Mediational Effect of Positive and Negative Affect on the Relationship Between Emotional Symptoms and Suicidal Risk

Abstract

Background:

Suicide has been linked to emotional disorders which, according to the transdiagnostic model, share common constructs such as positive and negative affect. This study examined the mediating role of positive and negative affect in the relationship between emotional symptoms and suicide risk.

Method:

The sample included 1,014 participants (33.82% male, 66.17% female) aged 18 to 75 years (M = 33.0, SD = 15.15). Four independent mediation analyses were conducted, using depressive, anxious, somatization, and obsessive symptomatology (measured with the LSB-50) as independent variables; positive and negative affect (measured with the Positive and Negative Affect Schedule, PANAS) as mediators; and suicide risk (measured with the Risk of Suicide Scale, RS) as the dependent variable. Sociodemographic variables were controlled.

Results:

Across all models, the relationship between emotional symptoms and suicide risk was positively mediated by negative affect and negatively mediated by positive affect.

Conclusions:

Positive and negative affect function as transdiagnostic factors that partially mediate the relationship between emotional symptoms and suicide risk.

Keywords

depression anxiety somatization obsessions positive affect negative affect suicide

Get full access to this article

View all access options for this article.

References

Aldao

Nolen-Hoeksema

Schweizer

(2009). Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical Psychology Review, 30(2), 217–237. https://doi.org/10.1016/j.cpr.2009.11.004

Antuña-Camblor

Esteller-Collado

Muñoz-Navarro

Rabito-Alcón

M. F.

Rodríguez-Díaz

F. J.

(2024). Emotional disorders, distress tolerance and suicide risk: A mediation model. OMEGA - Journal of Death and Dying. Advance online publication. https://doi.org/10.1177/00302228241299287

Antuña-Camblor

Rodríguez-Díaz

F. J.

Rabito-Alcón

M. F.

(2025). Depressive symptoms and suicide risk: A moderate mediation. Revista Iberoamericana de Psicología y Salud, 16(1), 10–15. https://doi.org/10.70478/rips.2025.16.02

Bullis

J. R.

Boettcher

Sauer-Zavala

Farchione

T. J.

Barlow

D. H.

(2019). What is an emotional disorder? A transdiagnostic mechanistic definition with implications for assessment, treatment, and prevention. Clinical Psychology: Science and Practice, 26(2), Article e12278. https://doi.org/10.1111/cpsp.12278

Cano-Vindel

Muñoz-Navarro

Moriana

J. A.

Ruiz-Rodríguez

Medrano

L. A.

González-Blanch

(2021). Transdiagnostic group cognitive behavioural therapy for emotional disorders in primary care: The results of the PsicAP randomized controlled trial. Psychological Medicine, 52(15), 1–13. https://doi.org/10.1017/S0033291720005498

Chu

J. P.

Goldblum

Floyd

Bongar

(2010). The cultural theory and model of suicide. Applied And Preventive Psychology, 14(1–4), 25–40. https://doi.org/10.1016/j.appsy.2011.11.001

de Rivera

J. L. G.

de Rivera

Abuín

(2012). LSB-50: Listado de síntomas breve. Manual. TEA Ediciones.

Díaz-García

González-Robles

García-Palacios

Fernández-Álvarez

Castilla

Bretón

J. M.

Baños

R. M.

Quero

Botella

(2021). Negative and positive affect regulation in a transdiagnostic internet-based protocol for emotional disorders: Randomized controlled trial. Journal of Medical Internet Research, 23(2), Article e21335. https://doi.org/10.2196/21335

Díaz-García

González-Robles

Mor

Mira

Quero

García-Palacios

Baños

R. M.

Botella

(2020). Positive and Negative Affect Schedule (PANAS): Psychometric properties of the online Spanish version in a clinical sample with emotional disorders. BMC Psychiatry, 20(1), Article 56. https://doi.org/10.1186/s12888-020-2472-1

10.

Fusar-Poli

Solmi

Brondino

Davies

Chae

Politi

Borgwardt

Lawrie

S. M.

Parnas

McGuire

(2019). Transdiagnostic psychiatry: A systematic review. World Psychiatry, 18(2), 192–207. https://doi.org/10.1002/wps.20631

11.

General Sub-Directorate for Health Information. (2021). Salud mental en datos: prevalencia de los problemas de salud y consumo de psicofármacos y fármacos relacionados a partir de registros clínicos de atención primaria. BDCAP Series 2 [Mental health in data: Prevalence of health problems and consumption of psychotropic drugs and related drugs based on Primary Care clinical records. BDCAP Series 2] [Internet Publication]. https://cpage.mpr.gob.es/

12.

