong sense of concern for the survivors.

This research investigated the latent structure and correlates of the 26-item Painful and Provocative Events Scale (PPES). For a sample of 290 community respondents, results from parallel analysis indicated a 5-factor structure. Based on principal axis factoring with varimax rotation, scales of Intense physicality, Physical and mental trauma, Physical risk taking, Psychopathy, and Body enhancement were constructed, and these demonstrated a pattern of convergent and discriminant correlations with suicide-associated and demographic variables that supported the delineation of these scales as being distinct. In general, results challenge the current scoring of the PPES and, with developed scales being differentially related to demographic variables, indicate that both respondent age and sex require consideration for scale score interpretation.

The aim of the present research was to evaluate the mediating effects of facets of the tolerance for psychological pain on the relationship between childhood trauma and suicidal ideation. A sample of 437 community individuals and a sample of 316 college students participated. For the community sample, managing the pain mediated the relationship between childhood trauma, the different types of traumatic experiences and suicidal ideation. In the college sample, managing the pain and enduring the pain mediated the relationship between childhood trauma, the different types of traumatic experiences and suicidal ideation, except for the case of sexual abuse. The present results have potential clinical implications. Mental health professionals should be aware of the long-term consequences of exposure to childhood trauma and need to assess the ability to tolerate psychological pain so as to implement appropriate psychological interventions that help individuals cope with their pain., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Major Depressive Disorder (MDD) is a leading cause of disability worldwide. Approximately one-third of patients with MDD do not respond to treatment, and often exhibit elevated inflammation biomarkers, which are associated with worse prognosis. Previous research has linked healthier dietary patterns, such as the Mediterranean Diet (MedDiet), with a lower risk of MDD and symptoms of depression, potentially due to their anti-inflammatory properties. The aim of this study is to evaluate the effectiveness of a nutritional counselling intervention promoting MedDiet to alleviate symptoms of depression in adults recently diagnosed with MDD and presenting with elevated inflammation biomarkers., Methods: This study is a randomized controlled trial (RCT) that will recruit adults from outpatient clinics, between the ages of 18 and 70 years who have been diagnosed with MDD and are currently receiving treatment with the first prescribed antidepressant, and who exhibit elevated inflammation biomarkers (interleukin-6 and/or C-reactive protein). The control group will receive treatment-as-usual (TAU) only. The primary outcome of the study will be the change in symptoms of depression, as measured by the Beck Depression Inventory 2 (BDI-II), after 12 weeks of intervention. Data analysis will follow an intention-to-treat approach. Secondary outcomes will include changes in inflammation biomarkers, quality of life, adherence to the MedDiet, and cost-effectiveness of nutritional counselling. All outcomes will be assessed at baseline, after the 12-week intervention, and at 6- and 12-months post-baseline., Discussion: This study will be the first RCT to evaluate the effect of a nutritional intervention with anti-inflammatory properties, as an adjuvant in the treatment of MDD, in individuals diagnosed with MDD and elevated inflammation biomarkers. The results of this study may contribute to the development of more effective and personalized interventions for MDD patients with elevated inflammation biomarkers., (© 2023. The Author(s).)

Objectives: This study tested the mediation effects of two facets of psychache - bearable and unbearable - in the relationship between exposure to suicide in the family and suicidal ideation in Portugal during the Covid-19 pandemic., Methods: Two hundred and forty-four adults aged between 19 and 64 participated. Two groups were defined: one exposed to suicide in the family (n = 42) and a control group (n = 192)., Results: Path analysis using structural equation modelling tested a mediation model. Results demonstrated that unbearable psychache fully mediated the relationship between exposure to suicide and suicidal ideation, even when controlling for the mediation effects of depressive symptoms, the presence of a psychiatric diagnosis, and years of education., Conclusions: These results suggest that rather than considering just the global experience of psychache in individuals exposed to suicide, researchers and clinicians should look to the presence of unbearable psychache given its contribution to suicidal ideation., Practitioner Points: Unbearable psychache fully mediated the relationship between exposure to suicide in the family and suicidal ideation It is not the global experience of psychache that contributes to suicide ideation in individuals exposed to suicide in the family rather the presence of unbearable psychache., (© 2021 The British Psychological Society.)

