The suicide crisis syndrome: A network analysis

Sarah Bloch-Elkouby, Bernard Gorman, Allison Schuck, Shira Barzilay, Raffaella Calati, Lisa J. Cohen, Ferhana Begum, Igor Galynker

Research output: Contribution to journalArticlepeer-review


Recent studies introduced the suicide crisis syndrome (SCS), a condition associated with imminent suicidal behavior and characterized by (a) a pervasive feeling of entrapment in which the escape from an unbearable life situation is perceived as both urgent and impossible (Criterion A) and (b) affective disturbance, loss of cognitive control, hyperarousal, and social withdrawal (Criterion B). The goal of the present study was to use some of the analytic tools provided by network analyses to further the understanding of the psychological, emotional, cognitive, behavioral, and physiological processes involved in the SCS by testing (a) whether the different symptoms of the proposed syndrome are related to each other, (b) whether symptoms form meaningful clusters, and (c) whether certain symptoms are more central than others. The study included 500 outpatient and 223 inpatient participants. A network analysis of the participants' scores on the various symptoms of the SCS was conducted. The network analysis suggested that most SCS symptoms are linked by strong connections and that entrapment and ruminative flooding are highly correlated with the other SCS symptoms. Three clusters of symptoms were identified, suggesting the existence of several interdependent psychological processes potentially involved in SCS phenomenology. Our findings support both the suggested symptoms of the SCS and the central role of entrapment in the proposed criteria for the syndrome. Emotional pain appears to be closely linked to entrapment and may belong in Criterion A.

Original languageEnglish
Pages (from-to)595-607
Number of pages13
JournalJournal of Counseling Psychology
Issue number5
StatePublished - Oct 2020
Externally publishedYes

Bibliographical note

Funding Information:
The research was supported by the Association for Suicide Prevention Grant RFA-1-015-14 (principal investigator: Igor Galynker). The funding agency was not involved in the design of the present study, the analysis of the data, or the presentation of the findings. There are no conflicts of interests to disclose.

Publisher Copyright:
© 2020 American Psychological Association.


  • Near term risk factors
  • Network analysis
  • Suicide crisis syndrome

ASJC Scopus subject areas

  • Social Psychology
  • Clinical Psychology
  • Psychiatry and Mental health


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