Grisham

J. R.

Brown

T. A.

Liverant

G. I.

Campbell-Sills

(2005). The distinctiveness of compulsive hoarding from obsessive–compulsive disorder. Journal of Anxiety Disorders, 19(7), 767–779. https://doi.org/10.1016/j.janxdis.2004.09.003

13.

Hayes

A. F.

(2018). Introduction to mediation, moderation and conditional process analysis: A regression approach. Guildford Press.

14.

Matsumoto

Yoo

S. H.

Nakagawa

(2008). Culture, emotion regulation, and adjustment. Journal of Personality and Social Psychology, 94(6), 925–937. https://doi.org/10.1037/0022-3514.94.6.925

15.

National Institute of Statistics. (2023). Defunciones según la Causa de Muerte Año 2022. Datos provisionales [Deaths by cause of death year 2022. Provisional Data].

16.

Nolen-Hoeksema

Wisco

B. E.

Lyubomirsky

(2008). Rethinking rumination. Perspectives On Psychological Science, 3(5), 400–424. https://doi.org/10.1111/j.1745-6924.2008.00088.x

17.

Ong

Thompson

(2019). The importance of coping and emotion regulation in the occurrence of suicidal behavior. Psychological Reports, 122(4), 1192–1210. https://doi.org/10.1177/0033294118781855

18.

Peris-Baquero

Osma

(2023). Unified protocol for the transdiagnostic treatment of emotional disorders in group format in Spain: Results of a noninferiority randomized controlled trial at 15 months after treatment onset. Wiley Hindawi - Depression and Anxiety, 2023, 1–16. https://doi.org/10.1155/2023/1981377

19.

Plutchik

Van Praag

(1989). The measurement of suicidality, aggressivity and impulsivity. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 13, S23–S34. https://doi.org/10.1016/0278-5846(89)90107-3

20.

Rezaei

Rahmani

Hemmati

Komasi

(2023). A head-to-head comparison of eight unique personality systems in predicting somatization phenomenon. BMC Psychiatry, 23(1), Article 912. https://doi.org/10.1186/s12888-023-05424-1

21.

Rojas

S. M.

Leen-Feldner

E. W.

Blumenthal

Lewis

S. F.

Feldner

M. T.

(2015). Risk for suicide among treatment seeking adolescents: The role of positive and negative affect intensity. Cognitive Therapy and Research, 39(2), 100–109. https://doi.org/10.1007/s10608-014-9650-8

22.

Rubio

Montero

Jáuregui

Salvador

Marín

J. J.

Santo-Domingo

(1998). Validación de la Escala de Riesgo de Violencia de Plutchik en población española [Assessing the Validity of the Plutchik Suicide Risk Scale in a Spanish Sample]. Archivos de Neurobiología, 61(4), 307–316.

23.

Sandín

Chorot

Lostao

Joiner

T. E.

Santed

M. A.

Valiente

R. M.

(1999). Escalas PANAS de afecto positivo y negativo: validación factorial y convergencia transcultural [PANAS scales of positive and negative affect: Factorial validation and transcultural convergence]. Psicothema, 11, 37–51.

24.

Santurtún

Zarrabeitia

M. T.

(2018). ¿Afecta el medio a los suicidios que se cometen en España? Análisis descriptivo del patrón temporoespacial [Does the environment affect suicides committed in Spain? Descriptive analysis of the temporal-spatial pattern]. Revista de Psiquiatría y Salud Mental, 11(4), 192–198. https://doi.org/10.1016/j.rpsm.2017.05.001

25.

Simons

J. S.

Gaher

R. M.

(2005). The distress tolerance scale: Development and validation of a self-report measure. Motivation And Emotion, 29(2), 83–102. https://doi.org/10.1007/s11031-005-7955-3

26.

Teismann

Brailovskaia

Margraf

(2019). Positive mental health, positive affect and suicide ideation. International Journal of Clinical and Health Psychology, 19(2), 165–169. https://doi.org/10.1016/j.ijchp.2019.02.003

27.

Toro Tobar

R. A.

Avendaño-Prieto

B. L.

Vargas Espinosa

N. M.

(2020). Transdiagnostic model of anxiety and depression according to the relationship with affect, intolerance of uncertainly, and anxiety sensitivity. CES Psicología, 13(1), 140–152. https://doi.org/10.21615/cesp.13.1.9

28.

Watson

Clark

L. A.

Tellegen

(1988). Development and validation of brief measures of positive and negative affect: The PANAS Scales. Journal of Personality and Social Psychology, 54(6), 1063–1070. https://doi.org/10.1037/0022-3514.54.6.1063

29.

World Health Organization. (2017). Depression and other common mental disorders: Global health estimates.

30.

World Health Organization. (2022). Analytical fact sheet. Suicide in Africa, a neglected reality.