Objectives: The association between childhood trauma and suicidal ideation has been well documented in several populations, including individuals with a substance use disorder (SUD). However, a gap still exists in the literature regarding the mechanisms by which childhood trauma later impacts suicide risk. This cross-sectional study tested the effect of childhood trauma on suicidal ideation, as well as the mediating effect of tolerance for psychological pain (managing the pain and enduring the pain) in that relationship, controlling for the effect of depressive symptoms, in individuals with a SUD., Methods: A sample of 102 adults with a SUD participated in the study. Path analysis by structural equation modelling tested a mediation model., Results: Depressive symptoms and lower levels of managing the pain were found to fully mediate the association between childhood trauma and suicidal ideation., Conclusions: Our results suggest that depressive symptoms and a lack of ability to manage psychological pain contribute towards explaining why traumatic childhood experiences may result in suicidal cognitions in individuals with SUDs. Moreover, they have relevant implications for prevention and clinical interventions regarding suicidal ideation in this population., Practitioner Points: Childhood trauma relates to suicidal ideation in individuals with a substance use disorder. Depressive symptoms contribute towards explaining why traumatic childhood experiences may result in suicidal cognitions. A lack of ability to manage psychological pain also contributes towards explaining this relationship. The obtained results have relevant implications for the prevention of and clinical intervention for suicidal ideation in SUD individuals., (© 2021 British Psychological Society.)

Self-harming behavior (SHB) represents an important public health issue and is one of the most critical predictors of completed death by suicide. The current study evaluated the incremental contribution of the Interpersonal Theory of Suicide constructs of thwarted belongingness and perceived burdensomeness for the prediction of SHB beyond that associated with having a psychiatric diagnosis. Community adults from two different countries included a Portuguese sample of 414 adults, aged between 18 and 65   years ( M   =   45.09, SD  = 13.11), and predominantly female (79%), and an American sample of 290 adults (198 men, 91 women, 1 unreported) with a mean age of 37.76   years ( SD   =   10.84) ranging from 20 to 71, who participated online. Results demonstrated mediation effects for perceived burdensomeness in the association of thwarted belongingness with SHB, partial mediation in the Portuguese sample and full mediation in the American sample. Findings also indicated that the interaction between thwarted belongingness and perceived burdensomeness failed to make a statistically significant contribution to the prediction of SHB. The results are discussed within the Interpersonal Theory of Suicide and its relevance for clinical practice.

This 5-month, 2-wave study evaluated the mediating effects of psychache and unmet interpersonal needs on the relationship between childhood trauma and suicide ideation in 208 young adults, controlling for depression. Path analysis demonstrated that changes in depression, perceived burdensomeness, and thwarted belongingness mediated the relationship between childhood trauma and changes in positive suicide ideation, and that changes in depression and perceived burdensomeness mediated the relationship between childhood trauma and changes in negative suicide ideation. Results indicated the importance of assessing interpersonal needs, in addition to depression, for understanding the mechanism linking childhood trauma to suicide ideation in young adults.

Across two countries and two languages, this research examined the multidimensional associations of suicide behaviors (i.e., life-time attempts, life-time communication of intent to others, life-time self-harming, life-time suicide notes, and current suicide ideation) and empirically relevant psychological risk factors (i.e., different facets of mental pain, perceived burdensomeness, thwarted belongingness, and acquired capability), controlling for depressive symptoms. For the Portuguese sample, two underlying dimensions emerged: an ideation dimension and a behavioral dimension, and for the Canadian sample, three dimensions emerged: an ideation dimension and two behavioral dimensions that can be viewed as a splitting of the Portuguese second dimension. Results highlight possible cultural differences between the two countries and that suicide behaviors should be viewed as a multidimensional phenomenon not as a one-dimensional continuum.

