The pathway from feeling of emptiness to suicidal ideation: Examining the mediating roles of psychological pain and hopelessness in clinical and non-clinical populations.

OBJECTIVE: The current study aimed to examine the relationship between the feeling of emptiness and suicidal ideation, and the mediating roles of psychological pain and hopelessness, in Iranian clinical and non-clinical populations within the framework of the Three-Step Theory (3ST). METHODS: Two hundred and twenty-seven individuals with emotional disorders (all with current suicidal ideation) and 449 individuals from the general population (45.2% with current suicidal ideation) completed self-report measures assessing emptiness, psychological pain, hopelessness and suicidal ideation. Path analysis was conducted to examine the mediating effects. RESULTS: Emptiness was significantly correlated with suicidal ideation in both the clinical r = .45 , p < .001 and non-clinical r = .73 , p < .001 populations. In the clinical sample, both psychological pain β = .18 , p < .001 and hopelessness β = .11 , p < .001 significantly mediated the emptiness-ideation relationship. In the non-clinical sample, pain β = .08 , p < .001 and hopelessness β = .18 , p < .001 were also significant mediators, though the strength of these indirect effects differed across samples. CONCLUSION: The findings offer new insights into the psychological processes linking emptiness to suicidal ideation and highlight the importance of addressing both psychological pain and hopelessness in suicide prevention efforts. Theoretical and clinical implications are discussed.