(PS13-19) Psychologization and Somatization of Pain: An Examination of Suicidal Ideation in an Asian American Sample

A biopsychosocial approach to studying mental health concerns has received increasing emphasis. For one, in addition to psychological symptoms, understanding somatic pain is crucial to a holistic case conceptualization. Given unique patterns of symptom emphasis and presentation across cultures, an attention to somatic symptoms may be particularly relevant for those with non-Western backgrounds, such as those with an Asian heritage. A call for considering somatic pain is reflected in the Three-Step Theory of Suicide (3ST; Klonsky & May, 2015), which proposed that pain (of any nature) and hopelessness, in combination with lack of connectedness, contributes to the development of suicidal ideation. The current study examined whether somatic pain, in addition to the frequently studied psychological pain, contributes to suicidal ideation, and whether the 3ST can be generalized to a community sample of Asian American adults. Participants (N = 42) completed a battery of self-report measures assessing somatic pain, psychological pain, hopelessness, interpersonal connectedness, and suicidal ideation. We used multiple imputation to compromise for our small sample size, and conducted hierarchical regression analysis in R Studio. Our analyses showed that when examining the two-way and three-way interaction effects of hopelessness on psychache and somatic symptom severity on average intensity of suicidal ideation, there was only a significant main effect of psychache (b = .06, SE = .02, 95% CI [.02, .10]). Furthermore, when examining the moderating effects of thwarted belongingness and perceived burdensomeness on psychache and average intensity of suicidal ideation, there was only a significant main effect of psychache (b = .05, SE = .01, 95% CI [.02, .07]). Our results revealed that psychological pain may be a critical consideration in differentiating those who endorse suicidal ideation and those who do not in an Asian American sample. We believe using alternative statistical methods, considering other culturally salient variables, and elucidating the position of somatic pain in suicidality may be potential areas for further research. Clinical implications are provided as recommendations in line with study findings.