Across two countries and two languages, this research examined the multidimensional associations between suicidality (e.g., past ideation/attempts, communication of intent) and empirically important psychological risk factors (e.g., mental pain, perceived burdensomeness, thwarted belongingness). For samples of 228 Canadian and 331 Portuguese university undergraduates, four dimensions emerged in each sample with two of these, intrapersonal and interpersonal, demonstrating strong replicability across countries and languages. It was concluded that suicidality is a phenomenon that demonstrates some multidimensional similarities across cultures., (© 2020 International Union of Psychological Science.)

Objectives: In this study, we tested whether the unbearable pain scale of the Psychache Scale provides value for the statistical prediction of a previous suicide attempt; we evaluated whether psychological pain has incremental value in the statistical prediction of a previous suicide attempt relative to the reporting of having had a psychiatric diagnosis, and we established a cut-score for the Psychache Scale., Method: Two samples participated: a sample consisting of 1,460 young adults and a sample of 628 Portuguese community adults., Results and Conclusions: Results demonstrated that unbearable pain is not a stronger predictor of a previous suicide attempt than is the bearable pain score of the Psychache Scale; that the total score of the Psychache scale provides an additional statistically significant contribution to the statistical prediction of a previous suicide attempt relative to the reporting of having had a psychiatric diagnosis., (© 2020 Wiley Periodicals LLC.)

The aims of the present study were to compare a sample of individuals exposed to suicide in their families with a control group, on suicidal ideation, and to test possible potentiating effects for unmet interpersonal needs. Three hundred eighty-six young Portuguese adults participated. Two groups were defined: a group exposed to suicide in the family (n = 38) and a control group (n = 335). Groups differed significantly on suicidal ideation, on depressive symptoms, and on perceived burdensomeness and tended to differ on thwarted belongingness. Results from a hierarchical multiple regression analysis demonstrated that having lost a family member by suicide and perceived burdensomeness each provided a significant unique contribution to explaining variance in suicidal ideation when controlling for levels of depressive symptoms and having had a psychiatric diagnosis. The interaction between group membership and perceived burdensomeness provided a further enhancement to the statistical prediction of suicidal ideation.

In the present study, the first with a Western sample, we tested the relationship between three dimensions of psychological pain and suicidal ideation in a sample of 331 Portuguese college students. When controlling for the effect of depressive symptoms, the avoidance dimension, but not the cognitive and affective dimensions of psychological pain, made a significant contribution in predicting the three indicators of suicidal ideation. According to these results, psychotherapeutic action may focus either on enabling clients to tolerate mental pain or on providing more effective and adaptive strategies to cope with this pain.

Objectives: A multidimensional psychological pain model of suicide has been developed that includes three dimensions: affective, cognitive, and avoidance. In the present research, we evaluated the relationships between the three dimensions of psychological pain and suicidal ideation., Method: Two community samples from Portugal and the U.S. participated in the research., Results: Hierarchical multiple regression analysis demonstrated that when controlling for the effects of depressive symptoms and psychache, the avoidance dimension, but not the cognitive or affective dimension of psychological pain, explained significant, and unique variance in suicidal ideation in each sample., Conclusion: Even when individuals perceive psychological pain, there may not be an elevated risk of suicide, provided that they do not consider suicide as a form of coping to decrease that pain., (© 2019 Wiley Periodicals, Inc.)

Several studies have consistently related psychological pain to suicide risk. Psychache, according to Shneidman's perspective and measured by the Psychache Scale has been confirmed as an important variable in risk prediction. In the present study, we evaluated psychache as a construct related to suicide risk using data obtained with the Portuguese version of the Psychache Scale translated from the original English version. A community sample of 628 individuals responded to the Portuguese version of the Psychache Scale, the Suicidal Behavior Questionnaire-Revised, the CES-D Scale, the Beck Hopelessness Scale, and the Suicide Ideation Questionnaire. Results supported the unidimensional scoring of the Psychache scale, its ability to differentiate between individuals at-risk for suicide from individuals not at-risk, its relationship with different, but related, constructs and its ability to predict suicide ideation.

