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According to the stress-diathesis model of suicidal behaviour, risk of suicide is not exclusively determined by a psychiatric illness (or an alternative stressor), but rather that individuals may have a predisposition or tendency towards suicidal ideation, which is aggravated further by one or more stressors [ 1].
We propose a cognitive model of suicidal behavior that is grounded in the empirical literature on cognitive and behavioral correlates of and risk factors for suicidal behavior.
Even though generalisations are difficult to make based on the reviewed studies, due to difficulties with data access and the potential methodological limitations described above, the search terms 'suicide' and 'depression' seem to be leading candidates for a model of suicidal behaviour which incorporates online search data.
However, it has to be acknowledged that, regarding the whole model of suicidal behaviour, there are many additional influencing factors which could not be included in this analysis.
A greater understanding of clinical and biological risk factors will help us understand more fully this model of suicidal behaviour and inform new therapies and tailored interventions.
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We integrate the findings of our review with contemporary psychological models of suicidal behaviour to develop a clear research agenda.
Future research should continue to identify variables that predict transition from suicidal thoughts to suicide attempts, as such work will enhance clinical assessment of suicide risk as well as theoretical models of suicide.
Although most theoretical models of suicide suggest that this behavior results from the interaction of different risk factors, most prior studies have tested only bivariate associations between individual risk factors and suicidal behaviors.
For EHE above 40% of disposable income, the consecutive 2 years with EHE is statistically significantly correlated with a higher rate of suicidal ideation (model 2; OR=2.67, 95% CI 1.10 to 6.46) (see online supplementary table S1).
Mann and coworkers have proposed that, given the multifactorial nature of suicidal behavior, a model that would incorporate several, largely independent, predictors would have greater predictive power [ 13].
Specifically, a three-block model was tested to determine whether protective factors would negatively predict variance in participants' suicidal behavior (i.e., total SBQ-R score, comprised of lifetime suicidal ideation and/or behavior, suicidal ideation in the past year, threats of suicide attempt, and likelihood of suicidal behavior in the future).
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