East Tennessee State University Digital Commons @ East Tennessee State University Electronic Theses and Dissertations Student Works 5-2017 Spirituality and Suicidal Behavior: The ediM ating Role of Self-Forgiveness and Psychache Benjamin B. Hall East Tennessee State University Follow this and additional works at: https://dc.etsu.edu/etd Part of the Clinical Psychology Commons, Health Psychology Commons, Multicultural Psychology Commons, and the Social Psychology Commons Recommended Citation Hall, Benjamin B., "Spirituality and Suicidal Behavior: The eM diating Role of Self-Forgiveness and Psychache" (2017). Electronic Theses and Dissertations. Paper 3222. https://dc.etsu.edu/etd/3222 This Thesis - Open Access is brought to you for free and open access by the Student Works at Digital Commons @ East Tennessee State University. It has been accepted for inclusion in Electronic Theses and Dissertations by an authorized administrator of Digital Commons @ East Tennessee State University. For more information, please contact [email protected]. Spirituality and Suicidal Behavior: The Mediating Role of Self-Forgiveness and Psychache __________________ A thesis presented to the faculty of the Department of Psychology East Tennessee State University __________________ In partial fulfillment of the requirement for the degree Master of Arts in Psychology __________________ by Benjamin Hall May 2017 __________________ Jon R. Webb, Chair Chris S. Dula Stacey L. Williams Keywords: Religion, Spirituality, Forgiveness, Psychache, Suicide ABSTRACT Spirituality and Suicidal Behavior: The Mediating Role of Self-Forgiveness and Psychache by Benjamin Hall Growing evidence for protective factors of spirituality against physical and mental health related outcomes has led to the consideration of spirituality as a protective factor for suicidal behaviors. Although initial support for this association is promising, spirituality has yet to be explored as it relates to psychache. Additionally, self-forgiveness has emerged as an important protective factor of suicidal behavior, but has not been explored in the context of psychache. Following a model developed by Webb, Hirsch, and Toussaint (2015), the current project explores the protective role of spirituality on suicidal behavior based on three dimensions of spirituality: ritualistic, theistic, and existential. A total of 262 individuals completed a self-report survey online through Amazon Mechanical Turk. Results indicate that only Existential Spirituality is related to suicidal behaviors. Further, self-forgiveness and psychache were found to be serial mediators of this relationship. Implications for clinical interventions and directions for future research are discussed. 2 TABLE OF CONTENTS Page ABSTRACT .......................................................................................................................................2 LIST OF TABLES .............................................................................................................................5 LIST OF FIGURES ...........................................................................................................................6 Chapter 1. INTRODUCTION Spirituality..................................................................................................................10 Conceptualizing Spirituality .........................................................................10 The RiTE Model ................................................................................12 Ritualistic Spirituality ............................................................12 Theistic Spirituality ................................................................12 Existential Spirituality ...........................................................14 Spirituality and Health ...................................................................................14 Suicide........................................................................................................................18 Global Prevalence ..........................................................................................18 U.S. Prevalence ..............................................................................................19 Understanding Suicide ...................................................................................20 Biological factors of suicide ..................................................21 Cultural factors of suicide ......................................................22 Sociological and interpersonal factors of suicide ..................23 Intrapsychic factors of suicide ...............................................23 3 The logic and philosophy of suicide ......................................24 Conscious and unconscious factors of suicide .......................25 Psychache ...................................................................................................................25 Empirical Evidence for Psychache ................................................................26 Forgiveness of Self ....................................................................................................27 Conceptualizing Forgiveness of Self .............................................................27 Self-Forgiveness and Suicide .........................................................................29 Self-Forgiveness and Spirituality ...................................................................30 Self-Forgiveness, Spirituality, and Suicidal Behavior: A Theoretical Model .............................................................................................................30 Hypotheses .................................................................................................................32 2. METHOD Participants .................................................................................................................34 Measures ....................................................................................................................34 Spirituality......................................................................................................34 Self-forgiveness .............................................................................................35 Psychache .......................................................................................................36 Suicidal Behavior ...........................................................................................36 Statistical Analysis .....................................................................................................37 3. RESULTS Sample Characteristics ...............................................................................................40 Bivariate Associations ...............................................................................................40 Multivariable Associations ........................................................................................40 4 Review of Hypotheses ...............................................................................................47 4. DISCUSSION Spirituality and Suicidal Behavior .............................................................................48 Ritualistic Spirituality ....................................................................................48 Theistic Spirituality ........................................................................................49 Existential Spirituality ...................................................................................50 Spirituality and Self-forgiveness ................................................................................50 Spirituality and Psychache .........................................................................................51 Self-Forgiveness and Psychache ................................................................................51 Limitations .................................................................................................................54 Conclusions and Future Directions ............................................................................57 REFERENCES ......................................................................................................................59 APPENDICES .......................................................................................................................80 Appendix A: Demographic Information ....................................................................80 Appendix B: The RiTE Spirituality Measure ............................................................83 Appendix C: The Heartland Forgiveness Measure ....................................................87 Appendix D: Suicidal Behaviors Questionnaire- Revised .........................................89 Appendix E: The Psychache Scale ............................................................................91 VITA ......................................................................................................................................93 5 LIST OF TABLES Table Page 1. Sample Characteristics ...................................................................................................................41 2. Bivariate Associations ...................................................................................................................42 3. Multivariable Associations in the Context of Ritualistic Spirituality ............................................44 4. Multivariable