The aim of the present study was to test whether the maladaptive personality traits of self-criticism and neediness predict suicide ideation when controlling for general distress. Further, potential interactive effects on suicide ideation of the two traits and distress were also evaluated. Two studies with nonclinical samples were conducted. The first investigation was cross-sectional and involved a final sample of 202 community adults while the second study was longitudinal with a final sample of 207 college students. Results of Study 1 demonstrated that self-criticism, but not neediness, associated with suicide ideation and, in doing so, also interacted with distress. Neediness also tended to interact with self-criticism in the prediction of suicide ideation. Results from Study 2 were similar and confirmed the Study 1 results. Changes in self-criticism, but not changes in neediness, predicted changes in suicide ideation after statistically controlling for changes in distress. Changes in the interaction between self-criticism and distress predicted changes in suicide ideation and changes in the interaction between self-criticism and neediness tended to predict changes in suicide ideation. Results are discussed with regard to their implications for psychological intervention.

The aim of the present study was to test whether perceived burdensomeness and thwarted belongingness are related to suicide ideation, when controlling for depressive symptoms. The sample consisted of elderly patients recovering from acute medical conditions who were recruited in a medical recovery clinic. Results demonstrated that depressive symptoms and thwarted belongingness related to the suicide ideation item of the Beck Depression Inventory-II, used as an indicator of suicide ideation. Depressive symptoms and thwarted belongingness also discriminated between participants with suicide ideation and participants without suicide ideation as defined by suicide items of the Symptom-Driven Diagnostic System for Primary Care. Results are discussed in terms of potential cultural influences, and clinical implications are highlighted.

Objective: The aim of the present study was to compare a sample of Portuguese individuals exposed to suicide in their families with a control group, for lifetime suicidality. This study also evaluated the incremental value of psychache (i.e., extreme psychological pain) in determining suicide risk beyond the contribution associated with having lost a family member by suicide., Method: A total of 225 community adults participated. Two groups were defined: a group exposed to suicide (n = 53), and a control group (n = 172)., Results: Results demonstrated that groups did significantly differ on the total score of the Suicide Behaviors Questionnaire-Revised (SBQ-R), on the four individual SBQ-R items, and on psychache. Results from a hierarchical multiple regression analysis demonstrated that having lost a family member by suicide and the construct of psychache each provided a significant unique contribution to explaining variance in suicide risk. The interaction between group membership and psychache also provided a further enhancement to the statistical prediction of suicide risk., Conclusion: Findings are discussed with regard to their implications for clinical intervention and postvention., (© 2017 Wiley Periodicals, Inc.)

The aim of the current study was to assess suicide ideation in a sample of older adults recovering from acute conditions in a clinical recovery facility of the Portuguese Red Cross. Four indicators of suicide ideation were used. Clinical, contextual, and psychological variables-namely, previous suicide attempts, death of a family member by suicide, loneliness, and interpersonal needs-were also tested to determine whether they were related to suicide ideation. Findings show suicide ideation is frequent at admission and related to patients' previous suicide attempts. Death of a family member by suicide and patients' functional dependency are related to some indicators of suicide ideation, and loneliness and interpersonal needs are important psychological variables relating to suicide ideation. Interpersonal needs were related to suicide ideation even after controlling for previous suicide attempts. Implications of the results for clinical practice are discussed. [Journal of Gerontological Nursing, 43(9), 31-37.]., (Copyright 2017, SLACK Incorporated.)

This study evaluated whether psychache (i.e., mental pain) mediates the association between general distress, assessed as the frequency and the intensity of psychological symptoms in the previous week, and suicide ideation in community adults. For a sample of 202 adults, psychache fully mediated the relationship between suicide ideation and the frequency of psychological symptoms, and partially mediated the relationship between suicide ideation and the intensity of psychological symptoms. As such, mental pain fully or partially explains the process linking the frequency and the intensity of general distress to suicide ideation and, thus, mental pain is a target for potential intervention.

