Theories of Suicide

Nursing theories

open access articles on nursing theories and models

Theories of Suicide


  • Suicide is a global concern to nurses and other health-care providers.1
  • Suicidal behavior is a leading cause of death and disability worldwide.2
  • Suicidal ideation refers to thinking about or formulating plans for suicide. Suicidal ideation is closely associated with both suicidal attempts and deaths, serving as a significant risk factor for future suicide attempts.3
  • Theoretical models are used to explain how the individual progresses from suicidal ideation to a suicide attempt.1
  • The problem of suicide has puzzled philosophers throughout the history and a person’s decision to live or die is a “fundamental question of philosophy”.4

Important Theories

  • Sigmond Freud proposed that suicide resulted from anger at a loved one directed inward.5 He conceptualized that in response to the experience of a loss, the individual internalizes the lost object as a way of holding on to it. The outcome of maintaining the loss is twofold: it helps to ease the grieving, and it provides an alternative target for hostility toward the lost object.6
  • Cognitive model of suicidal behavior – Aron Beck explains that two types of cognitive disturbances observed in suicidal people, trait cognitive disturbances and “state” cognitive disturbances. Hopelessness is more often associated with suicidality. Cognitive therapy is effective in reducing suicidal behaviors.7,8
  • Durkheim proposed that dysregulation of social force results in suicide.9
  • Durkheim proposed four types of suicide- egoistic, anomic, altruistic, and fatalistic suicide.9
  • Durkheim viewed egoistic suicide as a consequence of the deterioration of social and familial bonds.9
  • He considered anomic suicide to disillusionment and disappointment.10
  • He considered social integration as a protective strategy against suicide risk factors.10
  • Durkheim’s theory does not give attention to individual factors.11
  • Shneidman’s theory of suicide (psychache theory) focused on individual factors, with “psychache”—psychological and emotional pain that reaches intolerable intensity –as the primary factor causing suicide.12
  • Thomas Joiner's Interpersonal Theory of Suicide (IPTS) states that the need to belong is the need central to the development of suicidal desire.13
  • The most dangerous form of suicidal desire is caused by the simultaneous presence of two interpersonal constructs—thwarted belongingness and perceived burdensomeness.11
  • Thwarted Belongingness – when the “the need to belong” is not met social isolation develops and it is the strongest and most reliable predictors of suicide ideation.11
  • Perceived Burdensomeness - elevated likelihood of developing perceptions of burdensomeness on others is associated with suicide.11
  • Thwarted belongingness and perceived burdensomeness are presumed to be distinct, but related constructs.11
  •   Interpersonal theory of suicide states that when individuals experience intractable feelings of perceived burdensomeness and thwarted belongingness and that near-lethal or lethal suicidal behavior occurs in the presence of suicidal desire and capability for suicide.14
  • The three-step theory of suicide - explains suicide in terms of four factors: pain, hopelessness, connection, and capability for suicide.15
  • According to a stress-diathesis psychological model, in vulnerable individuals, a combination of stressors can increase the chance of suicide.16
  • Integrated motivational–volitional (IMV) – IMV is a second-generation suicide model, that describes a tri-partite biopsychosocial framework in which suicidal ideation and behaviour may emerge (pre-motivational phase), the factors that lead to the emergence of suicidal ideation (motivational phase) and the factors that govern the transition from suicidal ideation to suicide attempts/death by suicide (volitional phase).17
  • The fluid vulnerability theory of suicide indicates the strong likelihood that multiple pathways can lead to suicidal behavior.18
  • The fluid vulnerability theory emphasizes the dynamic nature of suicide risk across cognitive, emotional, behavioral, and physiological domains.19


  1. Keefner TP, Stenvig T. Rethinking Suicide Risk With a New Generation of Suicide Theories. Res Theory Nurs Pract. 2020 Nov 1;34(4):389–408.
  2. Klonsky ED, May AM, Saffer BY. Suicide, Suicide Attempts, and Suicidal Ideation. Annu Rev Clin Psychol. 2016;12:307–30.
  3. Harmer B, Lee S, Rizvi A, Saadabadi A. Suicidal Ideation. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 [cited 2024 May 24]. Available from:
  4. Millner AJ, Robinaugh DJ, Nock MK. Advancing the Understanding of Suicide: The Need for Formal Theory and Rigorous Descriptive Research. Trends Cogn Sci. 2020 Sep;24(9):704–16.
  5.   Yakeley J, Burbridge-James W. Psychodynamic approaches to suicide and self-harm. BJPsych Adv. 2018 Jan;24(1):37–45.
  6. Haddad SK, Neiderhiser JM, Spotts EL, Ganiban J, Lichtenstein P, Reiss D. DEPRESSION AND INTERNALLY DIRECTED AGGRESSION: GENETIC AND ENVIRONMENTAL CONTRIBUTIONS. J Am Psychoanal Assoc. 2008 Jun;56(2):515–50.
  7.   Wenzel A, Beck AT. A cognitive model of suicidal behavior: Theory and treatment. Appl Prev Psychol. 2008 Oct 1;12(4):189–201.
  8. Suicide I of M (US) C on P and P of A and A. COGNITIVE APPROACHES TO SUICIDE. In: Suicide Prevention and Intervention: Summary of a Workshop [Internet]. National Academies Press (US); 2001 [cited 2024 May 24]. Available from:
  9. Durkheim E. Le Suicide: Etude de socologie. Paris: F. Alcan; 1897.
  10. Kushner HI, Sterk CE. The Limits of Social Capital: Durkheim, Suicide, and Social Cohesion. Am J Public Health. 2005 Jul;95(7):1139–43.
  11. Van Orden KA, Witte TK, Cukrowicz KC, Braithwaite S, Selby EA, Joiner TE. The Interpersonal Theory of Suicide. Psychol Rev. 2010 Apr;117(2):575–600.
  12. Shneidman ES. A psychological approach to suicide. VandenBos, Gary R; 1987.
  13. Joiner T. Why People Die by Suicide. Harvard University Press; 2005. 304 p.
  14. Chu C, Buchman-Schmitt JM, Stanley IH, Hom MA, Tucker RP, Hagan CR, et al. The Interpersonal Theory of Suicide: A Systematic Review and Meta-Analysis of a Decade of Cross-National Research. Psychol Bull. 2017 Dec;143(12):1313–45.
  15. Klonsky ED, Pachkowski MC, Shahnaz A, May AM. The three-step theory of suicide: Description, evidence, and some useful points of clarification. Prev Med. 2021 Nov;152(Pt 1):106549.
  16. Fazel S, Runeson B. Suicide. N Engl J Med. 2020 Jan 16;382(3):266–74.
  17. O’Connor RC, Kirtley OJ. The integrated motivational–volitional model of suicidal behaviour. Philos Trans R Soc B Biol Sci. 2018 Sep 5;373(1754):20170268.
  18. Bryan CJ, Butner JE, May AM, Rugo KF, Harris J, Oakey DN, et al. Nonlinear change processes and the emergence of suicidal behavior: a conceptual model based on the fluid vulnerability theory of suicide. New Ideas Psychol. 2020 Apr;57:10.1016/j.newideapsych.2019.100758.
  19. Rugo-Cook KF, Kerig PK, Crowell SE, Bryan CJ. Fluid vulnerability theory as a framework for understanding the association between posttraumatic stress disorder and suicide: A narrative review. J Trauma Stress. 2021 Dec;34(6):1080–98.
This page was last updated on: 24/05/2024