Towards an enhanced understanding of suicide risk through the lens of the Integrated Motivational-Volitional (IMV) Model of Suicide

Unlu, Elvan (2025) Towards an enhanced understanding of suicide risk through the lens of the Integrated Motivational-Volitional (IMV) Model of Suicide. PhD thesis, University of Glasgow.

Abstract

Background and Aims: This thesis investigates the complex interplay of a range of psychological factors implicated in suicide risk, including multidimensional perfectionism, childhood trauma, and self-discrepancies within the context of the Integrated Motivational-Volitional Model (IMV) of Suicide. Although perfectionism, defined as striving for flawlessness and setting exceedingly high standards while being concerned about others’ evaluations, has been linked to suicide risk, the mechanisms and contextual factors underlying this relationship still require further investigation. It is also worth investigating the extent to which childhood trauma and self-discrepancies relate to established correlates of suicide risk, such as defeat and entrapment, within the IMV model’s framework. Therefore, this thesis set out to address these gaps by considering perfectionism, childhood trauma and self-discrepancies as pre-motivational risk factors. In addition, it aims to systematically explore the moderators and mediators of perfectionism (as a pre-motivational risk factor) and suicide risk relationship. Finally, by integrating Self-Discrepancy Theory within the IMV model’s framework, this research aims to better understand how different cognitive appraisals are associated with suicidal ideation.

Methods: This thesis consists of a series of studies that combine a systematic review (41 studies) and three empirical studies (N=579, N=579, N=529 participants, respectively). The systematic review searched nine databases, and it had the specific aim of identifying the mediators and moderators of the relationship between perfectionism and suicide risk. Building upon the systematic review, three empirical online studies with cross-sectional designs were undertaken with UK community-based samples. Multivariate analyses, including regression-based mediation and moderation analyses (utilising Hayes’ PROCESS Macro), were applied to test the pathways and interactions depicted in the IMV model. These analyses focused on the key roles of defeat, fear of humiliation, and internal/external entrapment in the pathway to suicidal ideation.

Results: The systematic review (Chapter 2) identified 41 potential mediators and 20 moderators that either elucidate or modify the trajectory from perfectionistic strivings/concerns to suicide risk. In Chapter 3, there was evidence that perfectionistic concerns and childhood trauma were associated with internal and external entrapment directly, and indirectly, via defeat and fear of humiliation. Although defeat emerged as a stronger mediator overall in the relationships of perfectionistic concerns and childhood trauma with internal/external entrapment, fear of humiliation indirect-only mediated relationships of perfectionistic strivings and childhood trauma with external entrapment and partially mediated the relationship between perfectionistic concerns and external entrapment. As expected, ruminative flooding moderated the relationships between defeat, fear of humiliation, and external entrapment, but not internal entrapment. The mediating roles of internal/external entrapment were consistently found to be significant in all the conceptual models in Chapter 4. However, contrary to the hypotheses, the potential moderating roles of goal adjustment factors, thwarted belongingness, and perceived burdensomeness were not significant. Finally, in Chapter 5, aspects of self-discrepancies (actual vs ideal and actual vs ought) were stronger correlates of defeat and internal/external entrapment, and subsequently, suicidal ideation directly and indirectly compared to perfectionistic concerns. Again, defeat and internal/external entrapment acted as significant mediators in all of the conceptual models, consistent with the IMV model.

Conclusions: Overall, the studies provided robust empirical support for the central components of the IMV model by elucidating how perfectionism interacts with various cognitive-emotional vulnerabilities to elevate suicide risk. The identification of key mediators, especially defeat and entrapment, and key pre-motivational vulnerabilities, such as self-discrepancies, offers promising additional targets for clinical interventions to prevent suicide risk. This thesis advanced the theoretical understanding of the IMV model and informed future research efforts. Despite several limitations, this research provides a strong foundation for future research exploring cognitive-emotional and pre-motivational vulnerabilities to suicide risk. The integration of the Self-discrepancy Theory into the IMV model’s framework advanced the theoretical understanding of suicide risk, as well as providing robust foundations for future clinical applications and endeavours in the suicide prevention field.

• Item Type: Thesis (PhD)
• Qualification Level: Doctoral
• Subjects: B Philosophy. Psychology. Religion > BF Psychology; R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
• Colleges/Schools: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing
• Supervisor's Name: O’Connor, Professor Rory C. and Melson, Dr. Ambrose J.
• Date of Award: 2025
• Depositing User: Theses Team
• Unique ID: glathesis:2025-85633
• Copyright: Copyright of this thesis is held by the author.
• Date Deposited: 01 Dec 2025 14:58
• Last Modified: 02 Dec 2025 09:57
• Thesis DOI: 10.5525/gla.thesis.85633
• URI: https://theses.gla.ac.uk/id/eprint/85633