Background and aims(s): The study evaluated the contribution of coping strategies, based on the Toulousiane conceptualization of coping, to the prediction of suicide risk and tested the moderating effect of gender, controlling for depressive symptoms., Method: A two-time data collection design was used. A community sample of 195 adults (91 men and 104 women) ranging in age from 19 to 65 years and living in several Portuguese regions, mostly in Alentejo, participated in this research., Results: Gender, depressive symptoms, control, and withdrawal and conversion significantly predicted suicide risk and gender interacted with control, withdrawal and conversion, and social distraction in the prediction of suicide risk. Coping predicted suicide risk only for women., Conclusions: Results have important implications for assessment and intervention with suicide at-risk individuals. In particular,the evaluation and development of coping skills is indicated as a goal for therapists having suicide at-risk women as clients.

Although suicidality is associated with mental illness in general and depression in particular, many depressed individuals do not attempt suicide and some individuals who attempt to or do die by suicide do not present depressive symptoms. This article aims to contribute to a more psychosocial approach to understanding suicide risk in nonclinical populations. In advocating a psychosocial perspective rather than a depression-focused approach, this article presents four diverse studies that demonstrate sampling and measurement invariance in findings across different populations and specific measures. Study 1 tests the mediation effects of 2 interpersonal variables, thwarted belongingness and perceived burdensomeness, in the association between depressive symptoms and recent suicidality. Studies 2 and 3 evaluate the contribution of hopelessness and psychache, beyond depressive symptoms, to suicidality. Study 4 tests the contribution of life events behind depressive symptoms, and other relevant sociodemographic and clinical variables, to the estimation of "future suicidality." Overall, results demonstrate that depressive symptoms do not directly predict suicidality in nonclinical individuals, but that other psychosocial variables mediate the association between depressive symptoms and suicidality or predict suicidality when statistically controlling for depressive symptoms. The article contributes to understanding some of the nonpsychopathological factors that potentially link depressive symptoms to suicide risk and that might themselves contribute to suicidality, even when controlling for depressive symptoms.

This study aimed to test if the preference for using certain types of defense mechanisms, according to Ihilevich and Gleser's (1969, 1986) perspective, is associated with personality styles, proposed by Millon (1993), and also, aimed to test if both constructs give a contribution to the identification of global types of psychological functioning in adolescents. Eight hundred and thirty adolescents, ranging in age from 14 to 19 years (M = 16.64, SD = 1.9) participated in the study. The Portuguese versions of the Defense Mechanisms Inventory for Adolescents and the Millon Adolescents Clinical Inventory were administered. Multiple linear regression analysis and principal component analysis were computed. Results demonstrate an association between defense mechanisms and personality styles and both constructs contribute to the identification of two types of psychological functioning in adolescents: an internalizing type and an externalizing type.

Objectives: Using structural equation modeling, we tested a primary model of suicide risk and 3 competing, alternative models based on 4 psychological variables deemed important in the literature (perception of parental rejection, depression, interpersonal needs comprising perceived burdensomeness and thwarted belongingness, and psychache), in a nonclinical sample of Portuguese adults., Method: A convenience sample of 203 adults (100 men, 103 women; aged 18-65 years) participated in this study., Results: Analyses demonstrated that the proposed primary model had the best fit to the observed data. The differences in fit indexes for this model and one of the alternative models, however, were not substantial., Conclusion: Perceived parental rejection related directly to suicide risk and indirectly via depression and interpersonal needs. Depression linked indirectly to suicide risk via interpersonal needs and psychache. Interpersonal needs related directly to suicide risk and indirectly via psychache, which related directly to suicide risk., (© 2015 Wiley Periodicals, Inc.)

