Руминации как психологический механизм формирования и поддержания суицидального поведения

Abstract

The role of rumination in formation and maintenance of suicidal thoughts (ST) and suicidal behavior (SB) is specified in the article. In leading foreign models SB is considered to be the process of phase restructuring and the resultant intersection of factors (Joiner's interpersonal theory, O'Connor's motivational-volitional model, Klonsky's three-step model). Analysis of traditional SB models shows insufficient consideration of metacognitive system-dynamic phenomena, which may explain the limitations of predictive theories, especially in relation to adolescents. Ruminations as one of such phenomena are designated as a component of the process of repetitive negative thinking, which intensifies the experience of problems insolubility and sets the basis for comprehension of suicide as a potential way to “complete” the situation. The typologies of ruminations and the contribution of each subtype to the maintenance of ST, SB are considered: 1) ruminations as a trait and a state; 2) brooding ruminations and reflection; 3) pre- and post-event ruminations. The interrelation of rumination and insomnia in the form of interdependent cycle of accumulation of undischarged psychophysiological tension in the context of SB formation is demonstrated. Russian psychology employs the methodology of the cultural and activity approach to explain the formation of SB, and analyzes the motives of personality and the possibility of their implementation, taking into account the systems of mediation and regulation of mental activity and the laws of ontogenesis. The role of metacognitive dysregulation of social anxiety in the formation of SB in adolescence is shown. The significance of the dynamic mechanism of SB provoking accumulation of tension outside the situation and contributing to self-reinforcement of symptoms is underlined.