Original studyThe Open Psychology Journal, 2026Read the paper →
The World Health Organization’s suicide fact sheet of 28 Aug 2026 states that suicide was the third leading cause of death among 15 to 29-year-olds globally in 2021. The authors also point to non-fatal self-harm without intent to die. The authors say hidden forms of psychological vulnerability often go unrecognised at this early stage. Their review argues that the attitudes which make suicide seem thinkable can take shape before suicidal thoughts fully emerge, and that this earlier stage is a chance to step in.
Researchers at L.N. Gumilyov Eurasian National University in Astana, West Kazakhstan Marat Ospanov Medical University, and the University of Johannesburg examined four prominent psychological theories of suicide. The review appears in The Open Psychology Journal. The work was funded by the Science Committee of the Ministry of Science and Higher Education of the Republic of Kazakhstan (IRN BR24993083).
The team searched five research databases for work published between 2000 and 2025 on people aged 12 to 25. They compared the theories side by side rather than pooling numbers.
Pre-suicidal attitudes describe the less visible stage before suicidal thoughts emerge, which can include self-harm without any wish to die. Hopelessness is the belief that this pain will not improve. Entrapment is the sense of no escape.
The Cognitive Model of Suicidal Acts focuses on negative core beliefs, often shaped by trauma or rejection, that lead young people to see themselves as worthless or helpless. The Interpersonal Theory of Suicide points to not belonging and feeling a burden on others as the basis of suicidal desire, with a separate idea of acquired capability for acting. The Integrated Motivational-Volitional Model centres on defeat and entrapment, while the Three-Step Theory holds that suicidal thoughts arise when pain and hopelessness outweigh a person’s sense of connection.
Together, the theories agree that suicidal attitudes in young people are not fixed beliefs but change over time, shaped by pain, thinking patterns, and relationships. The authors report other studies in which hopelessness was one of the strongest predictors of suicidal thinking, sometimes described as stronger than depression. They also report that feeling trapped accounted for suicidal thoughts in adolescents beyond depressive symptoms alone.
The theories also address why only some young people with suicidal thoughts act on them. Earlier self-harm, exposure to suicide among friends or in the media, impulsivity, and access to lethal means all appear to raise that risk. Social media cuts both ways, the review notes, spreading harm but also offering support.
The authors call for prevention that starts before suicidal thoughts appear, through school programmes that reduce bullying, family support, and therapy that challenges the belief of being a burden. For young people who already have suicidal thoughts, they point to safety planning, restricting access to means, and limiting exposure to suicide-related content.
As a narrative review, it did not use independent screening or formal quality checks. The four theories were largely developed in Western countries and with adults, and the suggested interventions have not been tested for cost, cultural fit, or possible harms such as stigma.
Few studies have explained the stage before suicidal thoughts. The authors call for long-term studies in young people that test how these mechanisms interact over time, including in digital and culturally diverse settings.
If you are struggling to cope, you can contact Samaritans for free on 116 123 (UK and Ireland, 24 hours).