The present study assessed the impact of suicide and distress on suicidal ideation in a sample of 93 Portuguese family members bereaved by suicide. A control community sample of 102 adults also participated. After controlling for educational level, those bereaved by the suicide of a family member were found to have higher levels of suicidal ideation. Forty-two percent of family members had Suicide Ideation Questionnaire scores at or above the cutoff point. General distress, depression, anxiety, and hostility related to suicidal ideation, whereas time since suicide also interacted with general distress and depression in predicting suicidal ideation.

In a 6-month longitudinal design, the authors examined the links between neediness and increases in depressive symptoms in women. Neediness was assessed with the self-report Depressive Experiences Questionnaire (DEQ), supplemented by a projective measure that assessed an important component of dependency, oral dependency, on the Rorschach. Results indicate that neediness correlated significantly with increases in depressive symptoms over the 6 months. Orality interacted with neediness to substantially increase the prediction of increases in depressive symptoms.

Relationships between Axis II personality disorders and Sidney Blatt constructs of dependency and self-criticism were explored in a late adulthood women sample. The sample consisted of 102 women (M = 72.07 years of age, SD = 7.04) who were administered two measures, the Personality Diagnostic Questionnaire-4+ and the Depressive Experiences Questionnaire. The histrionic, dependent, and obsessive-compulsive personality disorder scales are shown to be significant predictors of dependency, and the narcissistic, borderline, and avoidant scales are significant predictors of self-criticism. The application of a dimensional interpersonal approach to psychopathology is discussed.

The research literature consistently indicates that self-criticism is related to suicidality. Evidence for the role of dependency, however, is more controversial. This study examines the extent to which these personality vulnerabilities are mediated by psychological distress in the prediction of suicidality. As part of a study of adolescent psychopathology, a sample of 260 Portuguese adolescents (148 [56.9 %] female and 112 [43.1%] male), ranging in age from 15 to 18 years (M = 16.32, SD = 1.19) completed measures of personality, suicidal behavior, and current distress, in counterbalanced order. The measures were: self-criticism and dependency from the Depressive Experiences Questionnaire for Adolescents; two psychological distress scales, social withdrawal from the Youth Self Report and depression from the Center for Epidemiologic Studies of Depression Scale; and a measure of suicidality from the Suicide Behaviors Questionnaire Revised. Structural equation modeling indicated that self-criticism and dependency were both significantly associated with suicidality. Psychological distress, however, as measured by withdrawal and depression, fully mediated these relationships, but did not moderate them. The authors conclude that adolescents with higher levels of self-criticism and dependency are at greater risk for experiencing intense psychological distress-high levels of social withdrawal and depression-that account for their vulnerability to suicide risk.

As part of the research relating personality and depression, this study seeks to predict depressive experiences in aging women according to Sidney Blatt's perspective based on the Five-Factor Model of Personality. The NEO-Five Factor Inventory and the Depressive Experiences Questionnaire were administered. The domains Neuroticism, Agreeableness, and Conscientiousness predicted self-criticism, explaining 68% of the variance; the domains Neuroticism and Extraversion predicted dependency, explaining 62% of the variance. The subfactors Neediness and Connectedness were differently related to personality traits. These findings are relevant to the research relating personality and anaclitic / introjective depressive experiences in late adulthood.

The present study examines whether self-criticism and depressive symptoms mediate the relationship between recollections of parental rejection and suicidality. A community sample of 200 Portuguese adults completed, in counterbalanced order, a socio-demographic questionnaire, the short form of the Inventory for Assessing Memories of Parental Rearing Behaviour (EMBU), the Depressive Experiences Questionnaire (DEQ), the Center for Epidemiologic Studies Depression Scale (CES-D), and reports of any suicide intention and/or ideation and suicide attempts. Structural Equation Modeling (SEM) indicated that recollections of parental rejection are significantly associated with depressive symptoms and suicidality. Recollections of parental rejection are indirectly associated with depressive symptoms and suicidality through self-criticism. The association between self-criticism and suicidality is mediated by depressive symptoms. In addition to a significant direct association between recollections of parental rejection and suicidality, the final model indicated that recollections of parental rejection are significantly associated with self-criticism. That same self-criticism is significantly associated with depressive symptoms which, in turn, are significantly associated with suicidality. Individuals with recollections of parental rejection are at greater risk for suicide ideation and behavior, possibly because such experiences predispose them to intense self-criticism which is a risk factor for depression associated with suicidal ideation and behavior.

