Feeling Like a Burden Emerges as Strongest Link to Suicidal Thoughts in Four-Nation Study

Suicidal ideation has long been studied through individual risk factors examined one at a time, but a new cross-national investigation argues that the psychological experiences surrounding suicidal thoughts are better understood as an interconnected system. In one of the most comprehensive network analyses of its kind, researchers from Pusan National University, working with collaborators at the University of Glasgow, mapped the psychosocial architecture of suicidal ideation in 2,018 adults across Italy, South Korea, the United Kingdom, and the United States. The results, published in the Journal of Affective Disorders, reveal a striking pattern: the feeling of being a burden to others shows the strongest direct association with suicidal ideation, while feelings of defeat and internal entrapment act as central hubs within the wider psychological network.

The research team was led by Professor Eun-Jung Shim of the Department of Psychology at Pusan National University in Busan, South Korea, in collaboration with doctoral student Dapin Cho from the same department and Professor Rory O’Connor and Dr. Banu Cankaya Sahin from the Suicidal Behaviour Research Laboratory at the University of Glasgow. Their study drew on established theories of suicide, integrating them with constructs from social comparison research and the psychology of reasons for living. Rather than asking which single variable best predicts suicidal thoughts, the team modeled the relationships among these experiences as a connected system, testing whether similar configurations appeared consistently across four culturally distinct countries.

Participants aged 18 to 60 years completed validated measures covering a broad psychological landscape: severity of suicidal ideation, defeat and entrapment, perceived burdensomeness, thwarted belongingness, social comparison, relative deprivation, and reasons for living. The researchers then estimated a separate psychosocial network for each country, allowing them to compare both the overall structure and the country-specific patterns of association. This network approach treats psychological variables as nodes and statistical associations as edges, producing a map that shows which experiences cluster together and which occupy the most influential positions within the system.

The overall network contained 39 connections, and its strongest links were revealing in themselves. Ability-based social comparison was tightly coupled with opinion-based comparison, defeat was strongly tied to internal entrapment, and fear of social disapproval clustered with moral objections to suicide. Suicidal ideation itself was directly associated with perceived burdensomeness, defeat, and internal entrapment, while survival and coping beliefs showed negative associations with suicidal thoughts. In terms of network centrality, defeat displayed the highest expected influence, meaning it was the most strongly connected and predictive node within the system. Yet when the researchers calculated relative importance specifically for suicidal ideation, perceived burdensomeness topped the ranking. The full model accounted for 25.16 percent of the variance in suicidal ideation severity.

Professor Shim summarized the distinction in a statement accompanying the release: perceived burdensomeness showed the strongest direct association with suicidal ideation, while defeat and internal entrapment were more central within the wider psychosocial network. This separation between direct association and network centrality carries practical weight. A factor can be strongly linked to suicidal thoughts without being the most connected element of the surrounding system, and interventions that target only the most proximal factor may miss the broader web of processes that sustain risk.

The country-specific analyses added a layer of nuance that the pooled network concealed. Defeat was directly linked to suicidal ideation in Italy, Korea, and the UK, but not in the United States. Perceived burdensomeness, by contrast, was directly linked to suicidal ideation in Italy, the UK, and the US, but not in Korea. Survival and coping beliefs were negatively associated with suicidal ideation in the UK and Italy, while ability-based comparison was linked to defeat only in Korea. The explanatory power of the model also varied considerably by country, ranging from 20.74 percent of variance explained in Korea to 39.71 percent in the UK, a spread that underscores how differently these psychological systems may be configured across national contexts.

Professor Shim emphasized that the findings suggest understanding suicidal ideation may require attention both to experiences that are closely linked with suicidal thoughts and to those that are interconnected with multiple psychological processes. In other words, the same feeling can occupy different positions in different cultural settings, and a factor that appears peripheral in one country may be a direct correlate in another. The researchers are careful to note that these country differences should not be read as fixed cultural characteristics, because the study did not directly measure cultural dimensions; the variation instead signals that the pathways surrounding suicidal thoughts deserve context-sensitive investigation.

The methodological design also carries important limitations that the authors acknowledge. The study was cross-sectional, capturing a single moment in time, which means it cannot establish causal pathways among the psychological variables or between them and suicidal ideation. Network analyses of this kind describe patterns of association, not direction of influence, so it remains possible that suicidal thoughts themselves shape feelings of defeat, entrapment, and burden rather than the reverse. Longitudinal designs are needed to disentangle these temporal sequences, and the research team has already moved in that direction.

Indeed, the team reports that it has completed longitudinal follow-up data collection in selected countries and is now analyzing how these psychological processes change over time and relate to subsequent suicidal ideation. Such work could clarify whether the central nodes identified in the cross-sectional networks, particularly defeat and internal entrapment, function as leading indicators of later risk, and whether the country-specific patterns observed here persist or shift as participants are tracked across months and years.

For suicide prevention and mental health research, the study’s message is that context matters as much as content. Feeling like a burden, feeling defeated or trapped, and holding beliefs that support continued living may all provide relevant information about the broader psychological environment in which suicidal thoughts arise, but the strength and configuration of these associations differ across populations. By mapping these networks side by side across four countries, the Pusan National University-led team has produced a comparative framework that could help clinicians and researchers decide which psychological targets deserve priority in a given setting, and which widely assumed risk factors may operate differently than expected. The paper, titled Shared and distinct psychosocial network patterns of suicidal ideation across four countries, was made available online on September 6, 2026 and will appear in Volume 415 of the Journal of Affective Disorders on December 15, 2026.

Subject of Research: Cross-national psychosocial network analysis of suicidal ideation in adults

Article Title: Pusan National University researchers map psychological patterns linked to suicidal ideation across four countries

Article References: Pusan National University researchers map psychological patterns linked to suicidal ideation across four countries. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: suicidal ideation, psychosocial network analysis, perceived burdensomeness, defeat and entrapment, cross-cultural psychology, reasons for living, social comparison, Journal of Affective Disorders, Pusan National University, suicide prevention, mental health research, network analysis