Falling Behind Yourself: Perceived Decline in Wellbeing Predicts Suicidal Thoughts Better Than Income

When it comes to understanding who is most at risk of suicidal thoughts, the most telling signal may not be how much money a person earns, how old they are, or even the state of their physical health. Instead, according to a new study published in the journal Risk Analysis, the decisive factor is something far more personal and psychological: whether people feel that their lives are getting worse compared with where they stood only a year earlier. The research, based on six years of data from nearly fifteen thousand South Koreans, suggests that the trajectory of perceived wellbeing, and the intensity with which individuals experience setbacks as losses, may matter more than any static measure of life circumstances.

The study arrives against a sobering backdrop. South Korea records the highest suicide rate among developed nations, a public health crisis that has persisted for years despite economic growth and expanding welfare programs. That paradox, rising prosperity alongside persistent psychological distress, is precisely what motivated the research team to look beyond conventional socioeconomic indicators. Rather than asking whether people are objectively poor or wealthy, the investigators asked whether people feel they are gaining or losing ground relative to their own recent past, a distinction rooted in the psychology of how humans evaluate their circumstances.

To formalize that question, the researchers drew on Cumulative Prospect Theory, a framework from behavioral economics originally developed to explain how people make decisions under uncertainty. The theory holds that individuals do not evaluate outcomes in absolute terms. Instead, they judge gains and losses against a personal reference point, typically their own recent experience or expectations, and crucially, they feel losses far more intensely than equivalent gains. A pay cut of a fixed amount stings more than a raise of the same amount delights. This asymmetry, known as loss aversion, varies from person to person, and it became a central variable in the analysis.

The empirical foundation of the study is the Korean Welfare Panel Study, a longitudinal survey distributed by the Korea Institute for Health and Social Affairs and Seoul National University that tracks socioeconomic conditions and mental health across a large representative sample. The researchers analyzed annual observations spanning 2018 to 2023, covering 14,552 individuals. Each participant rated their life satisfaction on a zero-to-ten scale, often described as a ladder of life, allowing the team to compute year-over-year changes in perceived wellbeing for every person and to relate those changes to reports of suicidal ideation.

The headline result is striking in its simplicity. Individuals whose self-reported wellbeing had declined from the previous year were more than twice as likely to report suicidal ideation compared with those whose wellbeing had improved or remained unchanged, with rates of 3.02 percent versus 1.41 percent. In other words, two people with identical incomes, ages, and health statuses could face markedly different psychological risks depending solely on the direction in which their lives felt like they were moving. The finding challenges screening approaches that rely on single snapshots of a person’s situation and instead points to the predictive power of change over time.

Even more consequential was the role of loss aversion itself. How strongly a person reacts to setbacks emerged as the strongest individual predictor of suicide risk in the dataset. Participants who exhibited the highest levels of loss aversion reported suicidal ideation at rates more than twelve times higher than those with the lowest levels. This suggests that the psychological amplification of losses, rather than the losses alone, may be a critical mechanism linking adverse changes in circumstances to suicidal thinking. A modest decline in wellbeing, experienced acutely, may carry more risk than a severe decline experienced with equanimity.

The study also examined the role of optimism, and the results add an important nuance. A person’s positive outlook on the future, on its own, was not a meaningful predictor of suicidal ideation. Optimism only appeared to matter when it was combined with an assessment of how sharply the individual reacted to recent losses. Hope for the future, in other words, does not operate in isolation; its protective effect depends on the emotional weight a person assigns to their most recent experiences of decline. This interaction underscores the complexity of the psychological architecture underlying suicide risk and cautions against simplistic interventions that promote positive thinking without addressing sensitivity to loss.

Demographic patterns in the data revealed further insights. Young women emerged as the group most sensitive to declining wellbeing, showing the largest reduction in suicidal ideation risk when their circumstances improved. This finding carries practical implications, suggesting that interventions aimed at improving conditions for young women may yield outsized mental health benefits, while deterioration in their perceived circumstances may warrant particularly close attention from clinicians and policymakers.

One of the most counterintuitive results concerns the COVID-19 pandemic. During the period covered by the study, suicidal ideation rates in the sample declined even as average wellbeing fell. The authors attribute this pattern to a shared, society-wide sense of hardship. When everyone is struggling, individual declines may feel less like personal failures and more like a collective experience, softening the psychological sting of loss. The observation aligns with historical accounts of communities pulling together during crises and offers a provocative insight: the meaning people attach to their losses, and whether they perceive those losses as private failings or shared burdens, may shape the mental health consequences as much as the losses themselves.

The implications for suicide prevention could be substantial. The authors argue that screening practices might shift from monitoring static risk factors, such as income level, age, or clinical diagnosis, toward tracking recent changes in self-reported wellbeing and assessing an individual’s sensitivity to setbacks. Behavioral markers of loss aversion, they suggest, could help identify at-risk individuals before suicidal thoughts escalate, enabling earlier and more targeted intervention. As corresponding author Mamata Parhi, a professor at the University of Roehampton in London, put it, these results suggest that trajectory matters more than a single snapshot of someone’s life. Two people with identical income and health can face very different psychological risks depending on which direction their life feels like it is heading, and how strongly they experience that change as a loss. The research team, which also included Ramzi Benkraiem of Audencia Business School in France, Jishu Dey of the University of Southampton, Ranadeva Jayasekera of Trinity College Dublin, and Tapas Mishra of the University of Southampton, with several members affiliated with Vilnius University, presents a case that the economics of disappointment, how we weigh what we have lost against what we expected to keep, deserves a central place in suicide risk assessment. If future work confirms these findings across other populations, the humble year-over-year satisfaction survey could become one of the most powerful early-warning tools in mental health care.

Subject of Research: Behavioral economics of suicidal ideation and loss aversion in perceived wellbeing trajectories

Article Title: Feeling like you are losing ground predicts suicidal ideation more than income or age

Article References: Feeling like you are losing ground predicts suicidal ideation more than income or age. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: suicidal ideation, loss aversion, Cumulative Prospect Theory, South Korea, Korean Welfare Panel Study, wellbeing trajectory, Risk Analysis, mental health, COVID-19, suicide prevention, behavioral economics, life satisfaction