The present study examined whether distress mediates the relationship between suicidality and the personality predispositions of Self-Criticism, Dependency/Neediness, and Efficacy. A community sample of Portuguese young adults (N = 105) completed, in a counterbalanced order, a sociodemographic questionnaire, the Depressive Experiences Questionnaire (DEQ), the Brief Symptom Inventory (BSI), and reports of any suicide attempts and/or ideation. Structural equation modeling indicated that Self-Criticism is significantly associated with suicidality, but Dependency and Efficacy are not. High levels of Self-Criticism and of Dependency and low levels of Efficacy are associated with distress. Distress mediates the association between Self-Criticism and suicidality; whereas Dependency and Efficacy are indirectly associated with suicidality through their associations with distress. Self-Critical and Dependent individuals are at greater risk for suicide because of their vulnerability to distressful events; whereas certain levels of Efficacy may decrease vulnerability to distress and suicide risk.

Background: This study examined a theoretically based mediation model including participants' perceptions of early relationships with their mother, self-criticism, dependency, and current depressive symptoms. We expect that (a) early relationships characterized by low levels of care and high levels of overprotection will be positively associated with both current depressive state and self-criticism and dependency; (b) high levels of self-criticism and dependency will be positively associated with depressive symptoms; and (c) self-criticism and dependency will play a mediating role in the association between participants' perceptions of early relationships characterized by low levels of care and high levels of overprotection and their current depressive symptoms., Methods: A nonclinical community sample of 200 Portuguese adults participated in the study. Perceptions of early relationships were measured using the mother scales of the Parental Bonding Instrument (Parker et al. [1979: Br J Med Psychol 52:1-10]), levels of self-criticism and dependency were measured using the Depressive Experiences Questionnaire (Blatt et al. [1976: J Abn Psy 6:383-389]), and depressive symptoms were measured using the Center for the Epidemiological Studies of Depression Scale (Radloff [1977: Appl Psychol Meas 1:385-401]., Results: Structural equation modeling showed that the link between participants' perceptions of early caretaking relationships with their mothers and their current depressive symptoms is mediated by high levels of self-criticism--a personality trait associated with vulnerability to depression--but not Dependency. However, an ancillary analysis indicated that the link between participants' perceptions of early maternal overprotective relationships and their current depressive symptoms is mediated by high levels of Neediness., Conclusions: Findings underscore the role of perceived early relationships in psychological vulnerability to depression among highly self-critical and among highly needy individuals and highlight the negative role played by perceived mothers' early dysfunctional practices, characterized by low levels of caring and high levels of overprotection, for the self-critical vulnerability to depression and by perceived mothers' high levels of overprotection, for the neediness vulnerability to depression. These potential causal mechanisms warrant longitudinal evaluation. Theoretical and clinical implications of the findings are discussed.

The Depressive History Questionnaire is shown to have a single factor and acceptable internal consistency reliability in a sample of 205 community participants.

A Portuguese questionnaire was developed to assess the history of depressive symptoms. The Depressive History Questionnaire was based on the Depressive Experience Subscale from the Thalbourne Manic Depressiveness Scale, which was translated into Portuguese. The Depressive History Questionnaire was administered to 459 college students. Female students scored significantly higher than male students. Cronbach alpha was .64. Principal component analysis confirmed that the questionnaire measures only one dimension. Confirmatory factor analysis provided support for the fit of the one-factor model. The Depressive History Questionnaire correlated positively and significantly with the Portuguese versions of both the Beck Depression Inventory-II and the Depressive Personality Disorder Inventory.